Pay Grade/Pay Range: Based on Qualifications

Department/Organization: 208411 - UMC Business Office

Normal Work Schedule: Monday - Friday 8:00am to 4:45pm; limited extended hours

Job Summary: The Medical & Billing Coder is responsible for the timely and accurate processing of multi-specialty physician office visits, I/P and surgical hospital visits, and procedural coding in an academic environment. Review and correct charges submitted from the clinic and hospital electronic health record using CPT, HCPCS, ICD-10 and insurance payer standards. Responsible for accounts receivable follow-up on unpaid insurance claims, corrects denials and audit trails, and responds to patient statement inquiries.

Additional Department Summary: The Medical Billing Specialist performs medical billing services for the College of Community Health Sciences (CCHS). Prepares and submits clean claims to various insurance companies either electronically or by paper. Reviews and verifies that documentation supports diagnoses, procedures and treatment results. Trends problems in billing and coding and provides timely feedback to the Director of Billing and coding, Faculty, Residents, other learners, and clinical staff regarding proper documentation and coding services. Resolves coding edits at the time of charge entry to ensure timely claim submission. Answers questions from patients, clinicians, clerical staff and insurance companies. Identifies and resolves patient billing inquiries. Evaluates patient’s financial status and establishes budget payment plans. Identifies and flags delinquent accounts for submission to the collection agency. Completing worklog tasks and outstanding accounts receivable reports by contacting insurance companies to resolve denials, submitting appeals, and calling patients to resolve COB issues. Processes payments from patients and prepares an End of Day report. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Required Minimum Qualifications: High school diploma and three (3) years of medical billing and/or coding experience; OR Associate’s degree or medical coding certificate and one (1) year of medical billing and/or coding experience.

Additional Required Department Minimum Qualifications: Experience processing charges submitted in an electronic health record system.

Skills and Knowledge: Excellent organizational and effective written and verbal communication skills. Detailed oriented. Excellent customer service skills, with respect, cultural awareness, and sensitivity. Ability to work independently and problem-solving skills. Time management skills. Ability to maintain strict confidentiality

Preferred Qualifications: Demonstrated knowledge and skill in working with Excel spreadsheets and Word documents. Certified Professional Coder (CPC) by American Association of Professional coders (AAPC). Certified Coding Specialist by American Health Information Management Association (AHIMA). ICD-10 training/experience.

Background Investigation Statement: Prior to hiring, the final candidate(s) must successfully pass a pre-employment background investigation and information obtained from social media and other internet sources. A prior conviction reported as a result of the background investigation DOES NOT automatically disqualify a candidate from consideration for this position. A candidate with a prior conviction or negative behavioral red flags will receive an individualized review of the prior conviction or negative behavioral red flags before a hiring decision is made.

Equal Employment Opportunity: The University of Alabama is an Equal Employment/Equal Educational Opportunity Institution. All qualified applicants will receive consideration for employment or volunteer status without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, pregnancy, age, genetic or family medical history information, disability, protected veteran status, or any other legally protected basis, and will not be discriminated against because of their protected status. Applicants and employees of this institution are protected under Federal law from discrimination on several bases.