Coding Specialist II

Location: Remote, UNAVAILABLE, US

Employment Type: OTHER

Department Overview

The Department of Anesthesiology and Perioperative Medicine is integral to the healthcare, education and research missions at OHSU. In this extraordinary time, we have proudly stepped up our efforts to meet these commitments. We provide clinical services at OHSU hospitals and collaborate with the VA Portland Health Care System and Hillsboro Medical Center. We specialize in providing excellent perioperative care and anesthesia services to our patients using state-of-the-art technology and pharmacologic tools with an emphasis on patient safety. In the operating rooms our anesthesiologists work in care teams with our fellows, residents, and nurse anesthetists as well as independently. Post-operative care is under the medical supervision of our department. We play a prominent role in the caring for patients in the cardiovascular, neurosciences, and newly-launched virtual intensive care units. In the ICU our team includes anesthesiology intensivists, critical care fellows, physician assistants/nurse practitioners, and residents. The role of our team in the ICUs is comprehensive and critical to achieving the highest quality outcomes for our patients.

 

This position provides professional fee coding and billing support to the Department of Anesthesiology and Perioperative Medicine, with a primary focus on pain management and critical care services. Responsibilities include reviewing provider documentation to ensure services are accurately and appropriately coded and supported by the medical record; assigning CPT, ICD-10-CM, and HCPCS codes in accordance with applicable Medicare, Medicaid, payer, and coding guidelines; and ensuring accurate and timely charge submission for professional services rendered at OHSU. The position provides technical expertise on third-party payer and reimbursement requirements, resolves coding and documentation issues, and may provide education to physicians and other clinical staff regarding coding and billing practices, documentation requirements, and regulatory or coding changes. Coding assignments may vary based on departmental needs and operational priorities. The position is responsible for meeting established standards for coding accuracy, productivity, timeliness, and compliance.

Function/Duties of Position

• Billing review: Review provider documentation in Epic to ensure accurate, complete, and compliant coding of professional services. Initiate and manage provider documentation queries through Epic In Basket or Outlook to obtain clarification necessary for accurate coding. Assign CPT, ICD-10-CM, and HCPCS codes per applicable federal, state, and payer guidelines. Ensure timely charge capture and resolve coding edits to support accurate claim submission. Coordinate billing information and verify charges are complete before submission. Enter and maintain coding and billing information accurately in Epic and other applicable systems. Maintain a coding accuracy of 95% or greater while meeting departmental productivity standards of 8 to 15 codes per hour. Complete assigned work within established turnaround time expectations and comply with departmental policies and applicable coding guidelines.
• Compliance support: Resolve coding, documentation, and billing issues with providers prior to submission to CMMI/UPS for processing. May serve as a resource on professional billing policies and documentation standards. Monitor updates from CMS, AMA, CPT, ICD-10, HCPCS, payer bulletins, coding newsletters, and regulatory agencies. May communicate coding, billing, and regulatory updates to providers and coworkers. May assist with implementing process changes as needed. Ensure practices comply with applicable federal, state, payer, and organizational guidelines. Identify opportunities to improve coding quality, compliance, workflow efficiency, and accurate reimbursement. Participate in coding quality reviews, compliance initiatives, and ongoing education to maintain proficiency.
• Billing and collection support: Serve as a resource to billing staff on coding and billing questions, help resolve coding-related claim edits, assist with identifying coding issues that may delay billing or reimbursement, respond to coding inquiries and support accurate charge capture and timely charge submission.
• Other duties as assigned. 

Required Qualifications

• High school diploma or GED.
• Minimum two years of professional fee coding experience in a hospital or healthcare setting; completion of a medical records coding program through an accredited college or equivalent combination of education, training, and experience.
• Knowledge of CPT, ICD-10-CM, HCPCS, and relevant coding and reimbursement regulations, strong medical terminology, proficiency in Epic, Microsoft Word and Excel, excellent communication skills with the ability to collaborate across clinicians, billing, and administrators, plus the ability to work independently and meet productivity and turnaround times.
• Current Certified Professional Coder (CPC) required.
• Current coding certification from AAPC or AHIMA:
• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA). Active AHIMA membership may be required for some positions.
• Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification.
• Ability to perform the job duties with or without accommodation.

Preferred Qualifications

• Accredited coding program training.
• Two years of professional fee coding experience in pain management and critical care.

• Some college course work or education in classes related to anatomy and physiology, CPT and ICD-10-CM coding.

• Two years of professional fee coding experience in pain management and critical care.

• Current Certified Professional Coder (CPC)

Additional Details

Primarily remote with flexible work hours based on departmental needs and manager approval.

Why apply to OHSU?

We are Oregons only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portlands largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu