Reimbursement Coding Coordinator

at SIU Medicine in Springfield, Illinois, United States

Job Description

Description
The Revenue Cycle Denial Coordinator is responsible for evaluating and resolving denied
claims within the clinical departments at all SIU Federally Qualified Healthcare Centers under
the direction of the Deputy Director of FQHC Patient Billing and Coding. The Denial Coordinator works in conjunction with all other coding department personnel and members of the Revenue Cycle team. This position is responsible for providing feedback using reports and data to the Deputy Director of Coding. The Denial Coordinator applies official coding guidelines, payer policies and established departmental policies and procedures to resolve claim rejections, and ensuring that timely filing deadlines have not been exceeded. The Denial Coordinator will provide training and education to coding staff and billing providers regarding payer rejections. This position will service as the primary administrative figure to support the SIU School of Medicine Federally Qualified Healthcare Center's Revenue Cycle.
 Examples of Duties
1. Performs timely and accurate review of coding related denials, appeal and
submission, including tracking findings.
2. Addresses denied claims and performs research to resolve coding related rejections.
3. Reviews medical record and coded information to determine if coding needs to be
changed or if an appeal is needed for resolution.
4. Reviews all denial accounts for categorization, level of appeal, special requirements
for initiating appeals.
5. Create and maintain an appeal process for all outpatient, inpatient, and clinic denials.
6. Utilizes denial reports to assess root causes and identify trends.
7. Monitors and tracks denial trends to help identify education/feedback opportunities.
8. Proactively monitors Revenue Cycle communications and payer websites for policy
and guideline changes
9. Performs other Coding functions as appropriate, including assisting with coding
backlogs as necessary.
10. Stays up-to-date with all federal, state and departmental coding guidelines and
procedures.
11. Attends department meetings to discuss denial trends and prevention opportunities.
12. Support co-workers and engage in positive interactions.
 Qualifications
1. High School graduation or equivalent.
2. Current certification as a 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), or current certification as a Certified
Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American
Academy of Professional Coders (AAPC) (formerly CPC-H certification) or a Community
Health-Certified Billing Specialist (CH-CBS).
3. Three (3) years (36 months) of total work experience, two (2) years (24 months) of which
are comparable to that performed at the Reimbursement Coding Specialist level of this
series or in other positions of comparable responsibility.
 Supplemental Information

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.

Southern Illinois University School of Medicine is an Equal Opportunity Employer.