Senior Coding Specialist -Group Billing
Company: The University of Oklahoma
Posted on: June 8, 2021
OU Health Physicians is Oklahoma's largest employer group and
encompasses almost every adult and child specialty.
POSITION INFORMATION: Responsible for abstraction and accurate
coding of procedures from various forms and medical records to
ensure optimal reimbursement and compliance with all regulations,
policies and procedures.
- Abstracting and coding (CPT and ICD) procedures and diagnosis
from medical records.
- Verify medical record documentation requirements.
- Review charging procedures to insure compliance with Federal
Regulations, Medicare and Medicaid Policies, etc.
Functions as advisor/educator to faculty in regard to charge
documentation, diagnosis and procedure coding and charge
- Reimbursement Analysis
- Responsible for verifying that CPT, HCPCS & ICD coding used is
- Responsible for verifying that payment is correct for CPT,
HCPCS & ICD coding used.
- Verify that correct interpretation was used in the calculation
- Responsible for following the policies and procedures of the
unit and the department.
- Researches projects to find additional money.
- Coordinates and/or trains staff on reimbursement
- Monitor monthly financial flow charts to detect problems.
- Performs charge corrections.
May supervise others in the reimbursement or coding areas of the
organization in the absence of other supervisors.
- Patient Scheduling
- Patient Registration
- Review patient admitting records and extracts relevant
- Records patient identification and demographic information in
the computerized billing system.
Contacts agency representatives to verify type and extent of
- Charge Entry
- Performs preliminary review of source documents to determine
that sufficient data are present for processing.
- Using alpha-numeric keyboard, transcribes and/or verifies data
from source documents to the medium used for entering data into the
- Batch charges
- Generate hash totals
- Enter charges
Balances batches by comparing batch proofs to source documents
and hash totals.
- Works with all areas of the organization in getting any
necessary or requested documentation for patients, insurance
carriers or other areas.
- May interact with hospital patient accounting or records
personnel to obtain patient demographic or other billing
- Operates hospital information system terminal to obtain patient
demographic information, patient insurance information and status
of approvals or denials.
- Completes processing of all inpatient and outpatient documents
received on a daily basis.
- Assists in resolving department problems with patient
Maintains records of charges, payments, third party charges,
- Answers patient's questions regarding statements, agency
- Handles correspondence regarding collection activity and
- Identify patient accounts for collection action when accounts
become delinquent or when unable to contact patient or responsible
May receive patient payments and/or issue payment receipts.
- Initiates contact with patients and/or third party carriers if
there is a delay in responding to statements or claims.
- May process incoming and outgoing mail.
- May receive incoming telephone calls and resolve issues
- Records results of mail and telephone contacts on the computer
- Contacts insurance carriers regarding non-payment and/or
improper payment of claims.
- Reviews denials
Interfaces with patients, physicians, and others regarding
professional billing operations and funds.
- Assists in reviewing and balancing patient billing transaction
reports for administration.
- Reconciles daily patient billing receivables reports.
Prepares billing statements from statistical data.
- Credit Balance Resolution
- Review daily billing and accounts receivable credit balance
- Prepare daily refund check requests.
- Prepare other daily credit balances other than refunds.
- Post refund checks to patient accounts.
Mail refund checks with supporting documentation.
- As Needed
- Performs various duties as needed to successfully fulfill the
function of the position.
Education: High School diploma or GED
Experience: 24 months experience with medical insurance,
billing, or clinical or outpatient coding
Certifications/Licenses: Certified Professional Coder (CPC),
Registered Health Information Technician Certification (RHIT),
Certified Outpatient Coder (COC), Certified Coding Specialist
(CCS), Certified Coding Specialist-Physician-based (CCS-P), or
National Healthcareer Association Certification. (NHA)
- Knowledge of CPT and ICD coding processes and determine which
documentation is required to enter into the coding system
- Knowledge of the different insurance carriers and their
- Knowledge of medical billing
- Knowledge of Health Insurance Portability and Accountability
- Excellent customer service
- Ability to handle stressful situations in a professional
- Ability to recognize a problem and solve in a timely
- Experience with surgery a plus
- Experience with LDC's, NCD's and researching new
OU Health Hospitals and OU Health Physicians are merging into
one clinical enterprise. This position will transition employment,
along with existing staff to OU Health Physicians as of July 1,
Keywords: The University of Oklahoma, Norman , Senior Coding Specialist -Group Billing, Other , Norman, Oklahoma
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