Coding Specialist II

Join to apply for the Coding Specialist II role at Insight Health Systems
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This range is provided by Insight Health Systems. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$25.00/hr – $32.00/hr

At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team dedicated to delivering world‑class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients.

Be a part of the Insight Chicago team that provides patient care second to none! If you would like to be a part of our future team, please apply now.

Analyzes physician/provider documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD‑CM) diagnosis and procedure codes, and Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers.

These duties are performed in a highly confidential manner, in accordance with the mission, values and behaviors of Mercy Hospital and Medical Center. Employees are expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.

• Assign appropriate code(s) by utilizing coding guidelines established by Centers for Medicare/Medicaid Services (CMS) ICD‑CM Official Coding Guidelines, ICD‑PCS Official Guidelines, American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA) CPT Assistant, American Health Information Management Association (AHIMA) Standards of Ethical Coding, and Insight Hospital coding policies.
• Adhere to Insight Hospital confidentiality requirements regarding patient information.
• Navigate the patient health record and other computer systems to determine diagnoses, procedures and modifiers for AP Package calculation.
• Code Emergency Department and Outpatient Observation using encoder software and online reference tools.
• Consult reference materials to facilitate code assignment and ensure appropriate link of diagnosis to procedure.
• Append modifier(s) to procedure code or service when applicable.
• Collaborate with HIM and Patient Financial Services to resolve billing and utilization issues affecting reimbursement.
• Interpret bundling and unbundling guidelines (NCCI), LCDs/NCDs and payer policies.
• Track issues such as missing documentation or charges that require follow‑up to facilitate timely coding.
• Investigate claim denials and/or appeals as directed.
• Consistently meet or exceed coding quality and productivity standards.
• Maintain up‑to‑date knowledge of coding and reimbursement guideline changes.
• Identify concerns and provide resolution of moderate to complex problems, notifying leadership when appropriate.
• Perform other duties as assigned by Leadership.
• Maintain working knowledge of applicable coding and reimbursement laws and regulations, the Compliance Accountability Program, Code of Ethics, and other policies and procedures.

• Completion of an AHIMA‑approved coding program, an AAPC‑approved coding program, or an Associate degree in Health Information Management or related field (equivalent experience acceptable). Bachelor’s degree preferred.
• Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health…