Professional Fee Coder I

Summary

The Patient Business Services (PBS) Coding department is looking for a motivated, entry level coder to review 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. We focus on providing accurate and compliant coding assistance by coders who are certified and up-to-date on coding rules and regulations.

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

Job Duties

This position is responsible for reviewing and resolving all coding edits through Epic and Optum Claims Manager to ensure that all charges are accurately captured. Responsibilities include the following:

• Reviews and accurately resolves the National Correct Coding Initiative (NCCI) edits.
• Reviews Local Coverage Determination Diagnosis (LCD) and National Coverage Determination (NCD) edits.
• Reviews other coding and payer specific edits for clean claim submission.
• 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.
• Reviews coding denials and resolve issues in conjunction with the collections team.
• Participates in physician education regarding coding and billing topics.
• Attends and participates in coding education sessions.
• Keeps abreast of changes to ICD_10, CPT and HCPCS coding and communicate changes with providers and management.
• Performs other duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• No experience required.
• Certified Professional Coder (CPC). Certification must be obtained within one year of hire or promotion.

Preferred Qualifications

• Associate degree or certificate from an accredited program in Health Information Management.
• Three to six months of coding training which includes but not limited to medical terminology, human anatomy and physiology, and disease process.
• Proficiency in Microsoft Office, Excel, Epic EHR and Citrix portal.