Professional and Technical Fee Abstracting and Coding - Under general direction, obtain appropriate reimbursement levels for professional services by reviewing and coding procedures, analyzing denial and rejection reports, and appealing wherever appropriate. Ensure that the professional and technical components of services are processed and billed in a timely manner, in order to obtain payments appropriate for the department. Review and abstract the patient's medical chart for services performed by attending physician(s). Assign the appropriate ICD-9 and CPT-4 codes to the services provided by the physician(s). Process charges prior to submission to UCPG. Assure that charges are submitted in a timely manner in order to meet deadlines.
Coding Integrity & Compliance
Provide educational direction to physicians, administrators, support staff and hospital personnel as requested.
Provide regular feedback to physicians and support staff to improve on success and reduce errors.
Assure that physician signatures are noted on each charge ticket.
Recommend systemic changes and work with faculty and staff members to facilitate such change.
Participate in annual and on-going mandatory compliance training and maintain knowledge of regular updates on billing compliance regulations.
Keep informed of changes in policy by reviewing regular Medicare bulletins and other relevant resources.
Be knowledgeable of and continually in compliance with all federal and state health care laws, regulations, and rules (including Medicare and Medicaid billing requirements that are applicable to the employee's job duties). Â
Assist manager in reviewing, correcting and appealing, as appropriate, denials for professional services.
Review delinquent accounts and work with UCPG and Finance to obtain additional demographic and insurance information as necessary.
Respond to inquiries and/or provide factual information to relevant callers and insurance carriers.
Gather requests from third party carriers; supply additional requested information in order to obtain prompt payment from carriers. Â
Thorough working knowledge of medical terminology validated by testing and certification required.
Thorough working knowledge of ICD-9/10 CM and CPT-4 coding systems as demonstrated by certification through a nationally accredited body (e.g., AAPC, AHIMA) is required. Â
Thorough working knowledge of federal and state regulations regarding reimbursement is required.
Comprehensive knowledge of third party payer rules, procedures and policies in all areas of billing and collection is required.
Expertise in decision making and accountability, creativity, and ability to recommend new procedures and implementation of said procedures is required.
PC experience which includes spreadsheet, word processing, presentation and database software is required.
Familiarity with electronic billing and medical records systems (i.e., EPIC and Centricity, IDX) is required.
Knowledge of Interventional Radiology and Evaluation and Management preferred. Â
Knowledge of coding required.
Manage interpersonal relationships and interact/communicate with clarity, tact, and courtesy with patrons, patients, staff, faculty, students, and others required.
Communicate effectively in English, both orally and in writing required.
Ability to identify priorities and recognize and resolve/refer problems required.
Ability to work effectively with supervision and as part of a team required.
Use or learn a range of position-related software applications required. Â
Education, Experience, and Certifications:
High School diploma or GED is required.
Ability to work for long periods of time in a sitting position, at a keyboard, viewing a computer screen.
NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application
Pay Range: $22.27-$32.59
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Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via the Applicant Inquiry Form.
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Internal Number: JR06990
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