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Job ID: 7550
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Performs the same duties as Medical Coder I and II – Hosp IP and Medical Coder I, II, III – Hosp OP, but also serves as a resource for Medical Coders (IP and OP) when needed on complex application of codes. Participates in and mentors coders, provides problem resolution and feedback to supervisors. Assists and serves as back-up to the Medical Coder Auditor – Hosp IP &OP as needed on completing PWC SMART coding edits.
1. Assigns and/or audits International Classification of Diseases 10-CM (ICD-10) diagnostic and ICD-10-PCS procedural codes, Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes in an accurate and productive manner on inpatient, outpatient (observation, ambulatory surgery, and ancillary cases).
2. Queries providers when documentation is conflicting, needs clarification and specificity.
3. Groups codes and completed product into payment group.
4. Analyzes information for optimal and proper reimbursement.
5. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures.
6. Reviews work of staff as needed. Responds to questions and refers staff as appropriate to the Medical Coder Auditor.
7. Researches and resolves problems from coders as needed.
8. Provides input on performance of coders to supervisor for performance evaluations.
9. Performs coding audits at a minimum of two medical coders per month as needed to back up the Medical Coder Auditors – Hosp IP/OP.
10. Researches and resolves problems referred by coders in response to audited charts. Provides information on performance of coders’ audits to supervisors.
11. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
12. Provides training and serves as a general resource to assist other coders and members of department staff.
13. Reviews, analyzes and abstracts physician/other documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided. Communicates with physicians and other health care staff to obtain missing information or to clarify existing information.
14. Reviews and processes PWC SMART edits.
15. Utilizes a variety of software (e.g. EPIC, Optum CAC, PWC SMART, etc.) to compile and validate medical information.
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.