Coding Analyst, HB Coding

Northwestern Medicine; Chicago (IL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Benefits

Job summary

Northwestern Medicine seeks a HB Coding Analyst to serve as the coding and reimbursement expert for ICD-10-CM diagnoses and HCPCS codes in outpatient settings. You will ensure accurate coding, adhere to guidelines, and collaborate with accounts and clinical teams to optimize reimbursement.

Requirements include RHIT/RHIA/CCS/CCS-P/COC/CPC certification, AHIMA or AAPC membership, and at least 3 years in an acute care environment. Knowledge of NCCI edits and CPT/HCPCS coding is essential.

Qualifications

• RHIT or RHIA or CCS or CCS-P or COC or CPC certification required.
• AHIMA or AAPC membership required.
• 3 years of experience in acute healthcare setting.

Responsibilities

• Utilizes coding expertise to assign ICD-10-CM and CPT-4 codes to outpatient visit types.
• Applies Evaluation and Management coding for physician encounters.
• Reviews medical records to ensure accurate diagnoses and procedures.
• Collaborates with Patient Accounting, Registration, case managers and clinical areas for coding reimbursement.
• Interprets documentation to select diagnoses and procedures with high accuracy (≥95%).
• Resolves NCCI, NCD/LCD or other outpatient edits as assigned.
• Meets established coding productivity and quality standards for outpatient encounters.

Skills

ICD-10-CM coding

CPT-4 coding

NCCI edits understanding

Analytical thinking

Team collaboration

Education

RHIT or RHIA or CCS or CCS-P or COC or CPC

AHIMA or AAPC membership

Job description

Description

The HB Coding Analyst reflects the mission, vision, and values of Northwestern Memorial, 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 HB Coding Analyst is the coding and reimbursement expert in ICD-10-CM diagnosis coding and has expertise with HCPC Level I and II procedural codes. Also demonstrates expertise to resolve NCD/LCD and NCCI edits of hard-coded (Chargemaster) and soft-coded (coder assigned) HCPC codes.

RESPONSIBILITIES

• Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
• Utilizes technical coding expertise to assign Evaluation and Management codes for physician encounters
• Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses, procedures, and evaluation and management services
• Collaborates with Patient Accounting, Registration, case managers, and other clinical areas to provide coding reimbursement expertise
• Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures
• Follows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinic, Coding Clinic for HCPCs, CPT Assistant, interprets coding conventions and instructional notes to select appropriate diagnoses and procedures with a minimum of 95% accuracy
• Resolves NCCI, NCD/LCD or other outpatient edit claim failures as assigned
• Meets established minimum coding productivity and quality standards for each outpatient encounter type

Additional Functions

• Other duties as assigned

Qualifications

Minimum Requirements

Certification

• RHIT or RHIA or CCS or CCS-P or COC or CPC
• AHIMA or AAPC membership

Experience

• 3 years of experience in acute healthcare setting

Preferred

• RHIA/RHIT with CCS, CCS-P, COC, CPC
• 4 years’ experience in acute healthcare setting
• 4 years’ experience in a professional setting

Equal Opportunity

Northwestern Medicine is an equal opportunity employer (disability, VETS) 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.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.

Artificial Intelligence Disclosure

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events.

NorthwesternMedicine Career Page

https://jobs.nm.org/benefits

Please refer to the Benefits Eligibility by Employment Classification to determine benefits eligibility for job postings.

If sign-on bonus is included in a job posting eligibility is as followed: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign-on bonus. Exception: New graduate internal employees seeking their first licensed clinical position as a Registered Nurse at NM may be eligible.