Medical Coder and Billing Analyst (4627U), University Health Services 44199
University of California Berkeley
Location: Berkeley, California
Internal Number: 3548301
Medical Coder and Billing Analyst (4627U), University Health Services 44199
At the University of California, Berkeley, we are committed to creating a community that fosters equity of experience and opportunity, and ensures that students, faculty, and staff of all backgrounds feel safe, welcome and included. Our culture of openness, freedom and belonging make it a special place for students, faculty and staff.
The University of California, Berkeley, is one of the world's leading institutions of higher education, distinguished by its combination of internationally recognized academic and research excellence; the transformative opportunity it provides to a large and diverse student body; its public mission and commitment to equity and social justice; and its roots in the California experience, animated by such values as innovation, questioning the status quo, and respect for the environment and nature. Since its founding in 1868, Berkeley has fueled a perpetual renaissance, generating unparalleled intellectual, economic and social value in California, the United States and the world.
We are looking for equity-minded applicants who represent the full diversity of California and who demonstrate a sensitivity to and understanding of the diverse academic, socioeconomic, cultural, disability, gender identity, sexual orientation, and ethnic backgrounds present in our community. When you join the team at Berkeley, you can expect to be part of an inclusive, innovative and equity-focused community that approaches higher education as a matter of social justice that requires broad collaboration among faculty, staff, students and community partners. In deciding whether to apply for a position at Berkeley, you are strongly encouraged to consider whether your values align with our Guiding Values and Principles, our Principles of Community, and our Strategic Plan.
At UC Berkeley, we believe that learning is a fundamental part of working, and our goal is for everyone on the Berkeley campus to feel supported and equipped to realize their full potential. We actively support this by providing all of our staff employees with up to 80 hours (10 days) of paid time per year to engage in professional development activities. To find out more about how you can grow your career at UC Berkeley, visit grow.berkeley.edu.
UC Berkeley's University Health Services (UHS) is a comprehensive college health service providing fully accredited, primary medical care, counseling and psychological services, and innovative health promotion programs for students, faculty, and staff. UHS provides on-campus medical care and coordinates supplemental needs for off-campus care through a network of community specialists and hospitals. UHS manages the student health insurance and workers' compensation insurance programs.
Approximately 65,000 visits occur annually including Primary Care, Urgent Care, Occupational Health and Specialty Clinics. Services are designed to minimize the impact of illness, emotional distress and injury on studies and work. The Social Services (SOS) unit offers short-term counseling, groups, case management and nutrition services to the campus student population. Counseling staff consists of social workers who provide compassionate specialty counseling on a range of specific and highly sensitive topics. Coupled with health promotion and public health programs, UHS reaches all segments of the Berkeley campus community. Learn more about UHS by visiting uhs.berkeley.edu.
Application Review Date
The First Review Date for this job is: 10/28/22. The job will remain open until filled.
Interpret clinical data and medical information to medical coding using ICD-10 CM, CPT Standard, and HCPCS Standard coding systems. Maintain a high level of coding accuracy and timeliness to assure claims are billed in a timely manner. Participate regularly in coding audits of the providers and coding educational sessions with providers.
Assign and sequence all codes for services rendered
Follow up with providers on clarification of documentation.
Report any coding irregularities to the billing supervisor.
Accurately input codes and abstract data into the current Electronic Health Record (EHR) system.
Participate regularly in coding audits and coding educational sessions with providers. Provide feedback and training on annual coding updates.
Conduct audits and coding reviews to ensure all documentation is accurate and precise.
Collaborate with billing department to ensure claims all are satisfied in timely manner.
Contact physicians and other healthcare professionals with questions about diagnosis, treatments or diagnostic tests given to patients with regard to coding accurately and appropriately.
Knowledge of current medical terminology, disease processes, anatomy & physiology and current coding guidelines.
Working knowledge of current EHR system to be able to make updates and changes necessary for the system to be current and compliant.
Review claims in the current EHR system that are stalled in the revenue cycle due to coding issues.
Assist in submission of claims for payment through the current EHR system.
Understand and maintains patient confidentiality and IT security.
Functions as a resource to support staff on issues such billing claims, denial management, escalated customer service problems and vendor concerns as it relates to coding issues. Assist operations to:
Review and resolve any claims that have been on HOLD status to resolve payment or billing issues.
Review and correction of 'unauthorized tickets' in a timely manner due to coding issues.
Research and resolve outstanding claims on aging reports for medical, mental health for all periods of time, but particularly all claims greater than 60 days old in the Account Receivable (A/R) due to coding issues.
Correct coding errors in data entry (i.e.; wrong visit CPT, incorrect billing codes, etc.)
Review claims transaction reports daily to capture detail related to denials.
Identify and make corrections to denials, alerting IT or HIM of chronic denials due to coding or system configurations.
Prepares reports and analyses to include summaries of codes most used, evaluation of current and proposed coding practices, denials due to coding errors etc., for management review and decision-making.
Review and correct regularly denials due to coding errors.
