Physician / Surgical Claims Coding Specialist (Days- Local Remote) - The University of Chicago Medicine

Job Description

Join UChicago Medicine Care Network, as a Revenue Claims Coding Specialist for OB at UCM Care Network in the Burr Ridge, IL location. In this role you will primarily support Administrative Support Workers. This opportunity offers remote flexibility within the surround states of IL. 

LOCAL HYBRID REMOTE OPPORTUNITY 

Revenue Claims Coding Specialist (RCCS) works under the supervision of the Manager, Revenue Claims Coding Specialist. The RCCS team works collaboratively with Primary Healthcare Associates (PHA) physicians assigned to his/her team/group in order to provide an optimal revenue cycle environment that is efficient, effective, comprehensive and compliant. The RCCS team also works collaboratively with the PHA practice managers, billing staff and when needed, insurance payers to support a highly efficient, effective, and compliant revenue cycle program. The typical work includes the entry of professional charges from charge tickets into EPIC, resolution of coding edits for all payers, revenue reconciliation, identify and/or organize appropriate education for physicians. Effective communication with management, providers and practice directors will be key. The Revenue Claims Coding Specialist will also be responsible for the completion of all work assignments in a proficient and accurate manner; meeting productivity and quality standards set by the Revenue Claims Coding Specialist Manager.

Essential Functions/Responsibilities: 

• Works directly with manager as assigned to charges from PHA providers for non-office based services, i.e. inpatient, outpatient surgery, dialysis and nursing home visits to facilitate charge entry, resolve coding and charging issues for all payers (NCCI, OCE, MUE, LCD, payer custom edits), including but not limited to denials and disputes
• Serves as a charging/coding resource supporting physician’s/provider’s revenue capture. As such, organizes charge tickets for timely entry into EPIC.
• Review medical documentation for assigning billing modifiers to insurance claims where appropriate and applicable. Works assigned work ques daily with the goal to complete all assigned tasks
• Perform charge reconciliation and work with the physicians/providers and/or practice managers in instances of missing charges/ revenue; with the optimal goal of ensuring the missing revenue gets posted and realized
• Routinely communicates with manager and where possible, providers, practice administrators, billing staff and payers as needed to discuss clinical questions with respect to coding assignment or resolution of edits in a courteous and professional manner. Provide appropriate feedback to manager and provider for education on trends identified from errors or payer denials. Participate in meeting with provider, practice manager as assigned by manager to improve the overall claims, revenue cycle, and business functions of the practice.
• Attends and participates in team meetings to discuss coding/charging issues and participates on projects as requested. Maintains current knowledge of all billing and compliance policies, procedures and regulations and attends appropriate training sessions as required. Meets all productivity and quality expectations and participates in all scheduled audits and performs other duties as assigned.
• Meets all productivity and quality expectations and participates in all scheduled audits and performs other duties as assigned.

Required Qualifications

• Ability to identify trends and recommend solutions to billing and revenue cycle processes and problems.
• Coding certification through AAPC or AHIMA required.
• Coding certification required: CPC (Certified. Professional Coder), CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist Physician)
• 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 professional billing 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) payer 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.

Preferred Qualifications

• Epic experience strongly preferred.
• Prior experience working EM(Evaluation Management.
• Experience with provider E&M education strongly preferred.

Position Details

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days/ Monday-Friday 8am-4:30pm
• Location: Burr Ridge when required to come in office 
• CBA Code: Non-Union

Must comply with UCMC’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Why Join Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, The University of Chicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

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Bring your career to the next level at a hospital that is thriving; from patient satisfaction to employee engagement, we are at the Forefront of Medicine. Take advantage of all we have to offer and #BringYourPassiontotheForefront.

University of Chicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: www.uchospitals.edu/jobs 

The University of Chicago Medical Center is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.