Career Center

The University of Minnesota School of Dentistry has an opening for a Coding Specialist 2!  This is a unique opportunity for an established medical coder to use their skills while working at the University of Minnesota with our great benefits.

• The pay rate for this position is $55,000-62,000 depending on the qualifications that the finalist brings to the position.
• This position will be required to work on site in Minneapolis 5 days per week, with some potential options for future hybrid work.
• This position is eligible for the University’s excellent benefits package, including health and dental insurance, Regents Scholarship, and more.  You can read more at the "Working at the University" section below. 

The Coding Specialist 2 at the University of Minnesota School of Dentistry (SOD) will have responsibility for supporting all departments with the SOD that have medical coding needs. Departments include but may not be limited to Oral and Maxillofacial Surgery (OMS), Temporomandibular Disorders (TMD), General Practice Residency (GPR), Radiology, and Periodontics.

The employee in this position will:

• Work with the claims department to review and correct claim rejections and help appeal claim denials. 
• Analyze the electronic health record (EHR) for each patient encounter and applying the proper ICD-10, CPT, HCPCS, and CDT codes based on the service provided and based on the School of Dentistry’s billing policies and the industry standards to billing and coding compliance.
• Track and research recurring medical claim denials and rejections based on coding and/or insurance coverage and present their findings to the correlating SOD departments, providers, and coders.
• Identify, track, address, and resolve EHR documentation issues.
• Create and present coding compliance and proper EHR documentation presentations to SOD departments or groups of providers to train and educate on proper documentation for compliance with billing and coding guidelines and to meet CODA standards.
• Write letters of medical necessity, submit, track, and follow up on medical prior authorizations where required for all SOD departments that need medical prior authorization support (OMS, Faculty Practice Clinic, Periodontics, etc).
• Communicate with the clinic schedulers, OR coordinators, faculty and residents, and hospital financial specialists. 

The Coding Specialist 2 is a member of the SOD Coding Team. The SOD Coding Team is a part of the Patient Accounting Department under the Chief Financial Officer. We rely on each other to make the strongest team possible. Our department supports the mission of the School of Dentistry, which is to advance health through scientific discovery, innovative education, and the highest-quality care for all communities. 

POSITION RESPONSIBILITIES

SOD Coding Support 60%

• Serve as resource person for coding and compliance questions for TMD, Radiology, GPR, OMS, and other clinics that may need it. Instruct physician and non-physician practitioners (Includes residents, students, and faculty members) on compliance regulations and coding guidelines and documentation.
• Create and deliver presentations for ongoing education for students, residents, and faculty to educate on current coding changes and/or presentations on code and/or procedure groups and then type of documentation needed for billing and prior authorization
• Create and maintain training material and update as needed.
• Research and problem solve reoccurring claim rejections due to coding issues.
• Create and keep an open line of communication with SOD clinics and their doctors (OMS, Radiology, TMD, Periodontics, etc.).
• Review EHR documentation for other clinics that need help with coding and provide appropriate CPT/CDT/ICD-10/HCPCS codes.
• Work with clinics that utilize charge masters, check out forms, and order forms to insure they have the most current CPT/CDT/ICD-10 codes on the charge masters.
• Review medical claims rejections for the claims department.
• Work with the claims department and providers to write letters of medical necessity as needed for claim denials.
• Research problem claims identified by the claims department, compare coding with medical and/or dental record documentation and make any appropriate changes.
• Identify and problem solve reoccurring claim rejections due to coding issues and/or documentation issues and provide individual and group training as needed to limit reoccurring rejections.
• Identify and problem solve reoccurring claim denials rejections due to coding issues and/or documentation issues and provide individual and group training as needed to limit reoccurring rejections.
• Call insurance company and/or research individual insurance policies on claim rejections and/or claim denials to limit claim delays due to possible coding or documentation issues and provide individual or group training as needed.
• Answer coding questions from providers and other staff as needed.
• Educate clinics on proper use of ABNs and non-covered service agreements (NCSA). Work with the clinics to implement a process to identifying accounts that require signed ABNs or NCSA and getting patient signatures. Educate staff on proper use of modifiers when posting charges for accounts with ABNs/NCSA.
• Answering phones, triage of calls from patients, Fairview-University Medical Center, residents, doctors, other providers within U, front desk, and records requests.

