Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections.
PRIMARY DUTIES AND RESPONSIBILITIES:
Responsible for appealing claims denied by third party payers. Creates appropriate letters and compiles documentation to substantiate the validity of claims.
Investigates and problem solves reimbursement issues in collaboration other coding staff and faculty. Works directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals.
Researches payer policies and processes.
Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment.
Works with coders and IBC staff with medical terminology and policy interpretation as required.
Codes evaluation and management services to appropriate CPT code level. Ensures ICD codes are linked appropriately to services provided.
Responsible for charge corrections when necessary.
Works assigned Epic Work queues, CRM tasks, and reviews remittance advices for rejection and accuracy of payment amounts as needed. Identifies invoices that have been rejected per department criteria.
Perform accounts receivable (AR) functions in the Epic billing system, including updating insurance information, demographics.
Special projects as assigned.
Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee’s department).
The RHIT or RHIA (or eligible) certification in health information management may be recognized in lieu of a coding credential and does not require experience.
Knowledge of ICD-10, HCPCS, and CPT Coding required.
Must perform accurate and detailed work.
Must be able to keep goals and Department in mind when making decisions and problem-solving.
Must maintain a highly professional demeanor as a representative of the Department.
Excellent verbal and written communication skills and teamwork strategies are critical.
Organized in material, thought and action regarding a wide variety of duties.
Maintain patient confidentiality in regard to all financial and medical information.
Set personal goals as well as office goals; fully participate and complete tasks within time specified.
Equivalent of Associate's degree and 2+ years’ experience in coding or medical record review.
Working knowledge of medical terminology and related computer systems.
Department Name/Job Location:
This position is in the Department of WU Physicians Billing Service. This position is for the Medical School Campus.
This position is full-time and works approximately 40 hours per week. Regulary schedule Monday through Friday. Occasional overtime work may be involved.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account. If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor. To attach these documents, go to: My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.
The hiring range for this position is $20.83 - $26.06 per hour.
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. Current employees applying for a new position within the university may be subject to this requirement. The screenings will include a criminal background check and, as applicable for the position, other background checks, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.
Washington University in St. Louis, a medium-sized, independent university, is dedicated to challenging its faculty and students alike to seek new knowledge and greater understanding of an ever-changing, multicultural world. The University offers more than 90 programs and almost 1,500 courses leading to bachelor's, master's and doctoral degrees in a broad spectrum of traditional and interdisciplinary fields, with additional opportunities for minor concentrations and individualized programs. The faculty is composed of scholars, scientists, artists and members of the learned professions. They serve society by teaching; by adding to the store of human art, creativity, understanding, and wisdom; and by providing direct services, such as health care.