Reimbursement Coding Specialist - Imaging and Diagnostic Services

University of Illinois Chicago•Chicago, IL

48d•Onsite

About The Position

The Reimbursement Coding Specialist will perform coding for physician and ancillary department medical services for the purpose of receiving maximum allowable reimbursement from payers. The Reimbursement Coding Specialist will also perform other coding related functions such requesting prior authorization for imaging and diagnostic services. Lastly, the Reimbursement Coding Specialist will assist with training, research of coding issues, and provide education to Imaging and Diagnostic leadership.

Requirements

High school diploma or equivalent.
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).
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.

Nice To Haves

Skill in researching complex coding questions, customer service experience, EPIC- scheduling and registration experience.
Excellent attendance, interpersonal and communication skills, and relevant work experience required.

Responsibilities

Reviews outpatient documentation to assign the appropriate ICD-9-CM, ICD-10, CPT, and/or HCPCS diagnosis and procedures codes while adhering to coding guidelines.
Codes complex charge documents for imaging/diagnostic, procedural and physician services using standardized systems such as ICD-10-CM and CPT, with review of previous day’s procedural charges for completeness and accuracy verifying coding performed by clinical staff.
Application of modifiers as necessary.
Completes analysis and correction of coding errors as received from Patient Accounts department.
Reconciliation of ICD-10 and procedural coding.
Interacts with Radiology and Cardiology attending to obtain supporting clinical documentation.
Education of outside referral MD offices for order selection.
CPT codes for third party payer submission for approval/authorization for procedures.
Reference contact for billing questions from department.
Research and keeps abreast of policy changes mandated by state and federal reimbursement programs; notifies affected personnel on a routine basis.
Maintains applicable assigned work queues and expected lead times.
Obtains and / or coordinates with third-party payer to obtain authorizations for imaging and diagnostic services.
If necessary, contact patient / guarantor to notify them of denial or financial risk.
Perform other related duties and participate in special projects as assigned.