PB Coder

Wolcott, Wood and Taylor•Chicago, IL

About The Position

The PB Coder reviews, analyzes, and accurately codes ambulatory and/or hospital-based encounters. The role performs initial charge review for E/M visits, diagnostic tests, and procedures across multiple specialty departments, assigning appropriate CPT, ICD-10, and HCPCS codes and modifiers for reporting physician services to third-party payers. Coding must comply with established coding standards, regulatory requirements, and reimbursement policies. The position reviews provider documentation and encounter records, verifies documentation adequacy and consistency, and confirms that patient identification, signatures, attestations, and dates are present. The PB Coder monitors assigned services to ensure they are captured and coded, provides real-time feedback to providers through EPIC in-basket messages, resolves payer coding denials, and collaborates with providers, departments, and the Coding Management Team. The role also participates in coding meetings and maintains required coding credentials and continuing education.

Requirements

Hold a professional coding credential such as CCS-P, CPC, RHIT, or RHIA through AAPC or AHIMA.
Maintain continuing education in accordance with certification requirements.
Have a clear understanding of medical-office protocols and procedures, including health information management, confidentiality, and safety.
Demonstrate knowledge of medical coding and billing systems and regulatory requirements.
Organize and prioritize responsibilities while remaining flexible to changing demands.
Possess excellent written and oral communication skills and the ability to interact with patients, families, staff, and others.
Demonstrate strong analytical skills and attention to detail.
Be able to establish priorities and work independently.
Exercise a high level of discretion and judgment.
Demonstrate clear and concise verbal and written communication.
Be persistent and comfortable pursuing, rebutting, and escalating issues as appropriate.
Be goal-oriented and accountable for shared professional and personal goals.
Demonstrate customer orientation and build trust and respect by meeting and exceeding expectations.
Establish and maintain effective working relationships with employees and external parties.
Demonstrate high proficiency in Microsoft Office applications, especially Microsoft Excel, and other applications as required.
Have advanced writing skills, including the ability to present a compelling argument, punctuate properly, spell correctly, and transcribe accurately.

Nice To Haves

A minimum of two years of experience with CPT and ICD-10 coding of multispecialty services is preferred.

Responsibilities

Review provider documentation to assign appropriate E/M levels using current CPT and Evaluation and Management Guidelines.
Analyze documentation and assign appropriate CPT codes for surgeries and diagnostic procedures.
Apply coding standards, regulatory requirements, and reimbursement policies, including surgical global package rules.
Interpret outpatient office notes, hospital encounters, and charge documents to identify services provided and assign CPT, modifier, and ICD-10 diagnosis codes.
Review encounters for patient identification, signatures, attestations, dates, documentation consistency, and adequacy.
Ensure diagnoses accurately reflect the care and treatment rendered.
Monitor and follow up to ensure services are captured and coded within assigned responsibilities.
Follow organizational policies, including the Coding Audit Policy and Physician Coding Query In-Basket Policy.
Provide providers with real-time feedback on coding changes and trends through EPIC in-basket messages.
Participate in coding meetings and other ad-hoc meetings as needed.
Coordinate with members of physician offices and departments.
Collaborate with the Coding Management Team on assigned coding and billing projects.
Resolve assigned coding denials using coding knowledge and skills, working with payers, management, and other departments.
Maintain active coding credentials and continuing education units required for the role.
Perform other related duties as required and assigned.