Outpatient/Provider Coder II

University of Utah Health; Salt Lake City (UT); On-site; USD 52,000 - 70,000; Full time

Job summary

University of Utah Health seeks a detail-oriented professional to abstract, code, and interpret outpatient clinic and provider services for professional or facility billing. This role supports documentation and coding processes to ensure accurate reimbursement without direct patient care.

The candidate should have coding certifications or equivalent experience, with strong regulatory knowledge, and be capable of mentoring junior coders and collaborating with hospital staff.

Qualifications

• AHIMA or AAPC certification or RHIA/RHIT or CCS, etc., or three years coding experience.
• Two years of coding, clinical, or billing experience.
• If no certification, must obtain AHIMA or AAPC certification within six months of hire.

Responsibilities

• Reconciles clinic or provider visits and reports on documentation issues.
• Codes outpatient services and allocates appropriate coding classifications.
• Interacts with providers and staff on billing issues.
• Researches and resolves high-volume accounts and complex claims.
• Interprets regulatory guidelines for coding and reimbursement decisions.
• Ensures adherence to department quality and productivity standards.
• Supports other department coding needs.
• Mentors Level I Coders.

Skills

Effective communication

Regulatory compliance

Training others

Education

AHIMA/AAPC certification or RHIA/RHIT/CCS etc

Two years coding/clinical/billing experience

Certification within six months under equivalency rule

Tools

Microsoft Word

Microsoft Excel

Job description

Overview

As 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/AA

Overview

As 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/AA

This 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.

Required

Qualifications

• 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

Qualifications (Preferred)

• Experience in organizing and conducting coding or billing education.

Working Conditions and Physical Demands

• 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