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Coding Specialist
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Opportunity Snapshot
This position offers you the opportunity to showcase your coding expertise as well as your interpersonal skills and professional poise as you review DRG codes on site in hospitals in Northern Illinois and report your findings. While other companies are cutting back, Health Management Systems (HMS) has posted 18% growth year over year since 2001 -- yet we still maintain an entrepreneurial small-company culture in which individuals can make a difference and drive their own careers. In fact, our DRG review practice is growing and we'll need proven leaders to step up as we expand. Our comprehensive benefits include education reimbursement if you're considering continuing with school.
You will apply your knowledge of DRG coding to review medical information, collect data, and ensure appropriate billing of data. To be a good fit for this opportunity you will have a CCS, RHIA, or RHIT certification and at least three years of ICD-9 coding experience. A bachelor's degree is strongly preferred, ideally in Accounting, Health Information Management, or a related field. Knowledge of Medicaid and Medicare rules is a plus, although we'll train you if you don't already have it. We're looking for a professional with excellent communication skills, including the ability to provide feedback in a constructive way.
Since 1985 HMS has focused exclusively on the healthcare industry and during that time we have partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars, and save billions more through cost avoidance. Our portfolio of services, one of the broadest in the industry, includes coordination of benefits for Medicaid-Medicare, third-party liability, and pharmacy services; overpayment recovery; provider audits; medical support enforcement; and more.
What Else You'll Bring to the Table
In addition to the qualifications detailed above, you'll need:
Experience testifying in administrative or judicial proceedings within the last two years is preferred but not required.
A demonstrated ability to analyze and evaluate medical information necessary to evaluate and collect specific health care information.
At least three years of inpatient hospital coding experience.
A team player attitude.
A valid driver's license, clean DMV record, and reliable transportation.
Almost all of your activities will take place on site at various hospitals, so you will need to be willing and able to spend the majority of your time in the field. Occasionally you may stay overnight. You could be based anywhere in Northern Illinois, although the majority of the hospitals are in the greater Chicago area. We will have an office in Chicago, or you could be home based. Of course, we'll provide a laptop and a gas allowance, and you'll be paid for your travel time.
What's in It for You
Professional development -- you'll add another valuable program integrity skill to your resume: we'll train you to review accounts receivables ledgers in order to confirm who actually paid on certain claims. In addition, you'll deepen your knowledge of Medicare and Medicaid.
Autonomy and empowerment -- we'll entrust you with a degree of freedom and flexibility in achieving your goals, providing support when you need it and "elbow room" when you don't. Throughout HMS there are a number of home-based positions (as well as offices nationwide), and those with proven initiative and self-motivation enjoy multiple career choices.
Career growth -- you'll join a company rich with opportunity: HMS is the undisputed industry leader in the coordination of program integrity services and benefits for government healthcare programs. On top of that, you'll become part of our Program Integrity division, a strategically important product line.
A culture of growth and transition -- while we are growing strongly, we maintain the culture of a smaller company: employee input is welcome, and even new employees can make a visible impact in short order. Because of our growth we are looking for people with the initiative and resourcefulness to "take the ball and run with it." Excellence and innovation are highly valued.
Excellent compensation -- in addition to a competitive wage, we offer a comprehensive benefits package that includes all you would expect plus a few pleasant surprises, such as a 401(k) plan with generous employer match, flexible spending plans, and much more.
More About Your Role
If you're a good fit for this position, you already know most of what this job entails. However, to be sure we're providing a complete picture, here are some details.
We are ramping up to launch the Northern Illinois DRG Contract with the Illinois Department of Healthcare and Family Services (HFS) and you will join a team that includes the Project Manager (to whom you will report), another Coding Specialist, and a Project Specialist. The team's objective is to review DRGs in about 27 hospitals to ensure the assigned codes are correct.
You will apply your knowledge of Medicaid rules and regulations pertaining to appropriate billing and coding of Medicaid accounts to review medical information, collect data, and ensure appropriate billing of data. In addition you'll review accounts receivables ledgers to determine who made certain payments. When you find coding mistakes you will report them to HFS who will take action. At the same time, you will provide an "exit interview" report to each hospital at the end of your review session.
The hospitals will vary in size, but in the larger ones you can expect to review 500 to 700 files, which may take a couple of weeks. You'll work on your laptop, using one of HFS' databases.
In the rare case that a hospital challenges the findings, you may testify at an administrative or judicial hearing.
Keys to Success
While you will spend a good deal of your time focused on records, you also will be an ambassador of HFS and HMS as you interact with hospital staff. We'll look to you to maintain a cordial relationship with these contacts as you follow up on questions or concerns raised by healthcare providers through the process. You'll leverage your interpersonal skills as you deliver your exit interview report, framing it in a constructive way. In addition, as this is a new project, you'll need to be flexible and adaptable as processes and procedures evolve.
If this sounds like the right mix of challenge and opportunity for you, and you meet the minimum qualifications, we want to hear from you!
Who We Are
Health Management Systems has always been focused exclusively on the healthcare industry. In 1985, we began providing third party liability identification and recovery services to our first Medicaid agency client. Since then, we've partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars and save billions more through cost avoidance.
We take a proactive approach to growing our company, both organically and via mergers and acquisitions, to ensure we provide our clients with a broad offering of best-of-breed cost containment strategies to meet their financial and operational goals.
