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Requisition Number 18-0155
Title Coding & Billing Analyst II - Dept of Pediatrics
Location UVA Medical Center
City Charlottesville
State VA
Hours per week Full Time
Description POSITION TITLE: Coding & Billing Analyst II
LEVEL/FLSA: Level 11, Non-exempt

GENERAL SUMMARY: The incumbent is responsible for monitoring, communicating and training physicians and clinic staff on all coding and billing policies and procedures established in the clinical department, HSF Administrative Unit, the UVA Health System and governmental and other insurance carriers. The Analyst is the liaison to the clinical staff for all billing related issues that includes charge capture, CPT-4/ICD-10 coding and third party billing guidelines. Positions may vary in assignments depending on proficiency of specialties and departmental needs.

Essential Functions of the Job:
 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 management and physicians.
 Meets with physicians on a regular basis to review coding and billing performance and offers support to resolve any coding and billing question.
 Conducts physician training sessions to support effective billing of physician services, including annual training for all new fellow/residents.
 Perform periodic reviews of outpatient billing and consult service. Analyses and resolves any documentation issues as necessary.
 Oversees the implementation of semi-annual front desk office staff training.
 Monitors billing procedures to ensure timely and accurate charge capture and submission, appropriate payment posting and to ensure other related billing procedures are performed.
 Serve as a liaison between all UVA Health System entities in an effort to facilitate reimbursement issues (i.e. Registration, Hosp/Physician billing, Coding)
 Identifies, analyzes and resolves front-end system issues within the department.
 Monitors and analyzes charge rejects/denials from the Health Services Foundation and insurance carriers. Identifies trends and problem areas and recommend corrective action in billing policies and procedures to address deficiencies.
 Maintains charge capture documents to ensure appropriate utilization of up-to-date procedure and diagnosis codes.
 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 Health Services Foundation.
 Provides lead expertise to other billing staff related to coding, billing and reimbursement policies and procedures.
 Assigns appropriate ICD-10 diagnosis codes. Determines which CPT-4 codes can be charged, according to generally accepted coding guidelines.
 Assists keying charges to appropriate management system.
 Conducts regular A/R and collections analyses, including audits on particular departments and payors.
 Oversees charge capture process by resolving daily operation questions and problems that arise in the supervisor’s absence.
 Assists and supports supervisor with staff training, system and procedure implementation as required and completes other assignments as required.

UPG is an Equal Opportunity Employer
Requirements REQUIRED QUALIFICATIONS (Knowledge, Skills & Abilities):
 High School Diploma or GED
 College courses in business-related field
 Five years of experience in coding/billing position
 CPC Certified required by AAPC or CCS-P through AHIMA to qualify for all functional areas
 In depth knowledge of CPT-4 and ICD-10 coding
 In-depth knowledge of third-party payor reimbursement policies
 Must know modifiers and use of local policies
 Experience in a multi-specialty, academic, tertiary care physician practice a plus
 Experience providing training and guidance in coding a plus
Knowledge and 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
 Demonstrated ability to serve as a preceptor for special projects, systems preferred
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