Revenue Coding Analyst

Northwestern Memorial Healthcare - Chicago, IL

Full-time

Chicago, IL

Hospitals

About the position

The Revenue Analyst plays a crucial role in ensuring accurate coding and billing processes at Northwestern Memorial. This position is responsible for resolving edit/error reports, identifying error patterns, and recommending solutions to minimize billing errors. The Revenue Analyst works under the supervision of the Clinical Coding/Finance Manager and is expected to adhere to the organization's ethical standards and compliance programs.

Responsibilities

• Monitor and resolve bill hold edits for failed medical necessity (LCD), NCCI (National Correct Coding Initiative) and Charge/Edits.
• Identify and communicate coding or billing edit/error patterns to facilitate improved front-end processes.
• Review and validate the appropriateness of the patient ABN (Advanced Beneficiary Notice).
• Review clinical documentation to apply appropriate, complete, and consistent ICD-9-CM or CPT-4 codes for reimbursement, administrative uses, quality/patient safety measurement and research.
• Advance coding knowledge and practice through continuing education and utilize all available reference resources in 3M and MedAssets.
• Investigate and resolve coding/billing issues as identified by Patient Accounting, Denials & Appeals, Billing Inquiry Unit and Registration.
• Provide ICD-9-CM & CPT coding expertise to ancillary departments and physician offices via the coding Help Line.
• Ensure timely and accurate processing of billing.
• Understand APC reimbursement methodology.
• On-going maintenance of AHIMA/AAPC credentials.
• Education of HIT/HIM students that are completing their affiliations with NMH.
• Understand Medicare/Medicaid regulatory guidelines in reference to LCD coverage.

Requirements

• RHIA/RHIT, CCS, CPC or CPC-H

Nice-to-haves

• Degree in Health Information Technology or Health Information Management