Claims Coding Specialist, Full time - Days

Claims Coding Specialist

Be a part of a world-class academic healthcare system, Uchicago Medicine, as a Claims Coding Specialist in the Revenue Integrity department. This position will be primarily a work from home opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area.

The Claims Coding specialist (CCS) is responsible for ensuring accurate medical coding for billing to optimize revenue while maintaining compliance with government regulations. They work collaboratively with physicians, clinic staff and other departments to ensure accurate and compliant charge capture, coding and billing processes.

Essential Job Functions

• Working from Epic work queues, review Clinic Outpatient medical record documentation for assignment of correct diagnosis and procedure coding for healthcare services.
• Ensure documentation matches charges captured.
• Assign appropriate coding modifiers.
• Resolve claim and charge edits in Epic using appropriate coding guidelines, i.e. NCCI, OCE, MUE, LCD and customized payer edits.
• Serves as a primary resource for in-clinic physicians/providers. As such, organizes appropriate education for physicians and communicates regularly with physicians/providers to improve the overall claims, revenue cycle, and business functions of the practice.
• Responsible for identifying trends and opportunities to address root causes of errors, needed updates of system errors and/or needed education/training.
• Must maintain current knowledge of all coding and compliance policies, regulations and trends.
• Attend appropriate training sessions and team meetings as required.
• Performs other duties as assigned/required by department management.

Required Qualifications

• Ability to identify trends and recommend solutions to billing and revenue cycle processes and problems
• Coding certification required within 3 months of hire.
• Epic, IDX and Centricity experience strongly preferred
• High school diploma required. Associate or Bachelor's degree in a health-care information or health care finance related field preferred.
• Proven working knowledge of CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) coding systems required.
• Knowledge of Federal billing regulations governing Medicare and Medicaid programs, and working knowledge of other managed care and indemnity (third party) payor requirements.
• Must possess a working knowledge of Local and National Coverage Determination policies (LCD's and NCD's), Ambulatory Payment Classification (APC) related edits such as the National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE).
• Must be proficient in Microsoft Excel and Word
• Must be highly analytical, and have excellent written and verbal communication skills,
• Must possess excellent organizational, time management and multi-tasking skills, along with demonstration of excellent interpersonal skills.
• Prior current experience with hospital outpatient medical ICD-10 diagnosis and CPT procedure coding
• Experience with EPIC preferred
• Knowledge of virtual meeting platforms, i.e. Zoom, Microsoft Teams

Licenses and Certifications

• Healthcare Coding Certification required three months of hire:
• AAPC- CPC (Certified Professional Coder), COC (Certified Outpatient Coder), CCS (Certified Coding Specialist),
• AHIMA - RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician) CCS-P (Certified Coding Specialist Physician)

Position Details

• Job Type/FTE: 1.00 FTE
• Shift: Days Monday-Friday- Hyde Park (will need to commit to onsite training and workflow meetings)
• Unit/Department: Revenue Integrity
• CBA Code: Non-Union