The Coding Specialist II 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.
CANDIDATE MUST HAVE ANESTHESIA CODING EXPERIENCE. The PB Coding Specialist II performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record with a focus on more complex encounters and/or has expertise with HCPCs procedural codes.
As a Senior Clinical Informaticist, you will shape how clinical data is transformed and made usable for research by leading efforts in knowledge management, semantic normalization, and data quality. Your work will directly support high-impact research by ensuring that the right concepts are captured, standardized, and accessible across diverse data sources.
This position provides revenue cycle support services through efficient review and prompt resolution of assigned Medicare and third-party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. The employee is responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks include resolving standard billing edits.
Reviews clinical documentation and diagnostic results to extract data and apply appropriate ICD and CPT codes for billing, reporting, research and regulatory compliance. Accurately codes outpatient conditions and procedures as documented in the medical record, applying the ICD Official Guidelines for Coding and Reporting. Provides charge validation and capture processes for various patient types.