Program Representative 1: Medical Coder
Program Representative 1: Medical Coder
Oregon State University
Department: Student Health Services (MSH)
Appointment Type: Classified Staff
Job Location: Various Locations
Recommended Full-Time Salary Range:
Job Summary:
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 ).
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.
Why OSU?
Working for Oregon State University is so much more than a job!
Oregon State University is a dynamic community of dreamers, doers, problem-solvers and change-makers. We don’t wait for challenges to present themselves — we seek them out and take them on. We welcome students, faculty and staff from every background and perspective into a community where everyone feels seen and heard. We have deep-rooted mindfulness for the natural world and all who depend on it, and together, we apply knowledge, tools and skills to build a better future for all.
FACTS :
• Top 1.4% university in the world
• More research funding than all public universities in Oregon combined
• 1 of 3 land, sea, space and sun grant universities in the U.S.
• 2 campuses, 11 colleges, 12 experiment stations, and Extension programs in all 36 counties
• 7 https://hr.oregonstate.edu/work-life/diversity-and-cultural-resources that offer education, celebration and belonging for everyone
• 100+ undergraduate degree programs, 80+ graduate degrees plus hundreds of minor options and certificates
• 35k+ students including more than 2.3k international students and 10k students of color
• 217k+ alumni worldwide
• For more interesting facts about OSU visit: https://oregonstate.edu/about
Locations:
Oregon State has a statewide presence with campuses in Corvallis and Bend, the OSU Portland Center and the Hatfield Marine Science Center on the Pacific Coast in Newport.
Oregon State’s beautiful, historic and state-of-the-art main campus is located in one of America’s best college towns. Corvallis is located close to the Pacific Ocean, the Cascade mountains and Oregon wine country. Nestled in the heart of the Willamette Valley, this beautiful city offers miles of mountain biking and hiking trails, a river perfect for boating or kayaking and an eclectic downtown featuring local cuisine, popular events and performances.
Total Rewards Package:
Oregon State University offers a https://hr.oregonstate.edu/benefits/prospective-employee with benefits eligible positions that is designed to meet the needs of employees and their families including:
• Medical, Dental, Vision and Basic Life. OSU pays 95% of premiums for you and your eligible dependents.
• Free confidential mental health and emotional support services, and counseling resources.
• Retirement savings paid by the university.
• A generous paid leave package, including holidays, vacation and sick leave.
• Tuition reduction benefits for you or your qualifying dependents at OSU or the additional six Oregon Public Universities.
• Robust Work Life programs including Dual Career assistance resources, flexible work arrangements, a Family Resource Center, Affinity Groups and an Employee Assistance Program.
• Optional lifestyle benefits such as pet, accident, and critical illness insurance, giving you peace of mind and the support you need to thrive in all aspects of your life.
Future and current OSU employees can use the https://hr.oregonstate.edu/benefits/new-employees/benefits-calculator to learn more about the full value of the benefits provided at OSU .
Key Responsibilities
50% COMPLIANCE , INTERPRETATION OF POLICY , CODING
• Compliance, Interpretation of Policy, and Coding requirements of local, statewide, and federal guidelines
• Review encounters received for all pertinent information: patient information, insurance, information, ICD -10, CPT , HCPCs.
• Analyze and ensures accuracy of information within the billing system and monitoring of claims submission, review, and correct claims for adjudication.
• Review and correct CPT , HCPCs and diagnostic coding of patient services within the health center.
• Review and comprehend information on narratives, chart notes, lab reports and summaries in the medical record as well as make judgement determinations for the most accurate compliance regulations and current codes are being used for the services provided to ensure accurate insurance reimbursement.
• Decide appropriate action needed to resolve denials from insurance companies.
• Verify documentation supports billed services and query providers when clarification is needed.
• Abstract clinical data for billing, reporting and quality assurance purposes.
• Collaborate with providers, billing staff and administrative personnel to resolve coding discrepancies.
• Assist with coding audits and implement corrective actions as needed.
• Participate in training and educational initiatives for clinical staff regarding documentation best practices.
• Addresses insurance related inquiries posed by students
30% ACCOUNTS RECEIVABLE AND BILLING
• Perform various collection actions including, but not limited to insurance and student payments, correction, and resubmitting of claims to third party payers.
• Routine follow up of claims submitted to OSU sponsored insurance plans as well as CCARE , and Athletic third-party billing to see if claims are accepted and/or denied.
• Process payments from insurance companies and prepare a daily deposit or assigns task as needed.
• Prepare claims submissions for Domestic, International Student Insurance plans, and Graduate plan.
• Record information in EMR and Excel spreadsheets regarding billing information.
