Senior Coder - RCO Coding (Remote)

EDUCATION & EXPERIENCE: Minimum Qualifications: Three years of multi-specialty coding experience. Proficient in coding Professional services, and/or Outpatient professional and hospital technical services. Experience with communicating, training, and educating providers in proficiency. Preferred Qualifications: Three (3) or more years of hands-on experience in professional medical billing, with demonstrated knowledge of charge review, claim edits, and rejection/denial workflows. Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations. REQUIRED LICENSES, REGISTRATIONS, OR CERTIFICATIONS: One of the following: CCA – Certified Coding Associate (AHIMA) or CCS – Certified Coding Specialist (AHIMA) or CCS-P – Certified Coding Specialist – Physician Based (AHIMA) or RHIA – Registered Health Information Administrator (AHIMA) or RHIT – Registered Health Information Technician (AHIMA) CIC – Certified Inpatient Coder (AAPC) or COC – Certified Outpatient Coder (AAPC) or CPC – Certified Professional Coder (AAPC) or CPC-A – Certified Professional Coder – Apprentice (AAPC) or CRC – Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional services for inpatient and/or professional and hospital outpatient technical services for multiple specialty areas to ensure accuracy and optimal reimbursement from all third-party payers. ESSENTIAL JOB FUNCTIONS: Reviews documentation in EPIC and/or on paper as provided to appropriately assign ICD-10-CM, PCS and CPT codes. Communicates with and provides feedback to the education team and/or provider for query opportunities for documentation clarification or missing elements in the medical record. Utilizes the encoder and/or Optum software to correctly assign all appropriate ICD-10-CM, ICD10-PCS and CPT codes for diagnosis and procedures. Sequences diagnoses and procedures to generate clean claims in accordance with the Coding Guidelines based on the type of coding being reviewed. Verifies all ADT information is correct on all charge sessions; date of service, billing provider, service provider, place of service, referral information and claim form if required. Attends and participates in coding education sessions. Obtains required CEU’s for certification and completes any required education. Works coding related charge reviews/claim edits daily to ensure timely and accurate billing within filing deadlines. The coder is responsible for productivity and quality standards to adhere with coding compliance and federal regulations. Work all PB/HB claim edits and reject errors daily. Hospital DNB’s will be worked as assigned per Specialty. Work charge reconciliation to ensure all services provided are captured for coding in a timely manner. Adheres to internal controls and reporting structure. Marginal or Periodic Functions: Performs related duties as required. KNOWLEDGE/SKILLS/ABILITIES: Strong written and oral communication skills. WORKING ENVIRONMENT/EQUIPMENT: Standard office environment at UTMB’s main campus or other location. Occasional travel may be required. Standard office equipment SALARY RANGE: Actual salary commensurate with experience. WORK SCHEDULE: Remote, Monday through Friday, Full-Time Position. Equal Employment Opportunity UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.