Job Description

Job Description

Job Summary

The Medical Coder Outpatient - Denials is responsible for resolving coding-related accounts receivable denials by reviewing provider documentation and accurately assigning appropriate ICD-10-CM, CPT, and HCPCS codes, including modifiers and diagnosis codes, for professional charges. This role plays a critical part in ensuring compliant, accurate documentation and optimizing reimbursement. This position provides feedback to leadership and the Appeals Team on trends and recommends process improvements to prevent future denials. A strong understanding of surgical procedures, coding guidelines, medical terminology, knowledge of commercial and government payer policies, and regulatory standards is essential.

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities*

• Review coding denials in assigned work queue(s) to identify deficiencies in CPT code, ICD-10 code and modifier assignment based on clinical documentation in accordance with established coding guidelines.
• Accurately code procedures and diagnoses using ICD-10-CM, CPT, and HCPCS coding systems.
• Review and interpret clinical documentation to ensure appropriate code selection.
• Collaborate with medical coder compliance specialists, leadership, billing and coding staff for clarification and to ensure completeness of coding information.
• Maintain up-to-date knowledge of coding guidelines, regulations, government and commercial payers, and industry best practices.
• Handle confidential patient information with the utmost discretion and integrity.
• Participate in ongoing education and training to stay current with the evolving coding standards and medical practices.
• Monitor, interpret and advise management regarding changes to third party reimbursement activities and trends with coding related denials.
• Assist leadership, billing and coding staff to ensure that concerns are investigated, and appropriate action is taken.
• Initiate and prepare standardized and ad hoc reports and correspondence based on respective area needs.

Required Qualifications*

• Certification as a Certified Professional Coder (CPC), or Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC), or Registered Health Information technician (RHIT), or equivalent.
• Extensive knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
• Strong understanding of medical terminology, anatomy, surgical procedures, denials resolution, and revenue cycle functions.
• Minimum of 2 years of complex coding and 3rd party payer experience in a hospital setting.
• Excellent attention to detail, analytical, and problem-solving skills.
• Proficient in using electronic health records (EHR) and coding software.
• Strong communication skills and ability to work collaboratively with healthcare professionals.
• Commitment to maintaining patient confidentiality and data security.
• Knowledge of medical terminology, anatomy and physiology, treatment methods, patient care assessment, data collection techniques, and coding classification systems.

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.

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