Reimbursement Coding Representative - Surgery, College of Medicine

Reimbursement Coding Representative

The Reimbursement Coding Representative operates under the direct supervision of the Director of Administrative Operations; this position will be responsible for coding Department of Surgery clinical and surgical services, primarily E/M's. The Reimbursement Coding Representative will ensure proper financial authorization is in place before submitting charges and reviews Surgery Coding Denial Work Queue daily.

Duties & Responsibilities:

• In addition to lower level coding responsibilities, review inpatient and/or outpatient documentation to assign the appropriate ICD-10, CPT, and/or HCPCS diagnosis and procedures codes while adhering to coding guidelines.
• Keep abreast of bulletins, newsletters, and periodicals; attends workshops to stay current on coding issues, trends, and changes in regulations governing medical record coding documentation.
• Be responsible for abstracting codes and other information from the hospital system for billing and reporting purposes. Identifies and makes recommendations for coding edits.
• Assist in development of policies and procedures related to coding of medical providers, ancillary, and/or hospital services using ICD-10, HCPCS, and/or CPT.
• Track appeals to ensure appropriate strategies are employed and to adjust accordingly; assists in resolving day-to-day coding related issues; serves as a resource person for billing/coding purposes.
• May review charge tickets and/or documentation to determine accuracy of CPT and diagnosis coding.
• Review, analyze, and correct or resolve claim denials.
• May perform periodic audit reviews.
• Perform other related duties and participate in special projects as assigned.

Minimum Qualifications Required:

• 1. High school graduation or equivalent.
• 2. Any one or any combination totaling 18 months from the following categories:
• A. Work experience in a healthcare setting (i.e., hospital, physician's office, nursing home, billing agency) utilizing ICD-10, and CPT coding systems, Healthcare Common Procedure Coding System (HCPCS), and the Current Procedural Terminology (CPT) systems of coding to assign codes for services provided to patients.
• B. College course work relating to healthcare operations includes the following topics such as Medical Terminology, Human Anatomy and Physiology, ICD-10 Coding, and CPT Coding, or closely related courses.
• Current designation as Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) (formerly CPC-H certification) or current certification as a Certified Coding Associate (CCA), 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) satisfies all the requirements for this classification.

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.