Reimbursement Specialist - Healthcare jobs in the United States

Description

The primary purpose of this position is to be respsonsible for ICD-10 and CPT coding of services provided by physicians and mid-level providers for all outpatient and inpatient services for Decatur SIU Center for Family Medicine.

This position reviews charges to ensure documentation is appropriate for the CPT level of service indicated. In addition, the employee is responsible to ensure that theTeaching Physician Guidelines are accurately documented by the provider.

Hours : As needed

There are no benifits associated with this position

Examples of Duties

70% Coding

1. Assign ICD-10 and CPT codes for services provided at the Decatur SIU Center for Family Medicine clinic.

3. Bring discrepancies to the attention of the physicians and other providers to resolve coding issues.

4. Perform review on charge tickets and encounter forms and recommends needed changes.

5. Teach residents appropriate coding practices, familiarity with inpatient and outpatient levels and the requirements of same.

6. Review denied claims for coding errors, and corrects and / or provides chart documentation for re-submittal for claims payment consideration.

7. Keep abreast of Medicare and Medicard regulations as they apply to the teaching physician guidelines.

8. Code off-site services (Public Hlth Clinics, Nursing Home, Home Visit, etc.) by the Providers and ancillary personnel.

9. Attend monthly Billing and Coding User Group meetings.

30% Billing / Posting

10. Hospital Inpatient : This position works directly with faculty attendings to ensure Proper billing of hospital services.

This requires a verification system to make sure that double billing does not occur since the attending changes frequently.

In addition, follow-up on deliveries and newborns is required to ensure services are billed.

11. Periodically audit chart notes to determine all appropriate charges were billed and notes are completed on a timely basis report discrepancies to the Supervisor.

12. Reviews, in detail, completed encounter forms and posts charges for physician Services using practice management system.

13. Works TES edits to make sure adjustments are made to posted batches as required by Claims Manager claims scrubber.

14. Reconciles discrepancies by processing end of day reports.

15. Work and process the outstanding encounter report, bringing overdue charges to the attention of the Supervisor.

16. Assist the Supervisor in completing the open encounter report.

17. Assist the Supervisor in training residents, faculty and nurses on the specialized FQHC billing and coding procedures.

Qualifications

1. High School graduation 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 Procedural Coder (CPC) or a Certified Procedural Coder-Hospital (CPC-H) by the American Academy of Professional Coders (AAPC).

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.

Condition of Employment : Pursuant to the State Universities Civil Service System, an out-of-state resident who is hired into this position must establish Illinois residency within 180 calendar days of their start date.

Supplemental Information

If you require assistance, please contact the Office of Human Resources at or call 217-545-0223 Monday through Friday, 8 : 00am-4 : 30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

The SIU School of Medicine Annual Security Report is available online at . This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL.

This report is published in compliance with Federal Law titled the

Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act."

Southern Illinois University School of Medicine is an Affirmative Action / Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.

Last updated : 2024-05-12