Certified Coding Specialist or Medical Billing Specialist - Business Services

Christie Clinic's department of Business Services is seeking a full-time Certfied Coding Specialist or Medical Billing Specialist at the University clinic from Monday-Friday 7:00am-3:30pm, with no night or weekend requirements. There is a possibility of working hybrid remote in the future following the successful completion of training and competencies as determined by the department.

Certified Coding Specialist: Accurately codes office and hospital procedures for providers to ensure proper reimbursement.  Provides education to the providers to insure proper completion of Electronic Health Records (EHR) and proper assignment of ICD-9-CM, ICD-10-CM, HCPCS and CPT-4 codes.

Medical Billing Specialist: Duties include daily keying of MSRs, auditing and correction of charges/claims prior to submission to insurance, working of reports & various sorting duties.

Certified Coding Specialist:

JOB DUTIES:  (This list may not include all of the duties assigned)

• Audits records to insure proper submission of services prior to billing or on pre-determined selected charges
• Receives hospital information to properly bill services for hospital patients
• Supplies correct ICD-9-CM/ICD-10-CM diagnosis codes on all assigned claims
• Supplies correct HCPCS codes on assigned claims
• Supplies correct CPT-4 codes on all assigned claims
• Contacts providers to train and update them with correct coding information
• Attends seminars and in-services as required to remain current on coding issues
• Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct.  Reports compliance problems appropriately
• Determines the final diagnosis and procedures as stated by the physician or other health care providers are valid and complete
• Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code
• Answer telephones, take messages and provide information
• Utilize Carle Scheduling reports, Carle Signed Note reports, OSF Scheduling reports and Epic Provider schedules to identify coding opportunities
• Work various Epic Workqueues as assigned
• Review and complete Charge Review emails timely
• Provide coverage for other coding team members when needed
• Analyze assigned claim denials and provide additional information
• Performs other related duties, which may be inclusive, but not listed in the job description.

REQUIRED QUALIFICATIONS:

• High School Diploma or equivalent
• 3-5 years coding experience

CERTIFICATION/LICENSE:

• Certified Professional Coder Apprentice (CPC-A) or Certified Professional Coder (CPC) certification through the American Academy of Professional Coders (AAPC) required.

TYPICAL WORKING CONDITIONS:

Requires prolonged sitting.  Requires frequent bending, stooping, or stretching.  May require lifting up to 50 lbs.  Requires hand-eye coordination and manual dexterity.  Requires the ability to distinguish letters, numbers or symbols,  Requires use of office equipment, such as computer terminals, telephones, fax machines, scanners or photocopiers.  Requires normal range of vision and hearing.  Requires the ability to work under pressure and stress due to the diversity of our providers and team.

Medical Billing Specialist:

JOB DUTIES:  (This list may not include all of the duties assigned)

• Audit new claims for accuracy, prior to charges being filed to insurance.
• Remain current and knowledgeable of coding and diagnostic procedures.
• Remain current and knowledgeable of federal legislative changes that may affect outcomes.
• Attend various meetings and professional development programs on a regular basis; make recommendations for revision and/or new department procedures under the direction of the Coordinator.
• Perform Coding related work as required.
• Sorting and completion of paper MSRs.
• Enter data from paper MSRs into the billing system.  Verify information keyed to make sure it was all entered correctly.
• Working through coding issues as assigned in the Charge Review Workqueues.
• Working all coding related Claim Edit Workqueues.
• Working Lab Specials in the Charge Router Workqueue.
• Working through coding issues as assigned in the Follow Up Workqueues.
• Answer telephones, take messages and provide information.
• In depth review and correction of coding errors on new claims.
• Sorting & distribution of incoming faxes.
• Sorting & distribution of incoming mail.
• Processing of no-pay EOBs.
• Working of various reports including, but not limited to the End of Process Report.
• Sending of paper 1500 forms to insurances for remote team members
• Other duties as assigned.

REQUIRED QUALIFICATIONS:

• High School Diploma or equivalent

PREFERRED QUALIFICATIONS:

• Medical claims processing experience
• Microsoft Office Suite experience
• Epic experience
• Some coding experience

CERTIFICATION/LICENSE:

• Certified Professional Coder Apprentice (CPC-A) or Certified Professional Coder (CPC) certification through the American Academy of Professional Coders (AAPC) prior to or within 1 year of employment.

PAY AND BENEFITS:

The estimated pay range for this position is exclusive of fringe benefits and potential bonuses. Final offers are based on various factors, including skill set, experience, qualifications, and other job-related criteria. 

This position allows for interchangeable credentialed roles with varying pay ranges:

• Certified Coding Specialist pay range: $23.69 /hr. USD to $32.58 /hr. USD
• Medical Billing Specialist pay range: $17.54 /hr. USD to $24.12 /hr. USD

We also offer a substantial benefits package, including: