Medical Coding Specialist - Denials & Policy Education

Mercyhealth Wisconsin and Illinois; Town of King (WI); Remote; USD 33,000 - 49,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

FSA/HSA Options

Paid time off

Job summary

Mercyhealth is seeking a Medical Coding Specialist to review and analyze medical coding documentation, identify discrepancies, and address complex billing issues in accordance with AMA, CMS, and payer guidelines.

The role collaborates with departmental staff to provide coding education and respond to coding review requests while maintaining expertise in Epic billing systems for outpatient, inpatient, and professional coding practices.

Qualifications

• Problem solving skills required.
• Excellent written/oral/interpersonal communication.
• Analytical skills and extensive research abilities.
• Identify root causes during coding reviews.

Responsibilities

• Reviews, analyzes, and interprets documentation; identifies discrepancies and educates partners.
• Resolves pre-bill claim edits from all areas identified by claims scrubbing software.
• Maintains close working relationships with staff; provides coding education when discrepancies arise.
• Researches and educates partners on CMS outpatient, inpatient, and professional coding policies.
• Solves complex billing and denial issues by researching policies and guidelines.
• Demonstrates knowledge of AMA, CMS, and payer guidelines; differentiates professional coding in clinic vs hospital settings.
• 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.
• Works as a team to achieve productivity goals.

Skills

Problem solving

Excellent communication

Analytical skills

Extensive research skills

Identify root causes

Education

High School graduate or equivalent

Tools

Epic billing software

Job description

Mercyhealth is seeking a Medical Coding Specialist to review and analyze medical coding documentation, identify discrepancies, and address complex billing issues in accordance with AMA, CMS, and payer guidelines.

The role collaborates with departmental staff to provide coding education and respond to coding review requests while maintaining expertise in Epic billing systems for outpatient, inpatient, and professional coding practices.