Coding Specialist II

Summary

Join Northwestern Medicine as a Coding Specialist II and contribute to our patient-first approach to healthcare. You will perform CPT and ICD10 coding, abstracting medical records, and collaborating with providers to ensure accurate patient service reflection. This role requires expertise in disease processes, anatomy & physiology, and pharmacology. You will train staff on documentation, billing, and coding, and resolve coding edits. The position involves various administrative duties and collaboration with other departments to address claim issues and appeals. Northwestern Medicine offers competitive benefits.

Requirements

• 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

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)
• 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

Preferred Qualifications

• 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

Benefits

• 401(k) matching
• Tuition reimbursement
• Loan forgiveness