Professional Coder 2
University of Miami

Job Info

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The University of Miami/UHealth has an exciting opportunity for a full time Professional Coder 2 in the Pathology Department.

SUMMARY

The Professional Coder 2 (H) is responsible for reviewing the clinical documentation contained in the UHealth patient health records to validate the codes assigned by physicians. The incumbent validates and, as necessary, applies E&M and procedure codes for surgical specialties, Interventional Radiology and/or Interventional Cardiology, Critical Care, Trauma, and other specialties that are predominantly invasive codes for medical specialties including Ancillary, Non-Surgical, and Surgical services. The Professional Coder 2 will have a thorough understanding of ICD-10-CM diagnosis, CPT with E&M, and procedural codes used in reimbursement and data collection.

CORE JOB FUNCTIONS

• Identifies incomplete documentation and seeks clarification from the responsible physician.
  
• Identifies misplaced or potentially conflicting documentation and reports findings to appropriate party for action.
  
• Verifies patient information to identify documentation and/or report discrepancies and to ensure codes and other abstracted data are accurately applied to appropriate patient's account/encounter.
  
• Serves as a quality reviewer of scanned documents while reviewing the record for coding validation purposes.
  
• Identifies mis-scans (poorly scanned documents) and misplaced documentation; promptly reports findings to the Professional Coding Manager.
  
• Assesses documentation and/or queries physician for additional information when indicated to clarify or provide specificity to a diagnosis, symptom, or reason for services provided to ensure the organization receives its entitled reimbursement for care provided. Collaborates with others in the organization including medical staff and other clinicians to ensure the record accurately documents the services provided and to identify documentation trends that can prospectively address deficiencies.
  
• Assigns and sequences ICD-10-CM diagnosis and/or CPT E&M and procedural codes to professional encounters as needed.
  
• Adheres to University and unit-level policies and procedures and safeguards University assets.
  

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

Education:

High School diploma or equivalent

Certification and Licensing:

Certified Coding Associate (CCA), Certified Professional Coder (CPC; CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Office (CCS-P), and/or Registered Health Information Technician (RHIT)

Experience:

Minimum 3 years of relevant coding experience

Knowledge, Skills and Attitudes:

• Knowledge of, understanding of, and ability to adhere to the Health Insurance Portability and Accountability Act (HIPAA).
  
• Knowledge of and compliance with the UHealth Compliance Program, Policies and Procedures, and Safety Policies and Procedures.
  
• Ability to abide by the American Health Information Management Association's professional and ethical conduct standards.
  
• Ability to remain current with continuing education requirements to maintain credentials.
  
• Ability to work independently and/or in a collaborative environment.
  
• Communication skills (interpersonal, verbal, and written).
  
• Critical thinking, organizational, and analytical skills, as well as the ability to interpret, assess, and evaluate provider documentation.
  
• Ability to be proficient with Microsoft Office applications.
  
• Ability to sit for extended periods of time.
  
• Ability to work in a 100% remote environment with minimal supervision, while also staying focused on assigned tasks.
  

CORE JOB FUNCTIONS

Identifies incomplete documentation and seeks clarification from the responsible physician. Identifies misplaced or potentially conflicting documentation and reports findings to appropriate party for action. Verifies patient information to identify documentation and/or report discrepancies and to ensure codes and other abstracted data are accurately applied to appropriate patient's account/encounter. Serves as a quality reviewer of scanned documents while reviewing the record for coding validation purposes. Identifies mis-scans (poorly scanned documents) and misplaced documentation; promptly reports findings to the Professional Coding Manager. Assesses documentation and/or queries physician for additional information when indicated to clarify or provide specificity to a diagnosis, symptom, or reason for services provided to ensure the organization receives its entitled reimbursement for care provided. Collaborates with others in the organization including medical staff and other clinicians to ensure the record accurately documents the services provided and to identify documentation trends that can prospectively address deficiencies. Assigns and sequences ICD-10-CM diagnosis and/or CPT E&M and procedural codes to professional encounters as needed. Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

Education:

High School diploma or equivalent

Certification and Licensing:

Certified Coding Associate (CCA), Certified Professional Coder (CPC; CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Office (CCS-P), and/or Registered Health Information Technician (RHIT)

Experience:

Minimum 3 years of relevant coding experience

Knowledge, Skills and Attitudes:

• Knowledge of, understanding of, and ability to adhere to the Health Insurance Portability and Accountability Act (HIPAA).
  
• Knowledge of and compliance with the UHealth Compliance Program, Policies and Procedures, and Safety Policies and Procedures.
  
• Ability to abide by the American Health Information Management Association's professional and ethical conduct standards.
  
• Ability to remain current with continuing education requirements to maintain credentials.
  
• Ability to work independently and/or in a collaborative environment.
  
• Communication skills (interpersonal, verbal, and written).
  
• Critical thinking, organizational, and analytical skills, as well as the ability to interpret, assess, and evaluate provider documentation.
  
• Ability to be proficient with Microsoft Office applications.
  
• Ability to sit for extended periods of time.
  
• Ability to work in a 100% remote environment with minimal supervision, while also staying focused on assigned tasks.
  

DEPARTMENT ADDENDUM

Department Specific Functions

• Responsible for reviewing and assembling the necessary data in EPIC and or CoPath to release anatomical pathology (AP) and clinical laboratory pathological review (CP20) encounters and create electronic claims.
  
• Review AP and CP20 documentation to ensure compliance with University of Miami Policies.
  
• Ensures that AP and CP20 charges from UM and JHS are released within two days of receipt.
  
• Initiates corrective actions to ensure resolution of billing edits. Support the billing, collection, and reconciliation process for AP and CP20 line of business including client services.
  
• Review Pathology Claim Edits in coordination with the CBO to proactively prevent denials and optimize the Charge Review process.
  
• Work on Pathology Denial Workqueue resolving rejections and identifying possible trends.
  
• Collaborate closely with the Coding Manager Team on various coding and documentation reviews.
  
• Help the rest of the group with other assignments whenever is required
  

Any appropriate combination of relevant education, experience and/or certifications may be considered.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:
Full time

Employee Type:
Staff

Pay Grade:
H7

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