Medical Appeals Coding Specialist SR at University of Utah
Salt Lake City, UT 84112
About the Job
Medical Appeals Coding Specialist SR
Job Summary
REMOTE WORK OPPORTUNITY. 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 analyzes codes, charges and denial trends for complex or specialty services and will serve as a resource for UMB Coding, AR, and Quality staff. This candidate employs quality assurance processes better assist department's reduction in accounts receivable and provide education to internal team members and department as appropriate. Escalating identified trends to insurance payers and/or policy issues to the appropriate resource.
The starting salary for this position is $25-$28 per hour, depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University's comprehensive benefit package that includes 90% employer- paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more!
Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service.
Responsibilities
Essential Functions:
- Conduct high-level analysis of reports; provide feedback and recommendations to aid in reduction of denials.
- Quality assurance for appropriate coding and documentation, collaborate with Quality Assurance Educators and Coding supervisors on mitigation of denials related to coding and system processes.
- Responsible to provide training, presentations, and education on billing and coding procedures and workflows, one on one or in-group settings as needed.
- Responsible for identifying and summarizing payer concerns and escalating for resolution.
- Quality Review of team for appropriate coding and documentation (review coding denial letters, review for content, and accuracy.) Provide education and collaborate with providers, QA Educators and report trends for accuracy improvement.
- Assist in reviewing payer policy, procedures, workflows and updates. Working with Quality Assurance Educators, communicates to appropriate personnel and departments.
- Assists with backlog to maintain department quality and productivity standards, and assists with other department needs as requested.
- Manages projects as assigned.
- May participate on committees and/or workgroups.
- Maintain needed CEUs for coding certification.
- Other duties as assigned.
Minimum Qualifications
American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification such as: Certified Professional Coder (CPC), 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, AND 3 years coding, clinical, or billing experience or equivalency (one year of education can be substituted for two years of related work experience). Departments may prefer specific certifications over others.
Demonstrated knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations, reimbursement systems (federal, state and payer specific), and health insurance processing is required. Proficiency with computer software such as Microsoft Word and Excel, and effective human relations and communication skills are also required. Some areas may require knowledge of CMS, AMA, and AHA coding and billing guidelines.
This position has no responsibility for providing care to patients.
Incumbents in this position must maintain their Continuing Education Credits (CEUs) as required by the issuing coding organization.
Preferences
An especially qualified candidate will also possess the following:
- Demonstrated knowledge of revenue cycle.
- Working knowledge of insurance denials, appeals and expected reimbursement rates.
- Experience presenting findings and educating key stake holders.
- Strong written and verbal communication skills
Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
Disclaimer This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.
Special Instructions
While UMB is a remote department and this role will be performed remotely, interested applicants should note the following:
- This role is expected to work during UMB office hours which are Monday through Friday, 8am to 4:30pm Mountain Time.
- The University of Utah is committed to providing jobs to individuals located in Utah, and sees remote roles like this as an opportunity to provide amazing employment opportunities to those living in remote areas of the state. As such, Utah-based applicants may be prioritized in the screening process.
- At this time, the University of Utah is unable to employ individuals living in California, Colorado, New York, Oregon, or Washington.
Requisition Number: PRN38907B
Full Time or Part Time? Full Time
Work Schedule Summary: UMB Office Hours; M-F 8:00am to 4:30pm Mountain Time
Department: 00209 - Univ Medical Billing - Oper
Location: Other
Pay Rate Range: $25-$28 per hour
Close Date:
Open Until Filled: Yes
To apply, visit https://utah.peopleadmin.com/postings/166302
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