Opportunity Snapshot
This position offers you the opportunity to showcase your coding expertise as well as your interpersonal skills and professional poise as you review DRG codes on site in hospitals in Northern Illinois and report your findings. While other companies are cutting back, Health Management Systems (HMS) has posted 18% growth year over year since 2001 -- yet we still maintain an entrepreneurial small-company culture in which individuals can make a difference and drive their own careers. In fact, our DRG review practice is growing and we'll need proven leaders to step up as we expand. Our comprehensive benefits include education reimbursement if you're considering continuing with school.
You will apply your knowledge of DRG coding to review medical information, collect data, and ensure appropriate billing of data. To be a good fit for this opportunity you will have a CCS, RHIA, or RHIT certification and at least three years of ICD-9 coding experience. A bachelor's degree is strongly preferred, ideally in Accounting, Health Information Management, or a related field. Knowledge of Medicaid and Medicare rules is a plus, although we'll train you if you don't already have it. We're looking for a professional with excellent communication skills, including the ability to provide feedback in a constructive way.
Since 1985 HMS has focused exclusively on the healthcare industry and during that time we have partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars, and save billions more through cost avoidance. Our portfolio of services, one of the broadest in the industry, includes coordination of benefits for Medicaid-Medicare, third-party liability, and pharmacy services; overpayment recovery; provider audits; medical support enforcement; and more.
What Else You'll Bring to the Table
In addition to the qualifications detailed above, you'll need:
Experience testifying in administrative or judicial proceedings within the last two years is preferred but not required.
A demonstrated ability to analyze and evaluate medical information necessary to evaluate and collect specific health care information.
At least three years of inpatient hospital coding experience.
A team player attitude.
A valid driver's license, clean DMV record, and reliable transportation.
Almost all of your activities will take place on site at various hospitals, so you will need to be willing and able to spend the majority of your time in the field. Occasionally you may stay overnight. You could be based anywhere in Northern Illinois, although the majority of the hospitals are in the greater Chicago area. We will have an office in Chicago, or you could be home based. Of course, we'll provide a laptop and a gas allowance, and you'll be paid for your travel time.
What's in It for You
Professional development -- you'll add another valuable program integrity skill to your resume: we'll train you to review accounts receivables ledgers in order to confirm who actually paid on certain claims. In addition, you'll deepen your knowledge of Medicare and Medicaid.
Autonomy and empowerment -- we'll entrust you with a degree of freedom and flexibility in achieving your goals, providing support when you need it and "elbow room" when you don't. Throughout HMS there are a number of home-based positions (as well as offices nationwide), and those with proven initiative and self-motivation enjoy multiple career choices.
Career growth -- you'll join a company rich with opportunity: HMS is the undisputed industry leader in the coordination of program integrity services and benefits for government healthcare programs. On top of that, you'll become part of our Program Integrity division, a strategically important product line.
A culture of growth and transition -- while we are growing strongly, we maintain the culture of a smaller company: employee input is welcome, and even new employees can make a visible impact in short order. Because of our growth we are looking for people with the initiative and resourcefulness to "take the ball and run with it." Excellence and innovation are highly valued.
Excellent compensation -- in addition to a competitive wage, we offer a comprehensive benefits package that includes all you would expect plus a few pleasant surprises, such as a 401(k) plan with generous employer match, flexible spending plans, and much more.
More About Your Role
If you're a good fit for this position, you already know most of what this job entails. However, to be sure we're providing a complete picture, here are some details.
We are ramping up to launch the Northern Illinois DRG Contract with the Illinois Department of Healthcare and Family Services (HFS) and you will join a team that includes the Project Manager (to whom you will report), another Coding Specialist, and a Project Specialist. The team's objective is to review DRGs in about 27 hospitals to ensure the assigned codes are correct.
You will apply your knowledge of Medicaid rules and regulations pertaining to appropriate billing and coding of Medicaid accounts to review medical information, collect data, and ensure appropriate billing of data. In addition you'll review accounts receivables ledgers to determine who made certain payments. When you find coding mistakes you will report them to HFS who will take action. At the same time, you will provide an "exit interview" report to each hospital at the end of your review session.
The hospitals will vary in size, but in the larger ones you can expect to review 500 to 700 files, which may take a couple of weeks. You'll work on your laptop, using one of HFS' databases.
In the rare case that a hospital challenges the findings, you may testify at an administrative or judicial hearing.
Keys to Success
While you will spend a good deal of your time focused on records, you also will be an ambassador of HFS and HMS as you interact with hospital staff. We'll look to you to maintain a cordial relationship with these contacts as you follow up on questions or concerns raised by healthcare providers through the process. You'll leverage your interpersonal skills as you deliver your exit interview report, framing it in a constructive way. In addition, as this is a new project, you'll need to be flexible and adaptable as processes and procedures evolve.
If this sounds like the right mix of challenge and opportunity for you, and you meet the minimum qualifications, we want to hear from you!
Who We Are
Health Management Systems has always been focused exclusively on the healthcare industry. In 1985, we began providing third party liability identification and recovery services to our first Medicaid agency client. Since then, we've partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars and save billions more through cost avoidance.
We take a proactive approach to growing our company, both organically and via mergers and acquisitions, to ensure we provide our clients with a broad offering of best-of-breed cost containment strategies to meet their financial and operational goals.
HMS is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
