Loading...
Share this Job

Coding Re-imbursement Specialist

Hospital Coding

 

Address Work from home/Remote from within Indiana or Illinois

Hours  Days

Calendar  Full-Time

Education High School Diploma/ GED Required, Bachelor’s Degree preferred

WHAT WE NEED

Detail-oriented, multi-tasking reimbursement specialist

WHO WE ARE LOOKING FOR

Good learners.  Accurate reviewers. Our health information coding reimbursement specialists are an important part of the health information team. Ensuring diagnoses and procedures are accurately recorded is a big part of the job. The other part? Being able to follow state and federal compliance regulations.

Are you timely and accurate? Are you detail-oriented? Do you love knowing that you’re an integral part of the team? We’ve got a great place to put your skills to work.

WHAT YOU WILL DO
  • Abstract data necessary for billing and statistical purposes.
  • Assist with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
  • Collaborate with the Business Office to ensure compliant billing practices are being maintained.
  • Collaborate with clinical departments and physicians on documentation improvement.
  • Review medical record documentation in order to appropriately assign diagnoses and procedure codes.
  • Serve as a coding subject matter expert in clinical department meetings and during patient rounds.
  • Serve as coding subject matter expert for one of the following reimbursement methodologies:
    • Illinois Inpatient Medicaid (knowledge and understanding of APR-DRG's reimbursement methodologies)
    • Illinois Outpatient Medicaid (knowledge and understanding of EAPGs reimbursement methodologies and edits) 
    • Indiana Inpatient Medicaid (knowledge and understanding of aPR-DRGs reimbursement methodologies and edits)
    • Behavioral Health Inpatient prospective payment system(knowledge and understanding of DSM and Inpatient Psych Facility coding) 
    • Inpatient rehab prospective payment system (knowledge of IRF-PAI, CMG assignment and transmission to both CMS and UDSMR).
WHAT IT TAKES TO SUCCEED
  • Prior coding experience.
  • Knowledge of types of health information and the rules and regulations surrounding their use.
  • Advanced understanding of ICD10CM coding, ICD10PCS coding, CPT coding and coding guidelines.
  • Advanced understanding of coding grouping methodologies.
  • Understanding of payer relationships, requirements and compliant billing practices and Managed Care requirements under the Medicare/Medicaid and other third party payor programs.
  • Understanding of common medical terminology, anatomy and physiology and terminology used in diagnosis and classification of illnesses, injuries, and disabilities.
  • Understanding of anatomy and physiologic concepts as they relate to relevant diagnostic testing and course of treatment.
  • Critically evaluate and analyze information in written materials.
  • Work independently with minimal supervision.
  • Maintain a positive approach, work cooperatively with others, and demonstrate a constructive response to criticism and works with others as a team.
  • Proficient in Microsoft Office Applications.
  • Effectively communicate verbally and in writing as appropriate for the needs of the audience.


WHAT WE'RE LOOKING FOR

 

3-5 Years Experience, preferably Inpatient with Medicaid coding and reimbursement 

Certification(s): Minimum of Certified Coding Specialist (CCS) required, Registered Health Information Technology (RHIT) or Registered Health Information Administration (RHIA) preferred

 

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

BILLING & HEALTH INFORMATION ​​​​