Position Summary
Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections.
Primary Duties & Responsibilities
Responsible for appealing claims denied by third‑party payers. Creates appropriate letters and compiles documentation to substantiate the validity of claims.
Investigates and problem‑solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with physicians and other clinical staff as needed to provide documentation feedback and develop appeals.
Researches payer policies and processes.
Review clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient’s conditions and treatment.
Works with coders and IBC staff with medical terminology and policy interpretation as required.
Codes evaluation and management services to the appropriate CPT code level. Ensures ICD codes are linked appropriately to services provided.
Responsible for charge corrections when necessary.
Manages Epic work queues, CRM tasks, and reviews remittance advice for rejections and accuracy of payment amounts as needed. Identifies invoices that have been rejected per department criteria.
Performs accounts receivable functions in the Epic billing system, including updating insurance information and demographics.
Special projects as assigned.
Working Conditions
Normal office environment.
Works in the office one day per month.
Physical Effort
Typically sitting at desk or table.
Equipment
Office equipment.
Required Qualifications
Education: No diploma, certificate, or degree required.
Certifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS‑P); AAPC (CPC, CPC‑A, CPC‑H, CPC‑H‑A, or one of the AAPC specialty‑specific coding credentials; the specialty‑specific credential is only valid for that employee’s department).
Work Experience: No specific work experience required.
Skills: Not applicable.
Driver’s License: Not required.
Preferred Qualifications
Previous coding experience or experience equivalent to an associate’s degree in a related field.
Knowledge of ICD‑10 and CPT coding.
Associate degree – Medical Coding & Billing.
Computer systems, ICD‑10 Procedure Coding System, medical billing and coding, medical terminology.
Grade & Salary Range
Grade: C10‑H.
Salary: $25.30 – $37.94 per hour.
Benefits Statement
Personal
Up to 22 days of vacation, 10 recognized holidays, and sick time.
Competitive health insurance packages with priority appointments and lower copays/coinsurance.
Take advantage of our free Metro transit U‑Pass for eligible employees.
WashU provides eligible employees with a defined contribution (403(b)) retirement savings plan, which combines employee contributions and university contributions starting at 7%.
Wellness
Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
Family
We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.
WashU covers the cost of tuition for you and your family, including dependent undergraduate‑level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.
EEO Statement
Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.
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