PB Coder

Wolcott, Wood and Taylor Inc.•Chicago, IL

10d

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, HCPCS codes, and modifiers for reporting physician services to third-party payers. Coding must align with established coding standards, regulatory requirements, and reimbursement policies. The coder reviews provider documentation and encounter records for accurate service and diagnosis coding, completeness, consistency, and adequacy. The position also monitors charge capture, provides feedback to providers, resolves assigned coding denials, maintains required coding credentials and continuing education, and participates in coding meetings and projects.

Requirements

Certification as a professional coder, such as CCS-P, CPC, RHIT, or RHIA through AAPC or AHIMA.
Minimum of two years of CPT/ICD-10 coding experience for multispecialty services is preferred.
Maintain continuing education in accordance with certification requirements.
Knowledge of medical coding and billing systems and regulatory requirements.
Clear understanding of medical office protocols and procedures, including health information management, confidentiality, and safety.
Ability to organize and prioritize responsibilities while remaining flexible to changing demands.
Excellent written and oral communication skills and ability to interact with patients, families, staff, and others.
Strong analytical skills and attention to detail.
Ability to establish priorities and work independently.
High level of discretion and judgment.
High proficiency in Microsoft Office applications, especially Microsoft Excel, and other required applications.
Advanced writing skills, including the ability to present a compelling argument, punctuate properly, spell correctly, and transcribe accurately.
Persistence and comfort pursuing, rebutting, and escalating issues as appropriate.
Goal-oriented approach and accountability for shared professional and personal goals.
Customer orientation and ability to build trust and respect through consistent delivery against expectations.
Ability to establish and maintain effective working relationships with employees and external parties.

Nice To Haves

Minimum of two years’ experience with CPT/ICD-10 coding of multispecialty services is preferred.

Responsibilities

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