Coding Specialist II

Department Overview

The Department of Anesthesiology and Perioperative Medicine is integral to the healthcare, education and research missions at OHSU. In this extraordinary time, we have proudly stepped up our efforts to meet these commitments. We provide clinical services at OHSU hospitals and collaborate with the VA Portland Health Care System and Hillsboro Medical Center. We specialize in providing excellent perioperative care and anesthesia services to our patients using state-of-the-art technology and pharmacologic tools with an emphasis on patient safety. In the operating rooms our anesthesiologists work in care teams with our fellows, residents, and nurse anesthetists as well as independently. Post-operative care is under the medical supervision of our department. We play a prominent role in the caring for patients in the cardiovascular, neurosciences, and newly-launched virtual intensive care units. In the ICU our team includes anesthesiology intensivists, critical care fellows, physician assistants/nurse practitioners, and residents. The role of our team in the ICUs is comprehensive and critical to achieving the highest quality outcomes for our patients.

This position provides professional fee coding and billing support to the Department of Anesthesiology and Perioperative Medicine, with a primary focus on pain management and critical care services. Responsibilities include reviewing provider documentation to ensure services are accurately and appropriately coded and supported by the medical record; assigning CPT, ICD-10-CM, and HCPCS codes in accordance with applicable Medicare, Medicaid, payer, and coding guidelines; and ensuring accurate and timely charge submission for professional services rendered at OHSU. The position provides technical expertise on third-party payer and reimbursement requirements, resolves coding and documentation issues, and may provide education to physicians and other clinical staff regarding coding and billing practices, documentation requirements, and regulatory or coding changes. Coding assignments may vary based on departmental needs and operational priorities. The position is responsible for meeting established standards for coding accuracy, productivity, timeliness, and compliance.
Function/Duties of Position

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Billing review: Review provider documentation in Epic to ensure accurate, complete, and compliant coding of professional services. Initiate and manage provider documentation queries through Epic In Basket or Outlook to obtain clarification necessary for accurate coding. Assign CPT, ICD-10-CM, and HCPCS codes per applicable federal, state, and payer guidelines. Ensure timely charge capture and resolve coding edits to support accurate claim submission. Coordinate billing information and verify charges are complete before submission. Enter and maintain coding and billing information accurately in Epic and other applicable systems. Maintain a coding accuracy of 95% or greater while meeting departmental productivity standards of 8 to 15 codes per hour. Complete assigned work within established turnaround time expectations and comply with departmental policies and applicable coding guidelines.

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Compliance support: Resolve coding, documentation, and billing issues with providers prior to submission to CMMI/UPS for processing. May serve as a resource on professional billing policies and documentation standards. Monitor updates from CMS, AMA, CPT, ICD-10, HCPCS, payer bulletins, coding newsletters, and regulatory agencies. May communicate coding, billing, and regulatory updates to providers and coworkers. May assist with implementing process changes as needed. Ensure practices comply with applicable federal, state, payer, and organizational guidelines. Identify opportunities to improve coding quality, compliance, workflow efficiency, and accurate reimbursement. Participate in coding quality reviews, compliance initiatives, and ongoing education to maintain proficiency.

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