About UT Physicians
UT Physicians is dedicated to delivering top-tier, comprehensive, and cost-effective patient care. Our commitment is rooted in a patient-centered environment, distinguished by our national leadership in medical education and research.
Our History
Established in 1973 as MCO Associates by Dr. Lucien Morris, then Chairman of Anesthesiology at the Medical College of Ohio, our organization was formed to ensure physicians received fair compensation for both their academic and clinical contributions. The initial model involved splitting revenue between the hospital and the physician corporation, with MCO Associates handling billing and collections for the newly formed group.
In 2004, we transitioned from a for-profit to a not-for-profit entity, renaming ourselves MCO Physicians. Following the merger of the University of Toledo and the Medical College of Ohio in July 2006, our name was updated once more to University of Toledo Physicians (UTP).
Our Services
Today, UT Physicians offers extensive practice management support services to its physician members. These services include:
- Provider credentialing
- Health plan enrollment
- Managed care contracting
- Compliance
- Fee schedule maintenance
- Billing, payment processing, and collection services
Additionally, we provide comprehensive benefit administration services, covering:
- Medical malpractice
- Payroll
- Flexible spending accounts
- Retirement plans
- Accounts payable services
Position Summary: Certified Coder
As a Certified Coder, you will be responsible for accurately assigning ICD diagnosis and CPT facility and professional codes. Your coding assignments may include various outpatient services, such as clinic visits, diagnostic procedures, outpatient surgeries, observation and inpatient encounters, and emergency room charges. Your precise coding ensures proper reimbursement, supports research efforts, and maintains compliance with federal regulations based on ICD and CPT classification systems.
Essential Job Functions and Accountabilities
You will be expected to:
- Accurately assign CPT, ICD, and HCPCS codes to services performed by payable providers, ensuring correct usage of modifiers and descriptors.
- Review and assign CPT codes on encounters for accuracy, whether in a charge capture system, on paper, or within the current Electronic Medical Record (EMR).
- Assign ICD codes to the highest level of specificity, using provider documentation, coding books, or encoder/3M, and understand bilateral guidelines for major insurance carriers.
- Demonstrate a strong understanding of medical terminology, anatomy, diagnosis, coding/manifestation guidelines, CPT guidelines, CMS guidelines, modifiers, and NCCI edits.
- Possess a strong understanding of global surgical charges, including the ability to add alert notes in the EMR, clarify appropriate codes with providers, and enter procedures and modifiers in the correct order.
- Understand the process for unlisted procedures, which involves retrieving EMR documentation, researching the procedure, and providing support to get new codes entered into the EMR, potentially with physician input.
- Be able to work with current EMR claim scrubber edits during entry for submission to payers and monitor assigned coding worklists for missing scrub edits.
- Maintain a professional working relationship with follow-up staff, track denial trends, apply front-end changes, and provide feedback to providers.
- Professionally communicate with providers and staff regarding coding practices and updates to ensure clean claim submission.
- Maintain current coding credentials, staying informed on billing, coding, and documentation trends for your assigned specialties.
- Stay current on company training and mandatory testing.
- Adhere to all HIPAA and PHI laws and collaborate with the compliance department on auditing concerns as needed.
- Attend staff meetings, departmental meetings, or revenue-related meetings, assist team members with workflow as needed, and respond to emails within 24 hours.
- Adapt to workflow changes in line with best practices, accreditation guidelines, and revenue guidelines.
- Follow departmental guidelines for achieving daily productivity goals, daily turnaround times, and a work accuracy rate of 98%.
- Perform other duties as assigned.
Required Qualifications
- Education: High School Diploma or Equivalent.
- License and/or Certification: Current certification from an accredited coding association (e.g., CPC, CPC-H, CCS-P, RHIT, CCA).
- Skills:
- Strong communication skills.
- Interpersonal skills to effectively work with physicians, patients, and staff at all levels.
- Ability to build confidence and rapport with others.
- Computer and EMR experience.
Preferred Qualifications
- Education: Associate’s or Bachelor’s degree.
- Experience: 1+ years of experience in coding.
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