Job Description
The Financial Coding Specialist 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.
Responsible for the translation of diagnoses and diagnostic/therapeutic procedures into codes using the International Classification of Diseases and Procedures and the Current Procedural Terminology systems. Generates accurate claims to insurance companies, verifying that infusion documentation and charges coordinate and appropriate modifiers are added. Researches and resolves all inquiries from Revenue Cycle Departments in an efficient manner.
Responsibilities:
- Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
- Assigns Evaluation and Management codes for Facility Clinic visits
- Analyze and review clinical documentation to ensure documentation supports accurate charge capture and appropriate charging for services rendered
- Assigns appropriate CPT and HCPCS codes to medical procedures according to coding guidelines
- Collaborates with HB Coding, Revenue Integrity, 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
- Position offers working remote 2 days a week, after initial onboarding is completed
Additional Functions
Qualifications
Required:
- Six months coding experience in an oncology setting. 2 years of physician and/or hospital billing including infusion billing.
- Thorough understanding of Medicaid, HMO's, PPO's and private insurance companies.
- ICD9, CPT, and chemotherapy infusion billing knowledge.
- Effective in identifying and analyzing problems.
- Generates alternatives and possible solutions.
- Above average keyboarding and data entry skills.
- Ability to multi-task and work in a fast-paced environment.
- Ability to work with physicians and other staff in a collaborative manner.
Preferred:
- Associate's degree or CCSP.
- CERT CODER
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.
If we offer you a job, we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a case-by-case basis and follow all state and federal guidelines.
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 visit our Benefits section to learn more.
