Physician Coding Specialist II: Claims Resolution & ICD-10

University Hospitals; Shaker Heights (OH); Remote; USD 30,000 - 47,000; Full time

Job summary

University Hospitals in Ohio is seeking a Physician Coding Specialist II to monitor and analyze unresolved third party accounts for multi-specialty group practices. The role initiates contact, negotiates resolutions, and ensures timely payments of outstanding claims while maintaining PHI safeguards.

The candidate will handle coding edits, may code ICD-10 from documentation, abstract CPT/HCPCS codes, and perform computer assisted coding as required, all while meeting productivity and quality

Responsibilities

• Analyzes, on a daily basis and in accordance with established time frames, the outstanding insurance accounts. Initiates appropriate and effective telephone and/or written follow-up on the identified accounts.
• Communicates with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims.
• Researches and responds to all telephone inquiries from the customer service department, in a prompt, professional manner meeting departmental guidelines.
• Reviews and corrects coding edits and denials.
• May code ICD-10 from written documentation.
• May abstract CPT/HCPCS codes.
• May perform computer assisted coding functions.
• Working knowledge of coding rules and payer guidelines.
• Consistently meets department productivity standards
• Consistently meets department quality standards.
• Maintains patient/physician confidentiality at all times and maintains effective communication and professional interaction with patients and physicians.
• Provides appropriate information and feedback to various personnel within UHPS. Supports and utilizes established departmental guidelines. Recommends additional research to other CBO departments.
• Identifies trends with insurance related issues and reports findings to the Team Lead.
• Acts as a role model for professionalism through appropriate conduct and demeanor at all times.
• Interprets written correspondence and either resolves the problem or forwards it to another department for prompt resolution.
• Effectively communicates utilizing the telephone, form letters or internal correspondence to resolve patient inquiries.
• Handles multiple tasks simultaneously.
• Must have an understanding of insurance products and billing requirements to effectively resolve discrepancies in billing statements.
• Performs other related duties as assigned.
• This role will encounter Protected Health Information (PHI) as part of regular responsibilities. UH employees must abide by all requirements to safely and securely maintain PHI for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Job description

University Hospitals in Ohio is seeking a Physician Coding Specialist II to monitor and analyze unresolved third party accounts for multi-specialty group practices. The role initiates contact, negotiates resolutions, and ensures timely payments of outstanding claims while maintaining PHI safeguards.

The candidate will handle coding edits, may code ICD-10 from documentation, abstract CPT/HCPCS codes, and perform computer assisted coding as required, all while meeting productivity and quality