Oak Brook, IL, US
25 days ago
Revenue Recovery Midwest Physician Billing Appeal Coder

Major Responsibilities:

Provide comprehensive, consistent and accurate charge entry for assigned hospital departments. Identify, investigate, communicate and mitigate inconsistent trends in clinical documentation or charging with specific departments. Escalate issues regarding revenue capture or documentation when appropriate.Perform analysis of charges that correlate with documented medical/nursing interventions and resolve identified charging and billing issues. Collects, reports, and maintains appropriate data in relation to charge capture and/or quality. Collaborates with teammates to achieve shared goals and metrics. Perform periodic retrospective charge capture reviews of assigned departments to identify charging/billing issues. Verify and respond to questions from various departments, patients or leadership regarding charging accuracy. Provide orientation, education training and information to newly hired teammates regarding charge capture, policies, procedures, and underlying processes. Conduct quality audits of accounts processed by the team and report findings with department Quality and Education Coordinator. Review, identify, and process late, missing or lost charges for various hospital departments on an as needed basis.

License/Registration/Certification:

Certified Coding Associate (CCA) issued by American Health Information Management Association (AHIMA)


Education/Experience Required:

Education: Associate's Degree or equivalent knowledgeExperience: Typically requires 3 years of experience in hospital coding


Knowledge, Skills & Abilities Required:

Certified Coding Associate (CCA) valid and current certification required.Knowledge of third-party healthcare insurance plans, government regulations, hospital billing and claims.Able to review medical records, analyze, and apply billing and coding rules.Strong computer skills including Microsoft Office and Windows applications. Familiarity with hospital applications.Ability to work under time pressure and meet deadlines.Excellent communication skills including ability to document progress of routine work.Must be able to work independently yet have strong desire to collaborate with peers to meet team goals and metrics.Willing to modify personal workload/workflows in support of evolving department process and procedures for improved efficiencies. Ability to life 20 pounds and exposed to normal remote work environment.

#LI- remote

#LI- Coder


This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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