Claims Coding Specialist (OB)

Job Description

Join a world-class academic healthcare system, UChicago Medicine, as a Claims Coding Specialist (CCS) in our Revenue Cycle - Revenue Integrity Department, serving our OB unit.

This position will be primarily a work from home opportunity with the requirement to come onsite as needed to our Hyde Park location .

You may be based outside of the greater Chicagoland area.

Please double check you have the right level of experience and qualifications by reading the full overview of this opportunity below.

The Claims Coding Specialist (CCS) works under the supervision of the Revenue Integrity. The CCS team works collaboratively with physicians to provide an optimal revenue cycle environment that is efficient, effective, comprehensive, and compliant.

The CCS team also collaborates with ambulatory practice managers, billing staff, and insurance payers to support a highly efficient, effective, and compliant revenue cycle program.

Typical work includes resolving coding edits for all payers, revenue reconciliation, identifying and organizing appropriate education for physicians, and effective communication.

The Claims Coding Specialist will also be responsible for completing all work assignments proficiently and accurately, meeting productivity and quality standards set by the Revenue Integrity Director.

The Claims Coding Specialist reports directly to the Revenue Integrity Manager.

Essential Job Functions

• Works directly with hospital departments and ambulatory clinics to resolve coding and charging issues for all payers, including denials and disputes.
• Reviews medical documentation for assigning billing modifiers to insurance claims where appropriate.
• Works assigned work queues daily with the goal to complete all assigned tasks.
• Serves as a primary resource supporting in-clinic physicians / providers, organizing appropriate education for physicians, and communicating regularly to improve the overall claims and revenue cycle functions of the practice.
• Meets regularly with the practice manager and medical director to review revenue cycle performance and identify solutions for advancing an efficient, effective, and compliant revenue cycle program.
• Performs charge reconciliation and collaborates with physicians / providers in instances of missing revenue.
• Assists with identifying trends and opportunities to address root causes and provides feedback / education / training.
• Maintains current knowledge of all billing and compliance policies and attends appropriate training sessions as required.
• Assists with the orientation of newly hired Claims Coding Specialists.
• Attends and participates in team meetings to discuss coding / charging issues.
• Meets all productivity and quality expectations and participates in scheduled audits.
• Performs other duties as requested by management.

Required Qualifications

• Coding certification required within 3 months of hire : RHIA, RHIT, CPC, COC, CCS, CCS-P, or CCA.
• High school diploma.
• Ability to identify trends and recommend solutions to billing and revenue cycle processes.
• Proven working knowledge of CPT and ICD coding systems.
• Knowledge of Federal billing regulations governing Medicare and Medicaid programs.
• Working knowledge of Local and National Coverage Determination policies, Ambulatory Payment Classification related edits.
• Proficient in Microsoft Excel and Word.
• Highly analytical with excellent written and verbal communication skills.
• Excellent organizational, time management, and multi-tasking skills.

Preferred Qualifications

• Two or more years' experience coding.
• Epic, IDX, and Centricity experience.
• Associate or Bachelor’s degree in a healthcare information or finance related field.

Position Details :

• Job Type / FTE : Full Time (1.0 FTE)
• Shift : Days
• Work Location : Flexible Remote / Hyde Park Main Campus
• Unit / Department : Revenue Cycle - Revenue Integrity
• CBA Code : Non-Union

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, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters.

Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at : UChicago Medicine Career Opportunities.

UChicago Medicine 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.

Must comply with UChicago Medicine’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.

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