Claims Coding Specialist, Full Time- Days

Be a part of a world-class academic healthcare system, UChicago Medicine, as a Claims Coding Specialist in the Radiation Oncology department. This position is primarily a work-from-home opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area.

About the role

The Claims Coding Specialist (CCS) works under the supervision of Revenue Integrity. The CCS team collaborates with physicians, ambulatory practice managers, billing staff, and insurance payers to support a highly efficient, effective, and compliant revenue cycle program. Responsibilities include resolving coding edits, revenue reconciliation, organizing physician education, and maintaining effective communication.

Responsibilities

• Work directly with hospital departments and ambulatory clinics to resolve coding and charging issues for all payers (NCCI, OCE, MUE, LCD, payer custom edits), including denials and disputes.
• Review medical documentation to assign appropriate billing modifiers to insurance claims.
• Work assigned work queues daily with the goal of completing all tasks.
• Serve as a primary resource for in-clinic physicians/providers, organizing education and communicating regularly to improve claims, revenue cycle, and business functions.
• Routinely communicate with medical staff, practice administrators, billing staff, and payers to discuss clinical coding questions or resolutions.
• Meet regularly with practice managers and medical directors to review revenue cycle performance and identify solutions for efficiency and compliance.
• Perform charge reconciliation and address instances of missing revenue with physicians/providers or practice managers.
• Identify trends and opportunities to address root causes, update systems, and provide provider feedback, education, or training.
• Maintain current knowledge of billing and compliance policies, procedures, and regulations, and attend required training sessions.
• Assist with the orientation of newly hired Claims Coding Specialists.
• Attend and participate in team meetings to discuss coding/charging issues and serve on task forces as needed.
• Meet all productivity and quality expectations and participate in scheduled audits.

Requirements

• High school diploma required; Associate or Bachelor’s degree in healthcare information or healthcare finance preferred.
• Proven working knowledge of CPT (Current Procedural Terminology) and ICD (International Classification of Diseases) coding systems.
• Knowledge of Federal billing regulations governing Medicare and Medicaid programs, as well as other managed care and indemnity payor requirements.
• Working knowledge of Local and National Coverage Determination policies (LCDs and NCDs), Ambulatory Payment Classification (APC) edits (e.g., National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE)).
• Proficiency in Microsoft Excel and Word.
• Highly analytical with excellent written and verbal communication skills.
• Excellent organizational, time management, and multitasking skills, along with strong interpersonal skills.

Qualifications

• Coding certification required within 3 months of hire: RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician), CPC (Certified Professional Coder), COC (Certified Outpatient Coder), CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist-Physician), or CCA (Certified Coding Associate).
• Epic, IDX, and Centricity experience strongly preferred.
• Ability to identify trends and recommend solutions to billing and revenue cycle processes.

Schedule

• Full-time (1.00 FTE), Monday–Friday, day shift.
• Hyde Park location for onsite training and workflow meetings as needed.

Pay

The pay range reflects the anticipated wage or salary reasonably expected for the position, based on a full-time equivalent (1.0 FTE) and current market data. Compensation at hire will vary based on candidate qualifications, experience, and organizational considerations, such as internal equity.

Benefits

UChicago Medicine offers a full complement of benefits for eligible roles. Review the options at Benefits - UChicago Medicine.