Coding Specialist

At University of Maryland Charles Regional Medical Center (UM CRMC), our talented and diverse groups of professionals represent our strength. Through teamwork and a collaborative work environment, we proudly serve our patients and our community with unwavering commitment. It’s our passion for people that motivates us to do great work every single day.  Consistently named among the top 100 Best Places to Work in Maryland, our team members have the opportunity to grow professionally in a supportive and stimulating environment.

General Summary

Under direct supervision ensures physician billing charges are received from hospital, ambulatory surgical center, and off site practices on a timely basis. Ensures that charges are coded appropriately from the medical record by assigning the highest level of specificity for medical diagnoses codes and assigning the appropriate CPT. Responsible for reviewing and/or entering the information into the billing system accurately and timely.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Obtains, reviews, reconciles and logs charge batches from hospital, ambulatory surgical center, and off site practices.
2. Review provider medical documentation in EHR and charge tickets for accuracy. Includes dates of service, procedures, and levels of care, locations, diagnosis (for medical necessity), patient identification and provider signature. Return any incomplete charge tickets to the provider for correction.
3. Analyze and interprets patient medical records within an area of medical/clinical specialty in order to determine amount and nature of billable services.
4. Utilizes advanced, specialized knowledge of diagnoses and procedures coding to assign sequence appropriate diagnostic/procedures billing codes to operative and other physician medical record documentation in compliance with established standards and guidelines and third party payor requirements.
5. Interacts with providers and other medical professionals regarding billing and documentation policies, procedures, and regulations. Obtains clarification of conflicting ambiguous or non-specific documentation. Acts a liaison between the clinical and billing departments. Answers questions from billing in a timely manner
6. Meets established productivity and proficiency standards.
7. Monitors billing for optimal reimbursement while adhering to all insurer regulations regarding the prohibition of unbundling and other questionable practices.
8. Responsible for working and resolution of appropriate work queues in the billing system.
9. Assists in working denial work queue to resolution, with the primary focus on ICD-10 and CPT coding.
10. Utilizes appropriate customer relation skills to ensure all customers are treated with respect and dignity and that the confidentiality of their data is upheld.
11. Attends coding seminars, hospital and department meetings as required or assigned. Actively participates in hospital educational in services.

Education and Experience

1. High School Diploma or equivalent (GED) is required. Coding certification required, CPC or CCS-P preferred.
2. Completion of an accredited medical coding program; including course work in anatomy, medical terminology and pathology, and physiology is required.
3. Three (3) years’ experience in production coding in a surgical and/or physician practice environment required. Outpatient Professional fee revenue cycle management experience preferred.
4. Three years medical charge entry billing and data entry experience.

Knowledge, Skills and Abilities

1. Working knowledge of medical record practices, state, and federal laws to release of medical information.
2. Working knowledge of AAPC, AHIMA, or other accredited coding systems, medical terminology to understand diagnoses, and procedures, and the content and organization of a medical record.
3. Excellent typing/data entry skills are required.
4. Demonstrate ability to maintain applicable productivity standards level associated with the job, with less than a 3% error rate.
5. Demonstrated knowledge of MS Office software applications such as Microsoft Excel and Microsoft Word and billing system is required.
6. Ability to maintain a culture of excellent customer service, open and friendly staff relations with all levels of staff.
7. Effective verbal and written communication and listening skills are required to interact with various individuals seeking accounting-related information.
8. Ability to work to deadlines within a stressful environment during month end activities.

All your information will be kept confidential according to EEO guidelines.

 Compensation

• Pay Range: $27.44-$38.41
• Other Compensation (if applicable):

Review the 2024-2025 UMMS Benefits Guide