Hybrid Coding Specialist (CPC) – Denials & Reimbursement

Ladd Memorial Hospital; Town of Osceola (WI); Hybrid; USD 59,000 - 81,000; Full time

Job summary

Osceola Medical Center in Osceola, WI, is seeking a Coding Specialist to assign CPT, ICD-10-CM, and HCPCS codes for clinic and hospital encounters using the Epic EMR system. The role emphasizes accuracy, timely coding, and compliance with coding guidelines to support proper reimbursement.

Responsibilities include reviewing documentation, resolving denials, querying providers for missing information, and collaborating with revenue cycle teams to improve data integrity and audit readiness.

Qualifications

• High school diploma or GED required; associate degree in Health Information Management or related field preferred.
• Current Certified Professional Coder (CPC) credential required (through AAPC or equivalent) Experience with hospital, clinic, or CAH/RHC coding preferred.
• Strong knowledge of CPT, ICD-10-CM, HCPCS coding systems, and official coding guidelines.
• Familiarity with Epic EMR or comparable electronic medical record systems preferred.
• Strong analytical, organizational, and communication skills

Responsibilities

• Assign accurate CPT, ICD-10-CM, and HCPCS codes for both PB and HB encounters based on clinical documentation
• Apply critical thinking to interpret documentation and select appropriate codes when guidelines are complex or ambiguous
• Independently manage and resolve coding-related claim edits and denials in real time, including researching root causes, correcting codes, and submitting appeals as appropriate
• Review medical records to ensure completeness, accuracy, and compliance with coding and billing requirements, including identification of denial risk
• Query providers for clarification or additional documentation to support accurate coding, denial prevention, and reimbursement
• Ensure compliance with federal, state, and payer-specific regulations and guidelines to minimize denials and support audit readiness
• Identify trends in coding errors, edits, and denials; analyze root causes and take proactive steps to prevent recurrence
• Collaborate with providers, billing, and revenue cycle teams to resolve coding-related claim issues and denial trends
• Track, monitor, and follow up on coding-related denials to ensure timely resolution and appropriate reimbursement
• Maintain established productivity and quality benchmarks while effectively managing denial-related workload
• Stay current with coding updates, regulatory changes, and payer requirements impacting coding and denials
• Document coding actions, rationale, and denial research, corrections, and resolutions within the system

Skills

Attention to detail

Analytical thinking

Communication skills

Ability to resolve denials

Prioritization of workload

Education

High school diploma or GED

Associate degree in Health Information Management or related field

Current CPC credential

Tools

Epic EMR

Job description

Osceola Medical Center in Osceola, WI, is seeking a Coding Specialist to assign CPT, ICD-10-CM, and HCPCS codes for clinic and hospital encounters using the Epic EMR system. The role emphasizes accuracy, timely coding, and compliance with coding guidelines to support proper reimbursement.

Responsibilities include reviewing documentation, resolving denials, querying providers for missing information, and collaborating with revenue cycle teams to improve data integrity and audit readiness.