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.
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
Additional Functions
* Other duties as assigned
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