The Oral and Maxillofacial Surgery (OMS) Coding Specialist at the University Of Minnesota School Of Dentistry will have responsibility for coding all patient encounters in the Oral Surgery Department. This will include the review of the electronic health record (EHR) for each patient encounter. This position is responsible for applying the proper ICD-10, CPT, HCPCS, and CDT codes based on the service provided. The employee will review for accuracy and completion the type of insurance on record and submission of medical and dental prior authorizations where required. This position will require communication with the clinic schedulers, OR coordinators, faculty and residents, and hospital financial specialists. The educating and training students, residents, faculty on coding issues and compliance are a critical part of this position.
The OMS Coding Specialist is a member of the OMS Billing Team. The OMS Billing team is a part of Patient Accounting Department under the Director of Patient Accounting. 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.
The School of Dentistry and the University of Minnesota provides equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression.
Clinic and OR Coding 70%
Use Axium to review student, resident, faculty EHR notes for accuracy and completion
Ensure all medical records/charts have been set up to be signed by faculty and have an attestation, if required
Use Epic electronic charts to retrieve OR reports and/or inpatient consults
Create Axium charts when required and attached any Epic documentation required for the School of Dentistry to submit and process claims properly
Accurately assign the proper POS
Accurately assign ICD-10, CPT, CDT, and HCPCS codes, for each patient encounter, according to established coding guidelines and AHIMA standards of ethical coding.
Post the appropriate codes and charges to the patient account in Axium and assign to the appropriate insurance
Attach prior authorization reference numbers when required.
Identify and track issues and concerns resulting from EHR review. Ensure issues are resolved.
Notify the proper claims department personnel of any concerns, i.e. work comp, MVA claims
Consult with providers when necessary for reasons of clarifications of coding and compliance Issues.
Prior Authorizations (PA) 20%
Utilize the check out forms to identify cases that require medical and/or dental prior authorization and submit when required.
Determine medical necessity and communicate the necessity via proper ICD-10 codes and letters of medical necessity
Comply with Insurance company's submission requirements, where to send PA's, and submit records if needed for each insurance company
Track and follow up on all prior authorization request submissions.
Document all communication and encounters with insurance companies in regard 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 require
Serve as resource person for coding and compliance questions for Oral Surgery. Instruct physician and non-physician practitioners (Includes residents, students, and faculty members) on compliance regulations and coding guidelines.
Analyze problem claims identified by the claims department, compare coding with medical and/or dental record documentation and make any appropriate changes.
Answer coding questions from providers and other staff as needed.
Answering phones, triage of calls to OMS from patients, Fairview-University Medical Center, residents, doctors, other providers within U, front desk, and records requests.
Hourly range: $17.71 - $23.50
The University of Minnesota offers a comprehensive benefits package including:
Competitive wages, and paid holidays, vacation, and sick leave
Low cost medical, dental, and pharmacy plans
Health care and dependent daycare flexible spending accounts
Excellent retirement plans with employer match
Disability and employer paid life insurance
Wellbeing program with reduced insurance premiums
Tuition reimbursement opportunities covering 75%-100% of eligible tuition
** You must show all of the required qualifications on your application materials. **
High school diploma/GED and two years general accounts transaction experience.
CCS-P or CPC certification
CPT, ICD 10-CM and HCPCS Coding systems
Health information and medical record documentation, data integrity and quality
Basic understanding of Medicare/Medicaid billing rules and other Federal Regulations for billing and third party insurer billing policies and contract requirements
Minimum of two years as a practicing outpatient/clinic coder.
Knowledge of Epic
Experience with Medicare, Medicaid and other third party payer reimbursement.
Knowledge of State and Federal laws governing billing and coding practices.
Excellent written and verbal communication skills.
Ability to organize work efforts and follow through on projects independently.
Ability to maintain confidentiality.
Internal Number: 341397
About University of Minnesota, Twin Cities
The University of Minnesota, founded in the belief that all people are enriched by understanding, is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world.