Certified Coder (Hybrid) - Physicians Billing Service

WUSTL; St. Louis (MO); Vor Ort; USD 34.853 - 52.266; Vollzeit

Benefits dieser Stelle

Up to 22 days of vacation

Health insurance

Transit U-Pass

401(k) / Defined contribution

Tuition coverage at WashU

Zusammenfassung

Washington University in St.Louis seeks a skilled coder to perform advanced coding and appeals activities, investigate payer issues, and ensure timely filing of appeals to insurance companies. The role handles charge corrections and collaborates with physicians and staff to optimize documentation for accurate reimbursements.

Responsibilities include reviewing documentation, researching payer policies, and processing AR tasks in the Epic system.

Qualifikationen

• Education: A diploma, certification or degree is not required.
• Certifications/Professional Licenses: Must have one of the following coding credentials—AHIMA (CCA, CCS, or CCS‑P) or AAPC (CPC, CPC‑A, CPC‑H, CPC‑H‑A, or one of the AAPC specialty‑specific coding credentials).
• Work Experience: No specific work experience is required.
• Skills: None specified.
• Driver’s License: Not required.

Aufgaben

• Appeal claims denied by third‑party payers.
• Create appropriate letters and compile documentation to substantiate the validity of claims.
• Investigate and problem‑solve reimbursement issues in collaboration with other coding staff and faculty.
• Work directly with physicians and clinical staff to provide documentation feedback and develop appeals.
• Research payer policies and processes.
• Review clinical documentation to identify facts for accurate diagnoses and procedures.
• Code evaluation and management services to the CPT level; ensure ICD codes link to services.
• Handle charge corrections when necessary.
• Work Epic Work queues, CRM tasks, and review remittance advice for rejections and payment amounts.
• Perform AR functions in the Epic billing system, updating insurance information and demographics.
• Complete special projects as assigned.

Ausbildung

AHIMA CCS / CCA or AAPC CPC / CPC-A / CPC-H credentials

Associate degree in Medical Coding & Billing (preferred)

Tools

Epic

Epic Billing System

Jobbeschreibung

Position Summary

Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections.

Primary Duties & Responsibilities

• Appeal claims denied by third‑party payers.
• Create appropriate letters and compile documentation to substantiate the validity of claims.
• Investigate and problem‑solve reimbursement issues in collaboration with other coding staff and faculty.
• Work directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals.
• Research payer policies and processes.
• Review clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient’s conditions and treatment.
• Work with coders and IBC staff on medical terminology and policy interpretation as required.
• Code evaluation and management services to the appropriate CPT code level; ensure ICD codes are linked appropriately to services provided.
• Handle charge corrections when necessary.
• Work assigned Epic Work queues, CRM tasks, and review remittance advice for rejections and accuracy of payment amounts as needed; identify invoices that have been rejected per department criteria.
• Perform accounts receivable (AR) functions in the Epic billing system, including updating insurance information and demographics.
• Complete special projects as assigned.

Working Conditions

Normal office environment. Work in the office one day per month. Physical effort: Typically sitting at desk or table.

Required Qualifications

• Education: A diploma, certification or degree is not required.
• Certifications/Professional Licenses: Must have one of the following coding credentials—AHIMA (CCA, CCS, or CCS‑P) or AAPC (CPC, CPC‑A, CPC‑H, CPC‑H‑A, or one of the AAPC specialty‑specific coding credentials).
• Work Experience: No specific work experience is required.
• Skills: None specified.
• Driver’s License: Not required.

Preferred Qualifications

• Previous coding experience or experience equivalent to an associate’s degree in a related field.
• Knowledge of ICD‑10 and CPT coding.
• Associate degree in Medical Coding & Billing (preferred).
• No additional certifications or work experience required unless stated elsewhere.

Salary Range

$25.30 – $37.94 per hour (Grade C10‑H).

Benefits Statement

• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Free Metro transit U‑Pass for eligible employees.
• Defined contribution (403(b)) retirement savings plan with university contributions starting at 7%.
• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program, financial resources, access to dietitians, and more.
• Family: 4 weeks of caregiver leave to bond with a new child; family care resources for childcare needs; adult care options.
• Tuition coverage: WashU covers the cost of tuition for you and your family, including dependent undergraduate‑level college tuition up to 100% at WashU and 40% elsewhere after seven years.

EEO Statement

Washington University in St.Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.