UW Physicians -
701 Fifth Ave, Ste 700
Seattle , WA , United States
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Professional Fee Coder I/II at UW Physicians

Updated: October 9, 2017
Position Summary
The Professional Fee Coder I is responsible for coordinating accurate and timely submission of professional fees. S/he ensures the medical record reflects adequate attending physician documentation per practice plan and CMS/HCFA guidelines. Close collaboration with clinical departments and physicians is required. The Professional Fee Coder I is an entry and intermediate level position responsible for performing primarily E&M as greater than 50% of their work with some procedures initially and could develop to coding more procedures depending on assigned specialty. This position has a minimal to moderate degree of complexity. The Coder I will work under direct supervision.
For senior coders, this role has the potential to be a Professional Fee Coder II position.
Minimum Qualifications Education:
• High School Diploma or equivalency.
• Graduation from an accredited HIM program preferred.
• ICD-10 coding courses preferred .
• 1 year experience in a healthcare environment required
• 1 year coding experience preferred.
Certification Requirements:
•  Certification as CPC-A, CPC, RHIT, RHIA, CCA, CCS-P or specialty AAPC coding certification required.
•  ICD-10 Proficiency passed or possesses an ICD-10 Trainer certificate.
•  Other certifications subject to review.
Knowledge, Skills & Abilities:
• Knowledge of Anatomy and Physiology
• Knowledge of ICD-10 coding guidelines.
• Ability to accurately complete detail-oriented work in a timely manner.
• Ability to maintain confidentiality and handle sensitive information with solid judgment and discretion.
• Ability to prioritize workload and meet quality and production standards.
• Ability to read and understand written sentences and paragraphs in work related documents.
• Ability to work well with a variety of people and be a team player.
• Excellent oral and written communication skills, with the ability to convey a positive and professional image, and to interact effectively with diverse personalities and backgrounds.
• Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
• Strong customer service and relationship management skills.
• Proficiency with Windows based software and Microsoft Office Suite products in a network environment.
Professional Fee Coder II Requirements: The Coder II is expected to work independently with minimal to direct supervision.
•  3 years professional fee coding experience with at least 2 years abstract Procedural/Surgical Coding experience as greater than 50% of work or 6 years professional fee coding experience with greater than 50% of work E&M coding.
•  Experience coding in a Teaching Physician environment preferred.
•  2 years coding or related medical field, CPT, and ICD-9/10 coding experience, and on-line data entry with ability to interpret physicians’ documentation and identify/extract billable services from medical records.
•  Experience interacting with physicians regarding coding requirements.
Essential Duties and Responsibilities
• Identify all billable services (regardless of location rendered) requiring professional fee billing, as determined jointly by UWP and the Clinical Department:
o Review all applicable data sources (EPIC, ORCA, Mindscape,) or other, as applicable, for new admissions, transfers, discharges, expirations, ambulatory procedures, ambulatory visits or other possible sources of billable services.
o Access and review all available electronic or other appropriate information to identify billable services requiring professional fee billing.
• As necessary, request patient medical charts (for non-electronic providers).
• Code all documented required professional services, ensuring all are coded using the appropriate CPT & ICD-10 codes. Ensures coded services, provider charges and medical record documentation meet appropriate guidelines or standards.
• Reviews and resolves coding denials and coding claim edits in Epic daily as part of routine operations.
• Consult with physicians, as appropriate, to verify services rendered and documented. Provide feedback to assist in provider understanding of coding and documentation issues and opportunities.
• Assist physicians and/or their representatives with questions pertaining to professional fees.
• Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements. May participate in “huddles,” Grand Rounds, or department specific sessions to facilitate timely and relevant feedback.
• For services coded, enter charges and comments in Epic.
• Utilize appropriate methods to ensure all documented professional services are submitted in a timely manner.
• Resolve any (outpatient and inpatient) coding edits in the Epic charge review work queues. Bring system and repetitive issues to attention of supervisor and physician champions to provide timely feedback loop designed to address root cause and prevent ongoing errors.
• Perform other duties, as assigned.