Professional Fee Coding Specialist

Location: Fully-Remote

Employment Duration: 3 months

Patient Records Abstractor fulfills a role as a Medical Coder for UCSF’s physician practices. They review patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. They apply national and international coding classifications to ensure records reflect the care delivered, supporting accurate reimbursement and reliable clinical data.

The position requires knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), and Healthcare Common Procedural Coding System (HCPCS). The role operates within a healthcare records or billing team and requires close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries. Coders maintain current knowledge of coding updates, compliance requirements, and professional standards, participate in regular audits to monitor coding quality, process assigned case volumes accurately and timely, adhere to confidentiality and information governance standards, and contribute to process improvements that enhance data quality and coding efficiency.

Key Responsibilities:

• Work assigned moderate work queues daily as defined by UCSF leadership.
• Work simple work queues as needed.
• Work RFI and edit work queues as needed.
• Maintain or exceed a 95% accuracy rate.
• Maintain productivity standards as defined by UCSF leadership.
• Collaborate proactively with divisions within assigned areas of specialization to support appropriate revenue cycle practices and compliance with internal and external regulations.
• Code intermediate procedures and accounts requiring advanced knowledge of charge capture, workflow, hospital operations, authorizations, and the revenue cycle.
• Resolve Claims Manager and Epic edits to ensure accurate coding of services, including review of documentation for correct coding, evaluation and management (E/M) leveling, diagnosis coding, bundling issues, and modifier usage.
• Apply dashboards and processes to support continuous analysis of revenue cycle functions and audit data input supporting revenue cycle management.
• Complete coding work reports, reconcile charge lists, create charge sessions, update DEPs, and follow up on credential requests.
• Verify and correct statistical data abstracted and compiled by lower-level staff.
• Reconcile output statistics and perform medical coding.
• Review APeX PB Charge Edit and RFI work queues and resolve claim edits to support timely billing.
• Proactively communicate with faculty and ancillary providers regarding documentation updates and corrections.
• Run reports related to charge capture, missing charges, error resolution, and workflow throughput.
• Analyze charge integrity, reconciliation, and charge linkages from ancillary charging systems under supervision.

N/A

Required Qualifications

• 2–5 years of revenue cycle professional fee coding experience or equivalent experience/training.
• Strong communication skills with the ability to interpret and convey complex clinical finance information clearly and concisely and prepare informative reports and presentations.
• Strong analytical and problem-solving skills with the ability to evaluate workflows and systems and propose solutions.
• Strong interpersonal skills with the ability to collaborate effectively on complex projects with staff across business and clinical areas.
• Ability to successfully complete all required UCSF Medical Center computer systems training and UCSF coding and billing application training, which may include partner hospital billing systems.
• Demonstrated intermediate knowledge of medical terminology, CPT, ICD-10 coding conventions, and clinical documentation requirements.
• Prior experience in a healthcare-related setting.
• Knowledge of federal, state, and commercial carrier coding and billing standards.

Required Licenses and Certifications

• Certified Professional Coder (CPC), Certified Coding Specialist–Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or equivalent licensure as evaluated by FPRMO management.
   

Preferred Qualifications

• Secondary coding certification such as Certified Interventional Radiology Coder (CIRC), Certified Emergency Department Coder (CEDC), or similar certification.