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Posting Detail Information

Working TitleMedical Coder

Position LocationFort Collins, CO

Work LocationPosition qualifies for hybrid/in-office work

Research Professional PositionNo

Posting Number202400962AP

Position TypeAdmin Professional/ Research Professional

Classification TitleTechnical/Support II

Number of Vacancies

Work Hours/Week40

Proposed Annual Salary Range$47,000 - $54,000; Salary is commensurate with relevant experience and qualifications.

Employee Benefits

Colorado State University is not just a workplace; it’s a thriving community that’s transforming lives and improving the human condition through world-class teaching, research, and service. With a robust benefits package, collaborative atmosphere, commitment todiversity, equity and inclusion (https://inclusiveexcellence.colostate.edu/about/) , and focus on work-life balance, CSU is where you can thrive, grow, and make a lasting impact.

• Review our detailed benefits information here. (https://hr.colostate.edu/wp-content/uploads/sites/25/2021/01/benefits-summary-afap.pdf)

• Explore the additional perks of working at CSU here.

• For the total value of CSU benefits in addition to wages, use our compensation calculator (https://hr.colostate.edu/total-compensation-calculator/) .

• Lastly, click here for more information about why Fort Collins is consistently ranked in the top cities to live in (https://hr.colostate.edu/prospective-employees/our-community/) !

Desired Start Date

Position End Date (if temporary)

To ensure full consideration, applications must be received by 11:59pm (MT) on06/16/2024

Description of Work Unit

Billing and Coding

The Billing and Coding department within the Health Network at Colorado State University ( CSUHN ) provides the service of accurately coding and billing clinic charges to commercial insurance companies. The department acts as the liaison between student/parents and their insurance company to decipher contracting status and claim payment disputes. Our department follows the status of payments to ensure insurance companies are paying in a timely and accurate manner. The Billing and Coding department provides services between the hours of 8:00 am – 5:00 pm Monday-Friday, providing attractive work schedules for staff.

CSU Health Network

The Health Network at Colorado State University provides a full range of cost-effective mental health and primary care medical services on campus, referral for community specialty care, and comprehensive health education and prevention services programming. Services such as physical therapy, dentistry, and optometry are available. The CSU Health Network is active in creating a healthy campus environment to support learning and success. For more information about the Health Network at Colorado State University, seehttps://health.colostate.edu/.

Why work at Colorado State University?

CSU was recently ranked first among Colorado-based educational employers and fifth among all in-state employers in Forbes magazine’s “America’s Best Employers by State!”

Our Investment In You

Colorado State University ( CSU ) is committed to providing employees with a strong and competitive benefits and well-being package that supports you, your health, and your family.

These CSU resources help with many aspects of your life – financial, physical, emotional, medical, family, workplace wellness. These resources are part of our investment in you.

• Paid time off: 24 vacation days, 15 sick days, 11 paid holidays annually (prorated for part-time 50% or greater)

• Attractive work hours providing services Monday-Friday 8:00 am -5:00 pm

• FREE credit courses (up to 9-semester credits per year) through Employee Study Privilege

• Tuition Scholarships up to 50% for eligible family members

• Continuing education reimbursement program

• FREE employee growth/training/development opportunities

• After-school programs and summer camps for kids

• FREE MAX transit use with CSU identification

• Community Discounts

• Robust Employee Assistance Program for your overall well-being

For more detail about these and other Commitment to Campus programs, visit our CSU Well-Being Hub athttps://hr.colostate.edu/well-being-hub/and our Benefits programs for Administrative Professional employees:https://hr.colostate.edu/current-employees/benefits/afap/.

Retirement Programs

While employees of CSU do not contribute to Social Security, the University and the state of Colorado offer competitive retirement plans. As a condition of employment and required by Colorado law, employees are required to participate in either the University’s Defined Contribution Plan ( DCP ) or the Public Employee’s Retirement Plan ( PERA ) of Colorado. Each plan offers a generous employer match between 10% – 21%. For more information, visit:https://hr.colostate.edu/current-employees/benefits/afap/retirement/.

