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BSD UCP - Professional Billing Coding - Surgical Specialty

About the Department

The Biological Sciences Division (BSD) and the University of Chicago Medical Center (UCMC) are managed by a single Dean/Executive Vice President and comprises the largest unit of the University, accounting for 60% of its annual budget. All physician, hospital, and clinic services are managed through the Medical Center, which is a \$1.3 billion enterprise. The BSD includes the Pritzker School of Medicine, approximately 20 academic units, degree granting committees, and research centers and institutes. The BSD is located on the University\'s main campus in Hyde Park, ten minutes south of downtown Chicago. BSD\'s patient care operations are conducted primarily at the University of Chicago Hospital and clinics, which share the same campus. The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 850 clinically active faculty practicing at the University of Chicago. These clinically active faculty collectively form the University of Chicago Physicians Group (UCPG). The University of Chicago Physicians\' Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable collection and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD.

Job Information

Job Summary:

The Abstractor/Coder II performs a full range of complex specialty coding in support of orthopedic practices at multiple locations.

Responsibilities:

• Maintains an expert level of knowledge of CPT, ICD-10 and HCPCS coding principles, modifier usage, medical terminology, HIPAA compliance, governmental regulations and third-party payer requirements pertaining to billing, coding and documentation.
• Codes highly complex services in orthopedic specialty, maintaining departmental standards for productivity and accuracy.
• Works under minimal supervision using specialized expertise in the subject matter.
• Ensures all services documented in the patient\'s medical record are coded with appropriate diagnoses and procedure codes. When services are not documented appropriately, seeks to attain proper documentation in a timely manner based upon established protocols.
• Researches and resolves coding related system edits, payer rejections, and insurance denials.
• Acts as a knowledge resource to clinical staff in billing code matters. Provides feedback to providers on how to improve documentation and charge capture to ensure revenue optimization.
• Identifies risk areas and error trends for providers, procedures, facilities and/or coders.
• Understands HIPPA regulations, treats all patient information and data with complete confidentiality and takes all precaution to secure this information.
• Escalates issues as appropriate (e.g., to Director of Revenue or Compliance Office).
• Serves as a mentor and trainer to less experienced coders and answers questions as needed.
• Works with Director or Associate Director to implement training plans for new coders and coders learning new specialties.
• Performs quality reviews.
• Other duties as assigned.

Competencies:

• Ability to work well with other members of the coding and billing team to ensure maximum efficiency and reimbursement of properly documented services.
• Ability to communicate in a professional and collaborative manner.
• Maintain calm and courteous d meanor while working with less experienced staff.
• Ability to work in a fast-paced department and handle multiple tasks.

Additional Requirements

Education, Experience, or Certifications:

Education:

• High School Diploma or GED required.

Experience:

• 5 years of coding experience with 3 or more years coding highly complex services in Orthopedics required.

Licenses and Certifications:

• Coding certification through a nationally accredited body (AAPC or AHIMA) or degree (RIA or RHIT) required.
• Specialty certification preferred.

Technical Knowledge or Skills:

• Proficiency with Microsoft Office suite required.
• Knowledge and experience of Orthopedic billing and coding practices and procedures required.

Working Conditions and Physical Requirements:

Standard Office Environment.

Use Standard Office Equipment.

Sit for 4 hours or more.

Flexible work arrangements, including remo