Medical Coding and Denials Educator

Medical Coding and Denials Educator Job Summary University Medical Billing (UMB) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too. Job Summary Under the direction of the Quality Assurance Manager, the Medical Coding and Denials Educator is responsible for providing quality assurance education, analysis, and recommendations for the institution. This individual will develop and build direct, interactive, dynamic relationships with management, staff, physicians, and departments. The Educator will lead a team of coders and focus on quality improvements in the revenue cycle to assure accurate and consistent coding and billing as it relates to coding denials. The Educator will develop educational programs to ensure staff (i.e., Medical Account Coding Specialists and Coders) maintain and sustain proficient understanding of regulatory policy and coding standards. Examples of educational programs include coding regulations, coding updates, applicable clinical knowledge, and national, fiscal intermediary, and organization-specific coding and reimbursement guidelines. Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB's Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service. Compensation & Benefits The starting salary for this position is $80,000-$90,000/yr. depending on experience. Members of UMB are eligible for a bonus based on department performance. All team members are eligible for the University's comprehensive benefit package that includes 90% employer- paid medical insurance, a generous 14.2% retirement contribution, reduced tuition, PTO and holiday pay, and more! Responsibilities Essential Functions Provides individual and group coding, billing, and regulatory education/presentations to coding staff, physicians, and other stakeholders throughout the organization; monitors and reports progress to ensure compliance with coding standards and expectations. Directs, supervises, and evaluates the work activity of Medical Account and Coding personnel Distribute and evaluate work, recommend changes as needed Establish schedules, manage time-off requests Complete performance assessments, oversee performance improvement Assist in hiring new personnel as needed Monitors work quality and employee productivity to ensure adherence to department standards. Ensure team collaboration and provides continuous mentorship and feedback to medical account coding specialists and assists in building collaborative relationships with other operational teams (i.e. auditors, coders, accounts receivable (AR), authorizations, etc.) essential to the collective success of our department. Develops & coordinates curriculum related to diagnosis and procedural coding, all related federal and state billing regulations, and payer processes related to coding policy, medical necessity, denials and appeals. Research and evaluate coding, documentation practices, and processes, and identify billing policy and coding trends through data analysis or chart review. Responsible for denial prevention, recommendations, and communications through resolution. Research and respond to questions/concerns from internal and external staff. Special projects and other duties as assigned. Employment is contingent on the successful completion of a background check and the adherence to departmental policies, including UMB’s Telecommuting Agreement which requires a distraction-free and HIPAA compliant workplace, cameras on for all virtual calls/meetings, and the ability to work during office hours or assigned shift (M-F, approximately 8am to 5pm Mountain Time) regardless of what time zone you live in. Additionally, new hires are required to provide their own monitors (two) and reliable internet service. Minimum Qualifications AHIMA or AAPC Coding Certification. Minimum of Five years of progressively complex coding experience for outpatient and provider services or equivalency (one year of education can be substituted for two years of related work experience). Complete and accurate knowledge of ICD-10, HCPCS, and CPT coding. Ability to interpret and understand laws and regulations at a Federal and State level. Ability to identify coding and charging errors. Proficient knowledge of anatomy, physiology and pathophysiology. Comprehensive knowledge of Medicare/Medicaid and third party coding requirements. Demonstrated human relations and effective communication skills courses; excellent interpersonal skills and strong team player. Ability to work in a culturally diverse environment. Intermediate computer skills with Excel, PowerPoint, Word, Outlook, OneNote. Previous adult teaching experience is preferred. Preferences An especially qualified candidate will also possess the following: Revenue cycle expertise with a focus on coding denials and appeals Experience with CPT and CMS ICD-10 Guidelines 2 years of leadership experience Applicants must show the potential ability to perform the job’s essential functions as outlined in the position description. Disclaimer This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job. Special Instructions While UMB is a remote department and this role will be performed remotely, interested applicants should note the following: This role is expected to work during UMB office hours which are Monday through Friday, 8am to 5pm Mountain Time. The University of Utah is committed to providing jobs to individuals located in Utah, and sees remote roles like this as an opportunity to provide amazing employment opportunities to those living in remote areas of the state. As such, Utah-based applicants may be prioritized in the screening process. At this time, the University of Utah is unable to employ individuals living in California, Colorado, New York, Oregon, or Washington. Requisition Number: PRN37990B Full Time or Part Time? Full Time Work Schedule Summary: M-F 8:00am to 5:00pm Mountain Time Department: 00209 - Univ Medical Billing - Oper Location: Other Pay Rate Range: $80,000-$90,000/yr. Close Date: Open Until Filled: Yes To apply, visit https://utah.peopleadmin.com/postings/161972 jeid-f053793bb84b8c41b23a4b9725b3ebac