Coding Denials Specialist

The Coding Specialist supports Northwestern Medicine’s mission, vision, and values while adhering to the organization’s Code of Ethics, Corporate Compliance Program, and all applicable policies and regulatory standards.

This role performs CPT and ICD-9 coding through medical record abstraction, supports charge capture and billing accuracy, trains physicians and staff on documentation and coding, and completes a variety of administrative and clerical duties related to coding and billing.

Key responsibilities include:

• Abstracting and coding physician professional services and diagnosis codes for inpatient admissions, outpatient procedures, and diagnostic services
• Assigning appropriate CPT and ICD-9 codes
• Completing coding and billing worksheets
• Performing charge reconciliation and identifying missed billing opportunities
• Providing documentation feedback to physicians
• Maintaining coding reference materials and staying current on coding rule updates
• Training physicians and staff on documentation, billing, and coding practices
• Reviewing and communicating new or revised billing and coding guidance
• Resolving pre-AR edits, correcting billed services and modifiers, and maintaining non-compliance logs
• Drafting letters and coordinating appeals
• Working with Revenue Cycle and Account Inquiry Unit staff to obtain supporting documentation
• Providing invoice disposition instruction and additional code/modifier information