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About the Role

The University of Rochester is seeking an individual to review system edits, assign appropriate codes, and ensure the production of quality healthcare data and accurate professional payment. This role involves preparing reports and troubleshooting issues that affect claims processing.

Responsibilities

• Reviews system edits and assigns appropriate codes from appropriate coding classification system to ensure the production of quality healthcare data and accurate professional payment.
• Prepares reports for designated leader(s).
• Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign appropriate codes through medical record documentation as per designated workflow.
• Completes system edit reviews to make corrections before transmittal.
• Ensures work queue and responsibilities are handled within established guidelines and timeframes.
• Troubleshoots problems that prevent claims from being released.
• Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the nature of the problem.
• Consults with internal customers and external vendors to obtain greater specificity and/or clarification when documentation appears inconsistent or incomplete.
• Prepares reports for designated leader to document recurring problems and identifies the source of reimbursement delays.
• Works closely with designated leader to ensure effective communication to resolve invoice payment delays.
• Provides Providers and other staff with information relative to coding as necessary.
• Responds to coding information requests and inquiries from various sources.
• Performs other duties as assigned.

Requirements

• High School diploma or equivalent and less than 1 year of relevant experience required.
• Equivalent combination of education and experience.

Skills

• Knowledge of ICD-10CM, CPT and HCPSC preferred.
• Working knowledge of medical terminology and anatomy preferred.

Location

• 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623

Work Type

• Full time
• Regular

Experience Level

• Less than 1 year of relevant experience

Education Level

• High School diploma or equivalent

Salary/Compensations

• $20.34 - $28.51 per hour

About the Company

• As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
• The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better.

Equal Opportunity

• In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.