Certified Coder (Hybrid) - Physicians Billing Service

Scheduled Hours40

Position SummaryPosition reviews medical record documentation to determine appropriate billing codes and necessary documentation. Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections.

Job Description

Primary Duties & Responsibilities:

• Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers. Creates appropriate letters to substantiate the validity of claims.
• Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-10 code.
• Researches payer policies and processes.
• Meets with physicians to review documentation, resolve coding, and secure signature of unsigned dates of service, tagging files for follow-up. Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with compliance or physicians and other clinical staff as needed to provide documentation feedback and to develop appeals.
• May act as a lead person and assists coders with IBC staff with medical terminology and policy interpretation as required.
• Assists with efforts to increase physician awareness of documentation requirements.
• Works assigned Epic Work queues and CRM tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed. Identifies invoices that have been rejected per department criteria.
• Perform accounts receivable (AR) functions in the Epic billing system, including updating insurance information and demographics.
• Prepares case reports and initiates follow-up for billing process.
• Performs other duties as assigned.

Working Conditions:
Job Location/Working Conditions

• Normal office environment. Primarily remote, but is required to come into the office on a monthly basis

Physical Effort

• Typically sitting at desk or table.

Equipment

• Office equipment.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

A diploma, certification or degree is not required.

Certifications:

The list below may include all acceptable certifications and issuers. More than one credential or certification may be required depending on the role.

Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)

Work Experience:

No specific work experience is required for this position.

Skills:

Not Applicable

Driver's License:

A driver's license is not required for this position.

More About This Job

Required Qualifications:

• Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee’s department).

Preferred Qualifications:

• Previous coding experience or experience equivalent to an associate’s degree in a related field.
• Knowledge of ICD-10 and CPT coding.

Preferred Qualifications

Education:

Associate degree - Medical Coding & Billing

Certifications:

No additional certification beyond what is stated in the Required Qualifications section.

Work Experience:

No additional work experience beyond what is stated in the Required Qualifications section.

Skills:

Computer Systems, Epic EHR, ICD-10 Procedure Coding System, Medical Billing and Coding, Medical Terminology

GradeC10-H

Salary Range$25.30 - $37.94 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ.

Accommodation

If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.

Pre-Employment ScreeningAll external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits Statement

Personal

• Up to 22 days of vacation, 10 recognized holidays, and sick time.

• Competitive health insurance packages with priority appointments and lower copays/coinsurance.

• Take advantage of our free Metro transit U-Pass for eligible employees.

• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.

Wellness

• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

Family

• We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.

• WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO/AA StatementWashington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Diversity StatementWashington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply. Apply