Coding Quality Analyst - Clinical Practice Services

The Medical College of Wisconsin, Inc.; Madison (WI); On-site; USD 75,000 - 96,000; Full time

Benefits offered by this job

Health insurance

403B Retirement Package

Tuition Reimbursement

Job summary

The Medical College of Wisconsin, Inc. seeks an experienced healthcare coding professional to serve as a multispecialty coding, documentation and billing expert.

This role includes audits, education, and collaboration with clinicians to ensure compliant coding and reimbursement across specialties. Qualified candidates will hold CPC or CCS-P and RHIT/RHIA credentials, with at least six years of experience and proficiency in CPT, ICD-10-CM, HCPCS and Epic.

Qualifications

• Minimum Bachelor’s degree required.
• Six years of professional coding experience.
• CPC or CCS-P certification and/or RHIT/RHIA credential preferred.

Responsibilities

• Perform multispecialty coding audits for CPT/ICD-10-CM and modifiers.
• Educate clinicians and staff on documentation and coding regulations.
• Assist in payer policy reviews and denial analysis to improve reimbursement.

Skills

CPC or CCS-P certification

Epic knowledge

Encoder Pro knowledge

Education

Bachelor's Degree

RHIT or RHIA certification

Tools

Epic

Encoder Pro

Job description

SummaryServes as an expert resource for multi-specialty documentation, coding and billing. Assist in performing medical coding audits on clinicians and/or coding staff as needed within multi-specialty physician practices to identify deficiencies and ensure coding remains compliant with coding guidelines as well as government and third-party payer regulations and guidelines. Responsible for new and existing clinician and coder education, as well as team and/or clinical department educational sessions.All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AL, AZ, DE, FL, GA, IL, IN, MD, MI, MN, MO, NC, TN, TX, & UT.Primary ResponsibilitiesExpert 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.Knowledge – Skills – AbilitiesAbility 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.QualificationsAppropriate experience may be substituted for education on an equivalent basis.Minimum Required Education: Bachelor’s DegreeMinimum Required Experience: 6 yearsRequired Certification/Licensure(s): Coding certification (CPC or CCS-P) and/or Health Information Management credential (RHIT or RHIA).Preferred Experience: Front end professional coding, Epic, Encoder Pro#LI-RT1Physical RequirementsWork requires occasionally lifting moderate weight materials, standing, or walking continuously.Work EnvironmentOccasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.Sensory AcuityAbility to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.Target salary range for this position is between $75,300.00 and $95,900.00 annually. The final offered salary will depend on the applicant’s education, experience, skills, and knowledge, as well as considerations of internal equity and market alignment.Why MCW?Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options403B Retirement PackageCompetitive Vacation and Paid Holidays offeredTuition ReimbursementPaid Parental LeaveEmployee & Family Assistance Program (EFAP)Pet InsuranceOn campus Fitness Facility, offering onsite classesAdditional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.For a brief overview of our benefits see: Benefits OverviewFor a full list of positions see: MCW CareersAt MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring – Collaborative – Curiosity – Inclusive – Integrity – Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website.MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination:The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.