Coding and Billing Analyst II or III, Orthopaedics
Job ID: R0027969 | Medical Coding | Full time | Charlottesville, VA
The incumbent is responsible for monitoring, communicating and preparing materials for physician documentation reviews and departmental coding staff reviews in preparation for all Billing Quality Educators to train providers and coders on all coding and billing policies and procedures established in the UPG Administrative Unit, the UVA Health System and governmental and other insurance carriers. Incumbents typically responsible for advanced assignments depending on proficiency of specialties and departmental needs.

  • Reviews medical documentation on a prospective (prior to billing) and regular basis to determine if documentation supports the service being billed in accordance with coding and compliance guidelines and the appropriate third party regulations and /or standards.
  • Prepares written reports of review results and present the results to the Billing Quality Educators.
  • Meets with Educators on a regular basis to review coding and billing performance and offers support to resolve any coding and billing question.
  • Assist in conducting physician training sessions to support effective billing of physician services, including annual training for all new fellow/residents.
  • Serve as a liaison between all UPG Billing & Collections and Billing Quality Educators in an effort to facilitate reimbursement issues (i.e. Registration, Hosp/Physician billing, Coding)
  • Identifies, analyzes and recommends resolution of front-end system issues within the various clinical departments.
  • Monitors and analyzes -22 modifier denials from insurance carriers. Identifies trends and problem areas and recommends corrective action in documentation standards, billing policies and procedures to address deficiencies.
  • Monitors and analyzes management information reports to identify variances in physician billing productivity and reimbursement performance. Recommends corrective action to address deficiencies.
  • Assists Business/Billing Manager with the implementation of new policies and procedures to enhance the efficiency and accuracy of the capture, coding, submission and reimbursement of all physician charges to the UVA Physicians Group.
  • Assigns appropriate ICD-10 diagnosis codes. Determines which CPT-4 codes can be charged, according to generally accepted coding guidelines.
  • Conducts requested prospective documentation and coding audits on particular departments/providers and payors.
  • Assists and supports supervisor with system and procedure implementation as required and completes other assignments as required.

MINIMUM REQUIREMENTS - Coding & Billing Analyst II:

Education: 

  • High School Diploma or GED, College courses in business-related field

Experience:

  • Five (5) years of experience in coding/billing position

Licensure:

  • Must be CPC Certified by AAPC or CCS-P through AHIMA to qualify for all functional areas

Skills:

  • Intermediate knowledge of and experience utilizing a personal computer
  • Intermediate word processing, spreadsheet, and database software skills required
  • Must demonstrate the ability to both prepare and analyze data as determined by management
  • Demonstrated ability to implement and execute multi-task assignments independently

MINIMUM REQUIREMENTS - Coding & Billing Analyst III:

Education:

  • High School Diploma or GED

Experience:

  • Eight (8) years of experience in a coding/billing position

Licensure:

  • Must be CPC Certified by AAPC or CCS-P through AHIMA to qualify for all functional areas

Skills:

  • Intermediate knowledge of and experience utilizing a personal computer
  • Must demonstrate the advanced ability to both prepare and analyze data as determined by management
  • Demonstrated advanced ability to implement and execute multi-task assignments independently
  • Demonstrated advanced ability to serve as a preceptor for special projects

PHYSICAL DEMANDS

This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs.


COVID Vaccination Requirement

Due to the scope of President Biden's Executive Order 14042 issued in early September, all University employees, including remote employees, must receive their final vaccination dose by January 4, 2022, unless they have a University-approved religious or medical exemption. The University has updated policy SEC-045 to reflect these new requirements.

If hired by the Academic Division, excluding School of Medicine, School of Nursing, UVA Physicians Group, and the Health Systems Library, you will be required to provide proof of vaccination or be willing to be vaccinated by January 4, 2022. Academic employees may apply for a University-approved medical or religious exemption.

Note: Some medical and safety-sensitive positions require vaccination and are not eligible for an exemption. For more information on how vaccination requirements will apply to you, please visit the UVA New Hire Vaccination Requirements webpage.

Tina Rosson
Tina Rosson
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Charlottesville, VA
Charlottesville, VA 22908
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Tina Rosson
Tina Rosson
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Working here.

Since 1979, UPG has been the clinical partnership group managing, growing and providing direct patient care for all UVA entities. This strategic partnership allows UVA to expand on education, technology, diagnostics, resources and facilities while the teams at UPG can focus on managing and delivering high-quality, multi-specialty care.

The expansive network of UPG providers and clinical support teams work together to deliver world-renowned care to patients at UVA Medical Center in Charlottesville and in 24 primary and specialty care clinics located throughout central and northern Virginia.

Quality of Life

Charlottesville, Virginia is one of the nation’s most charming and picturesque places to live and work. Our area boasts many excellent restaurants, wineries and craft breweries; historic sites; Shenandoah National Park and Skyline Drive; and a great selection of homes in welcoming neighborhoods, as well as urban and rural locations. Public transportation is excellent, and you’re just a short drive from the beach or Washington, D.C.