Campus Culture and Principles of Community

Colorado State University has a campus culture that is driven by a desire always to do better and a vision to be the best place to learn, work, and discover. Our Principles of Community – Inclusion, Integrity, Respect, Service, and Social Justice – reflect our core values and support CSU’s mission and vision of access, research, teaching, service, and engagement. Each member of our community has a responsibility to uphold these principles when engaging with one another and acting on behalf of the University. For more information visit:https://hr.colostate.edu/prospective-employees/our-people/.

Live in Fort Collins

Fort Collins, which has been home to CSU since the University’s inception in 1870, is a vibrant, friendly city of 161,000 tucked against the foothills of the Rocky Mountains in Northern Colorado, just 60 miles from Denver. The city boasts a lively arts and cultural scene, shopping in historic Old Town, a strong economy, and is a haven for outdoor enthusiasts. With more than 200 miles of bike paths and trails, easy access to the scenic Poudre River and majestic Rocky Mountain National Park, and within easy driving distance of Colorado’s iconic ski areas, it is a year-round paradise. Boasting a mild climate, thriving high-tech industry, and some of the best microbreweries in the world, it’s no wonder Fort Collins annually ranks among the most livable small cities in the United States. For more information, visit:https://hr.colostate.edu/prospective-employees/our-community/.

Top Public Research University

Colorado State University is one of the nation’s top public research universities and an institution on the rise. In the last decade, CSU has produced record enrollment, built on all-time highs in student diversity and student success; record fundraising far outpacing ambitious goals; groundbreaking research driven by a highly productive faculty; a campus revitalized by a transformational building campaign; and, perhaps most important, an unrivaled learning environment where nine of 10 recent graduates say they would choose CSU again and rate their education as excellent.

Tobacco and Smoke-Free

Colorado State University is a tobacco and smoke-free campus. For the health of our university community, the use of smoking, vaping or tobacco products is prohibited on CSU grounds or in buildings.

Position Summary

The Medical Coder serves as advisor and consultant to all medical and ancillary staff on clinical coding, including the proper assignment of codes for clinical, insurance and reimbursement, regulatory compliance, and reporting functions. The position works directly with the medical record to evaluate medical coding to prepare for accurate billing and to ensure clinical staff are staying within the standards of appropriate documentation.

The position will perform the daily coding review and is responsible for working with providers, patients and parents, outside companies, including third party administrators ( TPA ), clearing house, insurance companies, regulatory bodies, as well as internal Health Network departments to enable proper coding and insurance interactions.

The position is going through transformation and will work collaboratively with the manager and rest of the medical coding staff to align the essential job duties amongst the various position levels to enhance ongoing efficiency for the department.

The Medical Coder works a hybrid onsite/remote schedule from 8:00 AM – 5:00 PM, Monday – Friday, and reports directly to the Billing and Coding Manager.

Required Job Qualifications

Education

• High School Diploma (or GED )

• Medical Coding Certification through AAPC or AHIMA

Experience

• One year of experience working as a certified medical coder in an outpatient or family practice medical environment, which may have included psychiatry, mental and behavioral health, orthopedics, optometry, women and gender care, immunizations, laboratory and/or physical therapy

Preferred Job Qualifications

Education

• Associates degree in Health Information Management

Experience

• Two years of experience working as a medical coder in an outpatient or family practice medical environment, which may have included psychiatry, mental and behavioral health, orthopedics, optometry, women and gender care, immunizations, laboratory and/or physical therapy

• Three years of experience working with insurance coding and billing using ICD10-CM/ ICD -10-CM, CPT -4, HCPCS , and DSM -5

• Experience with the electronic health record ( EHR )

• CDI experience

• Experience and knowledge of applying insurance contracts

• Working knowledge of and experience with Microsoft Office Suite, including Excel and related coding software