OMS Clinic and OR Coding Support 20%

• Use Axium to review and analyze student, resident, faculty EHR notes for each patient encounter for proper coding and billing compliance, accuracy and completion based in coding guidelines and regulations and School of Dentistry policies and procedures
• Ensure all medical records/charts have been set up to be signed by faculty and have an attestation, if required
• Track all EHR notes and/or compliance issue until problem is solved.
• Meet with and explain to dental students and residents the complex compliance regulations and coding guidelines, established coding guidelines, and the policies of the School of Dentistry for proper EHR documentation
• Apply proper CPT/CDT/HCPCS/ICD-10 codes to a patient’s account based on your analysis of the complete EHR documentation and within the complex compliance regulations and coding guidelines, established coding guidelines, and the policies of the School of Dentistry.
• Apply all proper claim information required for a clean claim: the place of service, in-patient dates, referral information, and prior authorization information.
• Use EPIC electronic charts to retrieve OR reports and/or inpatient consults and apply proper CPT/CDT/HCPCS/ICD-10 codes to a patient’s account based on your analysis of the complete EHR documentation and within the complex compliance regulations and coding guidelines, established coding guidelines, and the policies of the School of Dentistry.
• Create Axium charts when required and attached any Epic documentation required for the School of Dentistry to submit and process claims properly
• Provide account audits, and identify and track issues and concerns resulting from EHR review. Ensure issues are resolved. Provide reports of continued student/resident EHR documentation and coding issues to the OMS coding supervisor and team for continued education for students and residents and coding team.
• Provide reports and consult with faculty when necessary for reasons of clarifications of coding and compliance Issues after routine account audits.  

Prior Authorizations (PA) 20%

• Support OMS in submitting prior authorizations as needed and support other clinics within the SOD to submit medical prior authorizations as needed.
• Research and track each insurance company’s prior authorization requirements for the different treatments provided by OMS.
• Utilize the check out forms to identify cases that require medical and/or dental prior authorization and track them.
• Analyze EHR notes and records from other providers to determine medical necessity.
• Prepare letters of medical necessity
• Submit prior authorization and apply proper CPT/CDT/HCPCS/ICD-10 codes via the patient’s insurance company. Comply with the insurance’s submission requirements and where to send prior authorizations.
• Track and follow up on all prior authorization request submissions.
• Provide routine reports to providers of current status of outstanding prior authorizations.
• Routinely meet with and explain to dental students, residents, and faculty the complex policies and requirements of each insurance company’s unique documentation requirements to ensure for proper EHR documentation to support medical necessity
• Track and document all communication and encounters with insurance companies in regards to PA requests.
• Process authorization decisions properly based on the type of procedure being performed. This will include communication with the clinic and/or OR coordinators, communicating with the patient, communicating with OMS doctors and other doctors involved in the patients care.
• Review denials and appeal when required.

Required Qualifications ** Please detail all three of the required qualifications on your application materials **

1. Bachelor’s Degree or a combination of related education and relevant experience totaling four years
2. Must be certified as CCA (Certified Coding Associate), or CCS-P (Certified Coding Specialist-Physician based), or CPC (Certified Professional Coder)
3. Knowledge of:
   • Medical Terminology
   • CPT, ICD 10-CM and HCPCS Coding systems
   • Health information and medical record documentation, data integrity and quality
   • Medicare/Medicaid billing rules and other Federal Regulations for billing and third-party insurer billing policies and contract requirements
   • HIPAA regulations 

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