Sep 01, 2021

Coding & Billing Analyst II or III, Orthopaedics

  • University of Virginia
  • Virginia, USA

Job Description

The incumbent is responsible for monitoring, communicating and preparing materials for physician documentation reviews and departmental coding staff reviews in preparation for all Billing Quality Educators to train providers and coders on all coding and billing policies and procedures established in the UPG Administrative Unit, the UVA Health System and governmental and other insurance carriers. Incumbents typically responsible for advanced assignments depending on proficiency of specialties and departmental needs. Reviews medical documentation on a prospective (prior to billing) and regular basis to determine if documentation supports the service being billed in accordance with coding and compliance guidelines and the appropriate third party regulations and /or standards. Prepares written reports of review results and present the results to the Billing Quality Educators. Meets with Educators on a regular basis to review coding and billing performance and offers support to resolve any coding and billing question. Assist in conducting physician training sessions to support effective billing of physician services, including annual training for all new fellow/residents. Serve as a liaison between all UPG Billing & Collections and Billing Quality Educators in an effort to facilitate reimbursement issues (i.e. Registration, Hosp/Physician billing, Coding) Identifies, analyzes and recommends resolution of front-end system issues within the various clinical departments.  Monitors and analyzes -22 modifier denials from insurance carriers.  Identifies trends and problem areas and recommends corrective action in documentation standards, billing policies and procedures to address deficiencies. Monitors and analyzes management information reports to identify variances in physician billing productivity and reimbursement performance.  Recommends corrective action to address deficiencies. Assists Business/Billing Manager with the implementation of new policies and procedures to enhance the efficiency and accuracy of the capture, coding, submission and reimbursement of all physician charges to the UVA Physicians Group. Assigns appropriate ICD-10 diagnosis codes.  Determines which CPT-4 codes can be charged, according to generally accepted coding guidelines. Conducts requested prospective documentation and coding audits on particular departments/providers and payors. Assists and supports supervisor with system and procedure implementation as required and completes other assignments as required. MINIMUM REQUIREMENTS Coding & Billing Analyst II: Education: High School Diploma or GED, College courses in business-related field Experience: Five years of experience in coding/billing position Licensure: Must be CPC Certified by AAPC or CCS-P through AHIMA to qualify for all functional areas Skills: Intermediate knowledge of and experience utilizing a personal computer Intermediate word processing, spreadsheet, and database software skills required Must demonstrate the ability to both prepare and analyze data as determined by management Demonstrated ability to implement and execute multi-task assignments independently MINIMUM REQUIREMENTS Coding & Billing Analyst III: Education: High School Diploma or GED Experience: Eight years of experience in a coding/billing position Licensure: Must be CPC Certified by AAPC or CCS-P through AHIMA to qualify for all functional areas Skills: Intermediate knowledge of and experience utilizing a personal computer Must demonstrate the advanced ability to both prepare and analyze data as determined by management Demonstrated advanced ability to implement and execute multi-task assignments independently Demonstrated advanced ability to serve as a preceptor for special projects PHYSICAL DEMANDS This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs. The University of Virginia, including the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff.  We believe diversity is excellence expressing itself through every person's perspectives and lived experiences.  We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.

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Academic

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