Coding Quality Analyst - Clinical Practice Services

Milwaukee Succeeds; Wauwatosa (WI); A distancia; USD 75.000 - 96.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

403B Retirement Package

Vacation and paid holidays

Tuition reimbursement

Paid parental leave

EFAP

Pet insurance

Onsite fitness facility

Discounts on various services

Descripción de la vacante

The Medical College of Wisconsin (MCW) seeks a Coding Quality Analyst - Clinical Practice Services to serve as an expert resource for multispecialty coding, billing, and audits within MCW physician practices.

You will educate clinicians and coders on CPT/ICD-10-CM guidelines, participate in policy updates, onboard physicians, and analyze denial trends to improve reimbursement. Remote work must occur within MCW payroll states.

Formación

• Bachelor's degree required.
• Minimum 6 years of experience in coding/billing.
• CPC or CCS-P and/or RHIT/RHIA certifications.
• Epic and Encoder Pro experience preferred.
• Strong knowledge of CPT, ICD-10-CM and CMS coding.

Responsabilidades

• Audit clinician and coder documentation for coding accuracy.
• Educate/train staff on multispecialty coding and regulations.
• Onboard physicians and APPs on documentation and coding rules.
• Review payer policies and assist with appeals and denials.
• Analyze denial trends and propose corrective actions.
• Serve as SME for Encoder Pro and support projects.

Conocimientos

Interpersonal skills

Medical billing

Communication skills

Independent judgment

Excel & Word

Educación

Bachelor's Degree

CPC or CCS-P / RHIT or RHIA

Herramientas

Epic

Encoder Pro

Descripción del empleo

Coding Quality Analyst - Clinical Practice Services

Serves 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 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.

Knowledge – Skills – Abilities

• 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.

Qualifications

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).

Preferred Experience: Front end professional coding, Epic, Encoder Pro

Physical Requirements

Work requires occasionally lifting moderate weight materials, standing, or walking continuously.

Work Environment

Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.

Sensory Acuity

Ability 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 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.

For a brief overview of our benefits see: Benefits Overview

For a full list of positions see: MCW Careers

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.

EEO/AA – Minorities/Females/Vets/Disability

The Medical College of Wisconsin is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability or sexual orientation.