Medical Billing Coder - UMC Billing Office

Pay Grade/Pay Range: Minimum: $21.25 - Midpoint: $26.59 (Hourly N6)

Department/Organization: 208411 - UMC Business Office

Normal Work Schedule: Monday - Friday 8:00am to 5:00pm; some evening/weekend hours as needed

Job Summary: The Medical Billing Coder provides timely and accurate processing of multi-specialty physician office visits, I/P and surgical hospital visits, and procedural coding in an academic environment. Reviews and corrects charges submitted from the clinic and hospital electronic health record using CPT, HCPCS, ICD-10 and insurance payer standards. Follows-up with accounts receivable on unpaid insurance claims. Corrects denials and audit trails. Responds to patient statement inquiries.

Additional Department Summary: Supports medical billing services for the College of Community Health Sciences (CCHS). Prepares and submits clean claims to various insurance companies either electronically or by paper. Reviews and verifies that documentation supports diagnoses, procedures and treatment results. Trends problems in billing and coding and provides timely feedback to Supervisor. Advises Faculty, Residents, other learners, and clinical staff regarding proper documentation and coding services. Resolves coding edits at the time of charge entry to ensure timely claim submission.

Answers questions from patients, clinicians, clerical staff and insurance companies. Identifies and resolves patient billing inquiries. Evaluates patient’s financial status and establishes budget payment plans. Identifies and flags delinquent accounts for submission to the collection agency. Completes worklog tasks and outstanding accounts receivable reports by contacting insurance companies to resolve denials; submits appeals and calls patients to resolve COB issues. Processes payments from patients and prepares End of Day reports. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Required Minimum Qualifications: High school diploma or GED and four (4) years of medical bill coding experience; OR associate's degree or medical coding certificate and two (2) years of medical bill coding experience; OR bachelor's degree and some medical bill coding experience.

Skills and Knowledge: Experience processing charges submitted in an electronic health record system. Excellent organizational and effective written and verbal communication skills. Detailed oriented. Excellent customer service skills, with respect, cultural awareness, and sensitivity. Ability to work independently and problem-solving skills. Time management skills. Ability to maintain strict confidentiality.

Preferred Qualifications: Demonstrated knowledge and skill in working with Excel spreadsheets and Word documents. Certified Professional Coder (CPC) by American Association of Professional coders (AAPC). Certified Coding Specialist by American Health Information Management Association (AHIMA). ICD-10 training/experience.

Background Investigation Statement: Prior to hiring, the final candidate(s) must successfully pass a pre-employment background investigation and information obtained from social media and other internet sources. A prior conviction reported as a result of the background investigation DOES NOT automatically disqualify a candidate from consideration for this position. A candidate with a prior conviction or negative behavioral red flags will receive an individualized review of the prior conviction or negative behavioral red flags before a hiring decision is made.