Coding Specialist II

Medical College of Wisconsin; Orlando (FL); Remote; USD 45,000 - 75,000; Full time

Job summary

Join a pioneering institution dedicated to advancing medical knowledge as a Coding Specialist II. In this fully remote role, you will play a crucial part in ensuring accurate coding and billing processes, collaborating with physicians and administrative staff to enhance revenue and minimize claim denials. Your expertise in CPT and ICD-10 CM coding will be essential as you manage charge processing, reconciliation, and provider education. This position offers the opportunity to make a significant impact in academic medicine while enjoying the flexibility of remote work. If you are detail-oriented and passionate about improving healthcare operations, this role is for you.

Qualifications

• Strong knowledge of CPT and ICD-10 CM coding required.
• Ability to resolve coding and reimbursement issues effectively.

Responsibilities

• Perform coding duties accurately and timely for clinical departments.
• Coordinate professional service billings and resolve billing issues.

Skills

CPT coding

ICD-10 CM coding

Detail-oriented

Effective communication

Problem-solving

Education

Certification in Medical Coding

Associate's Degree in Health Information Technology

Tools

Electronic Health Record (EHR) systems

Billing software

Job description

Every great life-changing discovery begins the same way—with new knowledge. It can change everything, from a single life to the future of entire communities. That’s why academic medicine, and the continuous pursuit of knowledge, is at the center of everything we do at the Medical College of Wisconsin (MCW).

As a Coding Specialist II, you will perform coding and related duties using established billing office policies in an accurate and timely manner. You will be the primary contact with physicians, department administrators, hospital and/or clinical department administrators, their support staff, and billing staff. You will coordinate professional service billings for selected clinical departments.

This role is 100% remote for the following states: WI, FL, MN, NC, TN, & TX.

Responsibilities:

CHARGE PROCESSING

1. Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation. (Inpatient/Emergency Department abstraction, ambulatory coding, and/or surgical/procedural coding)
2. Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.
3. Charge Entry as needed.

RECONCILIATION OF CHARGES:

1. Monitor charge flow and act as a liaison with managers, department administrators, and other billing personnel to assure consistent and accurate charge flow. Work with clinic staff and physicians regarding missing or unclear information that is required for billing.

CLAIM DENIALS / BILLING ISSUES

1. Identify, report, and resolve coding and reimbursement issues. Work with physicians, department administrators, and other billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.

PROTOCOLS

1. Develop and maintain all protocols related to assigned areas.

PROVIDER EDUCATION

1. Maintain understanding of all Teaching Physician and provider documentation policies.
2. Actively participate in new provider orientations.
3. Note and address trends in provider documentation that may impact coding and billing.

Knowledge – Skills – Abilities

Working knowledge of CPT and ICD-10 CM coding. Understanding of medical insurance guidelines and governmental policies. Progressive computer skills. Detail-oriented. Ability to establish and maintain effective working relationships with the team and department staff (including administrative staff and faculty). Meet or exceed established production rate and performance standards.