Coding Specialist I

At Urology Austin , our mission is committed to improving the lives of patients and their families through compassionate, quality, and ethical care.

In choosing a career with Urology Austin, you are choosing to improve the lives of patients and their families through a collaborative team-driven approach in an innovative, quality-driven, community-based setting. Better Medicine. Better Care.

Position Summary:
This is a remote position that performs various duties to accurately interpret and bill physician charges for physician services. Enters in the Billing System appropriate CPT and ICD-10 codes and bills charges.

JOB RELATIONSHIPS

• Works in conjunction with providers, other front office staff, and billing staff to ensure complete and accurate billing.

ESSENTIAL JOB RESPONSIBILITIES

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Assists in entering data from inpatient facesheets including but not limited to demographics, insurance plans, etc.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.
• Enters appropriate data into AllScripts PM by selecting the appropriate codes, diagnosis, modifiers, pathology, and provider information to complete the process.
• Contacts physicians through EMR regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other reports of clinical activity to ensure billing is captured for all patients.
• Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
• Responsible for ensuring the batch processes for all coded charges.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for physicians.
• Works in coordination with other members of the Central Billing Office as necessary.
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
• Responsible for scrubbing claims to submit compliant, truthful, and correct coding based on payer rules.
• Performs other related duties as required and assigned.

ROLE QUALIFICATIONS

• Coding Certification through AAPC (CPC) or AHIMA (CCS) required.
• Surgery coding experience desirable
• Urology coding experience desirable
• High school diploma required; Associates degree of formal billing education preferred.
• Minimum three (2) years of billing/collections experience within a clinic or physician practice.
• Strong working knowledge of insurance plans, including Medicare and Medicaid.
• Strong working knowledge of ICD-10 and CPT coding.
• Proficiency in computer software use, including Microsoft Office, EMR and Practice Management systems.
• Effective time management and the ability to prioritize work.
• Excellent communication skills and the ability to interact with all levels of management, staff, and physicians.

PERFORMANCE REQUIREMENTS
Knowledge

• Knowledge of medical billing/collections practices.
• Knowledge of ICD-10 and CPT Coding and third-party operating procedures and practices
• Understanding of medical terminology.

Skills

• Interpersonal and communication both with internal staff and external customers.
• Skill in gathering and reporting insurance claim information.
• Skill in reading medical chart terminology.
• Time Management

Abilities

• Ability to communicate effectively with patients, staff, and external contacts via phone and through electronic mail.
• Elicit appropriate information for patients to clinic staff.
• Ability to read and understand information and ideas presented in writing.
• Ability to apply general rules to specific problems to produce answers that make sense – deductive reasoning.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Physical: Involves sitting for approximately 80% of the day; extensive use of computer, mouse, and phone.
• Environment: Professional office setting. Requires frequent interaction with patients and staff from various backgrounds.
• Stress: Frequent stress from high-volume deadlines and the need to resolve insurance conflicts quickly to prevent appointment cancellations.