Operations Coordinator, PB Coding Specialist

Summary

Join our team at Northwestern Medicine as an Operations Coordinator, PB Coding and contribute to better healthcare. This role involves CPT and ICD10 coding through abstraction of the medical record with a focus on complex encounters.

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 experience in a relevant role
• 94% accuracy on organization's coding test

Responsibilities

• Has deep understanding of disease process, A&P and pharmacology
• Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patients service
• Trains physicians and other staff regarding documentation, billing and coding
• 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
• 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