DCG Medical Coder

Job Summary

Analyze the medical/dental record documentation and transform healthcare diagnoses, procedures, medical services, and equipment into universal HIPAA-compliant dental/medical alphanumeric codes, which are applied and submitted during the billing process.

The role will be responsible for data entry into axiUm and CareVoyant billing systems using the appropriate CDT, CPT, ICD-10-CM, and HCPCS codes. Actions will be in accordance with federal, state, and payor billing requirements. Review medical record documentation in EPIC system for dental procedure coding and charge capture in offsite locations.

Responsibilities

The duties include, but are not limited to:

• PRE-BILL CODING REVIEW AND CHARGE CAPTURE (DENTAL/MEDICAL): Run a daily query/census report to identify the work queue. Review multispecialty surgical, dental, and medical pre-bill claims for DCG residency clinics using axiUm, EPIC and CareVoyant billing systems to verify provider coding accuracy and supporting documentation. Review multispecialty dental surgery and medical pre-bill claims for DCG offsite locations (Main OR, Children's Hospital of Georgia (CHoG), Augusta State Medical Prison (ASMP) using axiUm, EPIC, and CareVoyant billing systems to verify provider coding accuracy, supporting documentation, and/or charge capture. Assign documented CDT codes. Submit and record email queries to providers for clarification of conflicting, missing, or ambiguous information in the treatment/progress note to ensure accurate coding charge capture and claims submission.
• ABSTRACT CODING AND CHARGE CAPTURE (MEDICAL): Run daily query/census report to identify the work queue. Review dental/medical record documentation for multispecialty medical billing departments (Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery) and assign the correct CPT, HCPCS, and ICD-10-CM code(s). Submit and record email queries to providers for clarification of conflicting, missing, or ambiguous information in the treatment/progress note to ensure accurate coding charge capture and claims submission.
• AU SURGERY CENTER FACILITY CODING AND CHARGE CAPTURE: Run daily query/census report to identify the work queue. Review operative reports for specialty dental providers (Pediatric Dentistry, General Practice (GPR) Residency/Advanced Education in General Dentistry (AEGD), and Oral and Maxillofacial Surgery). Assign the correct CPT, HCPCS, and ICD-10-CM code(s) into axiUm and CareVoyant billing systems.
• REPORTING: Track trending patterns of coding errors, coding adjustments, and missing documentation for review with the DCG leadership.
• ADMINISTRATIVE: Coordinate with the Business Office for charge entry errors, write-offs, and adjustments to professional and facility services, where applicable for billing accuracy (statements and A/R); discuss and resolve coding denials with insurance staff/manager.
• TRAINING: Maintain current and applicable knowledge of payor billing rules, federal and state documentation, and billing laws and industry standards, CDT, CPT, ICD-10-CM, and HCPCS coding guidance through attendance of conferences, webinars, and other professional development activities.
• OTHER DUTIES: Perform all other job-related duties as assigned.

Required Qualifications

High school diploma, GED, or equivalent from a recognized State or Federal accrediting organization, training in an accredited medical coding program, two years of experience as a multi-specialty coder, and requisite coding certification(s).

Required Certifications

Certified Professional Coder, Certified Dental Assistant, or Certified Coding Specialist (Certifications CPC, CCS, CDA).

Preferred Qualifications

Associate's degree in a healthcare or healthcare business-related field. Advanced knowledge of third-party and federal payor insurance background/experience, and knowledge of coding, billing, documentation, and reimbursement criteria.

Preferred Experience

Four or more years of experience coding dental or medical codes and procedures. Four or more years of clinical or administrative experience in a dental or medical healthcare environment.

Knowledge, Skills, & Abilities

KNOWLEDGE: Knowledge and application of federal, state & payor coding and reimbursement guidelines, regulations, and medical necessity criteria.

SKILLS: Coding experience across multiple professional service lines as well as experience reviewing ASC services for appropriate use of CDT, CPT, HCPCS, ICD-10, and revenue codes. Strong organizational skills and the ability to take initiative and work independently.

ABILITIES: Ability to maintain confidentiality. Ability to apply a systematic approach to problem-solving and troubleshooting.

Certifications/License

Certified Professional Coder, Certified Dental Assistant, or Certified Coding Specialist (Certifications CPC, CCS, CDA).

Conditions of Employment

All selected candidates are required to successfully pass a Background Check review prior to starting with Augusta University. If applicable for the specific position based on the duties: the candidate will also need to have a credit check completed for Positions of Trust and or approved departmental Purchase Card usage. Motor vehicle reports are required for positions that are required to drive an Augusta University vehicle. For Faculty Hires: Final candidates will be required to provide proof of completed academic degree(s) as well as post-secondary coursework in the form of original transcript(s). Those candidates trained by a foreign institution will also be required to provide an educational/credential evaluation. All employees are responsible for ensuring the confidentiality, availability, and integrity of sensitive patient, student, employee, financial, business, etc. information by exercising sound judgment and adhering to cybersecurity and privacy policies during their employment and beyond.

Other Information

This position is also responsible for promoting a customer-friendly environment and providing superior service to our patients, students, faculty, and employees. 'Augusta University is a patient-and family-centered care institution, where employees partner every day with patients and families for success.' Augusta University is a tobacco-free environment, and the use of any tobacco products on any part of the campus, both inside and outside, is strictly prohibited. Equal Employment Opportunity: Augusta University is proud to be an equal opportunity employer welcoming applicants from underrepresented groups, including individuals with disabilities and veterans.

How To Apply

Consider applying with us today! Select University Faculty & Staff > External Applicants if you are a candidate from outside the university. Select University Faculty & Staff > Internal Applicants if you are a current university employee. If you need further assistance, please contact us at 706-721-9365. To apply, visit https://www.augusta.edu/hr/jobs/.