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, PB Coding performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD-10) coding through abstraction of the medical record. Focus on more complex encounters and/or expertise with HCPCS procedural codes.

Responsibilities:

• Deep understanding of disease process, A&P, and pharmacology.
• Collaborate with Providers and Clinical areas to ensure medical record accuracy.
• Train physicians and staff on documentation, billing, and coding.
• Resolve Optum coding edits.
• Thoroughly review medical records, abstract, and code physician professional services and diagnosis codes (including anesthesia, operative room, surgical procedural services, invasive procedures, and drug infusion encounters). Also, code Evaluation and Management services, bedside procedures, and diagnostic tests.
• Follow Official Guidelines and rules to assign CPT, ICD-10 codes, and modifiers with 95% accuracy.
• Capture charges by performing reconciliations (procedure schedules, OR logs, and clinical system reports).
• Provide documentation feedback to physicians.
• Maintain coding reference information and train staff on billing/coding guidelines.
• Attend meetings and educational roundtables, communicate pertinent information.
• Resolve pre-accounts receivable edits.
• Identify repetitive documentation problems and system issues.
• Correctly bill services, add missing services, provide missing data, and correct CPT and ICD-10 codes and modifiers.
• Add MBO tracking codes.
• Collaborate with Patient Accounting, PB Billing, and other operational areas for coding reimbursement expertise.
• Identify and resolve incorrect claim issues and draft appeal letters.
• Be the key point person for Revenue Cycle staff and Account Inquiry Unit staff in obtaining documentation.
• Provide code and modifier information to assist with appealing denials.
• Potentially contact providers for peer-to-peer reviews.
• Meet minimum coding productivity and quality standards.
• Perform other duties as assigned.

Required:

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

Preferred:

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

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