Note: The job is a remote job and is open to candidates in USA. The Medical College of Wisconsin is an academic healthcare organization seeking a Coding Quality Analyst to serve as an expert resource for multispecialty documentation, coding, and billing. The role performs coding audits, supports compliance with coding and payer regulations, analyzes denial trends, and provides education to clinicians, coding staff, and other employees.
Responsibilities
- Expert resource of multispecialty coding, charge capture and reimbursement which may include surgical, inpatient, emergency and/or ambulatory coding; assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation
- Participate in workgroups to evaluate, produce and/or update policies and procedures related to internal process in relation to documentation, coding, and billing
- Educate/train new and existing employees in multispecialty clinical areas, include government documentation and coding regulations. Assist lead/CS IV team in educational session, include coding/charge capture process and Epic related changes
- Onboard/educate new and existing physicians and APP’s on documentation and coding rules and regulations
- Perform documentation and coding audits on clinicians and coding specialist staff for coding accuracy
- Support Charge Capture Team in analyzing coding denial trends and troubleshooting solutions such as front-end system edits and/or front-end education to minimize reimbursement delays
- Assist in the training of coworkers, coding staff, clinicians as appropriate to provide evaluation, education and/or orientation adhering to CPT, ICD-10CM and Government documentation and coding regulations
- Subject Matter Expert for Encoder Pro
- Participates in new employee orientation to acquaint them with the charge capture process
- Maintain current knowledge of medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements and practices. Communicates changes to appropriate persons
- Review payer policy publications, notices and websites for coding and policy information to assist in appeal writing or to support other action determinations
- Responsible for the day-to-day prioritization and the execution of various projects
- Perform other duties or projects as assigned
- Other duties as assigned
Skills
- * Ability to interact with people effectively
- * Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments
- * Strong written and oral communication skills
- * Ability to take initiative and to exercise independent judgment, decision making and problem-solving skills
- * Proficient in Excel and Word, Medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools
- *Appropriate experience may be substituted for education on an equivalent basis.*
- **Minimum Required Education:** Bachelor's Degree
- **Minimum Required Experience:** 6 years
- **Required Certification/Licensure(s):** Coding certification (CPC or CCS-P) and/or Health Information Management credential (RHIT or RHIA)
- Work requires occasionally lifting moderate weight materials, standing, or walking continuously
- Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects
- **Preferred Experience:** Front end professional coding, Epic, Encoder Pro
Benefits
- Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
- 403B Retirement Package
- Competitive Vacation and Paid Holidays offered
- Tuition Reimbursement
- Paid Parental Leave
- Employee & Family Assistance Program (EFAP)
- Pet Insurance
- On campus Fitness Facility, offering onsite classes
- Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.
- Fully remote work
Company Overview
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