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Job Description
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.
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.
Qualifications
Required :
Preferred :
Additional Information
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.
Last updated : 2024-04-28
Full Time
Ambulatory Healthcare Services
$61k-79k (estimate)
04/30/2024
06/21/2024
rmg.nm.org
BARTLETT, IL
200 - 500
1990
TERRY BECKER
$5M - $10M
Ambulatory Healthcare Services
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