Clinical Coding Specialist I

Job Title

Clinical Coding Specialist I

Agency

Texas A&M University Health Science Center

Department

University Health Services

Proposed Minimum Salary

Commensurate

Job Location

College Station, Texas

Job Type

Staff

Job Description

Our Commitment

Texas A&M University is committed to enriching the learning and working environment by promoting a culture that respects all perspectives, talents & identities.  Embracing varying opinions and perspectives strengthens our core values which are: Respect, Excellence, Leadership, Loyalty, Integrity, and Selfless Service.

Who we are

As one of the fastest-growing academic health centers in the nation, the Texas A&M University Health Science Center encompasses five colleges and numerous centers and institutes working together to improve health through transformative education, innovative research and team-based health care delivery.

What we want

The Clinical Coding Specialist I is responsible for medical billing and coding processes to ensure maximum reimbursement for services provided.

What you need to know

Compensation will be commensurate to selected hire’s experience.

Other Requirements and Factors: This is a security-sensitive position. The individual in this position is required to handle Protected Health Information (PHI) as defined by HIPAA regulations. The individual is required to handle PHI in accordance with the A&M System policy and is further required to complete HIPAA training as a condition of employment, within a reasonable timeframe after the individual’s employment, and on an as-needed basis thereafter.

COVID-19 information: In accordance with the federal contractor vaccination mandate , specific facilities at The Texas A&M System may be considered a covered contractor workplace with covered contractor employees. Therefore, successful applicants for this position may be subject to the federal mandate and will be required to be fully vaccinated against COVID-19 as a condition of employment unless an approved medical or religious accommodation is in place. 

Required Education and Experience:

• Associate’s degree in relevant field or equivalent combination of education and experience.

• Three years of experience in medical billing and coding.

Required Licenses and Certifications:

• Must have the Certified Professional Coder (AAPC) license or the ability to obtain within six months of employment.

• Timely license renewal is required for continued employment.

Required Knowledge, Skills, and Abilities:

• Knowledge of medical billing procedures, insurance payments, and explanation of benefits (EOBs).

• Knowledge of insurance guidelines including Medicare, Medicaid, and other payer requirements.

• Knowledge of HIPAA/FERPA, and other health information management guidelines.

• Knowledge of ICD-10 and CPT coding guidelines.

• Understanding of compliance requirements for medical services documentation to support billing and appealing claims.

• Knowledge of word processing and spreadsheet applications.

• Proficient in using electronic medical records (EMR) applications.

• Ability to work with sensitive information and maintain confidentiality.

• Ability to multi-task and work cooperatively with others.

• Effective written and verbal communication skills.

• Time management and prioritization skills.

• Planning and organizational skills.

• Critical thinking skills.

Preferred Knowledge, Skills, and Abilities:

• Knowledge of Texas A&M systems AggieBuy, and Payments. Proficiency with Point and Click EMR system.

• Knowledge of general medical office procedures

Responsibilities:

• Medical Coding and Billing: Performs data quality reviews on patient charts and documentation for accuracy and completeness. Follows up with providers when code assignments and/or documentation is insufficient or unclear. Answers routine questions from medical staff regarding coding requirements. Prepares and submits claims using billing software. Codes encounters, builds invoices and releases for claims filing. Researches and appeals denied claims to ensure maximum reimbursement. Answers routine inquiries from insurance companies and patients regarding billing, accounting, and collections processes. Provides input and assists in developing policies, procedures, and guidelines for medical billing and coding.

• Insurance AR Follow Up: Assists in follow up of insurance payment and non-payment explanation of benefits. Monitors accounts receivable report and follows-up with insurance companies on pending claims. Reviews complex insurance claims to determine reprocessing needed. Reviews insurance correspondence received by mail. Contacts insurance companies for claim and billing status, insurance remittances, denials, submission confirmation, etc. Provides updates to Billing supervisor and appropriate staff.

• Patient Billing Customer Service: Assists Patient Services unit with complex billing questions. Answers incoming phone calls and gathers information to route calls appropriately. Responds to billing inquiries from patients regarding service charges, insurance filing process, patient refunds, etc. in person, by phone, and email. Explains, applies, and communicates information regarding the department’s financial policies and procedures. Performs other duties as assigned.

Instructions to Applicants: Applications received by Texas A&M University must either have all job application data entered or a resume attached. Failure to provide all job application data or a complete resume could result in an invalid submission and a rejected application. We encourage all applicants to upload a resume or use a LinkedIn profile to pre-populate the online application.

All positions are security-sensitive. Applicants are subject to a criminal history investigation, and employment is contingent upon the institution’s verification of credentials and/or other information required by the institution’s procedures, including the completion of the criminal history check.

Equal Opportunity/Affirmative Action/Veterans/Disability Employer committed to diversity.