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Claims Coding Specialist, Full Time- Days

Role overview

Qualifications

  • Coding certification required within 3 months of hire
  • High school diploma required
  • Proven working knowledge of CPT and ICD coding systems required
  • Must possess a working knowledge of Local and National Coverage Determination policies

Responsibilities

  • Review Clinic Outpatient medical record documentation for correct diagnosis and procedure coding
  • Ensure documentation matches charges captured
  • Resolve claim and charge edits in Epic using appropriate coding guidelines
  • Serve as a primary resource for in-clinic physicians/providers and organize education for them

Key facts

Hard skills

Other skills

  • Microsoft Excel
  • Microsoft Word
  • Analytical Skills
  • Organizational Skills
  • Time Management
  • Multitasking
  • Social Skills
  • Virtual Collaboration
  • Communication

About the company

UChicago Medicine logo

UChicago Medicine

The University of Chicago Medicine has been at the forefront of medicine since 1927, when we cared for our first patients. Our mission is to provide superior health care in a compassionate manner, ever mindful of each patient's dignity and individuality. To accomplish our mission, we call upon the skills and expertise of all who work together to advance medical innovation, serve the health needs of the community, and further the knowledge of those dedicated to caring. As one of the nation’s leading academic medical institutions, UChicago Medicine comprises the Medical Center, Pritzker School of Medicine and the Biological Sciences Division. Its main Hyde Park campus is home to the Center for Care and Discovery, Bernard Mitchell Hospital, Comer Children’s Hospital and the Duchossois Center for Advanced Medicine. It also has a 108,000-square-foot facility in Orland Park as well as an outpatient clinic in Chicago's South Loop, as well as affiliations and partnerships that create a regional network of doctors in dozens of Chicago-area communities. UChicago Medicine offers a full range of specialty-care services for adults and children through more than 40 institutes and centers including an NCI-designated Comprehensive Cancer Center. It has 805 licensed beds, nearly 850 attending physicians, about 2,500 nurses and over 1,100 residents and fellows. Harvey-based Ingalls Health joined UChicago Medicine’s network in 2016.

Company details

Company size5001 - 10000

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Job description

Be a part of a world-class academic healthcare system, Uchicago Medicine, as a Claims Coding Specialist in the Radiation Oncology 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 workqueues, 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: Radiation Oncology-Finance 
  • CBA Code: Non-Union

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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