HB Coding Analyst Remote - reside in IL, IN, IA, or WI

HB Coding Analyst, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI)

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.

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.

The analyst also demonstrates expertise to resolve NCD/LCD and NCCI edits of hard-coded (Chargemaster) and soft-coded (coder assigned) HCPC codes.

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

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, it 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 proofreading 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.
• Throug…