Coding Specialist I

Austin, TX
Full Time
Experienced

At Urology Austin, our mission is committed to improving the lives of patients and their families through compassionate, quality, and ethical care.

In choosing a career with Urology Austin, you are choosing to improve the lives of patients and their families through a collaborative team-driven approach in an innovative, quality-driven, community-based setting. Better Medicine. Better Care.

Position Summary:
This is a remote position that performs various duties to accurately interpret and bill physician charges for physician services. Enters in the Billing System appropriate CPT and ICD-10 codes and bills charges.

JOB RELATIONSHIPS
  • Works in conjunction with providers, other front office staff, and billing staff to ensure complete and accurate billing.

ESSENTIAL JOB RESPONSIBILITIES
  • Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
  • Assists in entering data from inpatient facesheets including but not limited to demographics, insurance plans, etc.
  • Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services.
  • Enters appropriate data into AllScripts PM by selecting the appropriate codes, diagnosis, modifiers, pathology, and provider information to complete the process.
  • Contacts physicians through EMR regarding procedures and other services billed to ensure proper coding.
  • Responsible for reviewing patient logs and other reports of clinical activity to ensure billing is captured for all patients.
  • Monitors and follows up to ensure all services that can be billed are captured and coded for billing.
  • Responsible for ensuring the batch processes for all coded charges.
  • Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
  • Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for physicians.
  • Works in coordination with other members of the Central Billing Office as necessary.
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
  • Responsible for scrubbing claims to submit compliant, truthful, and correct coding based on payer rules.
  • Performs other related duties as required and assigned.

ROLE QUALIFICATIONS
  • Coding Certification through AAPC (CPC) or AHIMA (CCS) required.
  • Specialty Certification is desirable.
  • High school diploma required; Associates degree of formal billing education preferred.
  • Minimum three (2) years of billing/collections experience within a clinic or physician practice.
  • Strong working knowledge of insurance plans, including Medicare and Medicaid.
  • Strong working knowledge of ICD-10 and CPT coding.
  • Proficiency in computer software use, including Microsoft Office, EMR and Practice Management systems.
  • Effective time management and the ability to prioritize work.
  • Excellent communication skills and the ability to interact with all levels of management, staff, and physicians.


PERFORMANCE REQUIREMENTS
Knowledge
  • Knowledge of medical billing/collections practices.
  • Knowledge of ICD-10 and CPT Coding and third-party operating procedures and practices
  • Understanding of medical terminology. 
Skills
  • Interpersonal and communication both with internal staff and external customers.
  • Skill in gathering and reporting insurance claim information.
  • Skill in reading medical chart terminology.
  • Time Management
Abilities
  • Ability to communicate effectively with patients, staff, and external contacts via phone and through electronic mail.
  • Elicit appropriate information for patients to clinic staff.
  • Ability to read and understand information and ideas presented in writing.
  • Ability to apply general rules to specific problems to produce answers that make sense – deductive reasoning.

PHYSICAL DEMANDS AND WORK ENVIRONMENT
  • Physical: Involves sitting for approximately 80% of the day; extensive use of computer, mouse, and phone.
  • Environment: Professional office setting. Requires frequent interaction with patients and staff from various backgrounds.
  • Stress: Frequent stress from high-volume deadlines and the need to resolve insurance conflicts quickly to prevent appointment cancellations.
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