Coding Quality Analyst – Clinical Practice Services
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Job Description
Coding quality analyst auditing multispecialty medical coding for the Medical College of Wisconsin. Educating clinicians and coders while supporting compliant reimbursement and charge capture.
Responsibilities:
- Serve as an expert resource for multispecialty documentation, coding, charge capture, and reimbursement
- Assign or verify CPT, ICD-10-CM codes and modifiers based on documentation
- Perform medical coding audits on clinicians and coding staff to identify deficiencies and ensure compliance
- Develop and deliver education and training for clinicians, coders, employees, teams, and clinical departments
- Participate in workgroups to evaluate, produce, and update documentation, coding, and billing policies and procedures
- Onboard and educate physicians and APPs on documentation and coding rules and regulations
- Support the Charge Capture Team by analyzing coding denial trends and troubleshooting reimbursement delays
- Act as subject matter expert for Encoder Pro
- Participate in new employee orientation regarding the charge capture process
- Maintain current knowledge of medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements, and practices
- Review payer policy publications, notices, and websites to support appeal writing and other actions
- Prioritize and execute day-to-day projects and perform other assigned duties
Requirements:
- Bachelor’s Degree; appropriate experience may be substituted for education on an equivalent basis
- Minimum 6 years of experience
- Coding certification (CPC or CCS-P) and/or Health Information Management credential (RHIT or RHIA)
- Expert knowledge of multispecialty medical coding, charge capture, reimbursement, professional medical coding, contracting, and payment processing
- Proficiency in Excel and Word
- Knowledge of medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools
- Strong written and oral communication skills
- Ability to exercise independent judgment, decision-making, problem-solving, and initiative
- Preferred experience with front-end professional coding, Epic, and Encoder Pro
- Ability to perform remote work within one of MCW’s registered payroll states
Benefits:
- Outstanding Healthcare Coverage, including Health, Vision, and Dental
- Flexible Spending options
- 403B Retirement Package
- Competitive Vacation and Paid Holidays
- Tuition Reimbursement
- Paid Parental Leave
- Employee & Family Assistance Program (EFAP)
- Pet Insurance
- On campus Fitness Facility, offering onsite classes
- Additional discounted rates on select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment
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