Full-Time Coding Specialist II (PB Coding)

Coding Specialist II reflects NM's mission, vision, and values, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and regulatory/accreditation standards.

Responsibilities:

• Reviews the medical record thoroughly, utilizing all available documentation to abstract and code physician professional services and diagnosis codes (including anesthesia, operative room, surgical procedures, invasive procedures, and drug infusions).
• Codes Evaluation and Management services, bedside procedures, and diagnostic tests as needed.
• Assigns CPT, ICD10 codes and modifiers with 95% accuracy, following Official Guidelines and rules.
• Reconciles charges (procedure schedules, OR logs, clinical system reports).
• Provides documentation feedback to physicians.
• Trains physicians and other staff on documentation, billing, and coding.
• Reviews and communicates new/revised billing and coding guidelines.
• Attends meetings, shares pertinent information with physicians and staff.
• Resolves pre-accounts receivable edits.
• Identifies documentation problems and system issues.
• Makes necessary changes to incorrectly billed services, adds missing services, corrects CPT/ICD codes and modifiers.
• Adds MBO tracking codes as needed.
• Collaborates with Patient Accounting, PB Billing, and other operational areas for coding expertise, identifying/resolving incorrect claim issues, and drafting appeal letters.
• Obtains necessary documentation (notes, reports, drug plans) for revenue cycle and account inquiry staff.
• Provides code/modifier information for appeal denials, contacting providers for peer reviews as needed.
• Meets minimum coding productivity and quality standards.
• Performs other duties as assigned.

Required: RHIA, RHIT, or CPC/CCS certification. 0-2 years relevant experience. 94% accuracy on organization's coding test.

Preferred: Bachelor's/Associate's degree in Health Information Management, previous experience with physician coding.

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