Certified Coder

Job Description

Job Description

University of Toledo Physicians' mission is to improve the human condition through excellence in patient care and medical discovery. Representing more than 200 physicians, UT Physicians are leaders in clinical care, research and education of the future physicians, providing care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family. The primary site of inpatient care services is at the University of Toledo Medical Center, but many of our physicians’ practice at hospitals and medical offices throughout the region.

University of Toledo Physicians offers competitive pay and benefits including : 403B, Pension, health and tuition waiver at UT.

POSITION SUMMARY

The Certified Coder is responsible for coding ICD diagnosis and CPT facility and professional codes. Assignment may include outpatient clinic visits, diagnostic procedures, outpatient surgeries, observation and inpatient encounters, and emergency room charges for the purpose of reimbursement, research, and compliance with federal regulation according to diagnosis, operation, and procedure ICD and CPT classification systems

ESSENTIAL JOB FUNCTIONS AND ACCOUNTABILITIES

• Accurately assigning CPT, ICH, and HCPCS codes to services performed by payable providers. This includes correct usage of modifiers and descriptors as required.
• Review Physician assigned CPT codes on encounters for accuracy or assign as necessary. This may be done on a charge capture system, on paperwork, or within current EMR
• Assign ICD codes to the highest level of specificity as indicated by the provider, coding books, or encoder / 3M. Understand bilateral guidelines for major insurance carriers
• Strong understanding of medical terminology, anatomy, diagnosis, coding / manifestation guidelines, CPT guidelines, CMS guidelines, modifiers, and NCCI edits
• Strong understanding of global surgical charges including the ability to enter alert notes in the current EMR or learn accordingly, review or clarify appropriate codes with the providers, enter procedures and modifiers in correct order
• Understand the process for unlisted procedures including retrieval of documentation from the current EMR, research of the procedure itself and support as necessary to get new codes entered in the current EMR. Physician input may be necessary for this process
• Ability to work current EMR claim scrubber edits at the time of entry for submission to payers. This includes monitoring assigned coding worklists for missing scrub edits
• Maintain a professional working relationship with follow-up staff while following denial trends to apply changes at the front end and provide feedback to providers
• Ability to professionally communicate with providers and the staff on coding practices and updates to better ensure clean claim submission
• Maintain current coding credentials. This includes on being current on billing trends, coding trends, and documentation trends for assigned areas of specialty
• Stay current on company training and mandatory testing
• Follow all HIPAA and PHI laws. Work with the compliance department as needed regarding auditing concerns
• Attend staff meetings, specific departmental meetings, or specific revenue related meetings. Backup and / or assist team members with workflow as needed. Respond to emails within 24 hours. Ability to adapt to workflow changes in conjunction with best practice, accreditation guidelines, and revenue guidelines
• Follow the department guidelines for achieving daily productivity goals, daily turn around times, and work accuracy rate of 98%
• Preforms other duties as assigned

REQUIRED QUALIFICATIONS

Strong communication skills

PREFERRED QUALIFICATIONS

The above list of duties is intended to describe the general nature and level of work performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of duties performed by the people so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct and control the work of employees under his / her supervision.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.

Equal Opportunity Employer / Drug-Free Workplace