Billing Coding Auditor

3 weeks ago


Chicago, Illinois, United States Rush University Full time
Job Summary

The Billing Coding Auditor at Rush University Medical Center is responsible for ensuring accurate and timely capture of all chargeable procedures. This role requires advanced knowledge of billing, coding, auditing, and documentation requirements.

Key Responsibilities
  • Use logic-based critical thinking and decision making to assess and trouble-shoot documentation, images, visit records, registration issues, physician orders, attestations, physician signatures, charges, CPT, HCPCS, ICD-10, and modifiers on patient accounts.
  • Responsible for accuracy on all accounts within the assigned Epic Work queues and ancillary software systems.
  • Solve edits related to National Correct Coding Initiatives (NCCI edits), Medically Unlikely Edits (MUE edits) Procedure to Procedure (PTP edits), and Outpatient Coding Edits (OCE edits) in Epic using patient documentation, coding rules, billing guidelines, and proper modifier use.
  • Assess the available charges in the Charge Description Master (CDM) and contribute to accurate CDM line items by evaluating revenue codes, descriptions, CPT/HCPCS code and pricing for applicable accounts being reviewed.
  • Reconcile charges against clinical documentation, code rules and charging methodologies for internal purposes along with external audits.
  • Works with external vendors, interfaced software, and ancillary software to review charge capture opportunities and documentation to identify missed charges and correct accounts.
  • Identify trends, analyze to propose and create meaningful solutions, improve processes, create training content, and participate in the education of departments regarding their CDM and missed charges.
  • Serves as subject matter expert for fellow team members to review questions and assist with resolving accounts.
  • Collaborates with operational departments to ensure accurate and complete medical records and charges.
  • Meets or exceeds accuracy, quality work, on-time delivery, and productivity standards set by CMS, OIG, and direct manager.
  • Researches all current and future complex payor requirements for compliant billing, timely payment, and maximum reimbursement.
  • Provides input and implements process improvement initiatives recognizing revenue enhancement and charge integrity opportunities.
  • Engages in continual education and training in the revenue integrity field and healthcare CDM, charges, auditing, data, and other duties or projects as assigned.
Requirements
  • Coding credential or certification from AAPC, AHIMA, or specialty-specific credentialling organization.
  • 5+ years of Epic HB & PB WQ and Charge entry experience.
  • Minimum of 10 years of healthcare experience working with billing, charge entry, charge capture, and code auditing with knowledge of CPT, HCPCS, ICD-10 codes and modifiers.
  • High School diploma.
  • Experience with practice management software.
  • Medical terminology, familiarity with technical billing.
  • Self-starter, can work independently.
  • Ability to handle multiple, changing priorities.
  • Good organizational skills and ability to work as a team member.
Preferred Qualifications
  • Some college.
Disclaimer

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.



  • Chicago, Illinois, United States Rush Full time

    Job SummaryThe Billing Coding Auditor at Rush is responsible for ensuring accurate and timely capture of all chargeable procedures. This role requires advanced knowledge of billing, coding, auditing, and documentation requirements.Key ResponsibilitiesUse logic-based critical thinking and decision making to assess and trouble-shoot documentation, images,...


  • Chicago, Illinois, United States Rush University Full time

    Job SummaryThe Billing Coding Auditor plays a critical role in ensuring the accuracy and integrity of medical billing and coding practices at Rush University Medical Center. This position requires a high level of expertise in billing, coding, auditing, and documentation requirements, as well as the ability to analyze complex charging scenarios and provide...


  • Chicago, Illinois, United States The LaSalle Group Full time

    Physician Coding Auditor OpportunityWe are seeking a skilled Physician Coding Auditor to join our team at The LaSalle Group. As a Physician Coding Auditor, you will play a critical role in ensuring the accuracy and integrity of our clients' medical records.Responsibilities:Review physician charges against medical records and applicable documentation to...


  • Chicago, Illinois, United States Rush University Full time

    About the RoleWe are seeking a highly skilled Billing Coding Auditor to join our team at Rush University Medical Center. As a key member of our Revenue Integrity team, you will play a critical role in ensuring the accuracy and integrity of our billing and coding processes.Key ResponsibilitiesUse advanced knowledge of billing, coding, and auditing to identify...


  • Chicago, Illinois, United States Health Care Service Corporation Full time

    Job SummaryThis position is responsible for conducting thorough billing and coding reviews for pre-payment services. The successful candidate will utilize medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Key responsibilities include conducting research, preparing documentation of findings, and...


  • Chicago, Illinois, United States Associated Medical Centers of IL LTD Full time

    Job DescriptionAssociated Medical Centers of Illinois is seeking a medical billing and coding specialist to fill a key role in our team. The ideal candidate will have experience with personal injury and MVA cases, Med Pay, and various private health insurance payors, as well as a strong knowledge of medical billing and claim submission.The successful...


  • Chicago, Illinois, United States Rising Medical Solutions Full time

    Job Title: Nurse AuditorRising Medical Solutions is seeking a skilled Nurse Auditor to join our team. As a key member of our medical cost containment team, you will be responsible for reviewing medical bills from a nurse's perspective, ensuring that services provided are reasonable, appropriate, and necessary.Key Responsibilities:Audit medical and billing...

