Physician Coding Accounts Receivable Specialist- Primary Care

Advocate Aurora Health - Oak Brook, IL

Full-time - Mid Level

Remote - Oak Brook, IL

Hospitals

About the position

The Physician Coding Accounts Receivable Specialist plays a crucial role in ensuring accurate coding and billing processes within the primary care setting. This position involves analyzing and resolving coding complaints, identifying trends in coding denials, and collaborating with various teams to improve coding practices and prevent future issues. The specialist will maintain up-to-date knowledge of coding guidelines and regulatory requirements while providing support and education to the coding team and other departments.

Responsibilities

• Analyze and resolve professional coding complaints in collaboration with Customer Service.
• Identify and analyze coding denials for a specific population of charges.
• Coordinate coding rejection data collection activities for reporting and accountability tracking.
• Identify trends and opportunities for improvement in coding practices.
• Research and document applicable regulatory, coding, and billing rules.
• Develop standardized processes and tools for the coding production team.
• Work with Professional Coding Leadership to develop monthly coding update reports.
• Maintain up-to-date information regarding coding denials and communicate changes.
• Identify and problem-solve trends and issues in coding.
• Collaborate with department leadership and clinic operations managers to resolve coding issues.
• Provide regular statistical reports to leadership regarding rejection/denial volumes and trends.
• Maintain knowledge of Medicare, Medicaid, and other regulatory requirements for coding policies.
• Develop expertise in coding for assigned specialties.
• Communicate changes in coding requirements and coordinate necessary updates.
• Conduct retrospective chart and claim coding reviews and recommend correct coding.

Requirements

• Certified Professional Coder (CPC) or equivalent certification (CCA, CCS-P, RHIA, RHIT, SCP).
• Advanced training in Medical Coding Specialist from an accredited program.
• Typically requires 5 years of professional coding experience.
• At least 3 years of payer background experience in physician revenue cycle processes.
• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Ability to identify coding discrepancies and provide recommendations for improvement.
• Ability to analyze trends and data and present them in a statistical format.
• Advanced knowledge of care delivery documentation systems and medical record documents.
• Proficient in Microsoft Office and electronic coding systems.
• Excellent interpersonal and communication skills.

Nice-to-haves

• Experience in a large, complex clinic or medical group.
• Familiarity with electronic coding systems or applications.

Benefits

• Full-time position with competitive salary range.
• Remote work options available.