This is not a remote position
Work accounts receivable denial work queues to resolve coding relating denials by assigning modifiers, diagnosis codes and CPT procedural codes to professional charges utilizing provider documentation. Provide feedback to leadership for process improvement and recommend edits to reduce denials.
- Review coding denials in assigned work queue(s) to identify deficiencies in CPT code, ICD-10 code and modifier assignment based on clinical documentation in accordance with established coding guidelines, third party payer rules, University Standard Practice Guidelines, CMS rules, regulations and guidance.
- Recommend updates and or corrections to resolve coding claim denial(s) to billing staff.
- Assist leadership, billing and coding staff to ensure that concerns are investigated and appropriate action is taken.
- Respond to complex coding inquiries as required.
- Communicate problems and barriers to leadership.
- Model, support and reinforce a culture of service excellence to all customers.
- Participate as an active member of Lean Thinking in daily work initiatives.
- Protect the confidentiality of primary and secondary health records and the information therein as mandated by law, professional standards and Health System policies.
- Monitor, interpret and advise management regarding changes to third party reimbursement activities and trends with coding related denials.
- Contact leadership, billing, and or coding representatives for information and assistance with denied or incorrectly paid claims.
- Represent the unit with limited authority regarding general administrative and operational matters on an as need basis.
- Initiate and prepare standardized and ad hoc reports and correspondence based on respective area needs.
- Other projects assigned by management
- CPC/RHIT/RHIA certification, with a minimum of 2 years of current experience
- Prior experience with correcting diagnosis codes, modifiers, and CPT codes, both procedures and E&M services, assigned to professional services. Emphasis on procedure coding (i.e GI, Card, Nephrology procedures, etc.).
- Minimum two years of progressively complex billing & third party payer experience.
- Knowledge of legal, regulatory and policy compliance issues related to medical coding and documentation and billing procedures.
- Ability to analyze, problem-solve, and work independently.
- Strong communication and interpersonal skills.
- Ability to provide guidance and training to professional billing and coding staff.
- Knowledge of University policies and procedures is necessary. Proficiency in use of computers and software, including Microsoft Office products.
- Demonstrates ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner.
- Demonstrates experience in professionally handling and protecting items confidential in nature.
- Demonstrates ability to work in a team environment, and to build trust in the working relationships with other staff and faculty.
- Demonstrates ability to learn and work independently.
- Demonstrated proficiency working with Epic work queues as well as prior charge posting experience.
- Knowledge of University of Michigan and UMHS policies and procedures.
- Experience in Internal Medicine / Pediatric Subspecialties, Primary Care and OB/GYN Procedure Coding and E&M leveling.
- Self-Starter, able to work independently with minimal supervision, goal oriented
- Knowledge of EXCEL
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.