Sr Physician Coding Specialist

University Hospitals•Shaker Heights, OH

About The Position

Under the direction of the Billing Supervisor, the Sr. Physician Coding Specialist monitors coder productivity, trains and audits coders, codes surgical encounters, and serves as a resource for physicians and other departments within the system. The specialist identifies trends in insurance-related issues and reports findings to the team. The role involves analyzing outstanding insurance accounts, following up with payors and internal departments, responding to customer service inquiries, and reviewing and correcting coding rejections. Coding duties may include ICD-9, CPT/HCPCS, computer-assisted coding, and E/M services. The specialist may audit work or be assigned to complicated subspecialties, and is expected to be a top performer in productivity and accuracy, require minimal supervision, and assist staff when the supervisor is unavailable. The specialist communicates coding trends and documentation requirements to physicians and practice managers, maintains patient and physician confidentiality, and handles inquiries and correspondence professionally. The position also supports departmental guidelines, recommends further research when appropriate, mentors new coders, and performs other assigned duties. Employees must comply with policies and standards and safely maintain protected health information (PHI), including applicable training, conduct requirements, and workplace policies.

Requirements

High school equivalent or GED.
At least 3 years of medical billing experience.
Required certification: CPC, CPC-H, CPC-P, CPC-A, CCS-P, RHIT, RHIA, RCC, or ROCC.
Excellent interpersonal skills to partner with others, influence, and gain cooperation.
Ability to recognize, evaluate, and solve problems.
Strong verbal and written communication skills.
Extensive knowledge of the claims development process and third-party insurance program requirements.
Basic knowledge of ICD-9 and CPT coding.
Ability to handle varied tasks with speed, attention to detail, and accuracy.
Computer literacy and experience with basic software packages.
Ability and willingness to handle protected health information in accordance with applicable requirements.
Ability to meet the position's physical demands, including prolonged sitting, frequent repetitive motions and eye/hand/foot coordination, and occasional standing, walking, handling, and grasping.
Travel requirement listed as 10%25.

Nice To Haves

Billing experience in a multi-specialty group.

Responsibilities

Monitor coder productivity, train and audit coders, code surgical encounters, and serve as a resource for physicians and other departments.
Analyze outstanding insurance accounts daily within established time frames and initiate appropriate telephone or written follow-up.
Communicate with payors and internal departments to obtain information affecting current and future claims.
Research and respond promptly and professionally to telephone inquiries from customer service.
Review and correct coding rejections.
Code ICD-9 from written documentation, abstract CPT/HCPCS codes, perform computer-assisted coding, and code E/M services as assigned.
Perform at a top level in department productivity and accuracy.
Perform auditing functions and handle assignments in complicated subspecialties as needed.
Train and mentor new coders and assist staff when the supervisor is unavailable.
Communicate coding trends and documentation requirements to physicians and practice managers.
Maintain patient and physician confidentiality and communicate professionally with patients and physicians.
Provide information and feedback to personnel within UHPS, support departmental guidelines, and recommend additional research to other CBO departments.
Identify insurance-related trends and report findings to the Team Lead.
Interpret written correspondence, resolve issues or forward them for prompt resolution, and respond to patient inquiries through telephone, form letters, or internal correspondence.
Handle multiple tasks simultaneously and comply with policies, standards, PHI requirements, and other assigned duties.