Job Description

Extended Job Title
Sr Coding & Reimburs Spec

Org Level 1
Texas Tech Univ Health Sciences Ctr

Org Level 7
512406 - Neurology Dept Lbk Genl

Position Description
Reviews official medical records with physician/healthcare provider documentation and assigns appropriate codes for all physician/healthcare provider services from current editions of official coding sources. Ensures accurate, complete, and timely code assignments for all physician/healthcare providers.

Requisition ID
19509BR

Optional Attachments
Professional/Personal Reference, Recommendation/Referral, Other Documents Supporting Qualifications

Travel Required
Up to 25%

Major/Essential Functions
Reviews official medical records and accurately assign the code for all procedures/services, all diagnoses, and supplies using CPT/ICDCM/ HCPCS coding conventions, third party payer rules, and applicable documentation guidelines. Sequence the diagnoses and procedures using coding guidelines.

Abstracts and interprets physician/healthcare provider documentation to assign the most appropriate codes to ensure all entitled reimbursement.

Ensures compliance with all federal and state regulations for coding, reimbursement, and documentation requirements.

Develops and implements systems to ensure the identification of all documented professional services and supplies and to assign the corresponding correct codes. Includes all inpatient, clinic, and outpatient services to include surgical procedures, E&M services, and other physician/healthcare services for reimbursement and statistical purposes.

Resolves claim denials according to coding conventions, third party payer rules, and federal and state regulations.

Stays informed of federal and state regulations regarding professional service descriptions, coding, fee billing, reimbursement, and documentation guidelines.

Consults with and educates physicians and other personnel on coding practices and documentation requirements.

Acts as departmental resource for coding and reimbursement and review difficult classification situations and determine the most appropriate codes.

Responsible for functions of department clinical practice business office, managed care and medical records divisions.

Performs tasks which require advanced skills and knowledge in organization, planning, interpersonal relations, in-depth knowledge of clinic operations relative to patient accounts, billing, coding, managed care and medical records.

Works with administrator and providers to establish and implement effective revenue cycle management processes.

Serves as coding and billing educator for the department to include proper documentation for evaluation and management services, procedures and diagnostic reports.

Works with administrator to review Missing Charge, A/R, Self Pay and Co-Pay Reallocation reports to confirm accuracy and to research for possible funding/coverage.

Manages revenue cycle processes relative to managed care, billing, data and charge capture, timely documentation, collections, etc., to maximize productivity and reimbursement.

Works with Managed Care Coordinator (MCC) to contact patients prior to their scheduled appointment to inform of any co-payment, deductible, co-insurance, etc. due at time of visit. Ensures documentation of outcome via Insurance Verification Form (IVF) or Pre-Visit work-flow process.

Works with Managed Care Coordinator (MCC) to meet expectations related to verification of benefits for all clinic and Neuro Lab patients. Ensures MCC obtains all required referral authorizations, prior-authorizations, etc.

Responsibilities include training employee, addressing complaints and working with administrator to resolve issues or concerns.

Works with administrator to create and maintain standard operating procedures manual for managed care coordinator and billing staff.

Supports Service Plus philosophy of TTUHSC and Texas Tech Physicians of Lubbock to include the mission, vision and SPIRIT values.

Understands, cooperates with and supports all initiatives of our 5 key performance indicators: patient satisfaction, quality, financial performance, business development and people development.

Supports and follows the TTUHSC Values-Based Culture:  One-Team, Kindhearted, Integrity, Visionary and Beyond Service.

Adheres to institutional and departmental safety policies and procedures.

 

Grant Funded?
No

Minimum Hire Rate
16.89

Pay Basis
Hourly

Work Location
Lubbock

Preferred Qualifications
Neurology experience preferred

Campus
HSC - Lubbock

Department
Neurology Dept Lbk Genl

Required Attachments
Professional License or Certification, Resume / CV

Job Type
Full Time

Pay Statement
Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as, the institutional pay plan. For additional information, please reference the institutional pay plan on the Human Resources webpage.

Job Group
Clerical/Secretarial

Occasional Duties
Demonstrates professionalism, interpersonal skills, service focus, teamwork, initiative, accountability, communication, compliance, confidentiality, diversity/inclusion, integrity/honesty, job knowledge, problem solving/decision making, quality of work, quantity of work, flexibility and adaptability to assigned duties and any other duties as assigned.

Shift
Day

EEO Statement
As an EEO/AA employer, the Texas Tech University System and its components will not discriminate in our employment practices based on an applicant’s race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information or status as a protected veteran.

Required Qualifications
Education:
A minimum of a high school diploma or equivalent.

Experience: 
A minimum of three (3) years of coding and reimbursement experience that includes procedural and diagnosis coding.
 
Certification: 
Current certification through the American Health Information Management Association (AHIMA) in the following areas:
  • Certified Coding Specialist-Physician based (CCS-P)
  • Certified Coding Specialists (CCS) 
  • Certified in Healthcare Privacy (CHP) 
  • Registered Health Information Administrator (RHIA) 
  • Registered Health Information Technician (RHIT) 
  • Certified Coding Associate   
OR current certification through the American Academy of Professional Coders (AAPC) in of the following areas: 
  • Certified Professional Coder (CPC) Certified Professional Coder-Hospital (CPH-H).


Does this position work in a research laboratory?
No

Application Instructions

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