Medical Coding Specialist - Denials & Education (Epic)

Mercy Health Corporation; Wisconsin; Remote; USD 33,000 - 49,000; Full time

Job summary

Mercyhealth in Wisconsin is seeking a Medical Coding Analyst to review and analyze coding documentation, identify discrepancies, and correct them in accordance with AMA, CMS, and payer guidelines. This full-time role emphasizes collaboration with departmental staff to provide coding education and respond to coding review requests while maintaining strong Epic billing system proficiency.

The position requires resolving pre-bill edits, researching CMS outpatient/inpatient/professional policies,

Qualifications

• High School diploma or equivalent
• Three years of experience coding professional or hospital services in an outpatient or clinic setting preferred
• Knowledge of denial management preferred

Responsibilities

• Reviews, analyzes, and interprets documentation; identifies discrepancies between code selection and documentation, corrects them, and educates partners
• Resolves pre-bill claim edits from all areas and as identified by claims scrubbing software
• Maintains close working relationships with departmental staff and provides education when coding discrepancies arise
• Researches CMS policies related to outpatient, inpatient, and professional coding and presents findings to partners
• Solves complex billing and claim denial issues by researching policies and guidelines
• Demonstrates knowledge of AMA, CMS, and payer guidelines and differences between clinic and hospital coding
• Maintains knowledge of Epic billing, ambulatory, and hospital modules
• Responds to customer concerns through coding reviews requested by other departments
• Assists with all coding functions at or above Medical Coding 1 level
• Works as a team to achieve productivity goals

Skills

Problem solving

Communication skills

Analytical thinking

Research skills

Root cause analysis

Education

High School diploma or equivalent

3 years coding experience in outpatient/hospital

Tools

Epic billing system

Job description

Mercyhealth in Wisconsin is seeking a Medical Coding Analyst to review and analyze coding documentation, identify discrepancies, and correct them in accordance with AMA, CMS, and payer guidelines. This full-time role emphasizes collaboration with departmental staff to provide coding education and respond to coding review requests while maintaining strong Epic billing system proficiency.

The position requires resolving pre-bill edits, researching CMS outpatient/inpatient/professional policies,