Coding Specialist II: Neurosurgery, Orthopedic & Ambulatory Surgery Coding - Clinical Practice Services

The Medical College of Wisconsin, Inc.; Madison (WI); On-site; USD 55,000 - 72,000; Full time

Job summary

The Medical College of Wisconsin, Inc. is seeking a skilled coder/biller focused on accurate CPT and ICD-10 CM coding for neurosurgery, orthopedics and ambulatory surgery. You will verify documentation, enter charges, and help resolve denials with the billing team.

The role emphasizes collaborating with physicians and department staff to improve revenue and ensure compliant billing practices in a controlled environment.

Qualifications

• Knowledge of CPT and ICD-10 CM coding.
• Understanding of medical insurance guidelines and governmental policies.
• Progressive computer skills.

Responsibilities

• CHARGE PROCESSING: Assign/verify CPT, ICD-10 CM coding and modifiers per documentation for Neurosurgery, Orthopedic & Ambulatory Surgery coding.
• Charge Entry as needed.
• RECONCILIATION OF CHARGES: Monitor charge flow and liaise with managers to ensure accurate changes.
• CLAIM DENIALS / BILLING ISSUES: Identify, report, and resolve coding and reimbursement issues with physicians and staff.
• PROTOCOLS: Develop and maintain protocols related to assigned areas.
• PROVIDER EDUCATION: Participate in provider orientations and address trends in documentation affecting coding and billing.

Skills

CPT coding

ICD-10 CM coding

Modifiers

Detail oriented

Team collaboration

Education

High school diploma

Job description

SummaryPerform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments.All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AL, AZ, DE, FL, GA, IN, MD, MI, MN, MO, NC, TN, TX, & UT.Primary ResponsibilitiesCHARGE PROCESSING:Assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation. (Neurosurgery, Orthopedic & Ambulatory Surgery Coding)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.Charge Entry as needed.RECONCILIATION OF CHARGES:Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel to assure consistent and accurate change flow.Work with clinic staff and physicians regarding missing or unclear information that is required for billing.CLAIM DENIALS / BILLING ISSUES:Identify, report, and resolve coding and reimbursement issues.Working with physicians, department administrators and other billing office staff, including reimbursement staff.Identify opportunities to reduce denials and enhance revenue.PROTOCOLS:Develop and maintain all protocols related to their assigned areas.PROVIDER EDUCATION:Maintain understanding all Teaching Physician and provider documentation policies.Actively participate in new provider orientations.Note and address trends in provider documentation that may impact coding and billing.Knowledge – Skills – AbilitiesWorking 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.QualificationsMinimum Required Education: High school diplomaMinimum Required Experience: 2 years of related coding experience.Required Certification/Licensure(s): Coding certification (CPC, CPC-A, CCS-P, or CCA) and/or Health Information Management credential (RHIT or RHIA).Preferred Experience: Neurosurgery, Orthopedic & Ambulatory Surgery Coding experience. Insurance denial experience as well.#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.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.