Reimbursement Coding Representative (U) (4839)

The primary purpose of this position is to assign ICD-10-CM, CPT, and HCPCS codes for inpatient and outpatient services by reviewing medical records documentation for those services provided by a physician or other qualified healthcare professionals.

1) Review documentation and assign diagnosis and procedure codes for ancillary and other physician services using standardized coding systems such as ICD-10-CM, CPT, and HCPCS.
2) Review records for accuracy in the usage and/or assignment of modifiers for Evaluation and Management services along with any procedure modifiers as applicable.
3) Respond to requests from Patient Business Services for assistance in correction of claim information in regard to coding, dates of service, place of service, provider information, etc. This assistance is also inclusive of writing appeal letters that would be submitted to insurance for reconsideration of a denied claim.
4) Provide advice and guidance to administrators, faculty, and staff as it relates to coding and documentation along with any third party payer regulations.
5) Assist other coding staff in the unit to provide coverage as needed and assist in training other coders when requested.

1. High school graduation or equivalent.
2. Any one or any combination totaling 18 months from the following categories:
   1. Work experience in a healthcare setting (i.e., hospital, physician's office, nursing home, billing agency) utilizing ICD-10, and CPT coding systems, Healthcare Common Procedure Coding System (HCPCS), and the Current Procedural Terminology (CPT) systems of coding to assign codes for services provided to patients.
   2. College course work relating to healthcare operations includes the following topics such as Medical Terminology, Human Anatomy and Physiology, ICD-10 Coding, and CPT Coding, or closely related courses.
      1. 6 semester hours equals 6 months
      2. 12 semester hours equals 12 months
      3. 18 semester hours equals 18 months

• Current designation as Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) (formerly CPC-H certification) or current certification as a Certified Coding Associate (CCA), Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician-based (CCS-P) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA) satisfies all the requirements for this classification.

If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

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"Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act."

Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.