Coding Educator

Froedtert ThedaCare; Appleton (WI); Remote; USD 65,000 - 90,000; Full time

Job summary

Froedtert ThedaCare is seeking a skilled Coder (Clinic - III) to review and assign CPT/ICD-10-CM codes for professional and surgical services within ThedaCare Physician Services. The role emphasizes accuracy, compliance with guidelines, and education of providers.

The position is fully remote with a 40-hour work week, requiring 3+ years of coding experience and dual AAPC/AHIMA certifications. You will mentor staff and help reduce denials through audits.

Responsibilities

• Reviews and assigns CPT/ICD-10-CM codes for professional and surgical services with high accuracy.
• Educates providers on documentation improvement opportunities and conducts internal audits.
• Performs internal reviews in response to third party data and creates mitigation plans.
• Manages coding inventory, internal reporting, payer denials, and claim edits.
• Mentors and trains team members to skills matrix; conducts orientation for new hires.
• Delivers prompt, professional service to customers and inquiries.

Education

High School diploma or GED

Coding certificate or associate degree in medical business or coding/health information

Three years of experience in general medical or specialty coding

Dual certifications through AAPC and/or AHIMA

Must be 18 years of age

Job description

The Coder (Clinic - III) performs coding review for surgical specialties for ThedaCare Physician Services to accurately reflect services rendered. Reviews and processes charges using industry standard methodologies (CPT, ICD-10-CM, HCPCS), abides by Standards of Ethical Coding (AAPC/AHIMA), and complies with official coding guidelines and other regulatory requirements. Audits medical record documentation and educates providers on documentation improvement opportunities and risks. Educates and trains new team members to department standards. Mentors and observes team members in department responsibilities. Upholds and demonstrates department expectations and accuracy in regards to coding responsibilities including payer denials and claim edits.

Job Description:

SCHEDULE:

• 40 hrs/week
• Fully remote
• Preferred Experience: previous work with clinicians, hospital coding experience, coding inpatient charges, and/or HCC Coding.

KEY ACCOUNTABILITIES:

• Reviews and/or assigns proper CPT procedures and/or diagnosis codes (ICD-10-CM including HCC risk adjustment diagnosis) for professional services including specialty medical services, in and outpatient E&M, and surgical procedures (i.e., cardiology, orthopedic, and general surgery) with a high degree of accuracy.
• Educates providers on documentation improvement opportunities. Conducts and reports internal documentation audits to ensure ThedaCare compliance by providers and team members.
• Performs internal reviews in response to third party data summaries and/or investigations. Creates mitigation plan to reduce future risk.
• Manages and maintains coding inventory responsibilities, internal reporting and payer denials, and claim edits to ensure timely reimbursement for services provided. Researches policy and communicates with payers.
• Mentors and trains team members to skills matrix requirements. Provides orientation training to new team members.
• Performs world class service to our customers, responding timely and professionally to inquiries.

QUALIFICATIONS:

• High School diploma or GED preferred
• Must be 18 years of age
• Coding certificate or associate’s degree in medical business or coding/health information
• Three years of experience in general medical or specialty coding
• Dual certifications through AAPC and/or AHIMA

PHYSICAL DEMANDS:

• Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
• Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

WORK ENVIRONMENT:

• Normally works in climate controlled office environment
• Frequent sitting with movement throughout office space
• Use of computers throughout the work day
• Frequent use of keyboard with repetitive motion of hands, wrists, and fingers