Under the direction and supervision of the Manager, YMA Coding and Billing, the Coding/Charge Review position provides work queue resolution of medical billing charges by analyzing clinical documentation to code and/or validate diagnostic (ICD-9/ICD-10) and procedural (CPT/HCPCS) codes for Yale Medicine. Ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Maintains effective workflow processes to assure complete, accurate and timely billing activity and optimal reimbursements.
Posting Position Title: Account Assistant 4
University Job Title: Account Assistant 4, Coder/Charge Review
Work Week: Standard (M-F equal number of hours per day)
Required Skill/ability 1: Demonstrated knowledge of ICD-9/ICD-10, CPT-4 and HCPCs coding, medical terminology, third party payers,
Required Skill/ability 2: Proficiency with electronic data entry and retrieval, electronic mail and web-based applications. Demonstrated ability to analyze and interpret evaluation and management documentation guidelines as well as procedure reports in an academic medical setting.
Required Skill/ability 3: Working knowledge of insurance/government payers billing and reimbursement policies and procedures. Proven ability to interpret and apply guidelines. Adheres to YMG policies and procedures.
Required Skill/ability 4: Demonstrated strong interpersonal, verbal and written communication skills. Ability to effectively communicate with team members and providers to resolve questions regarding documentation or coding issues.
Required Skill/ability 5: Demonstrated ability to work independently; organize and prioritize work with minimal supervision; ability to work in a stressful environment meeting timely deadlines and maintaining productivity and quality standards. Proven ability to work effectively as a team member with a common goal.
Preferred Education, Experience and Skills: Typically requires certification as an AAPC Professional Coder (CPC). EPIC experience strongly preferred.
Required Licenses Or Certifications:
Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate's degree, or an equivalent combination of experience and education.
Yale University is an American private Ivy League research university located in New Haven, Connecticut. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States.