Job Description

University of Utah Job Description

Job Summary

Outpatient/Provider Coder Level 2 responsibilities include, but are not limited to abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding.

Qualifications

American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification such as: Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS- P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other specialty certification indicated by the department, OR 3 years coding experience required.

AND an additional 2 years of coding, clinical, or billing experience or equivalency (one year of education can be substituted for two years of related work experience) required.

Departments may prefer specific certifications over others.

Basic knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations, health insurance processing, proficiency with computer software such as Microsoft Word and Excel, and effective human relations and communication skills are also required.

Incumbents qualifying for this position under the equivalency requirement, without certification, may be required to obtain an American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification within 6 months of hire.

This position has no responsibility for providing care to patients.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Disclaimer

This job description has been designed to indicate the general nature and level of work performed by employees within this classification.  It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Essential Functions

1. Reconciles clinic or provider visits and reports on missing, incomplete, or inconsistent documentation by contacting appropriate personnel
2. Reviews, abstracts, and codes multiple/sub specialty services and assigns appropriate coding classification.
3. Interacts with and provides feedback to providers, hospital staff, and clinic managers on billing related issues.
4. Researches and resolves high volume accounts and complex, suspended claims.
5. Interprets and applies basic regulatory guidelines to coding and reimbursement decisions
6. Assures adherence to department quality and productivity standards.
7. Assists with other department coding needs as requested

8. Serves as a mentor for and assists in the training of Level 1 Coders

Problem Solving

This position receives direction from department leadership. Incumbents work closely with co-workers, supervisors, and department leadership in the resolution of regulatory and complex issues. Incumbents also work cooperatively with physicians, nurses, other ancillary staff, and external contacts.

Comments

Incumbents in this position must maintain their Continuing Education Credits (CEUs) as required by the issuing coding organization.

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking.

Often: Repetitive hand motion (such as typing), walking. 

Seldom: Bending, reaching overhead.