10% ADMINISTRATIVE SERVICES
• Serve students who request bills and make payments, exhibiting at all times a strong customer service orientation.
• Assist the Insurance Liaison in answering insurance questions.
• Assist in the resolution of student complaints related to the billing or coding.
• Assist in Oregon CCare Office qualifying applicants and program enrollment when the CCare office staff is absent. Also assist with program billing.
• Provide back-up assistance for other SHS staff members in order to provide consistent service in times of absences.
• Access student and financial information.
• Contact with outside insurance companies and providers as necessary to answer questions regarding claim denials, reductions, and other questions. These answers are relayed to the plan holders and clinicians.
5% PUBLIC RELATIONS
• Respond to information requests regarding Student Health Service programs, policies, and services.
• Answer questions from students, staff, and insurance companies.
• Identify and resolve patient billing complaints.
• Enlist the help of or routes the public to other Student Health Services departments to answer inquiries as indicated.
• Travel and occasional overnight stays may be required to attend seminars necessary to obtain recent updates and changes regarding insurance billing requirements.
5% OTHER DUTIES AS ASSIGNED
• Other duties as assigned by Revenue Cycle Manager.
What You Will Need
• Knowledge of medical billing/business office procedures in a human healthcare environment using electronic medical record (EMR ).
• Experience working with and strong knowledge of medical coding including CPT , Level 1 HCPC’s and ICD 10 coding.
• Certified Professional Coder (CPC ), Certified Coding Specialist (CCS ), or equivalent credential.
• Understanding of HIPAA regulations and healthcare compliance standards
• Excellent oral, written and interpersonal communication skills.
• Demonstrated experience with and/or commitment to working effectively with individuals from diverse backgrounds, in support of an inclusive and welcoming environment
• Be able to work independently without daily oversight.
This position is designated as a critical or security-sensitive position; therefore, the incumbent must successfully complete a criminal history check and be determined to be position qualified as per University Standard: 05-010 et seq. Incumbents are required to self-report convictions and those in youth programs may have additional criminal history checks every 24 months.
What We Would Like You to Have
• 3 years of experience working with and knowledge of medical coding including CPT , Level 1 HCPC’s and ICD 10 codes.
• Experience in college or university health care services.
• Experience with preventive care, primary care, women’s health, mental health, and GAC medical coding.
• Knowledge of student insurance plans and third-party payer requirements.
• Experience that includes entering, compiling, reporting and auditing information/data to ensure regulatory compliance.
• Organizational skills with the ability to meet deadlines.
Working Conditions / Work Schedule
Working schedule for this position will be 40 hours per week. This will be a completely remote position where the person in this role will work independently from a remote location with support supplied by Student Health Services.
Special Instructions to Applicants
Applications will be reviewed based on the information submitted on the employment profile with education and work history along with any other requested documentation i.e. posting specific question responses, transcripts, etc. Your profile MUST clearly show how you meet the minimum/required qualifications for the position. Resumes are NOT accepted at the application stage for this position. Cover letters are optional for this position and will not be used for evaluating your qualifications.
Equivalent required experience is based on full-time equivalent (40 hours per week).
PLEASE NOTE : If you have volunteer experience relevant to this position, please include in the Employment History section and note length of time, average number of hours per week and major duties.
Typically, the starting salary is at the lower end of the salary range.
For additional information please contact:
Robin Prososki
Robin.prososki@oregonstate.edu
541-737-4184
We are an Equal Opportunity Employer, including disability, protected veteran, and other protected status.
OSU will conduct a review of the National Sex Offender Public website prior to hire.
OSU is a fair chance employer committed to inclusive hiring. We encourage applications from candidates who bring a wide range of lived experience including involvement with the justice system. This job has “critical or security-sensitive” responsibilities. If you are selected as a finalist, your initial job offer will be contingent upon the results of a job-related pre-employment check (such as a background check, motor vehicle history check, sexual misconduct reference check, etc.). Background check results do not automatically disqualify a candidate. Take a look at our https://hr.oregonstate.edu/careers/background-checks website including the https://hr.oregonstate.edu/careers/candidates section for more details. If you have questions or concerns about the pre-employment check, please contact OSU’s Employee and Labor Relations team at employee.relations@oregonstate.edu.
The Certified Professional Coder (CPC ), Certified Coding Specialist (CCS ), or equivalent credential may be uploaded as License or Certification 1. The online application system will allow you to attach your license/certification if the PDF file is 9MB or less. If over 9MB in size, submit to contact person listed. The license and/or certification must be received by the closing date if not uploaded with your application.
To apply, please visit: https://apptrkr.com/7141306
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