Coding Specialist III – Clinical Practice Services
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Job Description
Coding Specialist III managing CPT/ICD-10-CM coding, charge processing, and reimbursement issues for Medical College of Wisconsin. Supporting clinical departments, provider education, and billing accuracy remotely within Wisconsin.
Responsibilities:
- Perform coding and related duties using established billing office policies accurately and timely
- Serve as primary contact with physicians, department administrators, hospital and clinical department administrators, support staff, and billing staff
- Coordinate professional service billings for selected clinical departments
- Assist in analysis, development, and implementation of new professional service lines related to coding, billing, and charge capture
- Assign or verify CPT, ICD-10-CM coding, and modifiers based on documentation
- Resolve electronic charge edits and ensure claim requirements and data elements are applied
- Serve as a coding resource for single- or multi-specialty services
- Provide out-of-office coding coverage to other team members
- Monitor charge flow and liaise with managers, administrators, clinic staff, physicians, and billing personnel
- Identify, report, and resolve coding and reimbursement issues
- Identify opportunities to reduce denials and enhance revenue
- Develop and maintain protocols for assigned areas
- Maintain understanding of Teaching Physician and provider documentation policies
- Participate in new provider orientations
- Identify and address provider documentation trends affecting coding and billing
- Meet or exceed established production and performance standards
Requirements:
- High School diploma
- 3 years of experience
- Coding certification (CPC or CCS-P) and/or Health Information Management credential (RHIT or RHIA)
- Advanced knowledge of CPT and ICD-10-CM coding
- Knowledge of payer and governmental policies
- Knowledge of EMRs and electronic charge workflows
- Excellent oral and written communication skills
- Detail oriented
- Ability to establish and maintain effective working relationships with team and departmental staff
- Ability to work independently
- Excellent computer skills
- Ability to meet or exceed established production rate and performance standards
- Ability to detect and translate speech or other communication
- Occasional ability to distinguish colors and perceive relative distances between objects
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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