Operations Coordinator-PB Coding

Summary

Join Northwestern Medicine as an Operations Coordinator, PB Coding and contribute to our mission of better healthcare. You will perform CPT and ICD-10 coding by abstracting medical records, focusing on complex encounters and HCPCS procedural codes. Responsibilities include collaborating with providers, training staff on documentation and coding, ensuring charge capture, providing documentation feedback, maintaining coding references, and resolving coding edits. You will also communicate with various departments to resolve claim issues and participate in appeals. The role requires a deep understanding of disease processes, anatomy, and pharmacology. Meeting minimum coding productivity and quality standards is essential.

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
• 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. Also demonstrates expertise to resolve Optum coding edits
• 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. Maycontact 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

From tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits