Edits Coder

Job Description

UW Medicine Enterprise Records and Health Information has an outstanding opportunity for a Coding Specialist 1 - Edits Coder

WORK SCHEDULE

• 100% FTE

• Mondays - Fridays

• 100% Remote

POSITION HIGHLIGHTS

The Edits Coder position reports to the Outpatient Coding Supervisor within the Enterprise Records and Health Information Management department. Under the general supervision of the Manager of Facility Coding, and the direct supervision of the Supervisor of Outpatient Coding, the Edits Coder is responsible for implementing the mission and goals of Enterprise Records and Health Information, and incorporating a “patients are first” service culture. The Edits Coder is responsible for performing daily activities related to analyzing medical records to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal reimbursement for facility and/or professional fee coding and billing for Clinic, Outpatient and related charges needing coding review in compliance with State and Federal guidelines.

PRIMARY JOB RESPONSIBILITIES

• Validates codes entered at the point of care and/or by other charge sources by reviewing electronic data and making corrections based on a review of all available electronic and other appropriate documentation to support all billable procedures and services.
• Reviews and resolves coding accounts failed validations, revenue guard, missing modifiers, incorrect modifiers, missing charges, incorrect charges,  medical necessity edits, CCI edits, claim edits, and payor denials in Epic; verifies accuracy of ICD diagnosis codes and CPT/HCPCS procedure codes.
• Investigates and researches coding issues identified by Revenue Integrity (RI) and Patient Financial Services (PFS) related to inquiries, complaints and/or denials. Makes coding corrections to resolve coding issues; supports RI by reviewing specified procedures for charge accuracy; reroutes accounts to correct coding team for coding resolution based on revenue codes.
• Maintains Epic WQ turnaround times for coding error and edits resolution to prevent charge lags for facility and professional fee services. Identifies potentially avoidable delays to timely billing and help identify systemic issues that contribute to delays in service or inefficient uses of resources to address root cause and prevent ongoing errors.
• Identifies the need for documentation clarity to support the integrity of the record and for reimbursement compliance; identifies charge error trends and escalate to supervisor.
•  Performs special projects or other duties assigned.
• May perform the work of lower level classifications of the Coding Specialist series.

REQUIRED POSITION QUALIFICATIONS

High school diploma or equivalent

AND

Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC).

AND

One year coding experience or equivalent education/experience.

Equivalent education and/or experience may substitute for minimum qualifications except when there are legal requirements, such as a license, certification, and/or registration.

Compensation, Benefits and Position Details

Pay Range Minimum:

Pay Range Maximum:

Other Compensation:

Benefits:

Shift:

Temporary or Regular?

FTE (Full-Time Equivalent):

Union/Bargaining Unit:

About the UW 

Working at the University of Washington provides a unique opportunity to change lives – on our campuses, in our state and around the world.  

UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for professional growth and the chance to work in an environment known for its diversity, intellectual excitement, artistic pursuits and natural beauty. 

Our Commitment 

The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81.

To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or [email protected]. 

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.