Physician Billing Auditor

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Day (United States of America)

Location

Ann & Robert H. Lurie Children's Hospital of Chicago

Job Description

K.S.A.'s:

• High School Diploma required; College degree preferred.  
• Certified Professional Coder (CPC) or Certified Coding Specialist- Physician Based (CCS-P) required or Registered Health Information Administrator (RHIA) and/or Registered Health Information Technician (RHIT) certification in conjunction with physician based coding experience, to include evaluation & management (E/M), may be considered contingent upon CPC or CCS-P certification acquired within the first 90 days of employment.
• A minimum of three (3) years coding experience is required.  
• Prior experience with claims processing preferred. 
• Prior experience working in a hospital or clinical setting is preferred. 
• Must be able to demonstrate thorough knowledge of CPT and ICD9 coding by passing a test. 
• Strong communication and organizational skills.
   

Job Duties:

• Follows a pre-determined or assigned audit schedule for provider and coder audits. Participates in special audits as assigned.
• Using CPT, ICD-10, HCPCS, provider documentation and other approved resources, evaluates the proper assignment of procedure, modifier, and diagnosis codes to Physician Billing charges to validate for accuracy and compliance.
• Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing is being performed in an accurate and timely manner and is supported by documentation.  
• Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to appropriate committees. 
• Reviews assigned Claim Edit and Follow-up Work queues to resolve reimbursement issues based on coding and payer guidelines. Identifies inconsistency or improvement opportunities that impact reimbursement and/or reduce denials.
• Establishes effective communication to provide feedback to providers, coders, and leadership.
• Maintains knowledge of coding, compliance, and reimbursement procedures. 
• Attends department meetings, webinars, seminars to maintain coding certificate requirements.
• Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. 
• 1Other job functions as assigned.
   

Education

High School Diploma/GED (Required)

Pay Range

$65,520.00-$107,120.00 Salary

At Lurie Children’s, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability

• Critical Illnes