Revenue Cycle Professional Billing is looking for a medical coder to resolve coding related insurance denials by validating or assigning modifiers, diagnosis codes, and CPT procedural codes for professional charges utilizing provider documentation and provide feedback to leadership for process improvement and system changes to reduce denials.
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.
- 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, University Standard Practice Guidelines and 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 coding issues 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.
- Coding certification such as CPC, RHIT, or RHIA.
- Prior experience with assigning diagnosis codes, procedure codes and modifiers to professional services.
- 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.
- Proficiency in use of computers and software, including Microsoft Office products.
- At least two years of progressively complex billing & third-party payer experience.
- 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 with surgery coding and E&M leveling.
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. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening 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.