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SIU Medicine is Hiring a Reimbursement Coding Specialist (U) (Hybrid/PRN) (Decatur) Near Decatur, IL
Department: Family and Community Medicine/Decatur-SMS Division: NA Location: Decatur Job Category: Office Support Overview: 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. Salary: $20.45/hour Hours: As needed SIU School of Medicine CIVIL SERVICE POSITION DESCRIPTION INCUMBENT CSN: _____________FLSA STATUS Exempt PRESENT CLASSIFICATION Reimbursement Coding Specialist DATE October 2023 DEPARTMENT/DIVISION SIU Center for Family Medicine/ FQHC Coding and Billing Unit FUNCTION 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. ORGANIZATIONAL RELATIONSHIPS This position reports to the Reimbursement Coding Coordinator who reports to the Director of Finance who in turn reports to the Executive Director of the SIU Center for Family Medicine. DUTIES AND RESPONSIBILITIES The following information is intended to be representative of the work performed by incumbent in this position and is not all-inclusive. The omission of a specific duty or responsibility will not preclude it from the position if the work is similar, related, or a logical extension of position responsibilities. Demonstrates, by actions, commitment to the mission and the behavioral standards of SIU School of Medicine. Provides excellent service to both internal and external customers through collaboration and partnership; compassion and respect; integrity and accountability; diversity and inclusion; as well as continuous learning and improvement. 70% Coding 1. Assign ICD-10 and CPT codes for services provided at the Decatur SIU Center for Family Medicine clinic. 2. Through periodic audit reviews and utilizing the electronic health record, determine that chart documentation supports services indicated on encounter form, and teaching physician supervision involvement requirements are met for resident services. 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. Page 2 – Reimbursement Coding Specialist 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. SKILLS AND ABILITIES NEED FOR THE POSITION Sensitive to the needs of underrepresented minority populations RESPONSIBILITY A. Supervisory Controls – The supervisor, as needed, assigns duties. The employee establishes the procedures with the assistance and approval of the supervisor. The employee will then be expected to work independently, except for occasional consultation with the supervisor. Page 3 – Reimbursement Coding Specialist B. Guidelines – The individual in this position must follow the requirements of the industry standards for Medicare, Medicaid, ICD-10, CPT-4, and the coding procedures for teaching institutions dictated by government regulations. DIFFICULTY A. Complexity – Must be knowledgeable regarding government regulations for coding and billing. B. Scope and Effect – The individual in this position has a financial impact on services provided at the Center and outside the Center. It is extremely important to resident training and education. PERSONAL CONTACTS The individual in this position will have frequent contact with all faculty, residents and staff, as well as contact with individuals in the P&S Patient Business Office and other offices outside the Center. ENVIRONMENTAL, HEALTH AND SAFETY RESPONSIBILITIES Participates in meetings, trainings, and other environmental, health and safety activities as required by SIU School of Medicine. WORKING CONDITIONS See attached Physical and Environmental Requirements form. UNIT SIGNATURES: INCUMBENT: __________________________________ DATE: ___________________ REVIEWED BY: _________________________________ DATE: ___________________ Jennilee Dunn, Supervisor _________________________________ DATE: ___________________ Stefanie Garman, Deputy Director of FQHC Coding and Billing ADMINISTRATIVE APPROVAL: ___________________________________ DATE: ___________________ Iris Wesley, Executive Director