Outpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, MO - Sign-on bonus eligible)

Northwestern Medicine; Chicago (IL); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Northwestern Medicine is seeking an Outpatient Coder II to accurately code outpatient encounters using ICD-10-CM and CPT, including complex cases such as Observation stays and Same Day Surgery. You will review documentation, interpret medical records, and ensure compliant coding with Coding Clinic guidance.

The role requires 3-4 years of acute-care coding experience and AHIMA credentials (RHIT/RHIA/CCS); a Bachelor’s degree is preferred.

Qualifications

• Credentialed by AHIMA and maintain CE requirements.
• 3-4 years of coding experience in an acute healthcare setting.
• RHIT, RHIA or CCS credentialed; Bachelor's degree preferred.

Responsibilities

• Assign ICD-10-CM and CPT-4 codes to outpatient encounters.
• Review medical records to ensure accurate documentation for coding.
• Query physicians for documentation clarification when needed.
• Apply coding clinics and modifiers to resolve appropriate codes.
• Analyze system changes and participate in CAC software testing.
• Meet minimum coding productivity and quality standards for each encounter type.

Skills

ICD-10-CM coding

CPT coding

Anatomy knowledge

Pharmacology knowledge

Education

RHIT, RHIA or CCS credential

Bachelor's degree in related field

Tools

3M Encoder

Job description

Description

Required:

• 3-4 years of coding experience in an acute healthcare setting
• RHIT, RHIA or CCS credentialed

The Outpatient Coder 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. Follows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinics, interprets ICD-10-CM coding conventions and instructional notes to select appropriate diagnoses with a minimum of 95% accuracy. Meets established minimum coding productivity per departmental protocol and guidelines.

The Outpatient Coder IIis the coding and reimbursement expert with ICD-10-CM diagnosis coding, HCPCS and CPT codes and modifiers. The focus is on complex outpatient encounters that include Observation stays, Same Day Surgery, Surgery Center, and Outpatient in a bed. Should have more in-depth knowledge of disease process, A&P and pharmacology as it relates to the entire body system for accurate coding and reimbursement. Expanded knowledge with HCPCS, Level I, II Chargemaster and CPT soft codes with approved facility modifiers to resolve NCCI Edits. Coder II should also have the knowledge and expertise of Coder Associate and Coder I.

Responsibilities:

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

Qualifications

Required:

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

Preferred:

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

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.