Billing and Coding Specialist

Billing and Coding Specialist-37575University Staff

Description

University of Colorado Anschutz Medical Campus

Department :  Neurosurgery

Job Title Billing and Coding Specialist

Position – Requisition # : 37575

Job Summary :

The Billing and Coding Specialist is responsible for ensuring accurate and compliant coding and billing practices for professional medical services within a neurosurgery clinical setting. This position will work in partnership with the CU Medicine departments (Audit, Compliance & Education (ACE) and Revenue Services Client Management) to focus on clinician documentation evaluation, review, and recommendations via education to maximize coding / documentation. They will also work closely with ECG who we will be contracting with via CU Medicine to assist with improvements to our Revenue Cycle. The Billing and Coding Specialist will operate within the Department of Neurosurgery mission area and will work collaboratively with various service centers within CU Medicine to optimize billing / collection processes for the department of Neurosurgery.

Key Responsibilities :

Education / Efficiency Development / Fiscal Monitoring - 35%

Serve as the neurosurgery coding / billing liaison possessing high level knowledge and skills in neurosurgery billing / coding and EPIC to work with ECG consultants on the revenue cycle improvement plan.

• Serve as the Departmental Coding / Billing Expert, helping clinical faculty to improve their revenue cycle through education and training.
• Serve as the training expert for clinical faculty in coding / billing and best use of EPIC.
• Determine what the key issues are, who are Champions already maximizing their billing and who needs the extra training and support.
• Provide regular f / u through reports available in MyBi to clinical faculty to ensure they are on track with their productivity targets and maximizing their billing potential using all the tools.
• Assist department clinical faculty with optimizing coding and charge capture procedures. Create efficiencies and reproducibility in the processes employed.
• Prepare formalized reports and present results to department leadership, medical directors, clinical program directors, and clinicians.

Respond to inquiries from clinicians and administrative staff regarding billing, coding, and documentation.

Perform follow-up reviews after new provider training and provide additional education as needed.

Work closely with the DFA and Chair to analyze new services to generate an estimated profit / loss statement for any new service in collaboration with CU Medicine Client Services Manager assigned to Neurosurgery.

Collaborate on joint projects with internal clinical financial staff and CU Medicine departments to resolve billing and documentation issues.

Compliance - 35%

Perform review of medical records to ensure accurate assignment of diagnosis / HCC and procedure codes, requiring high level of knowledge of neurosurgery coding / billing and EPIC.

Perform coding compliance reviews as applicable to the specialty of Neurosurgery.

Review weekly charges processed reports for changes or deletions for Neurosurgery providers.

Review provider and billing data from MyBi reports.

Maintain current knowledge of coding guidelines, reimbursement guidelines, medications, and documentation requirements.

Attend CU Medicine meetings with Office of Value Based Performance, Revenue Cycle, Audit / Compliance, and other related meetings as a representative for the department of Neurosurgery

Maintain coding knowledge and billing regulations related to CPT, ICD-10, HCPCS, HCC and other CMS regulations.

Continual Improvement Plan and Implementation - 30%

Experience in developing QA / QI plans for coding / billing using EPIC, to provide expertise to develop this process.

Develop a QA / QI plan after working with ECG consultation to provide continual feedback and improvements to maximize earnings and ensure clinical faculty are always using tools and systems and have the knowledge to maximize their billing and productivity.

Follow up on open-ended issues and manage action plans.

Tracking, aggregating, and summarizing the changing coding and billing rules impacting Neurosurgery.

Work collaboratively with CU Medicine Applications for EHR system changes / updates to ensure accurate charge capture and sequencing.

Work Location :

Hybrid – this role is eligible for a hybrid schedule, 3 days in office and 2 days remote with occasional travel to meet with the clinicians at each of our HOPD practices, attend Program and APP meetings on a PRN basis, and attend the faculty meetings as requested.

Why Join Us