Anesthesia Coding Specialist II-PB Coding Full-time Days Remote-Must reside in IL IN IA or WI-S[...]

Northwestern Medicine; Chicago, Site (IL, AZ); Remote; USD 50,000 - 90,000; Full time

Job summary

An established industry player is seeking a Coding Specialist II to join their team. In this role, you will utilize your coding expertise to ensure accurate coding of medical records, focusing on complex encounters. You will collaborate with healthcare providers, train staff, and maintain compliance with coding guidelines. This position is vital in enhancing the quality of documentation and billing practices within the organization. If you are passionate about health information management and coding, this opportunity offers a chance to make a significant impact in a supportive and dynamic environment.

Qualifications

• Certification in health information management or coding is required.
• Experience in a relevant role preferred but not mandatory.

Responsibilities

• Review medical records and code physician services with high accuracy.
• Train staff on documentation, billing, and coding processes.
• Collaborate with operational areas to resolve claim issues.

Skills

CPT Coding

ICD10 Coding

HCPCs Procedural Codes

Medical Record Abstraction

Documentation Feedback

Coding Guidelines Compliance

Education

Registered Health Information Administrator (RHIA)

Registered Health Information Technician (RHIT)

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Bachelor's or Associate's degree in Health Information Management

Job description

Remote work from Illinois, Wisconsin, Indiana, and Iowa

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.

Equal Opportunity

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.