Hybrid Coding & Compliance Analyst (WI) — Revenue Integrity

Family Health Center; Chippewa Falls (WI); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Family Health Center in Wisconsin requires a Coding and Billing Compliance Analyst for a hybrid role with travel. You will safeguard coding accuracy, ensure regulatory compliance, and support revenue cycle initiatives across service lines.

You will audit documentation, monitor denials, update policies, and train staff on coding updates and compliance best practices. Strong experience in EHR systems and FQHC guidelines is essential.

Qualifications

• 3–5 years of experience in medical billing, coding and/or compliance in healthcare.
• Proficiency with EHR and practice management systems (Epic, NextGen, eClinicalWorks).
• Associate's degree in Health Information Management, Healthcare Administration, or related field preferred.

Responsibilities

• Reviews provider documentation and charges to ensure correct ICD-10, CPT, HCPCS, and modifiers per guidelines.
• Conducts regular coding, billing, and claims audits for accuracy and compliance.
• Monitors claims submissions, pre-bill edits, denials, and payer feedback for action.
• Develops and maintains coding and billing compliance policies and training materials.
• Collaborates with providers, clinical teams, and billing staff to ensure compliant coding and Medicaid coverage.
• Analyzes denied or underpaid claims to identify root causes and drive process improvements.
• Stays updated on CMS, HRSA, Medicaid and payer policy revisions and communicates changes.
• Ensures compliance with FQHC PPS and encounter-based billing guidelines.
• Performs charge reviews and prepares audit reports for leadership.

Education

Associate's degree in Health Information Management or related field

Tools

Epic Systems

NextGen Healthcare

eClinicalWorks

Job description

Family Health Center in Wisconsin requires a Coding and Billing Compliance Analyst for a hybrid role with travel. You will safeguard coding accuracy, ensure regulatory compliance, and support revenue cycle initiatives across service lines.

You will audit documentation, monitor denials, update policies, and train staff on coding updates and compliance best practices. Strong experience in EHR systems and FQHC guidelines is essential.