At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better?

The HB Coding Analyst reflects the mission, vision, and values of Northwestern Memorial, 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 HB Coding Analyst is the coding and reimbursement expert in ICD-10-CM diagnosis coding and has expertise with HCPC Level I and II procedural codes.  Also demonstrates expertise to resolve NCD/LCD and NCCI edits of hard-coded (Chargemaster) and soft-coded (coder assigned) HCPC codes.

Responsibilities:

• Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
• Utilizes technical coding expertise to assign Evaluation and Management codes for physician encounters
• Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses, procedures, and evaluation and management services
• Collaborates with Patient Accounting, Registration, case managers, and other clinical areas to provide coding reimbursement expertise
• Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures
• Follows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinic, Coding Clinic for HCPCs, CPT Assistant, interprets coding conventions and instructional notes to select appropriate diagnoses and procedures with a minimum of 95% accuracy
• Resolves NCCI, NCD/LCD or other outpatient edit claim failures as assigned
• Meets established minimum coding productivity and quality standards for each outpatient encounter type
• Other duties as assigned

ADDENDUM

The Coding Analyst, Performance Improvement coordinates the work effort in compiling, analyzing and trending data for the various divisions within the HB Coding Department.  Under the guidance of the Manager, provides reporting and analysis of data in a clear and concise method.  Utilizes critical thinking skills to evaluate data and the predicted outcomes.  Experience in Inpatient Coding, industry guidelines and rules and educates coding operations on trends.

• Strong Knowledge of Microsoft:  Excel, PowerPoint, Word, Project, Visio

• Demonstrates analysis and problem-solving skills
• Collaborates with other team members (Coding division Managers and Operation Coordinators)
• Excellent oral and written communication skills
• Experience in working both independently and in a team-oriented, collaborative environment
• Experience in project management
• Demonstrates ability in presenting data in a clear and concise manner utilizing PowerPoint tools
• Demonstrates excellent proof-reading skills used in meeting high quality standards
• Basic understanding of the healthcare Revenue Cycle including account workflows, claim submission and denial process
• Demonstrates ability to write payer appeals (specifically for DRG Downgrades)
• Analyze, track and interpret Coding, Clinical Documentation and Revenue Cycle (Denial) data to support efforts in efficiently diminishing payer denials
• Demonstrates ability to analyze and manipulate large amounts of data
• Supports leadership’s strategic, financial and operational decision-making
• Collaborate with leadership to fulfill requests in support of business and clinical objectives
• Maintain a portfolio of monthly reports, dashboards and ad hoc reports as requested
• Through the use of data analytics identify trends and opportunities for improvement
• Utilize Microsoft applications to communicate results to requestor
• Support management in Epic build decisions
• Assists in management of Service Now tickets submitted by Hospital Coding
• Assesses Epic & Solventum CAC functionality enhancements to align with Coding workflows
• Subject matter expert for Coding in the use of CAC and Epic coding workflows
• Remains current on all upgrades and provides upgrade information to management through written communication or by demonstration
• Maintains and submits a weekly Service Now ticket report with status update

Required:

• 3 years of experience in acute healthcare setting
• RHIT or RHIA or CCS or CCS-P or COC or CPC
• AHIMA or AAPC membership

Preferred:

• RHIA/RHIT with CCS, CCS-P, COC, CPC
• 4 years’ experience in acute healthcare setting
• 4 years’ experience in a professional setting

Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check.  Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.

Sign-on Bonus Eligibility: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.