Full-Time Coding Specialist II (Remote)

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.

The PB Coding Specialist II performs CPT and ICD-10 coding through medical record abstraction, focusing on complex encounters or HCPCS procedural codes. This role requires deep understanding of disease processes, anatomy & physiology, and pharmacology.

This position collaborates with providers and clinical areas to ensure accurate patient service reflection in the medical record.

Responsibilities:

• Thoroughly reviews the medical record, abstracting and coding physician services and diagnosis codes (including anesthesia, OR procedures, invasive procedures, and drug infusions).
• Codes Evaluation and Management services, bedside procedures, and diagnostic tests as needed.
• Assigns CPT, ICD-10 codes, and modifiers with 95% accuracy.
• Ensures accurate charges by performing reconciliations (procedure schedules, OR logs, clinical system reports).
• Provides documentation feedback to physicians.
• Trains physicians and staff on documentation, billing, and coding.
• Reviews and communicates billing/coding guidelines and updates.
• Attends meetings and educational sessions, communicating pertinent information to physicians and staff.
• Resolves pre-accounts receivable edits.
• Identifies and addresses repetitive documentation and system issues.
• Corrects billed services, adds missing services, and corrects codes/modifiers.
• Adds MBO tracking codes as needed.
• Collaborates with Patient Accounting, PB Billing, and other departments for coding reimbursement expertise.
• Identifies and resolves claim issues, drafting appeal letters.
• Serves as a key contact for Revenue Cycle and Account Inquiry staff for documentation retrieval.
• Provides additional code and modifier information to support appeal denials.
• May conduct peer-to-peer reviews with providers.
• Meets coding productivity and quality standards for each encounter type.
• Performs other duties as assigned.

Required Qualifications:

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

Preferred Qualifications:

• Bachelor's or Associate's degree in Health Information Management (CAHIIM accredited).
• Previous experience with physician coding.

Location Requirements: Remote, residing in IL, IN, IA, or WI. Sign-on bonus eligible.

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