Senior Coder - RCO Coding (Remote)

UTMB Health•Galveston, TX

5d•Remote

About The Position

Properly codes and/or audits professional services for inpatient and/or professional and hospital outpatient technical services for multiple specialty areas to ensure accuracy and optimal reimbursement from all third-party payers. This role involves reviewing documentation in EPIC and/or on paper to assign ICD-10-CM, PCS and CPT codes, communicating with the education team and/or providers for clarification, and utilizing encoder software to assign codes. The coder will sequence diagnoses and procedures, verify ADT information, attend coding education sessions, and work coding-related charge reviews and claim edits daily to ensure timely and accurate billing. The position requires adherence to productivity and quality standards, coding compliance, and federal regulations. It also involves working PB/HB claim edits, reject errors, and hospital DNBs as assigned, as well as charge reconciliation to ensure all services are captured.

Requirements

Three years of multi-specialty coding experience.
Proficient in coding Professional services, and/or Outpatient professional and hospital technical services.
Experience with communicating, training, and educating providers in proficiency.
One of the following certifications: CCA, CCS, CCS-P, RHIA, RHIT, CIC, COC, CPC, CPC-A, or CRC.
Strong written and oral communication skills.

Nice To Haves

Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations.
Plastic Surgery coding experience preferred.

Responsibilities

Reviews documentation in EPIC and/or on paper as provided to appropriately assign ICD-10-CM, PCS and CPT codes.
Communicates with and provides feedback to the education team and/or provider for query opportunities for documentation clarification or missing elements in the medical record.
Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures.
Sequences diagnoses and procedures to generate clean claims in accordance with the Coding Guidelines based on the type of coding being reviewed.
Verifies all ADT information is correct on all charge sessions; date of service, billing provider, service provider, place of service, referral information and claim form if required.
Attends and participates in coding education sessions.
Obtains required CEU’s for certification and completes any required education.
Works coding related charge reviews/claim edits daily to ensure timely and accurate billing within filing deadlines.
The coder is responsible for productivity and quality standards to adhere with coding compliance and federal regulations.
Work all PB/HB claim edits and reject errors daily.
Hospital DNB’s will be worked as assigned per Specialty.
Work charge reconciliation to ensure all services provided are captured for coding in a timely manner.
Adheres to internal controls and reporting structure.
Performs related duties as required.