About UofL Health:
UofL Health is a fully integrated regional academic health system with five hospitals four medical centers nearly 200 physician practice locations more than 700 providers the Frazier Rehab Institute and Brown Cancer Center.
With more than 12000 team membersphysicians surgeons nurses pharmacists and other highly skilled health care professionalsUofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.
Position Summary and Purpose
This employee is responsible for reviewing and evaluating medical record documentation to assign sequence edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes for services provided at the Brown Cancer Center (BCC) including Bone Marrow Transplant (BMT) and infusions and injections (I&I) and clinic charges. The specialist performs code validation across multiple entities and applies the appropriate coding guidelines and criteria for code and modifier selections. The specialist adheres to the Official CMS Coding Guidelines and Facility Coding Compliance policies and procedures for the assignment of complete accurate timely and consistent codes for charge entry. The specialist supports the facilitys overall operational goals by efficiently and effectively providing account data needed for accurate and timely Revenue Cycle processing and billing.
Essential Functions:
Uses ICD-10-CM and/or HCPCS/CPT codes to assign validate and/or work pre-bill coding edits for the following patient types:
Medical Oncology (Med-ONC) Radiation Oncology (Rad-ONC) Bone Marrow Transplant (BMT) Infusion & Injections and multispecialty hospital-based outpatient clinics (Oncology HepC MS Pulmonary etc.)
Works pre-bill edits daily to resolve issues related to coding assignments charge errors and missed modifiers
Maintains or exceeds established productivity standard (minimum of 75 pre-bill edits cleared daily or a combination of daily charge capture and pre-bill edits)
Ensures that all assigned charges are captured timely and consistently within the 3-day charge goal
Performs coding audits for BCC coders upon request and as needed to reduce coding error trends
Utilizes the complete medical record documentation in code assignment validation and/or editing of codes
Other Functions:
Works collaboratively and supports efforts of team members
Ensures adherence to the official coding guidelines infusion and injection coding guidelines ethical coding standards as well as HIM coding compliance policies and procedures
Meets all educational requirements and attend required continuing education workshops webinars assigned by manager for coding compliance
Maintains compliance with all company policies procedures and standards of conduct
Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
Performs other duties as assigned
Job Requirements
(Education Experience Licensure and Certification)
Education:
High school diploma or GED/Equivalent (required)
Completion of a Certified Coding Program (required)
Experience:
Three (3) years outpatient coding experience (required)
Three (3) years of prior oncology coding experience (preferred)
Prior billing to include government and commercial payer experience (preferred)
Prior experience with 3M Coding and Allscripts STAR and TruBridge billing systems (preferred)
Certification:
Nationally accepted Certified Coding Credentials (RHIT RHIA CPC CPC-H CCA CCS CCS-P or CHONC) (required)
Job Competency:
Knowledge Skills and Abilities critical to this role:
Working knowledge of medical terminology anatomy and physiology
Demonstrates a working knowledge of Infusion & Injections and Oncology Billing
Working knowledge of Official CMS Coding Rules and Guidelines ethical coding standards as well as HIM coding compliance policies and procedures
Ability to complete project assignments in a timely manner and identify trends in charge reconciliation data
Language Ability:
Must be able to communicate effectively in both verbal and written formats
Reasoning Ability:
Ability to break down problems or tasks; using prior knowledge and experience to identify causes and consequences of events
Computer Skills:
Demonstrates strong Microsoft Office knowledge skills
Demonstrates strong coding skills; knowledge of 3M Coding and Allscripts STAR and TruBridge billing systems preferred
Additional Responsibilities:
Demonstrates a commitment to service organization values and professionalism through appropriate conduct and demeanor at all times
Maintains confidentiality and protects sensitive data at all times
Adheres to organizational and department specific safety standards and guidelines
Works collaboratively and supports efforts of team members
Demonstrates exceptional customer service and interacts effectively with physicians patients residents visitors staff and the broader health care community
UofL Health Core Expectation:
At UofL Health we expect all our employees to live the values of honesty integrity and compassion and demonstrate these values in their interactions with others and as they deliver excellent patient care by:
Honoring and caring for the dignity of all persons in mind body and spirit
Ensuring the highest quality of care for those we serve
Working together as a team to achieve our goals
Improving continuously by listening and asking for and responding to feedback
Seeking new and better ways to meet the needs of those we serve
Using our resources wisely
Understanding how each of our roles contributes to the success of UofL Health
Required Experience:
IC
UofL Health provides comprehensive care at our UofL Health – UofL Hospital location in Louisville Ky. Learn more about UofL Health – UofL Hospital and the various services we provide.