Professional Fee Coder - Analyst II

UCSF•Emeryville, CA

16h

About The Position

The Analyst II Coder, under the direction of the Revenue Manager/Associate Director, provides support in areas of revenue operations related to production coding, auditing, and training for their designated areas. Under general supervision, applies acquired skills as a revenue cycle analyst to perform charge capture and charge flow, PB coding, charge edit reviews, claim edits, RFIs, support setting up new charging practices/units, and reporting. Gaining expertise to act as a specialist for designated divisions. Manages a diverse range of 1,000 – 3,500 procedural code set combinations, plus Evaluation and Management services coding. Demonstrates core coding competency and proficiency in moderately complex duties, including Prof Fee and technical coding. Provides analysis to support department revenue cycle management and improve work queue design and management. Provides education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. The Analyst II will perform an in-depth review of physician documentation and is responsible for presenting findings along with recommendations to the department on physician education. Familiar with all applicable billing and coding regulations and effectively communicates these regulations to all levels of faculty, management, and staff. Applies broad knowledge of hospital operations, different payor guidelines, charge capture and work flows, Epic systems, authorizations, and charge trigger to assign codes based on review of clinical charts, evaluate and resolve denial issues, and identify areas of revenue cycle improvement.

Requirements

Core coding competency and proficiency in moderately complex duties, including Prof Fee and technical coding.
Familiarity with all applicable billing and coding regulations.
Broad knowledge of hospital operations, different payor guidelines, charge capture and work flows, Epic systems, authorizations, and charge trigger.

Responsibilities

Provides support in areas of revenue operations related to production coding, auditing, and training for their designated areas.
Performs charge capture and charge flow, PB coding, charge edit reviews, claim edits, RFIs, support setting up new charging practices/units, and reporting.
Manages a diverse range of 1,000 – 3,500 procedural code set combinations, plus Evaluation and Management services coding.
Demonstrates core coding competency and proficiency in moderately complex duties, including Prof Fee and technical coding.
Provides analysis to support department revenue cycle management and improve work queue design and management.
Provides education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines.
Performs an in-depth review of physician documentation and is responsible for presenting findings along with recommendations to the department on physician education.
Familiar with all applicable billing and coding regulations and effectively communicates these regulations to all levels of faculty, management, and staff.
Applies broad knowledge of hospital operations, different payor guidelines, charge capture and work flows, Epic systems, authorizations, and charge trigger to assign codes based on review of clinical charts, evaluate and resolve denial issues, and identify areas of revenue cycle improvement.