This recruitment will be used to fill one full-time Program Representative 1: Medical Coder position for the Student Health Services at Oregon State University (OSU).
This is a fully remote position.
Student Health Services provides health care services and health education to the students of Oregon State University. Under the direction of the Revenue Cycle Manager this position supports the daily administrative operations of SHS and works with confidential and time-sensitive information involving student health information. This is a completely remote position where the person in this role will work independently from a remote location with support supplied by SHS.
The Program Representative 1 is charged with ensuring claims are coded correctly and troubleshooting claims errors to confirm the accuracy of the billing records which comply with the claims, coding and coverage requirements of each insurance company or agency. The Medical Coder is responsible for reviewing clinical documentation and accurately assigning appropriate diagnosis using the International Classification of Diseases version 10 (ICD-10), and procedure codes using Current Procedural Terminology (CPT) with use of CPT Level 1 modifiers and Healthcare Common Procedure Coding System (HCPCS)completing coding for services provided at Oregon State Student Health Center. This position will conduct periodic training of physicians and licensed medical staff to ensure appropriate coding practices are used, as well as developing training curriculum for use by the medical staff. This position ensures compliance with federal, state, and payer regulations while supporting timely and accurate billing, reimbursement, and reporting.
This position ensures that chargeable procedures and services are recorded accurately and in a timely fashion, to satisfactorily complete the coding of services rendered. The incumbent is responsible for responding to questions regarding insurance company programs and requirements by phone, in person and emails. This position provides expertise in, and acts as an educator for multiple insurance billing requirements to the clinicians and providers regarding the unique programs the students may be utilizing. This work is done on the phone, in virtual meetings or by email. The position responds to numerous questions from clinicians and providers regarding federal coding requirements utilizing ICD-10, CPT codes and HCPCS.
The employee in this position will engage regularly with staff members in the Administrative Services office, SHS staff and clinicians, clients, patients, and students on behalf of Student Health Services. The employee in this position will assist with the determination of appropriate and correct billing, problem resolution and corrective action(s) required to successfully complete the reimbursement of covered services and comply with the billing requirements of the agencies and insurance programs. The position requires a high degree of ability to interpret current guidelines, regulations and rules in order to ensure proper compliance with State/Federal and correct coding requirements.
This position responds to questions and provides information and assistance to patients, Student Health services staff, and the university community, which requires the exercise of responsible judgment, tact, efficiency, and the ability to work under pressure. The individual in this position must be able to prioritize their time according to the work and multiple deadlines. They must be able to re-direct themselves as situations change and act proactively in solving or referring patient problems and complaints.