Medical Coding Reviewer

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Job Requisition ID: IG51383

Start Date: 11/12/2025
Closing Date: 11/26/2025
Agency: Department of Healthcare and Family Services
Class Title: EXECUTIVE I

BPIS: 09264
Skill Option: None
Bilingual Option: None
Salary: Anticipated starting salary $5,928/monthly; Full salary range $5,928 - $8,493/monthly
Job Type: Salaried
Category: Full Time
County: Cook
Number of Vacancies: 1
Bargaining Unit Code: RC062 Technical Employees, AFSCME
Merit Comp Code:

This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position.

All applicants who want to be considered for this position MUST apply electronically through the website. State of Illinois employees should click the link near the top left to apply through the SuccessFactors employee career portal.

Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered.

Why Work for Illinois?

Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you're helping to improve schools, protect our natural resources, or support families in need, you're part of something bigger—something that touches the lives of every person who calls Illinois home.

No matter what state career you're looking for, we offer jobs that fit your life and your schedule—flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.

Position Overview:

The Department of Healthcare and Family Services, Office of Inspector General (OIG), Bureau of Medicaid Integrity seeks to hire a Medical Coding Reviewer who will assist OIG's audit management in the oversight of an audit contractor program from management to the administrative details, including planning, reviewing, and tracking each audit and referral.

The ideal candidate will have experience in program monitoring; Illinois Medicaid policies, rules, and regulations; and experience with spreadsheets and data reports. Familiarity with medical terminology and medical coding are a plus. The ideal candidate will demonstrate the ability to exercise sound judgment in the identification of priorities, proactively addressing issues, and ensuring timely completion of work. This position works collaboratively with internal and external partners. The ideal candidate will exhibit strong leadership skills, be able to make effective recommendations for the program, excellent communication skills, while possessing the ability to work independently.

HFS values employees with different backgrounds, life experiences, and talents.

Employees receive a robust benefit package including:

• Monday-Friday work schedule
• Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)
• Health, Life, Vision, and Dental Insurance
• Pension Plan
• Paid Parental Leave
• Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
• Employees earn (12) paid Sick Days annually.
• New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
• Employees earn (3) paid Personal Days annually.
• paid holidays annually (based on start date)

If you are seeking a new opportunity, and this position appeals to you, please apply today

At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained.

HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.

Essential Functions

• Under direction, serves as the Medical Coding Reviewer for the Bureau of Medicaid Integrity in the Office of Inspector General (OIG) for the Illinois Department of Healthcare and Family Services (HFS)
• Confers with Audit Management, Medicaid Contractors, and providers and/or their representatives concerning findings and recommendations relating to compliance with federal and state Medicaid policy, claims processing, and Current Procedural Terminology (CPC)
• Develops and updates audit reports
• Confers with supervisor and other management staff on all stages of the audit review process
• Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above

Specialized Skills

• One (1) year of experience working with Medicaid program policies
• One (1) year of experience ensuring compliance with healthcare billing requirements
• One (1) year of experience reviewing, analyzing, and using billing data reports
• One (1) year of experience interpreting Current Procedural Terminology (CPT) codes
• One (1) year of professional experience in medical coding or billing of patient records

Minimum Qualifications

• Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college, preferably with coursework in business or public administration
• Requires one (1) year of responsible administrative experience in a public or business organization, or completion of an agency approved professional management training program

Preferred Qualifications

• One (1) year of experience working with Medicaid program policies
• One (1) year of experience ensuring compliance with healthcare billing requirements
• One (1) year of experience reviewing, analyzing, and using billing data reports
• One (1) year of experience interpreting Current Procedural Terminology (CPT) codes
• One (1) year of professional experience in medical coding or billing of patient records
• One (1) year of professional experience identifying trends in coding or billing errors
• Basic proficiency with Word and Excel
• One (1) year of professional experience with information systems, such as Integrated Eligibility System (IES), Application for Benefits Eligibility (ABE), Recipient Eligibility Verification Program (REV), or Electronic Medical or Health Records (EMR/EHR)
• Working knowledge of medical terminology

Conditions of Employment

• Requires the ability to pass a background check and self-disclosure of criminal history
• Requires ability to travel in the performance of duties, with overnight stays as appropriate
• Requires the ability to utilize state issued equipment such as a laptop
• The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description

Work Hours: Monday - Friday 8:30 a.m. - 5:00 p.m.
Work Location: 401 S Clinton St, Chicago, Illinois, 60607
Email:
Posting Group: Leadership & Management

This position DOES contain "Specialized Skills" (as that term is used in CBAs).

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