Outpatient Coder II

Summary

Join Northwestern Medicine as an Outpatient Coder II and contribute to our mission of providing better healthcare. You will utilize your expertise in ICD-10-CM, CPT, and HCPCS coding to accurately process complex outpatient encounters. This role requires a strong understanding of anatomy, physiology, and disease processes, along with proficiency in resolving NCCI edits and utilizing coding resources like 3M Encoder. The ideal candidate possesses relevant credentials (RHIT, RHIA, or CCS) and significant coding experience in an acute healthcare setting. Northwestern Medicine offers competitive benefits, including tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits.

Requirements

• Be credentialed by the AHIMA (American Health Information Management Association)
• Complete CE requirement to remain credentialed (20-30 CE's every two years)
• Have 3-4 years of coding experience in an acute healthcare setting
• Be RHIT, RHIA or CCS credentialed
• Be able to work with minimal supervision

Responsibilities

• Utilize technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
• Review the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures
• Interpret health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures
• Send appropriate physician queries when required for documentation clarification
• Follow Coding Clinic for HCPCs, CPT Assistant, and interpret coding conventions and instructional notes to select appropriate diagnoses and procedures with a minimum of 95% accuracy
• Maintain a broad focus of anatomy on the entire body system
• Provide technical expertise to analyze system-related changes and participate in testing of software modifications
• Identify opportunities to enhance CAC (computer-assisted coding), i.e., notifying IT liaison of documents filing to the Default folder, incorrect system-assigned codes, etc
• Resolve NCCI Edits with approved hospital modifiers
• Utilize 3M Encoder resources to ensure optimal coding accuracy
• Articulate rationale for coding selections, when necessary, i.e., prompted by results of data quality audit
• Meet established minimum coding productivity (90%) and quality standards (95%) for each outpatient encounter type

Preferred Qualifications

• Have a Bachelor’s degree in a related field
• Have 4 years of coding experience in an acute healthcare setting

Benefits

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