Coding Quality Specialist 2 (PB - PM&R |Musculoskeletal)

The Rector & Visitors of the University of Virginia; Charlottesville (VA); On-site; USD 28,929 - 41,328; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Paid Time Off

Retirement Savings

Job summary

The Rector & Visitors of the University of Virginia is seeking a Coding Quality Specialist 2 to ensure accurate coding of diagnostic and procedural services. The role involves reviewing and assigning codes, managing charge review edits, and mentoring junior staff in coding practices.

The ideal candidate will have at least three years of coding experience, possess CPC or CCS-P certification, and demonstrate strong knowledge of coding guidelines. This position offers comprehensive benefits and the opportunity to work with a dedicated team.

Qualifications

• Minimum of three years of coding/clinical experience.
• CPC certification through AAPC or CCS-P certification through AHIMA.
• Strong knowledge of documentation guidelines and coding policies.

Responsibilities

• Assign and review diagnostic codes for billing and reporting.
• Resolve charge review edits and claim edits for accurate capture.
• Provide mentorship to junior coding staff.

Skills

CPC certification

ICD-10-CM coding

CPT coding

Medical terminology

Education

High School Diploma or GED

Job description

Coding Quality Specialist 2 (PB - PM&R | Musculoskeletal)

$21.95 hourly. Compensation will be determined by candidate's qualifications, previous work experience, and/or education.

Responsibilities

• 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 in all settings for billing, research, and regulatory reporting.
• Reviews documentation in medical records to appropriately assign ICD-10-CM, CPT-4, HCPCS, and modifiers within a timely manner to capture all services rendered by providers at all locations. Encounters may be within Epic, outside electronic medical record systems, or based on paper documentation.
• Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow‑up work queues, identifying areas of opportunity based on findings/resolution of errors.
• Manages assigned charge review and coding‑related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow‑up steps.
• Assists physicians/providers with questions regarding coding and documentation guidelines.
• 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 team.
• Ensures all coded services meet appropriate governmental regulations and guidelines, National Correct Coding Initiative (NCCI) or payer‑specific guidelines.
• Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency, Epic, and coding reference software and/or books).
• Trains and provides mentorship to Coding Quality Specialist Level 1 staff to effectively perform their job responsibilities following current coding policies and procedures at the discretion of coding leadership.
• Assists coders with medical terminology, disease processes, and surgical techniques.
• Assists other coders in resolving coding issues/questions.
• Performs peer review as directed from coding leadership.
• Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
• Performs other duties as assigned.

Minimum Requirements

• Education: High School Diploma or GED.
• Experience: Three years of coding/clinical experience.
• Licensure: Must be 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. The job does occasionally require traveling some distance to attend meetings, and programs.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance.
• Paid Time Off, Long‑term and Short‑term Disability, Retirement Savings.
• Health Savings Plans and Flexible Spending Accounts.
• Certification and education support.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA's commitment to non‑discrimination and equal opportunity employment.