Professional Fee Coder II

Baylor College of Medicine; Houston (TX); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Baylor College of Medicine’s Patient Business Services Coding department seeks an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. The role focuses on maximizing revenue by accurate documentation of charges and clean insurance claims, with telecommute opportunities from Greenway Plaza.

The ideal candidate has organizational and communication skills and coding certification.

Qualifications

• High school diploma or GED.
• Three years of relevant experience.
• CCS-P (AHIMA) or CPC (AAPC) certification.

Responsibilities

• Review and accurately review and capture physician and outpatient facility coding through Epic and Optum Claims Manager.
• Resolve NCCI, LCD, NCD, and MUE edits and assign appropriate modifiers for clean claim submission.
• Abstract CPT, ICD-10 and HCPCS codes from medical records for procedures and surgeries.
• Audit physician assigned E/M CPT codes for accuracy and documentation compliance.
• Review coding denials and work with the collections team to resolve issues.
• Provide training to entry level coders in coding and Epic edits.

Education

High school diploma or GED

CCS-P (AHIMA) or CPC (AAPC)

Tools

Epic EHR

Citrix portal

Job description

Work Schedule: Monday – Friday, 8 a.m. – 5 p.m.

Summary

The Patient Business Services (PBS) Coding department is looking for an experienced mid-level coder to review and abstract CPT, ICD-10 and HCPCS coding for physician services. Our coders assist in maximizing the revenue by completely capturing and accurately documenting physician, professional, and departmental charges to ensure submission of clean insurance claims, as well as accurate patient statements. They apply correct coding guidelines to patient charge encounter, while assuring timely turnaround of charges.

The PBS Coding department is responsible for accurately capturing the revenue for all physician specialties at Baylor College of Medicine as well as outpatient facility charges at McNair Cancer Center. We focus on providing accurate and compliant coding assistance by coders who are certified and up-to-date on coding rules and regulations.

The ideal candidate will have good organizational, communication and critical thinking skills.

This position is located at Greenway Plaza with opportunities to telecommute.

Job Duties

This position is responsible for accurately reviewing and capturing physician and outpatient facility coding through Epic and Optum Claims Manager. Responsibilities include the following:

• Reviews and accurately resolves NCCI, LCD, NCD, and MUE edits as well as other payer specific coding edits.
• Assigns appropriate modifiers to charges for clean claim submission.
• Utilizes the encoder to review and/or assign ICD-10-CM, CPT, and HCPCS Level II codes on charges.
• Accurately abstracts from medical records all CPT, ICD-10 and HCPCS codes for procedures and surgeries.
• Audits physician assigned evaluation and management CPT codes for accuracy and documentation compliance.
• Reviews coding denials and resolves issues in conjunction with the collections team.
• Participates in physician education regarding coding and billing topics.
• Keeps abreast of changes to ICD_10, CPT and HCPCS coding and communicate changes with providers and management.
• Provides training to entry level coders in coding and working Epic edits.
• Performs other job-related duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Three years of relevant experience.
• Certified Coding Specialist – Physician-based (CCS-P) by the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).

Preferred Qualifications

• Proficiency in Microsoft Office, Excel, Epic EHR and Citrix portal.

Work Authorization Requirement:

This position is not eligible for visa sponsorship.Candidates must be legally authorized to work in the United States at the time of application and throughout the duration of employment.

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.

Baylor College of Medicine fosters diversity among its students, trainees, faculty, and staff as a prerequisite to accomplishing our institutional mission and setting standards for excellence in training healthcare providers and biomedical scientists, promoting scientific innovation, and providing patient-centered care. Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.