Physician Coder II

The University of Kansas Hospital Kansas City, KS
Overview

The University of Kansas Health System is a world-class academic medical center and destination for complex care and diagnosis. We are driven by our commitment to service, to continuous improvement and to the highest degree of excellence. Every member of our team shares an unwavering commitment to put patients first. We offer a wide array of career opportunities, along with competitive pay and outstanding benefits. We invite you to join us as we continue to advance the power of academic medicine.

Position Summary/Career Interest

The primary functions of this position are to provide staff support for coding of charges with CPT, ICD-10 and HCPCS and to be a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician billing.

Responsibilities

* Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing. Reviews departmental reporting structures and requests modifications as needed, i.e. adding billing areas, providers, etc. Monitors CPT, ICD-10, and HCPCS code changes. Codes diagnosis for specialty/surgical accounts using ICD-10 nomenclature. Codes physician's specialty/surgical procedures using CPT codes. Interface charges are then released through the billing system. Paper charges are keyed and released through the billing system.

* Reviews coding by physicians and suggest possible modification of codes to maximize reimbursement. Reviews reimbursement from third-party payers to ensure payment through proper use of codes.

* Identifies and resolves potentially troublesome service/billing areas such as continuity of care, discharge summaries, admission history and physicals and consultations.

* Works denied claims.

* Works requests for additional information and correspondence from insurance companies.

* Communicates pertinent information on appropriate documentation to physicians and staff.

* Maintains knowledge of requirements for appropriate charge generation.

* Checks, verifies and updates patient demographic and insurance information or transfers information to Virtual Registration for update as needed.

* Remains current and knowledgeable of various insurance plans for purposes of processing referral and /or pre-authorization requirements.

* Identify unspecified diagnosis used and determine if documentation supports a more specific diagnosis

* Provide education/training to physicians and other providers on coding and clinical documentation.

* Review the complex (problematic coding that needs research and reference checking) medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.

* Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to inpatient and outpatient diagnoses and procedures.

* Consult with and educate/train physicians on coding practices and conventions in order to provide detailed coding information.

* Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.

* Provide real-time feedback to surgical/procedural providers as it pertains to proper coding and clinical documentation of services performed.

* Mentor and assists in training of other coders within the department.

* Participate in the development of coding policies and procedures as identified.

* Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

* Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Qualifications

Required:

* High School Diploma or GED

* Familiarity with data processing applications in a Windows environment, especially in the health care accounts receivable area.

* Knowledge of medical terminology, billing procedures, medical insurance.

* Two years of specialty and surgical coding experience

* CPC, COC, CIC or CCA

Additional details:

* This is a certified position, RHIA, RHIT, or CCS-P would also be acceptable in addition to the CPC

* Laptop provided.

* Work schedule: four 10 hour days with rotating 4 day weekends off

* Once trained (and if fully staffed to allow) there is a possibility to work two days at main campus and two days from home

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