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Coding Specialist 2

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Department Overview

This position provides support for billing of physician’s fees. This position is responsible for reviewing documentation to make sure the documentation supports the levels or types of service billed and to ensure the documentation is in compliance with Medicare/Medicaid billing regulations and documentation guidelines, CPT, ICD-9 and ICD 10 documentation guidelines. Responsible for meeting performance standards set for accurate and timely submission of charges for professional services rendered at The Knight Cancer Institute Community Hematology/Oncology. Provide technical expertise regarding a broad range of third-party payer and reimbursement issues, working in collaboration with the Revenue Cycle staff. Is responsible for charge verification, auditing, and follow-up as to the reasons that a charge will not drop to resolute to be billed.

Function/Duties of Position

Billing Review

Review documentation of professional services in EPIC, obtain copies of chart notes, reports (i.e., admission/discharge records, patient medical records) and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services’ (CMS) documentation of professional services and assign correct CPT, ICD-9-CM, and HCPCS codes. Utilizes ICD-9-CM, ICD-10, CPT codebook and Coding Clinic references to verify code specificity and follow ICD-9-CM Official Guidelines for Coding and Reporting and AMA Official Guidelines for CPT.
Enter billing information into EPIC Resolute.
Establish and maintain procedures and other controls necessary in carrying out all insurance billing activity.
Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
Coordinate all billing information and ensure that all information is complete and accurate.
Resolve with providers, any issues or questions which are found prior to submission to UMG for processing.
Coordinate with the Revenue Cycle staff for audit of problem areas.
Perform audits for levels of service and diagnosis coding and provide feedback to Practice Manager and/or Revenue Cycle staff.
Attend education meetings and training as appropriate

Community Hospital Cards

Process hospital cards by verifying information related to the provider, hospital, date of service, diagnosis codes, patient name, spelling, and date of birth and account numbers.
Print out all demographic and insurance information on all new hospital patients and forward to UMG for processing.
Charge entry of hospital cards for established patients.
Perform follow-up on questions from UMG.
Create and maintain audit system to ensure receipt of all billable services.

Provider Support

Serve as a resource to providers for a broad range of billing policy and procedure issues.
Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and governmental agencies as well as attend training seminars to learn and understand changing medical terminology, new diseases, new treatments, new drugs, and experimental procedures used in clinics, hospitals, and research facilities in order to advise physicians of billing practice changes in CPT, ICD-9-CM, ICD-10, HCPCS and insure changes are implements to maximize revenue.
Make recommendations and implement remedial actions for problems.

Work Queues

Manage the following work queue’s daily to ensure timely filing of charges:
- Pending work queue, charge review work queue, charge router charge review work queue
Maintain charge entry workflow and keep charge entry staff informed of changes in procedure to maintain consistency.

Required Qualifications

High School diploma or GED.
Minimum two years of hospital or professional services (dependent on position) experience reviewing, abstracting, and coding medical records using ICD-10-CM and CPT coding;
Certification in one of the following
- Coding certification from AAPC or AHIMA:
  - Registered Health Information Administrator (RHIA),
  - Registered Health Information Technician (RHIT),
  - Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA).
  - Active AHIMA membership may be required for some positions.
  - Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR
  - equivalent certification.

Preferred Qualifications

At least 2 years in a medical oncology office setting.
Knowledge of CPT Outpatient coding guidelines. CCI edits

Additional Details

This position is a telecommuting position which provides support for billing pf physician's fees for 5 clinic locations.

Day Shift, Monday - Friday.

All are welcome

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.

Average salary estimate

$70000 / YEARLY (est.)

min

max

$60000K

$80000K

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What You Should Know About Coding Specialist 2, Oregon Health & Science University

If you're looking to make an impact in the medical coding field, The Knight Cancer Institute has an exciting opportunity for you as a Coding Specialist 2, fully remote! In this role, you're not just crunching numbers—you're actively supporting billing for physician services and ensuring that every piece of documentation is compliant with Medicare and Medicaid regulations. Your knack for detail will shine as you review clinical records in EPIC, verify coding accuracy using CPT, ICD-9, and ICD-10 guidelines, and collaborate closely with the Revenue Cycle staff to tackle any issues before charges are processed. This role isn’t just about coding; it's also about providing invaluable technical expertise, troubleshooting billing issues, and keeping everyone informed of the latest changes in medical terminology and billing practices. You’ll have the chance to use your experience to perform audits, establish controls, and assist providers in navigating complex billing questions. The ideal candidate will have a minimum of two years of relevant hospital experience and coding certification, along with a passion for healthcare and a desire to work in a diverse environment. Join us for a rewarding career while enjoying the comforts of working from home. Don’t miss this chance to contribute to patient care from behind the scenes; apply today!

Frequently Asked Questions (FAQs) for Coding Specialist 2 Role at Oregon Health & Science University

What are the responsibilities of the Coding Specialist 2 at The Knight Cancer Institute?

As a Coding Specialist 2 at The Knight Cancer Institute, your primary responsibilities include reviewing medical documentation to ensure compliance with Medicare and Medicaid billing regulations, coding services accurately using CPT, ICD-9, and ICD-10 guidelines, entering billing data into EPIC Resolute, performing audits, and collaborating with the Revenue Cycle staff to resolve coding issues. Your expertise will help maintain the integrity of billing procedures across multiple clinic locations.