Sr Physician Coding Specialist

About the role

Under the direction of the Billing Supervisor, the Sr. Physician Coding Specialist monitors coder productivity, trains, audits, codes surgical encounters, and serves as a resource for physicians and other departments within the system. Identifies trends with insurance-related issues and reports findings to the team.

Responsibilities

• Analyzes outstanding insurance accounts daily within established time frames and initiates appropriate telephone and/or written follow-up.
• Communicates with payors and internal departments to obtain critical information impacting resolution of current and future claims.
• Researches and responds to telephone inquiries from customer service promptly and professionally per departmental guidelines.
• Reviews and corrects coding rejections.
• May code ICD-9 from written documentation.
• May abstract CPT/HCPCS codes.
• May perform computer-assisted coding functions.
• Applies in-depth knowledge of coding rules and payer guidelines.
• May code E/M services.
• Maintains top performer status in department productivity and accuracy.
• May perform auditing functions.
• May be assigned to complicated sub-specialties.
• Trains and mentors new coders.
• Assists staff when supervisor is not available.
• Requires minimal supervision.
• Effectively communicates coding trends and documentation requirements with physicians and practice managers.
• Maintains patient/physician confidentiality at all times and maintains effective communication and professional interaction with patients and physicians.
• Provides appropriate information and feedback to various personnel within UHPS.
• Supports and utilizes established departmental guidelines.
• Recommends additional research to other CBO departments.
• Identifies trends with insurance-related issues and reports findings to the Team Lead.
• Acts as a role model for professionalism through appropriate conduct and demeanor at all times.
• Interprets written correspondence and either resolves the problem or forwards it to another department for prompt resolution.
• Effectively communicates via telephone, form letters, or internal correspondence to resolve patient inquiries.
• Handles multiple tasks simultaneously.
• Performs other duties as assigned.
• Complies with all policies and standards.
• Abides by all requirements to safely and securely maintain Protected Health Information (PHI) for patients, including annual training, the UH Code of Conduct, and UH policies and procedures.

Requirements

Education

• High School Equivalent / GED (Required)

Experience

• 3+ years of medical billing experience (Required)
• Billing experience in a multi-specialty group (Preferred)

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