University Hospitals

The specialist is responsible for the accurate and timely coding of moderately complex medical encounters, including hospital same-day surgery, observations, ancillary, and ED encounters, following established coding guidelines and federal regulations. This role involves ensuring optimal assignment of CPT, ASC, APC, and APG codes, resolving coding edits, and supporting the Clinical Documentation Improvement program while maintaining productivity standards.

The specialist is responsible for the accurate and timely coding of inpatient medical records, assigning diagnostic ICD-10-CM and/or ICD-10-PCS codes following established guidelines and regulations. This includes maintaining productivity standards, updating coding knowledge, and abstracting data into the 3M encoder/Epic software.

This position involves submitting and resolving medical claims of moderate to high complexity, requiring adherence to governmental and third-party billing, follow-up, and appeal requirements for both inpatient and outpatient claims. Responsibilities include utilizing worklists to analyze account balances, communicating with customers to resolve inquiries, and performing follow-up with insurance companies to ensure appropriate payment.