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University of Rochester Lead Medical Records Coder - 226380 in Rochester, New York

Lead Medical Records Coder Job ID 226380

Location Medical Faculty Group Full/Part Time Full-Time Favorite Job Regular/Temporary Regular Opening

Full Time 40 hours Grade 010 URMFG United Business Office

Schedule

8 AM-4:30 PM

Responsibilities

Position Summary:

Professional Service Coding and Revenue Integrity are vital to ensure the continued financial viability of the University of Rochester Medical Center. This position's responsibility encompasses managing medical coding analysis for professional services of URMC providers throughout the entirety of the medical center (all UR Medicine locations - inpatient and outpatient, long term care, etc.). Under the general direction of MFG Director of Coding and Revenue Integrity, this lead coding analyst position has responsibility for monitoring and advising leadership on all activities of the coding, documentation and dassification of clinical data, with latitude for independent work. Must maintain expertise in clinical ICD-10 (11) and CPT coding to provide consultation or expert advice to management. MFG (Medical Faculty Group) resource for creation of internal policies, along with interpretation of coding guidelines and principles. Liaison for MFGBO Revenue Cycle Managers and leadership and compliance for Professional Services. Works with MFG Coding Manager and Director for coding education to the MFG Coders, URMC faculty and others, on professional fee coding. conduct independent investigation and resolution of issues. Use Faculty Practice Solutions Center (FPSC) data and other external and internal database information to formulate comparisons and make recommendations to management on best practices for professional fee coding and charge capture.

Responsibilities:

  • Maintains expert knowledge of clinical coding CPT, E&M, ICD-10 (11), HCPCS, requirements for multiple specialties. Able to provide expert advice on all URMC clinical areas. Works collaboratively with MFG Revenue Cycle Managers and Revenue Integrity team, MFGBO leadership, Compliance, and Payer Relations to assure that coding for billings are compliant, accurate and reimbursement is optimized. May provide consultation and direction to Revenue Cycle Managers and/or faculty and other leadership and staff on proper coding. As necessary, provides Physicians and other staff with information relative to coding.

  • Performs in depth analysis of medical records to abstract diagnoses and procedures. Confers with Physicians and Providers to obtain greater specificity and/or clarification on possible diagnoses and CPT codes. Uses thorough knowledge of coding systems and edit logic to assign appropriate codes. Understands third party payers to enable selection of appropriate codes and sequencing, including modifier assignment. Assists others in this understanding and body of knowledge. Able to communicate well with peers, leadership, faculty, and staff.

  • Prepares reports ad hoc, as requested, and as part of independent judgement as appropriate. Assure accuracy of coding by performing quality reviews and/or working with appropriate compliance staff to review coding. Participate in external coding audits. Ensure that coding insurance denials are tracked and appropriate education results. Run wRVU and coding denial reports (and future ePARC and revenue integrity reports) and report to Director of MFG Coding and Charge Capture. Analyze improvements for net collection ratio of MFG departments. Analyze FPSC reports to identify areas of coding and documentation improvement.

  • Responds to non-routine/complex requests, inquiries or problems. Resolves complex problems that require a high level of expertise and knowledge of clinical coding, charge capture, charge entry and systems including but not limited to eRecord and Flowcast/ePARC, for compliance for billing and revenue integrity. Investigates and resolves matters of significance on behalf of Director of Coding and Revenue Integrity and MFG Coding Manager. Provides guidance to MFGBO staff and Revenue Cycle Managers for nonĀ­routing/complex issues.

  • Make recommendations on policies and procedures. Assist MFG Director of Coding and MFG Coding Manager with planning and development of changes in coding policies and procedures and education thereof.

  • Test new computer programs. Develop communication and education on, and plan for changes in the coding system and workflow processes.

  • Provides observations and analysis on Flowcast/ePARC work queue monitoring and mitigation of issues ad hoc on a daily basis as issues are identified. Provides guidance on education and resolution of issues and opportunities.

    Qualifications:

    Associates degree in Health Information Technology or Bachelors in Health Information Administration preferred with three years coding in an acute care facility in a training/detailed project role; or equivalent combination of education and experience. Successful completion of American Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred. Knowledge of ICD-9CM and ICD-10CM required.

    How To Apply

All applicants must apply online.

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