Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35 locations and we are continuing to grow.

We offer the following benefits to eligible team members : Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more.

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PURPOSE

Under the supervision of the Revenue Integrity Supervisor, is responsible for being a resource for employees and completing assigned daily job duties of the Charge Review team.

Collaborates with the Professional Coding Team Leader to develop and implement training plan for coders within the department, and report effectiveness of training plan.

Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization supported.

ESSENTIAL FUNCTIONS

• Performs all of the tasks of the Medical Coder I and Medical Coder II as needed or assigned.
• Coordinates and performs on-the-job training for all new and existing medical coders.
• Reviews charges in the Charge Review Work Queue for accuracy and takes appropriate action.
• Provides direction, support, and acts as a resource for staff with coding & CRWQ related questions or concerns.
• Schedules and chairs internal centralized CRWQ group meetings.
• Communicates frequently with Professional Coding Team Leader or Supervisor to remain knowledgeable concerning policy / procedure and helps disseminate information to staff as needed
• Ensures business processes and protocols are followed in the business office areas
• Partners with RIU management team to develop and work toward team goals
• Maintains all workflows and processes within the Centralized CRWQ group
• Helps monitor standardized processes
• Helps implement processes and suggests improvements.
• Make well-informed, compliant, and timely decisions based on research and data.
• Initiate, lead, and report on monthly charge review initiatives.
• Creates, validates or updates medical coder (CRWQ) resource materials.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Follows the core competencies set forth by the Company, which are available for review on CMSweb.
• Works holiday shift(s) as required by Company policy.

OTHER DUTIES AND RESPONSIBILITIES

• Obtains insurance eligibility and benefit details.
• May review records for completeness, accuracy and compliance with regulations
• Works with the providers to communicate coding issues and submit adjustment journals as needed.
• Attends meeting as requested.
• May be responsible for CBO Site Requests regarding insurance claim denials due to coding issues; notifies CBO of appropriate action based on medical records and / or Provider’s response.
• Assist with planning and coordinating special projects
• Performs other duties as assigned.

QUALIFICATIONS

Education and Experience

Required : High school diploma or GED. One (1) or more years of experience working in an office or a healthcare related facility.

Experience using a PC in a Windows environment. Proficient in at least one of the following areas : CBO Site Requests, CRWQ, Hospital Tickets.

Two (2) or more years of experience working with ICD-10 and CPT coding.

Knowledge, Skills and Abilities

• Excellent verbal and written documentation and communication skills.
• Knowledge of medical terminology,
• Familiarity with procedural and diagnostic coding.
• Familiarity with ICD and CPT coding methodology.
• Knowledge of medical insurance, collections, and appointments.
• Keyboarding ability.
• Excellent customer service skills.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent interpersonal and problem solve skills.
• Ability to work in a team environment.
• Ability to manage competing priorities.
• Ability to engage others, listen and adapt response to meet others’ needs.
• Ability to perform job duties in a professional manner at all times.
• Ability to align own actions with those of other team members committed to common goals.
• Ability to understand, recall, and communicate, factual information.
• Ability to understand, recall, and apply oral and / or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Certificate / License

• Certification as a Certified Professional Coder or other certified coding certificate through AAPC. Must maintain coding certification.
• Must attend and complete all work queue training and successfully pass all tests based on the guidelines listed in the Compliance Plan.

Last updated : 2024-08-22