Senior Certified Coder

OSUPhysicians, Inc.

LEADING NATIONALLY, DELIVERING LOCALLY

 

Join our world-class physician team as we deliver an unmatched level of expertise, and an integrated system of care that has the capacity to take the latest discoveries and turn them into better models for total health care delivery.

 

Ohio State University Physicians, Inc. (OSUP) is a governed multi-specialty group comprised of over 700 physicians affiliated with the Ohio State University Medical Center.

 

General Description:

The Senior Certified Coder manages and monitors the coding and reimbursement activities for professional services provided to patients within Physical Medicine and Rehabilitation with responsibility for lead supervision of others or performance of the more advanced and difficult assignments.  This position utilizes advanced knowledge of specialty coding to analyze patient medical records, ensuring that documentation by providers conforms to legal and procedural requirements.  The Senior Certified Coder will assign specified codes to medical diagnoses and/or clinical procedures.  Willingness to adapt to an evolving job description and expand your responsibilities as the company grows.  The Senior Certified Coder performs within established OSUP standards, applying knowledge and understanding of the practice plan.

 

Work Experience Requirements:Determine accurate CPT, HCPCS procedure and professional supply codes and ICD-9-CM diagnosis codes used for billing services provided by physicians and licensed non-physician providers. Keep current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues. Perform various auditing activities related to physician practice management and coding to maintain compliance with payer reimbursement policies and Federal health care program requirements. Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation as well as communication on coding and compliance issues. Performs audits and analyses of payer denials; provides information on compliance issues arising from audits and formulates recommendations to providers regarding improved documentation practices to avoid future claims denials. Researches inquiries from providers and patients about fees, reimbursements, and denials. Monitors data sources to ensure receipt and analysis of all charges. Update encounter forms/super bills on an annual basis with respect to diagnostic, procedural and supply code changes. Ensures strict confidentiality of financial and medical records. Interacts with department administrators and other administrative staff regarding implementation of new codes and revision of charge documents. Assists in training and provides assistance and support to new and/or lower level coders, as appropriate. Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations. Serves as liaison between billing staff, physicians and management.

 

Job Qualifications:

 Requires a High School diploma or GED; Certification in CPC, CCS, CCS-P; or specialty coding with three years experience directly related to coding and reimbursement for physician services; or equivalent combination of education and experience. Knowledge of CPT, HCPCS procedure and professional supply codes and ICD-9-CM diagnosis codes used for billing services provided by physicians and licensed non-physician providers. Knowledge of third party fee profiles and reimbursement requirements. Knowledge of current and developing issues and trends in medical coding procedures and requirements. Ability to exercise initiative, independent judgment, discretion and decision-making to achieve organizational objectives.Demonstrates an understanding of job responsibilities and uses appropriate knowledge and skills to effectively complete work.Must have high level of interpersonal skills to handle sensitive and confidential situations.  Position continually requires demonstrated poise, tact and diplomacy. A wide degree of creativity and latitude is expected. Analytical ability to gather and interpret data and develop, recommends, and implement solutions. Establish and maintain effective working relationships with physicians, non-physician providers, and compliance staff. Work effectively with individuals and teams, able to contribute to and influence management. Must be able to interact and communicate with individuals at all levels of the organization.


 

OSUP offers competitive pay & benefits package including an employer sponsored Pension Plan.

Please apply on-line or e-mail resumes to heather.rice@osumc.edu or fax to Attn: Heather Rice (614) 293-7292