General Information
| Payroll Title | HEALTH INFO CODER 3 | Title Code | 004733 | Grade/Step | Working Title | Physician Coder | |
|---|---|---|---|---|---|---|---|
| Department Name | Clinical Affairs Dept | Supervisor | Cianci, Catheryne Diane | Department Head | Glascock, Catheryne Elizabeth (Beth) |
Special Requirements and Conditions
| Critical Position |
| Travel |
Level of Supervision Received
| General Direction |
Items Used
| Standard Office Equipment: Computer, Copier, Fax, etc |
| Will be required to travel to UCR clinic and affiliate locations. |
Position Purpose
| The Physician Coder will contribute to our growth and success in meeting our mission by reviewing, analyzing and assuring the final diagnoses and procedures as stated by the practicing providers are valid and complete. This position serves as the technical expert and resource for the school and clinical enterprise. Accurately codes for both the inpatient and outpatient environments to include physician office visits, in-office procedures, and/or surgeries/procedures performed at affiliate hospitals to ensure proper reimbursement. Provides education to the providers to ensure proper completion of electronic health records and proper assignment of ICD-9 CDM and ICD-10 CDM, HCPCS and CPT codes. All delivered in a patient centric environment. |
Essential Functions
| Essential Function | % Time |
|---|---|
| Coding | 80 |
| 1. Abstracts information from various chart documentation, dictated reports, electronic health records, encounter forms, hand-written progress notes and various other venues with the use of audit tools to reach appropriate CPT/ASA procedure codes, E/M (Evaluation & Management) codes and all other appropriate billing codes in compliance with University policies and government billing policies. Takes appropriate action if documentation does not support codes. 2. Analyzes and evaluates findings, diagnosis & procedure codes identified by physicians. Reports to supervisor, inconsistencies and/or incomplete charts, to inform the department and/or provider to improve billing/coding practices. 3. Uses sound professional coding judgment in establishing priority sequencing of diagnosis codes & services to assure maximum allowable reimbursement, consistent with but not limited to University Compliance Regulations, CMS Medicare & Medi-Cal, HMO, commercial insurance carriers and other related entities, and confirm that all codes/modifiers are appropriate. 4. Interacts with internal and external resources to facilitate all aspects of medical coding. |
|
| Education and Training | 10 |
| 1. Maintains highly skilled technical knowledge through workshops, seminars, and classes aimed at educating coders with the most recent coding updates, techniques and procedures for achieving correct and maximum reimbursement. Reviews documentation, such as bulletins, coding/billing subscriptions, publications, updates and all other related coding resource materials. 2. Develops, recommends, and facilitates training for others on coding policies and procedures. |
|
| Travel and Other Duties | 10 |
| 1. Travel to UCR Health practices and affiliates in the Riverside and Palm springs area. 2. Project management and other duties as assigned. |
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Minimum Requirements
| Minimum Requirement | Display Ranking |
|---|---|
| No information record yet | |
Preferred Qualifications
| Preferred Qualification | Display Ranking |
|---|---|
| No information record yet | |
| Posted Position Purpose |
|---|
| UCR Health is a team of physicians, specialists and healthcare professionals dedicated to improving the health of Inland Southern California residents and families by bringing health home to our communities.
Established alongside the School of Medicine at the University of California, Riverside, UCR Health is growing to meet the healthcare needs of the region - bringing innovative, culturally sensitive medical care to our communities. Our patient-centered primary care and specialty services deliver university-based healthcare excellence and innovation to the communities where we live, work and play. To learn more about UCR Health, please visit: www.ucrhealth.org.
The Physician Coder will contribute to our growth and success in meeting our mission by reviewing, analyzing and assuring the final diagnoses and procedures as stated by the practicing providers are valid and complete. This position serves as the technical expert and resource for the school and clinical enterprise. Accurately codes for both the inpatient and outpatient environments to include physician office visits, in-office procedures, and/or surgeries/procedures performed at affiliate hospitals to ensure proper reimbursement. Provides education to the providers to ensure proper completion of electronic health records and proper assignment of ICD-9 CDM and ICD-10 CDM, HCPCS and CPT codes. All delivered in a patient centric environment. |
| Posted Minimum Requirements |
| 1. Current certification as a Professional Coder from the AAPC; ability to provide current documentation from appropriate agency. 2. A minimum of 1.5 years' experience of CPT, ICD-10 and HCPCS coding and charge capture. 3. Comprehensive knowledge of medical diagnostic and procedural terminology. 4. Comprehensive knowledge of federal, state and third-party-payer coding and documentation guidelines. 5. Demonstrated skill/experience working with computerized reports to abstract information. 6. Ability to interact in a professional and diplomatic manner with difficult and/or emotionally charged people. 7. Demonstrated ability to work independently with only general supervision. 8. Working knowledge of Microsoft software applications. 9. Organizational skills to prioritize workload and meet deadlines; develop and carry out project assignment in an efficient and timely manner. 10. Excellent written and verbal communication skills to interact with tact and diplomacy with administration, physicians, and staff at all levels. Ability to generate error-free documents and correspondence. |
| Posted Preferred Qualifications |
| 1. An additional 3 years of advanced experience and knowledge of CPT, ICD-10 and HCPCS inpatient/outpatient coding with a Neurosurgery, Women's Health (OB, Uro-Gyn, Gyn-Onc), Orthopedics focus. 2. Experience with M.D. Audit. 3. Experience working in healthcare in an academic setting. |