Coding Specialist II, PB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI - Sign-on bonus eligible)
Company Description
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?
Job Description
The Coding Specialist II reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The PB Coding Specialist II performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record with a focus on more complex encounters and/or has expertise with HCPCs procedural codes. This position has deep understanding of disease process, A&P and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. This position trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function. The Coding Specialist II also demonstrates expertise to resolve Optum coding edits.
Responsibilities:
- Utilizes technical coding expertise to reviews the medical record thoroughly, utilizing all available documentation abstract and code physician professional services and diagnosis codes (including anesthesia encounters, operative room and surgical procedural services, invasive procedures and/or drug infusion encounters). Additionally, may include coding for Evaluation and Management services, bedside procedures and diagnostic tests as needed.
- Follows Official Guidelines and rules in order to assign appropriate CPT, ICD10 codes and modifiers with a minimum of 95% accuracy.
- Ensures charges are captured by performing various reconciliations (procedure schedules, OR logs and clinical system reports)
- Provides documentation feedback to physicians
- Maintains coding reference information
- Trains physicians and other staff regarding documentation, billing and coding.
- Reviews and communicates new or revised billing and coding guidelines and information
- Attends meetings and educational roundtables, communicates pertinent information to physicians and staff.
- Resolves pre-accounts receivable edits. Identifies repetitive documentation problems as well as system issues.
- Makes appropriate changes to incorrectly billed services, adds missing unbilled services, provides missing data as appropriate, corrects CPT and ICD9 codes and modifiers. Adds MBO tracking codes as needed.
- Collaborate with Patient Accounting, PB Billing, and other operational areas to provide coding reimbursement expertise; helps identify and resolve incorrect claim issues and is responsible for drafting letters in order to coordinate appeals
- Acts as key point person for Revenue Cycle staff and Account Inquiry Unit staff in obtaining documentation (notes, operative reports, drug treatment plans, etc.). Provides additional code and modifier information to assist with appealing denials. May contact providers for peer-to-peer reviews.
- Meets established minimum coding productivity and quality standards for each encounter type
- May perform other duties as assigned.
Qualifications
Required:
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS).
- Zero (0) to two (2) years of experience in a relevant role.
- 94% accuracy on organizations coding test.
Preferred:
- Bachelor's or Associate's degree in a Health Information Management program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).
- Previous experience with physician coding.
Additional Information
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.
Average salary estimate
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As a Coding Specialist II at Northwestern Medicine, you'll have the chance to make a real impact on patient care from the comfort of your own home! This full-time role is perfect for those who reside in IL, IN, IA, or WI and are eager to contribute toward a transformative healthcare journey. Your primary responsibility will revolve around the accurate coding of medical records, specifically focusing on CPT and ICD-10 codes. With a keen eye for detail and a solid understanding of disease processes, anatomy, and pharmacology, you'll collaborate closely with providers and clinical areas to ensure that every patient's service is accurately documented. It's not just about numbers; you'll be training physicians and staff on essential billing and coding practices, providing invaluable feedback, and attending meetings to share new coding guidelines. Here at Northwestern Medicine, we pride ourselves on fostering a supportive and innovative work environment. With benefits like tuition reimbursement and a 401(k) matching plan, you’re not only joining a team that prioritizes patient care but one that values your professional growth. As you work towards meeting a minimum of 95% coding accuracy, you will also play a vital role in resolving coding edits and direct communication with the Revenue Cycle staff to enhance service quality. If you are ready to embrace a rewarding career and take part in our quest for better healthcare, Northwestern Medicine welcomes you aboard!
Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine. The entities involved in Northwestern Medicine remain separate organizations. Northwestern Medicine is a t...
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