Reimbursement Coding Specialist

Hiring Department: Pediatrics

Location: Peoria, IL USA

Requisition ID: 1027775

Posting Close Date: 10/16/24

This position is located on the Peoria campus 170 miles southwest of Chicago. (On-Site Work – Not Remote).

The University of Illinois College of Medicine Peoria (UICOMP) educates 265 medical students and more than 300 physician residents and fellows annually. Additionally, it provides clinical care to more than 31,000 patients annually and conducts basic science, clinical and outcomes research. UICOMP is a regional campus of the University of Illinois College of Medicine, a part of the University of Illinois Chicago and University of Illinois System. The College of Medicine Peoria is home to the Cancer Research Center, Center for Wellbeing, and is a collaborator in Jump Simulation. Learn more about UICOMP at http://peoria.medicine.uic.edu.

Description:

Position Summary
The Peds Reimbursement Coding Specialist codes physician & ancillary medical services for the purpose of receiving maximum allowable reimbursement from payors. The position performs other coding related functions such as patient registration, auditing coding transactions, research of coding issues, training and review of departmental coding procedures. They function under general supervision of the Director of Administrative Operations.

Duties & Responsibilities

Codes complex charge documents for ancillary and physician services using standardized coding systems such as ICD-9-CM, ICD-10 and CPT, or verifies coding performed by clinical staff and lower level coders for accuracy.

Determines actions such as submissions of additional documentation on individual claims to increase reimbursement levels and provide additional/supplementary documentation needed for payor consideration of non-routine charges.

Consults with physicians and ancillary personnel to resolve problems with specific charges.

Reviews documentation in order to verify accuracy of codes, dates of service, and assures documentation supports codes; processes provider’s services as needed.

Verifies that demographic and insurance carriers are accurate within patient registration.

Performs periodic reviews of department charge tickets and researches needed changes; recommends needed changes to appropriate supervisor; researches, reports and recommends policy changes mandated by federal and state reimbursement programs as well as those required by the payors.

Processes all electronic & paper claims that are entered manually.

Reviews Epic workques (Charge Review) and corrects all errors that are delaying claim submission.

Reviews Epic workques & make corrections: Claim Edit & Denials workques.

Corrects coding errors, reviews documentation, contacts the clinics/departments to determine the correct code to submit. Identifies discrepancies, potential quality of care, and coding/billing issues. Recommends and facilitates plan of action to correct discrepancies and prevent future coding errors.

May train lower level employees in this series and shares coding expertise with physicians/residents. Serves as a resource and subject matter expert to other coding staff. Attends coding & reimbursement workshops to maintain level of competence & coding certification. Keeps abreast of changes in field.

Performs other related duties as assigned Performs duties listed in lower level of this classification series Assists in the preparation of coding reports as requested

Qualifications:

Minimum Qualifications

1. High school diploma or equivalent.
2. Current certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist—Physician-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.

Preferred Qualifications

FY25 Benefit Booklet: https://cms.illinois.gov/benefits/stateemployee/fy2025-benefit-choice-resources.html


NOTE: Each posting requires a separate on-line application. Applications cannot be re-used. Submission of application including complete work and education history is required; all information submitted will be verified. 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.

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 https://www.hr.uillinois.edu/cms/one.aspx?portalId=4292&pageId=5705 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 of Illinois conducts background checks on all job candidates upon acceptance of a contingent offer of employment. Background checks will be performed in compliance with the Fair Credit Reporting Act.

As an EOE/AA employer, the University of Illinois encourages applications from individuals regardless of an applicant’s race, color, religion, sex, gender identity, sexual orientation, national origin, and Veteran or disability status.

The university provides accommodations to applicants and employees. Request an Accommodation at https://jobs.uic.edu/request-and-accomodation/