Coding Specialist

Basic Function and Scope of Responsibilities: This job is responsible for daily review, coding, and billing of insurance claims, follow-up unpaid claims and insurance denial management.

Principal Responsibilities:

• Completes charge audits, reviews documentation to identify all services provided by the provider, and reviews medical records to ensure accuracy.
• Communicates effectively over the phone and through written correspondence to clinic staff to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements.
• Communication effectively with providers to provide clarification or education as updates and policy changes occur.
• Accurately assigns appropriate procedure, administrative, and diagnosis codes using knowledge of medical coding.
• Review and pre-audit charge billing report to assure all required billing information has been accurately received.
• Teamwork with other coders and billers to ensure charges are entered timely and accurately.
• Provide training for other employees as requested by management.
• Resolve coding errors identified by Advanced Claim Edits.
• Resolve coding related denials.
• Maintain medical coding certification.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

Education Requirements:

• High School Diploma or GED equivalent required.
• Previous experience in charge-entry and or coding is preferred.
• Previous EPIC experience preferred.
• Coding Certification Required

Performance Requirements:

Knowledge:

• Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms.
• Knowledge of electronic medical record system.
• Knowledge of manual and electronic billing systems and procedure.
• Knowledge of eligibility, benefits and authorizations processes.
• Detailed knowledge of billing, HCPCS, CPT and ICD-10 codes.
• Familiarity with medical terminology.
• Evaluates and understands contractual language and health plan payment policies as it relates to payment, compliance, reimbursement methodologies, and appeals processes.
• Knowledge of all coding applications relevant to Oncology/Hematology/Infusion coding.

Skills and Abilities:

• Skills in operating personal computer utilizing word processing, spreadsheets, databases, email and other office equipment.
• Strong Excel, Word, and Power Point skills.
• Effective communication with peers, supervisors, and patients.
• Ability to handle stressful situations.
• Ability to meet deadlines
• Must be detail oriented with excellent verbal and written communication skills, organizational skills, and time management skills.
• Must possess high degree of professionalism and adaptability.
• Skill in negotiating issues and resolving problems.
• Exceptional multi-tasking, organizational skills and superb attention to detail.
• Strong analytical skills.

Working Conditions: Work may be stressful at times due to continual interaction with others and the nature of the medical specialty.

Must possess the physical and mental abilities to perform the tasks normally associated with the role including bending, reaching and sitting.

Physical surroundings: Medical office

Adverse working environment Work may be stressful due to continual interaction with others, long hours required and nature of the medical specialty.

Physical Effort: Must possess the physical and mental abilities to perform the tasks normally associated with this role including prolonged sitting, walking, bending, standing, stooping and reaching. Lifting up to 10 pounds at times.

Local Travel: Occasional, within city limits only

Domestic/International Travel: None

Extensive Hours: Varies due to need

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this position. They are not intended to be an exhaustive list of all associated responsibilities, skills, efforts or working conditions. Mission Cancer Blood, part of University of Iowa Health Care reserves the right to change, amend, add, delete, and otherwise assign any and all duties, responsibilities and position titles as it deems necessary to meet the needs of the business.

Mission Cancer Blood, part of University of Iowa Health Care is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender, sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need.

In the interest of ensuring the safety of our employees, patients and community, Mission Cancer Blood, part of University of Iowa Health Care has adopted a mandatory vaccination policy for COVID-19. All employees are required to be fully vaccinated against COVID-19 unless granted a reasonable accommodation for disability, religious or other extenuating circumstances. New employees will be granted a reasonable time to come into compliance with the policy, if necessary.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• High school or equivalent (Required)

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Multiple locations