Coder Quality Specialist 2 - OBGYN

The Rector & Visitors of the University of Virginia; Charlottesville, Virginia, Evanston Township (VA, MN, IL); On-site; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented coding specialist to ensure accurate coding for various medical services. This role involves reviewing documentation, managing charge reviews, and providing education to staff. The ideal candidate will have significant experience in OBGYN coding and hold relevant certifications. Join a dynamic team dedicated to compliance and quality in healthcare coding, where your expertise will contribute to the efficiency of medical billing and reporting processes. This position offers competitive hourly compensation and the opportunity to work in a supportive environment focused on professional growth.

Qualifications

• 3+ years of coding/clinical experience required.
• Must hold CPC or CCS-P certification.
• Experience in OBGYN coding preferred.

Responsibilities

• Assign and review diagnostic codes for billing and reporting.
• Manage charge review and coding-related claim edits.
• Train and mentor Coding Quality Specialist Level 1 staff.

Skills

ICD-10-CM coding

CPT coding

HCPCS coding

charge review

medical terminology

Education

High School Diploma or GED

CPC certification

CCS-P certification

Tools

Epic

Diagnostic Imaging systems

coding reference software

Job description

Assigns and reviews the accuracy of diagnostic codes (ICD-10-CM) and CPT codes for providers' Evaluation and Management Services (E/M), procedures, and diagnostic testing across all settings for billing, research, and reporting to government and regulatory agencies. The incumbent may perform only some of the following responsibilities depending on their work assignment.

Preferred Qualifications

The ideal candidate will have OBGYN coding experience.

Key Responsibilities

1. Reviews documentation in medical records to appropriately assign ICD-10-CM, CPT-4, HCPCS, and modifiers in a timely manner to capture all services rendered by providers at all locations. Encounters may be documented within Epic, other electronic medical record systems, or on paper.
2. Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow-up work queues, identifying opportunities based on error findings and resolutions.
3. Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Deciphers charge error reasons and plans follow-up steps.
4. Assists physicians/providers with questions regarding coding and documentation guidelines.
5. Provides ongoing feedback based on observations from coding physician/provider documentation. Identifies opportunities for education and communicates trends to coding leadership and/or provider education teams.
6. Ensures all coded services comply with governmental regulations, guidelines, the National Correct Coding Initiative (NCCI), and payer-specific requirements.
7. Utilizes available resources for code assignment, such as Diagnostic Imaging systems, Lab systems, Emergency, Epic, and coding reference software and/or books.
8. Trains and mentors Coding Quality Specialist Level 1 staff to perform their responsibilities effectively, following current coding policies and procedures, at the discretion of coding leadership.
9. Assists coders with medical terminology, disease processes, and surgical techniques.
10. Supports other coders in resolving coding issues/questions.
11. Performs peer reviews as directed by coding leadership.
12. Queries physicians to clarify or obtain missing information in records to ensure correct coding.
13. Performs other duties as assigned.

Position Compensation Range

$21.10 - $32.71 Hourly

Minimum Requirements

• High School Diploma or GED
• Three years of coding/clinical experience
• Must hold CPC through AAPC or CCS-P through AHIMA to qualify for all functional areas

Physical Demands

This is primarily a sedentary job involving extensive use of desktop computers. Occasional travel to attend meetings and programs may be required.

Equal Opportunity Statement

The University of Virginia, including UVA Health System, values diversity and is committed to equal opportunity employment. All qualified applicants will receive consideration regardless of age, race, gender identity or expression, marital status, national or ethnic origin, political affiliation, religion, sex, pregnancy, sexual orientation, veteran or military status, or family medical or genetic information.