Full-Time Operations Coordinator, PB Coding

Operations Coordinator, PB Coding 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 regulatory and accreditation standards.

Responsibilities:

• Performs CPT and ICD-10 coding through abstraction of the medical record, focusing on complex encounters or HCPCS procedural codes.
• Demonstrates deep understanding of disease process, anatomy & physiology, and pharmacology.
• Collaborates with providers and clinical areas to ensure accurate medical record reflection of patient services.
• Trains physicians and staff on documentation, billing, and coding.
• Resolves Optum coding edits.
• Reviews medical records thoroughly to abstract and code physician professional services, diagnosis codes, anesthesia, operative room, surgical, invasive procedures, and drug infusion encounters.
• Includes coding for Evaluation and Management services, bedside procedures, and diagnostic tests.
• Assigns CPT, ICD-10 codes, and modifiers with 95% accuracy.
• Captures charges by performing reconciliations (procedure schedules, OR logs, and clinical system reports).
• Provides documentation feedback to physicians.
• Maintains coding reference information.
• Reviews and communicates billing and coding guidelines.
• Attends meetings and educational roundtables, communicates information to physicians and staff.
• Resolves pre-accounts receivable edits.
• Identifies repetitive documentation problems and system issues.
• Corrects incorrectly billed services, adds missing services, provides missing data, and corrects CPT/ICD-9 codes and modifiers.
• Adds MBO tracking codes.
• Collaborates with Patient Accounting, PB Billing, and other operational areas to provide reimbursement expertise; identifies and resolves claim issues, and drafts letters for appeals.
• Acts as key point person for Revenue Cycle staff and Account Inquiry Unit staff in obtaining documentation (notes, reports, treatment plans).
• Provides code and modifier information to assist with appealing denials.
• May contact providers for peer-to-peer reviews.
• Meets coding productivity and quality standards.
• Performs other duties as assigned.

Required:

• RHIA, RHIT, or CPC certification.
• 0-2 years experience in a relevant role.
• 94% accuracy on organization's coding test.

Preferred:

• Bachelor's or Associate's degree in Health Information Management.
• Previous physician coding experience.

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