  • Coding Specialist

    1 month ago


    Chicago, Illinois, United States Northwestern Memorial Healthcare Full time

    About the RoleWe are seeking a skilled Coding Specialist to join our team at Northwestern Medicine. As a key member of our healthcare team, you will play a critical role in ensuring the accuracy and completeness of patient data.Key ResponsibilitiesAbstract and code physician professional services and diagnosis codes for inpatient admissions, outpatient...

  • Auditor IV

    2 days ago


    Chicago, Illinois, United States City of Chicago Full time

    Job SummaryThe City of Chicago is seeking a highly skilled Auditor IV to join our team. As a key member of our financial management team, you will be responsible for providing expert guidance on financial reporting, auditing, and compliance.Key ResponsibilitiesParticipate in the preparation and review of financial statements, regulatory agency filings, and...

  • Night Auditor

    3 days ago


    Chicago, Illinois, United States Residence Inn OhareRosemont Full time

    Job Title: Night AuditorLocation: Residence Inn Ohare/Rosemont, 7101 Chestnut St, Rosemont, IL 60018Job Summary:We are seeking a detail-oriented and organized Night Auditor to join our team at Residence Inn Ohare/Rosemont. As a Night Auditor, you will be responsible for reconciling all hotel cashier transactions, reviewing and compiling management reports,...


  • Chicago, Illinois, United States Enhanced Medical Revenue LLC Full time

    Job SummaryWe are seeking a skilled Medical Coding Specialist to join our team at Enhanced Medical Revenue LLC. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and efficient coding of medical records to optimize reimbursement and improve financial performance.Key Responsibilities:Apply CPT-4, ICD-10-CM, HCPCS, and...


  • Chicago, Illinois, United States University of Illinois Full time

    About the RoleWe are seeking a skilled Reimbursement Coding Representative to join our Endoscopy Lab Scheduling team at the University of Illinois Hospital & Health Sciences System (UI Health). As a key member of our team, you will play a critical role in ensuring accurate and timely coding and reimbursement for endoscopy lab procedures.Key...


  • Chicago, Illinois, United States The University of Chicago Medicine Full time

    Job SummaryWe are seeking a highly skilled Claims Coding Specialist to join our Revenue Cycle - Revenue Integrity Department at The University of Chicago Medicine. As a Claims Coding Specialist, you will play a critical role in ensuring the accuracy and compliance of our revenue cycle processes.Key ResponsibilitiesWork collaboratively with physicians,...

  • Coding Associate III

    19 hours ago


    Chicago, Illinois, United States R1 RCM Full time

    Job SummaryR1 RCM is seeking a skilled Coding Associate III to join our team. As a key member of our Coding Operations Team, you will be responsible for reviewing clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM, HCPCS, and CPT-4 codes for billing, review, and correction. You will work closely with the Coding...

  • Internal Auditor

    2 days ago


    Chicago, Illinois, United States Lawndale Christian Health Center Full time

    Job Title: Internal AuditorLawndale Christian Health Center is seeking a highly skilled Internal Auditor to join our team. As an Internal Auditor, you will play a critical role in assessing the overall efficiency and reliability of our financial control mechanisms.Key Responsibilities:Objectively review our business processes to identify areas for...

  • Coding Associate III

    2 weeks ago


    Chicago, Illinois, United States R1 RCM Full time

    About the RoleR1 RCM is seeking a skilled Coding Associate III to join our team. As a Coding Associate III, you will play a critical role in reviewing clinical documentation and diagnostic results to ensure accurate coding and compliance with industry standards.Key ResponsibilitiesAssign codes for diagnoses, treatments, and procedures according to the...


  • Chicago, Illinois, United States Associated Medical Centers of IL LTD Full time

    Job SummaryWe are seeking a skilled Medical Billing Specialist to join our team at Associated Medical Centers of IL LTD. The ideal candidate will have experience with medical billing and coding, as well as a strong understanding of healthcare regulations and compliance.Key ResponsibilitiesProcess and manage medical claims for patientsEnsure accurate and...


  • Chicago, Illinois, United States Associated Medical Centers of IL LTD Full time

    About Associated Medical Centers of IL LTDWe are a leading provider of quality medical services, specializing in the evaluation, management, and rehabilitation of injuries. Our team is dedicated to delivering exceptional patient care and outcomes.Job DescriptionAssociated Medical Centers of IL LTD is seeking a skilled Medical Billing and Coding Specialist to...


  • Chicago, Illinois, United States Goodwill TalentBridge Full time

    Job Title: Payment Policy and Medical Coding AssociateWe are seeking a detail-oriented and knowledgeable Payment Policy and Medical Associate to join our team at Goodwill TalentBridge.Job Summary:This role is ideal for someone with a strong background in medical or dental coding, policy analysis, and a desire to support the healthcare community through...


  • Chicago, Illinois, United States American Hospital Association Full time

    About the RoleWe are seeking a highly skilled ICD 10 CM Coding Consultant to join our team at the American Hospital Association. As a member of our Central Office coding team, you will advise providers and coding professionals on official medical coding principles and provide guidance on emerging issues.Key ResponsibilitiesResearch and draft responses to...