Knowledge, Skills, Abilities, and Other Characteristics

• Strong decision making and problem-solving skills

• Ability to maintain confidentiality of patient information in accordance with HIPAA ; CSU Health Network policies; Colorado State University; state and federal regulations

• Strong listening, interpersonal, verbal and written communication skills

• Organizational skills with the ability to meet deadlines

• Strong attention to detail

• Ability to complete continuous education to keep abreast of new developments in coding updates, technology, research and regulatory data

• Ability to adjust to changing priorities and workload volume

• Ability to analyze policies, programs, and initiatives to make recommendations for quality improvement

• A personal or professional commitment to diversity, equity, and inclusion through active planning and purposeful effort

Diversity Statement

Reflecting departmental and institutional values, candidates are expected to have the ability to advance the Department’s commitment to diversity and inclusion.

Essential Duties

Job Duty CategoryDaily Clinical Coding Review/Audit

Duty/Responsibility

• Ensures the proper utilization and assignment of daily coding for clinical documentation, insurance and reimbursement, regulatory compliance, and reporting functions after review of the medical record

• Provides information and feedback on coding related software edits, denial issues, reimbursement trends, and billing and coding errors to pertinent departments/individuals

• Releases medical records to insurance companies upon request of coding review or the need for reimbursement by the insurance company

• Performs daily pre-billing edits on clinic visits to ensure that insurance claims are submitted with correct codes and that the medical record supports the codes used

• Reviews clinical records daily; determines appropriate coding based on the content of the record, medical necessity, and complexity of services

• Interprets medical staff documentation daily to determine the procedure performed and assign the correct code(s) along with pricing information

• Performs other duties as requested by Manager

Percentage Of Time60%

Job Duty CategoryCollaboration with Business Services Staff

Duty/Responsibility

• Interacts with Health Network Billing and Coding and Student Insurance Departments regarding insurance carrier payment denials and recommends appropriate resolution

• Collaborates with other departments and business associates (e.g. outside laboratories and radiology departments) to provide outstanding patient care

• Communicates with Business Services Staff Team members regarding completion of Microsoft Excel prebilling tabular spreadsheet

• Performs other duties as requested by Manager

Percentage Of Time15%

Job Duty CategoryCollaboration with Third-Party Vendors

Duty/Responsibility

• Works with TPA , Clearing House, and insurance companies to advocate for payments when denials are inaccurately denied due to CPT or diagnosis coding

• Provides support to third party vendors contracted with insurance companies to review medical records under the governmental risk adjustment assessments

• Performs other duties as requested by Manager

Percentage Of Time10%

Job Duty CategoryCustomer Service

Duty/Responsibility

• Provide excellent customer service and teaching to patients and staff as indicated regarding insurance and coding procedures

• Assist students with understanding the insurance billing process and the status of their claims, while using multiple systems (PyraMED, Banner, Arise Web)

• Contact from students, parents and insurance may be by phone, e-mail, or on location at the CSU Health Network. Ensure you are reviewing PyraMED for appropriate releases in order to follow HIPAA regulations

• Understanding of all departments within CSU Health Network to ensure you are referring student’s questions to other departments when they do not pertain to billing

• Understanding of how SHIP , RamCare, and RamCare Grant interact with the CSU Health Network and the student

• Performs other duties as requested by Manager

Percentage Of Time10%

Job Duty CategoryCharge Posting Backup Support

Duty/Responsibility

• Access the Electronic Health Record ( EHR ), billing system, or other CSU systems in order to complete postings

• Verify medical insurance eligibilities to determine accurate claim submission to prevent denials utilizing Availity and other insurance companies web pages. It may be necessary to call the insurance company to get accurate information

• Post charge to the students account in PyraMED; user must review the medical record to ensure encounter has been finalized by the provider; review coding to ensure there is a diagnosis code, procedure code with the correct amount of units applied; and then determining if the charge will go to the students self-pay account, or determine which health plan the charges will be billed to

• Review and post CSU Health Network charges prior to submission to the Availity (our contracted clearing house which submits claims to insurance companies electronically)

• Performs other duties as requested by Manager

Percentage Of Time5%

Application Details

Special Instructions to Applicants

CSU is committed to full inclusion of qualified individuals. Applicants needing assistance to submit application materials may contact Tammy Roehrich at Tammy.Roehrich@colostate.edu.

