Revenue Integrity Coding Specialist
Company Description
The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state’s future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System’s anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.
Job Description
General Summary
Under general supervision this position will review and resolve National Correct Coding Initiative, Outpatient Claim Editor, and Medically Unlikely Edits related to facility charge capture and coding for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10 diagnosis coding and CPT-4 procedure coding classification systems.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Knowledge of CPT, HCPCS, and revenue codes for accuracy and compliance with all state and federal guidelines.
- Responsible for reviewing and resolving charge capture, coding, and revenue integrity check workqueues in Epic.
- Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
- Communicates with various departments within the hospitals regarding billing and charge capture issues. Refers any problems to management timely, providing clear details.
- Responsible for making independent decisions regarding charge adjustments and other charge resolution techniques.
- Advises management of possible billing problems.
- Complete all tasks in a timely manner with accurate documentation.
Qualifications
Education and Experience
- Associates or Bachelor’s degree is preferred.
- AAPC or AHIMA certification is required.
- Two years minimum experience working hospital coding related edits.
- EPIC EMR experience in preferred.
Knowledge, Skills and Abilities
- Concern for quality and ability to identify errors and implement corrections.
- Ability to interpret and implement regulatory standards.
- Serves as a resource to others in the resolution of problems and issues.
- Effective customer service skills, with the ability to work with all levels within the organization.
- Excellent organization skills, demonstrates confidence and creativity.
- Strong time management skills and keen attention to detail.
- Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.
- Good interpersonal relationship skills.
- Self-motivated, detail oriented, problem solver.
- Knowledge and ability to learn and understand HSCRC/CMS regulations, CPT (Current Procedural Terminology), and ICD-10 coding.
- Ability to operate a personal computer is required. Proficiency with the following applications is required: MS Excel, MS Word, and PowerPoint. MS Access, SAS, & Tableau is preferred.
- Ability to handle confidential issues with integrity and discretion.
- Ability to prioritize and manage work in a stressful environment.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $27.44-$38.41
Other Compensation (if applicable):
Review the 2024-2025 UMMS Benefits Guide
Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at [email protected].
Average salary estimate
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Join the University of Maryland Medical System (UMMS) as a Revenue Integrity Coding Specialist in Linthicum Heights, MD, where you’ll play a crucial role in enhancing our healthcare services. At UMMS, we’re dedicated to delivering compassionate, top-notch care while partnering with esteemed institutions like the University of Maryland School of Medicine. As a Revenue Integrity Coding Specialist, your primary responsibility will be to review and resolve coding and charge capture issues, ensuring compliance with federal and state regulations. You’ll dive into the National Correct Coding Initiative and Outpatient Claim Editor, applying your knowledge of ICD-10 and CPT-4 coding systems to ensure correct and timely reimbursement for our services. Your keen eye for detail will help in identifying errors and implementing necessary corrections, while your solid communication skills will allow you to collaborate effectively with hospital departments on billing and charge capture matters. We’re looking for someone who is proactive, self-motivated, and adept at navigating a dynamic healthcare environment. If you hold an AAPC or AHIMA certification, have at least two years of experience in hospital coding, and are familiar with EPIC EMR, we would love to meet you. Come be part of a team that is dedicated to innovation and the future of healthcare by applying your expertise to help us deliver the best for our patients. Together, we can make a difference!
We dedicate every day to providing a better state of care in Maryland. We are committed to strengthening the social fabric of our communities with high quality care centered on patients and their families, and our size and geographical reach all...
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