Physician Coding Specialist II Remote

University Hospitals Pain Management; Shaker Heights (OH); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a detail-oriented Physician Coding Specialist II to join their team. In this vital role, you will analyze and resolve outstanding insurance accounts, ensuring timely payments for multi-specialty practices. Your expertise in coding and knowledge of payer guidelines will be essential as you navigate complex billing issues and maintain confidentiality of patient information. This position offers a collaborative environment where you can contribute to improving financial outcomes while supporting healthcare providers and patients alike. If you thrive in a fast-paced setting and are passionate about healthcare, this opportunity is perfect for you.

Qualifications

• Strong analytical skills to assess insurance accounts effectively.
• Excellent communication skills for professional interaction with payors.

Responsibilities

• Analyze outstanding insurance accounts and follow up for resolutions.
• Communicate with payors to obtain critical information for claims.

Skills

Analytical Skills

Communication Skills

Problem-Solving

Knowledge of Coding Rules

Time Management

Education

Certification in Medical Coding

Associate's Degree in Health Information Technology

Tools

ICD-10 Coding

CPT/HCPCS Coding

Computer-Assisted Coding Software

Job description

DescriptionA Brief Overview

Under the direction of the Revenue Cycle Supervisor - Coding, the Physician Coding Specialist II monitors and analyzes unresolved third-party accounts for multi-specialty group practices. This position initiates contact and negotiates appropriate resolutions to ensure timely payments of outstanding claims.

What You Will Do

1. Analyze, on a daily basis and in accordance with established time frames, the outstanding insurance accounts. Initiate appropriate and effective telephone and/or written follow-up on the identified accounts.
2. Communicate with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims.
3. Research and respond to all telephone inquiries from the customer service department, in a prompt, professional manner, meeting departmental guidelines.
4. Review and correct coding edits and denials.
5. May code ICD-10 from written documentation.
6. May abstract CPT/HCPCS codes.
7. May perform computer-assisted coding functions.
8. Maintain a working knowledge of coding rules and payer guidelines.
9. Consistently meet department productivity standards.
10. Consistently meet department quality standards.
11. Maintain patient/physician confidentiality at all times and maintain effective communication and professional interaction with patients and physicians.
12. Provide appropriate information and feedback to various personnel within UHPS. Support and utilize established departmental guidelines. Recommend additional research to other CBO departments.
13. Identify trends with insurance-related issues and report findings to the Team Lead.
14. Act as a role model for professionalism through appropriate conduct and demeanor at all times.
15. Interpret written correspondence and either resolve the problem or forward it to another department for prompt resolution.
16. Effectively communicate utilizing the telephone, form letters, or internal correspondence to resolve patient inquiries.
17. Handle multiple tasks simultaneously.
18. Understand insurance products and billing requirements to effectively resolve discrepancies in billing statements.
19. Perform other related duties as assigned.
20. 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.

Additional Responsibilities

1. Perform other duties as assigned.
2. Comply with all policies and standards.
3. For specific duties and responsibilities, refer to documentation provided by the department during orientation.
4. Abide by all requirements to safely and securely maintain Protected Health Information (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.