A Brief Overview

Under the direction of the Billing Supervisor – the Sr. Physician Coding Specialist monitors Coder Productivity, Train, Audit, Code Surgical Encounters, and be a Resource for Physicians and other Department within the system. Identifies trends with insurance related issues and reports findings to the Team.

What You Will Do

• Analyzes, on a daily basis and in accordance with established time frames, the outstanding insurance accounts. Initiates appropriate and effective telephone and/or written follow-up on the identified accounts.
• Communicates with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims.
• Researches and responds to all telephone inquiries from the customer service department, in a prompt, professional manner meeting departmental guidelines.
• Reviews and corrects coding rejections.
• May code ICD-9 from written documentation.
• May abstract CPT/HCPCS codes.
• May perform computer assisted coding functions.
• In depth knowledge of coding rules and payer guidelines.
• May code E/M services.
• Top performer in department productivity.
• Top performer in department accuracy.
• May perform auditing functions.
• May be assigned to complicated sub-specialties.
• Trains/mentors new coders.
• Assists staff when supervisor is not available.
• Requires minimal supervision.
• Effectively communicates coding trends and documentation requirements with physicians and practice managers.
• Maintains patient/physician confidentiality at all times and maintains effective communication and professional interaction with patients and physicians.
• Provides appropriate information and feedback to various personnel within UHPS. Supports and utilizes established departmental guidelines. Recommends additional research to other CBO departments.
• Identifies trends with insurance related issues and reports findings to the Team Lead.
• Acts as a role model for professionalism through appropriate conduct and demeanor at all times.
• Interprets written correspondence and either resolves the problem or forwards it to another department for prompt resolution.
• Effectively communicates utilizing the telephone, form letters or internal correspondence to resolve patient inquiries.
• Handles multiple tasks simultaneously.

Additional Responsibilities

• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.