HB Coding Analyst, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI)

Northwestern Memorial Healthcare•Chicago, IL

5d•Remote

About The Position

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.

Requirements

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

Nice To Haves

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

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
Other duties as assigned
The Coding Analyst, Performance Improvement coordinates the work effort in compiling, analyzing and trending data for the various divisions within the HB Coding Department.
Under the guidance of the Manager, provides reporting and analysis of data in a clear and concise method.
Utilizes critical thinking skills to evaluate data and the predicted outcomes.
Experience in Inpatient Coding, industry guidelines and rules and educates coding operations on trends.
Strong Knowledge of Microsoft: Excel, PowerPoint, Word, Project, Visio
Demonstrates analysis and problem-solving skills
Collaborates with other team members (Coding division Managers and Operation Coordinators)
Excellent oral and written communication skills
Experience in working both independently and in a team-oriented, collaborative environment
Experience in project management
Demonstrates ability in presenting data in a clear and concise manner utilizing PowerPoint tools
Demonstrates excellent proof-reading skills used in meeting high quality standards
Basic understanding of the healthcare Revenue Cycle including account workflows, claim submission and denial process
Demonstrates ability to write payer appeals (specifically for DRG Downgrades)
Analyze, track and interpret Coding, Clinical Documentation and Revenue Cycle (Denial) data to support efforts in efficiently diminishing payer denials
Demonstrates ability to analyze and manipulate large amounts of data
Supports leadership's strategic, financial and operational decision-making
Collaborate with leadership to fulfill requests in support of business and clinical objectives
Maintain a portfolio of monthly reports, dashboards and ad hoc reports as requested
Through the use of data analytics identify trends and opportunities for improvement
Utilize Microsoft applications to communicate results to requestor
Support management in Epic build decisions
Assists in management of Service Now tickets submitted by Hospital Coding
Assesses Epic & Solventum CAC functionality enhancements to align with Coding workflows
Subject matter expert for Coding in the use of CAC and Epic coding workflows
Remains current on all upgrades and provides upgrade information to management through written communication or by demonstration
Maintains and submits a weekly Service Now ticket report with status update