Review annually coding changes and provide updates to managers, supervisors and providers. Assists with ensuring that financial processing functions which may include Accounts Payable, Accounts Receivable, Cashiering and Collections are performed with accuracy and that daily operations run smoothly.
Knowledge of cash collections directly from students from service rendered at the UHS.
Knowledge of what benefits may be covered at 100% under the Affordable Care Act.
Completed and maintain annual compliance training on credit card process and handling.
Working knowledge of the functions of the Cashier Department.
Functions as a resource to support staff on issues such as researching complex financial discrepancies, escalated customer service problems and vendor concerns. Assist operations to:
Provide customer service to student/patients who need assistance in resolving issues with their share of cost for services rendered.
Provide customer service to students/patients pertaining to their financial responsibility for services rendered at UHS.
Maintain current, accurate knowledge of Berkeley SHIP policies in order to explain benefits and limitations of the plan to clients when discussing claims.
Verify patient's Berkeley SHIP enrollment status and work with Berkeley SHIP benefits counselors to determine appropriate claims payment.
Review questions that may arise related to care at UHS and in the community; may include explaining an EOB to a patient and working with carrier to help in resolution.
Claims payment and adjustment calls for other third-party payers: accept calls and resolve requests from students who require a copy of their bill on a 1500 HCFA form.
Subject-Matter expert in all things medical coding.
Participates in audits of coding and processes and prepares recommendations for changes as needed.
High School Graduation and/or equivalent.
Two plus years' experience coding and abstracting in a health care facility.
Working knowledge of financial processes, policies and procedures.
Knowledge of ICD-9, ICD-10-CM, CPT standards, HCPCS National Level II coding systems.
Knowledge of medical coding with the ability to translate medical notes and medical information into universally used alphanumeric codes.
Accurately input codes and abstract data into current coding systems.
Meet or exceed department production standards for coding level.
Meet or exceed department quality standards for coding level.
Follow up and clarify provider medical documentation.
Knowledge of financial data management and reporting systems.
Must be proficient in use of Microsoft Office and common desktop/web applications.
Strong interpersonal skills, analytical skills, service orientation, active listening, critical thinking, attention to detail, ability to multi-task in a high-volume environment, organizational skills, effective verbal and written communication skills, sound judgment and decision-making.
Employment experience in the medial health industry, including but not limited to, medical coding (outpatient and or inpatient claims), insurance billing, insurance adjudication, customer service with benefits counseling or claims processing.
Direct experience with, or knowledge of, medical claims processing for a major medical health insurance plan.
Knowledge of medical coding sufficient to verify completeness and accuracy of coding on insurance claims.
Uphold high standards of customer service in a demanding and complex health care organization.
Excellent communication skills, both written and verbal.
Excellent research and problem-solving skills.
Ability to function under fluctuating workloads, with frequent distractions and interruptions, and complete heavy workloads within established time frames.
Strong organizational skills to coordinate multiple, varied billing processes simultaneously.
Demonstrated strong interpersonal skills to build effective, professional working relationships with a diverse student customer service base, and diverse staff in a complex organizational structure.
Ability to handle sensitive information (HIPAA/FERPA) and to maintain confidentiality.
Well-developed touch typing/computer skills.
Functional knowledge of Practice Management System, Windows NT and the Microsoft Office suite, including word-processing, spreadsheet, and database programs.
Ability to pay attention to and manage detailed insurance information.
Demonstrated initiative, resourcefulness, integrity and dedication to timeliness to achieve high customer satisfaction levels.
At least one of the following certifications:
College degree in medical coding
CPC (Certified Professional Coder)
COC (Certified Outpatient Coder)
CCS (Certified Coding Specialist)
RHIT (Registered Health Information Technician)
RHIA (Registered Health Information Administrator)
Salary & Benefits
This is a 100% full-time (40 hrs a week) non-exempt career position, which is paid bi-weekly and eligible for full UC Benefits.
Hourly pay for this role is commensurate with experience within the range of $27.06 - $36.83.
Please submit your cover letter and resume as a single attachment in the Resume section of your application.
Your employment is dependent on obtaining and maintaining a credentialing clearance (if applicable), background clearance, and medical clearance according to University Health Service policies.
Conviction History Background
This is a designated position requiring fingerprinting and a background check due to the nature of the job responsibilities. Berkeley does hire people with conviction histories and reviews information received in the context of the job responsibilities. The University reserves the right to make employment contingent upon successful completion of the background check.
This position has been identified as a Mandated Reporter required to report the observed or suspected abuse or neglect of children, dependent adults, or elders to designated law enforcement or social service agencies. We reserve the right to make employment contingent upon completion of signed statements acknowledging the responsibilities of a Mandated Reporter.
Equal Employment Opportunity
The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. For more information about your rights as an applicant see:
The University of California was chartered in 1868 and its flagship campus - envisioned as a "City of Learning" - was established at Berkeley, on San Francisco Bay. Today the world's premier public university and a wellspring of innovation, UC Berkeley occupies a 1,232 acre campus with a sylvan 178-acre central core. From this home its academic community makes key contributions to the economic and social well-being of the Bay Area, California, and the nation.