Outpatient/Provider Coder II

Utah; Oregon; Hybrid; USD 60,000 - 82,000; Full time

Job summary

The University of Utah Health seeks a skilled outpatient coder to abstract, code, and interpret clinic and provider services for billing. This role supports documentation and coding efforts without providing patient care.

Responsibilities include reviewing records, ensuring accurate coding classifications, and mentoring Level I Coders while collaborating with providers and billing teams to resolve issues and maintain quality standards.

Qualifications

• AHIMA/AAPC certification or equivalent required.
• Two years coding, clinical, or billing experience required.
• If not certified, certification must be obtained within six months of hire.

Responsibilities

• Reconciles clinic or provider visits and reports on missing, incomplete, or inconsistent documentation.
• Reviews, abstracts, and codes multiple/sub specialty services and assigns appropriate coding classifications.
• Interacts with providers, hospital staff, and clinic managers on billing issues.
• Researches and resolves high volume accounts and complex, suspended claims.
• Interprets and applies regulatory guidelines to coding and reimbursement decisions.
• Ensures adherence to department quality and productivity standards.
• Assists with other department coding needs as requested.
• Mentors Level I Coders.

Skills

Communication skills

Clinical documentation knowledge

Computer software

Certifications maintenance

Train others

Potential to perform essential duties

Education

AHIMA/AAPC certification or equivalent

Two years coding/billing experience

Tools

Microsoft Word

Microsoft Excel

Job description

OverviewAs a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AAThis position is responsible for the abstracting, coding, and interpreting of outpatient clinic and provider services for professional or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position is not responsible for providing care to patients.

Corporate Overview

The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Essential Functions

• Reconciles clinic or provider visits and reports on missing, incomplete, or inconsistent documentation by contacting the appropriate personnel.
• Reviews, abstracts, and codes multiple/sub specialty services and assigns appropriate coding classification.
• Interacts with and provides feedback to providers, hospital staff, and clinic managers on billing related issues.
• Researches and resolves high volume accounts and complex, suspended claims.
• Interprets and applies basic regulatory guidelines to coding and reimbursement decisions.
• Assures adherence to department quality and productivity standards.
• Assists with other department coding needs as requested.
• Serves as a mentor and assists in the training of Level I Coders.

Knowledge / Skills / Abilities

• Demonstrated potential ability to perform the essential functions as outlined above.
• Demonstrated human relations and effective communication skills.
• Demonstrated knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations, and health insurance processing.
• Demonstrated proficiency in computer software. (e.g. Microsoft Word and Excel).
• Ability to maintain certifications through continuing education credits.
• Ability to train others.

Qualifications

Required

• An American Health Information Management Association (AHIMA) or American Academy of Professional coders (AAPC) recognized certification such as: Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Registered Health Information Administrator (RHIA, Registered Health Information Technician (RHIT), or other specialty certification indicated by the department, or three years of coding experience.
• Two years of coding, clinical, or billing experience.
• Incumbents qualifying under the equivalency requirement, without certification, must obtain an American Health Information Management Association (AHIMA) or American Academy of Professional coders (AAPC) recognized certification within six months of hire.

Preferred

• Experience in organizing and conducting coding or billing education.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking