Outpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI - Sign-on bonus eligible)

📋 Description

• • Serve as a certified Outpatient Coder II within Northwestern Medicine’s Hospital Billing (HB) Coding division, translating complex clinical documentation into accurate ICD-10-CM/PCS and CPT/HCPCS codes for outpatient encounters that drive appropriate reimbursement, quality reporting, and population-health analytics across a $5 B+ academic health system.
• • Own a high-volume, multi-specialty caseload (average 120–150 encounters/shift) that spans same-day surgery, observation, interventional radiology, infusion, ED E/M, ancillary diagnostics, and recurring clinic visits; apply Medicare, Medicaid, and commercial payer rules, NCCI edits, and facility-specific charging protocols while maintaining ≤ 2 % DNFB and 95 % accuracy on quarterly audits.
• • Perform real-time collaboration with physicians, CDI specialists, and charge-capture teams via Epic messaging, Microsoft Teams huddles, and optional webcam rounding to clarify ambiguous documentation, resolve conflicting diagnoses, and capture every reportable HCC, APC, and quality measure without delaying the revenue cycle.
• • Leverage Epic HB coding workspaces, 3M 360 Encompass, CAC (computer-assisted coding), and Nuance NLP tools to streamline workflow; customize Epic smart-phrase libraries and build reusable coding templates that cut keystrokes by 20 % and raise productivity baselines for the entire 60-person remote coding pod.
• • Act as a subject-matter resource for new hires and Coder I teammates, hosting twice-monthly virtual lunch-and-learns on topics such as spinal device coding, infusion hierarchy, and modifier -25/-59 nuances; provide peer-to-peer audits and constructive feedback that support NM’s goal of 100 % coder certification within 18 months of hire.
• • Monitor weekly denial and rebill queues, root-cause trending reports, and payer bulletins; propose workflow fixes, education blitzes, or charge-description-master updates that recapture revenue (target $250 k+ annually) and prevent future denials.
• • Maintain strict HIPAA and HITRUST compliance while working remotely—utilize NM-issued encrypted laptop, secure VPN, and dual-factor authentication; complete annual privacy and security modules with 100 % pass rate and zero PHI incidents.
• • Participate in system-wide coding roundtables, AHIMA advocacy events, and quarterly “Coding Grand Rounds” with NM’s physician champions to stay ahead of ICD-10-CM/PCS and CPT annual updates, ensuring zero-day readiness for code-set changes and payer policy shifts.
• • Champion diversity, equity, and inclusion by flagging documentation that lacks socioeconomic or gender identity granularity, thereby improving data completeness for community-health needs assessments and reducing care-disparity blind spots.
• • Contribute to continuous improvement projects such as automation pilots, Epic upgrades, and quality-scorecard redesign; present outcomes to the Revenue Cycle Steering Committee and earn recognition through NM’s “Excellence in Action” award program.