Assigns and reviews the accuracy of the diagnostic codes ICD-10-CM and CPT codes for providers Evaluation and Management Services EM procedures and diagnostic testing in all settings for purposes of billing research and providing information to government and regulatory agencies. Incumbent may perform only certain of the following responsibilities depending on their work assignment.
Reviews documentation in medical record to appropriately assign ICD-10-CM CPT-4 HCPCS and modifiers within a timely manner to capture all services rendered by providers at all locations. Encounters may be within Epic outside electronic medical record systems or based on paper documentation.
Monitors analyzes and resolves charge review claim edit and coding-related denial trends and shares trends with supervisor managers and team members to facilitate root cause analysis and continuous process improvement.
Reviews and resolves charge sessions that fail charge review edits claim edits and follow-up work queues identifies areas of opportunity based on findingsresolution of errors.
Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps.
Provides ongoing feedback based on observations from coding physicianprovider documentation. Identifies opportunities for education and communicates trends to coding leadership andor provider education team.
Assists coding staff physicians and other health care practitioners with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding physicianprovider documentation. Identifies opportunities for education and communicates trends to leaders.
Ensures all coded services meet appropriate governmental regulations and guidelines National Correct Coding Initiative NCCI or payer-specific guidelines.
Utilizes available resources for assignment of codes as necessary e.g. Diagnostic Imaging system Lab system Emergency Epic and coding reference software andor books.
Trains and mentors Coding Quality Specialists to effectively perform their job responsibilities following current coding policies and procedures at the discretion of coding leadership Assists coders with medical terminology disease processes and surgical techniques.
Assists other coders in resolving coding issuesquestions. Performs peer review as directed from coding leadership.
Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
Provides ICD-10 and CPT codes for Business Services and physician office requests regarding non-billed or non-reimbursed claims.
Completes special projects as directed by coding leadership.
Performs charge corrections when appropriate.
Performs other duties as assigned.
MINIMUM REQUIREMENTS
PHYSICAL DEMANDS
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings and programs.
The starting base rate for this role is 24.24 hourly. Individual compensation will be determined by the selected candidates qualifications previous work experience andor education.
Benefits
UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report Best Hospitals" guide rates UVA Health University Medical Center as High Performing" in 5 adult specialties and 14 conditionsprocedures.
We are one of 70 National Cancer Institute designated cancer centers. UVA Health Childrens is named by 2023-2024 U.S. News & World Report as the best childrens hospital in Virginia with 9 specialties ranked among the best in the nation.
Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville Culpeper Northern Virginia and beyond.
The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply including veterans and individuals with disabilities. Learn more about UVAs commitment to non-discrimination and equal opportunity employment .