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 all other regulatory and accreditation standards.

The Operations Coordinator performs CPT and ICD-10 coding through abstraction of the medical record, focusing on complex encounters or having expertise with HCPCS procedural codes.

Responsibilities:

• Deep understanding of disease process, anatomy & physiology (A&P), and pharmacology.
• Collaborates with providers and clinical areas to ensure medical record accuracy.
• Trains physicians and staff on documentation, billing, and coding.
• Resolves Optum coding edits with technical expertise.
• Thoroughly reviews medical records, utilizing all available documentation to abstract and code physician professional services and diagnosis codes, including anesthesia, operative room, surgical procedures, invasive procedures, and drug infusion encounters.
• Codes evaluation and management services, bedside procedures, and diagnostic tests as needed.
• Assigns CPT, ICD-10 codes, and modifiers with 95% accuracy, following official guidelines.
• Ensures charges are captured by performing reconciliations (procedure schedules, OR logs, clinical system reports).
• Provides documentation feedback to physicians.
• Maintains coding reference information.
• Reviews and communicates new or revised billing and coding guidelines.
• Attends meetings and educational roundtables, communicating pertinent information to staff.
• Resolves pre-accounts receivable edits.
• Identifies and resolves repetitive documentation and system issues.
• Makes appropriate changes to incorrectly billed services, adds missing services, corrects codes and modifiers, and adds tracking codes.
• Collaborates with Patient Accounting, PB Billing, and other areas for coding and reimbursement expertise.
• Identifies and resolves incorrect claim issues, drafts appeal letters.
• Serves as a point person for Revenue Cycle and Account Inquiry Unit staff in obtaining documentation.
• Provides code and modifier information for appealing denials.
• May conduct peer-to-peer reviews with providers.
• Meets established coding productivity and quality standards.
• Performs other duties as assigned.

Required Qualifications:

• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
• 0-2 years of experience in a relevant role.
• 94% accuracy on the organization's coding test.

Preferred Qualifications:

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

Benefits

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