What are the responsibilities and job description for the Reimbursement Coding Representative- Medical Billing position at University of Illinois?
Reimbursement Coding Representative- Medical Billing
Hiring Department: Medical Billing
Location: Peoria, IL USA
Requisition ID: 1031185
FTE: 1
Work Schedule: M-F 8:30a-4:30p
Shift: Days
# of Positions: 1
Workplace Type: On-Site
Posting Close Date: 4/7/25
The previously determined salary for this position is $21.28-$28.22/hr
Final salary offered will be determined by a thorough assessment of available market data, internal salary equity, candidate experience and qualifications, and budget constraints.
It is not typical for an individual to be offered a salary at or near the top of the full range for a position.
Benefits eligible positions include a comprehensive benefits package which offers: Health, Dental, Vision, Life, Disability & AD&D insurance; a defined benefit pension plan; paid leaves such as Vacation, Holiday and Sick; tuition waivers for employees and dependents. Click for a complete list of Employee Benefits.
This position is located on the Peoria campus 170 miles southwest of Chicago. (On-Site Work – Not Remote).
About UICOMP
The University of Illinois College of Medicine Peoria (UICOMP) educates 265 medical students and more than 300 physician residents and fellows annually. Additionally, it provides clinical care to more than 31,000 patients annually and conducts basic science, clinical and outcomes research. UICOMP is a regional campus of the University of Illinois College of Medicine, a part of the University of Illinois Chicago and University of Illinois System. The College of Medicine Peoria is home to the Cancer Research Center, Center for Wellbeing, and is a collaborator in Jump Simulation. Learn more about UICOMP at http://peoria.medicine.uic.edu.
Position Summary
The Reimbursement Coding Representative works with departments and staff within the Medical Billing Service to review routine claim denials. This may include contacting payers or staff by telephone, email or internet portal to correct CPT or ICD-10 codes and submitting appeals with the payer. Works under direct supervision from the Health Care Compliance Officer.
Duties & Responsibilities
- Reviews and corrects, if necessary, ICD-10, HCPCS, and CPT codes of routine denied claims for resolution based on commercial insurance, CMS, and UICOMP guidelines.
- Applies a general knowledge of medical coding, in communication with providers, clinical and billing staff members via telephone or email to complete adjudication of denied claims or discrepancies in medical record documentation.
- Composes basic correspondence to third-party payers to resolve charge and billing problems via appeal process.
- The Reimbursement Representative will seek guidance from, or defer to, the Reimbursement Coding Specialists on complex issues.
- Reviews Epic coding work ques and corrects all errors delaying claim submission.
- Confirms the transmission and acceptance of submitted claims in either the contracted clearinghouse or Epic.
- Corrects claim rejections in work queues to facilitate payment of open balances.
- Provides explanation of benefit decisions by third-party payers to patients and staff.
- Reviews Epic queues for charges that no payment or denial have been received.
- Works closely with billing department staff to resolve and authorize routine adjustments as needed.
- Determines if proper information is included in billing system to ensure claims are accurate
- Attends training for certification maintenance and departmental needs.
- Perform other duties and participate in special projects as assigned. Attends and participates in departmental staff meetings, coding meetings, or other meetings as requested.
Minimum Qualifications
- High school graduation or equivalent.
- Any one or any combination totaling 18 months from the following categories:
- 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.
- 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.
- 6 semester hours equals 6 months
- 12 semester hours equals 12 months
- 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.
To Apply: For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.
Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date. Illinois Residency is required within 180 days of employment.
The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.
The university provides accommodations to applicants and employees. Request an Accommodation
Salary : $21 - $28
