Reimbursement Coding Specialist

Reimbursement Coding Specialist

The Reimbursement Coding Specialist will analyze complex physician and ancillary medical billing charges to verify correct documentation and assign the correct codes to obtain the maximum reimbursement allowed by the payers. Performs other coding-related functions including training new coding staff, education other billing staff on correcting and resubmitting denied claims, serves as a coding resource/liaison, interfaces with outside auditors and research mandated coding/billing changes to determine the proper course of action. Works under the general supervision of the Revenue Cycle Billing Manager.

Duties & Responsibilities

• Reviews and maintains an expert level of knowledge of CPT, ICD-10 and HCPCS coding principles, modifier usage, medical terminology, HIPAA compliance, governmental regulations and third-party payer requirements pertaining to billing, coding and documentation.
• Codes highly complex services, maintaining departmental standards for productivity and accuracy.
• Works under minimal supervision using specialized expertise in the subject matter.
• Ensuring all services documented in the patient's medical record are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, they seek proper documentation in a timely manner based upon established protocols.
• Acts as a knowledge resource to provider education regarding code matters and provides feedback on how to improve documentation and charge capture to ensure revenue optimization.
• Identifies risk areas and error trends for providers, procedures, facilities and/or coders.
• Understands HIPPA regulations, treats all patient information and data with complete confidentiality and takes all precautions to secure this information.
• Research and resolve coding related system edits, payer rejections, and insurance denials.
• Serves as a mentor and trainer to less experienced coders and answers questions as needed.
• Perform other duties and participate in special projects as assigned.
• Attends and participates in departmental staff meetings, coding meetings, or other meetings as requested.

Minimum Qualifications

1. High school diploma or equivalent.
2. Current certification as a Certified Coding Specialist (CCS) or Certified Coding SpecialistPhysician-based (CCS-P) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA), or current certification as a Certified Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) (formerly CPC-H certification).
3. One (1) year/twelve (12) months of work experience comparable to that performed at the Reimbursement Coding Representative level of this series or in other positions of comparable responsibility.

To Apply

For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date. Illinois Residency is required within 180 days of employment.

Sponsorship for work authorization is not available for this position.

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

The university provides accommodations to applicants and employees. Request an Accommodation

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.