Complete applications must include:

• Cover letter addressing Required Job Qualifications, Preferred Job Qualifications and Essential Job Duties

• Resume

For full consideration, complete applications must be received by 11:59 pm Mountain Time on Sunday, June 16, 2024. References will not be contacted without prior notification of candidates.

Application materials will be held in confidence by the Search Committee through semi-finalist interviews. Confidentiality of application materials detaches at the point where a candidate accepts participation in a finalist interview. At that time, redacted application materials are shared with campus stakeholders when invited to participate and give feedback to the Search Committee.

Conditions of EmploymentPre-employment Criminal Background Check (required for new hires), Special Requirements/Other - Health Network follows CDC guidelines for Employee Health in a healthcare setting, including proof of vaccinations. Employees must show proof of compliance/willingness to comply by start date.

Search ContactTammy Roehrich, tammy.roehrich@colostate.edu

EEO Statement

Colorado State University is committed to providing an environment that is free from discrimination and harassment based on race, age, creed, color, religion, national origin or ancestry, sex, gender, disability, veteran status, genetic information, sexual orientation, gender identity/expression, or pregnancy in its employment, programs, services and activities, and admissions, and, in certain circumstances, marriage to a co-worker. The University will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Colorado State University is an equal opportunity and equal access institution and affirmative action employer fully committed to achieving a diverse workforce and complies with all Federal and Colorado State laws, regulations, and executive orders regarding non-discrimination and affirmative action. TheOffice of Equal Opportunity (https://oeo.colostate.edu/) is located in 101 Student Services.

The Title IX Coordinator is the Director of the Office of Title IX Programs and Gender Equity, 123 Student Services Building, Fort Collins, CO 80523-0160, (970) 491-1715,titleix@colostate.edu.

The Section 504 and ADA Coordinator is the Director of the Office of Equal Opportunity, 101 Student Services Building, Fort Collins, CO 80523-0160, (970) 491-5836,oeo@colostate.edu.

The Coordinator for any other forms of misconduct prohibited by the University’s Policy on Discrimination and Harassment is the Vice President for Equity, Equal Opportunity and Title IX, 101 Student Services Building, Fort Collins, Co. 80523-0160, (970) 491-5836,oeo@colostate.edu.

Any person may report sex discrimination under Title IX to theOffice of Civil Rights, Department of Education (https://www2.ed.gov/about/offices/list/ocr/docs/howto.html) .

Background Check Policy Statement

Colorado State University strives to provide a safe study, work, and living environment for its faculty, staff, volunteers and students. To support this environment and comply with applicable laws and regulations, CSU conducts background checks for the finalist before a final offer. The type of background check conducted varies by position and can include, but is not limited to, criminal history, sex offender registry, motor vehicle history, financial history, and/or education verification. Background checks will also be conducted when required by law or contract and when, in the discretion of the University, it is reasonable and prudent to do so.

References Requested

References Requested

Minimum Requested3

Maximum Requested3

Supplemental Questions

Required fields are indicated with an asterisk (*).

• • Do you have a High School Diploma or GED?

• Yes

• No

• • Do you have a Medical Coding Certification through AAPC or AHIMA?

• Yes

• No

• • Do you have one year of experience working as a certified medical coder in an outpatient or family practice medical environment, which may have included psychiatry, mental and behavioral health, orthopedics, optometry, women and gender care, immunizations, laboratory and/or physical therapy?

• Yes

• No

Applicant Documents

Required Documents

• Cover Letter

• Resume

Optional Documents