Medical Coding Technician-Remote

Mercyhealth Wisconsin and Illinois; Madison (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

Parental leave

Tuition and certification reimbursment

Well-being Programs

Employee Discounts

On-Demand Pay

Job summary

Mercyhealth Wisconsin and Illinois is seeking a Medical Coding Specialist to review and analyze documentation, correct coding discrepancies, and resolve pre-bill edits across outpatient and inpatient settings. You will collaborate with department staff to educate on CMS policies and improve coding accuracy.

The role requires CPC or CPC-H certification, strong knowledge of AMA, CMS guidelines, and proficiency with Epic billing systems.

Qualifications

• High School diploma or equivalent.
• Three years of professional or hospital coding experience preferred.
• Knowledge of denial management preferred.

Responsibilities

• Reviews, analyzes, and interprets documentation to identify discrepancies and correct codes.
• Resolves pre-bill claim edits identified by claims scrubbing software.
• Educates partners on CMS policies related to outpatient, inpatient, and professional coding.
• Maintains in-depth knowledge of Epic billing modules and hospital/clinic coding practices.

Skills

Problem solving

Communication skills

Analytical skills

Research skills

Education

High School diploma

Tools

Epic Billing

Job description

Overview

Reviews and analyzes medical coding documentation to identify and correct discrepancies, resolve pre-bill claim edits, and address complex billing issues and claim denials in accordance with AMA, CMS, and payer guidelines. Collaborates with departmental staff and other partners to provide coding education, research policy updates, and respond to coding review requests while maintaining extensive knowledge of Epic billing systems and professional, outpatient, and inpatient coding practices. Supports all coding functions at or above the Medical Coding 1 level while working collaboratively to achieve departmental productivity goals.

Schedule

Full-Time, 40 hours per week

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Reviews, analyzes, and interprets documentation and identifies discrepancies between the code selection and the documentation; corrects them, and presents findings and education to the appropriate partner.
• Resolves pre-bill claim edits from all areas and as identified by claims scrubbing software.
• Maintains a close working relationship with departmental staff, frequently querying them and providing education when coding discrepancies arise.
• Researches and provides education to all partners regarding CMS policies related to outpatient coding, inpatient coding, and professional fee coding, and presents findings to them.
• Solves complex billing and claim denial issues related to coding by researching policies and guidelines.
• Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare & Medicaid Services (CMS) and contracted payers.
• Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.
• Maintains an in-depth 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 the level of a Medical Coding 1 job description.
• Works as a team to achieve productivity goals.

EDUCATION AND/OR EXPERIENCE

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

CERTIFICATION/LICENSURE

Certified in professional or hospital coding (CPC, CPC-H) or other equivalent coding certification required.

OTHER SKILLS AND ABILITIES

Problem solving skills. Excellent written/oral/interpersonal/communication skills. Analytical skills. Extensive research skills. Identify root causes.

LEVEL OF SUPERVISION

N/A

SUPERVISES/N/PA PAY RANGE

:$23.65 - $35.48 Mercyhealth is an

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.

Benefits

• Medical, Dental, Vision
• Life & Disability Insurance
• FSA/HSA Options
• Generous, accruing paid time off
• Paid Parental and caregiver leave
• Career advancement and educational opportunities
• Tuition and certification reimbursement
• Certification Reimbursement
• Well-being Programs
• Employee Discounts
• On-Demand Pay
• Financial Education
• Annual recognition/awards events
• Partner appreciation days
• Family entertainment/attractions discount
• Community service/improvement opportunities

About Mercyhealth

At Mercyhealth, we don't simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin. Mercyhealth has been nationally recognized for our commitment to our people and culture, including:

• #1 in the nation on AARP's Best Employers for Workers Over 50
• One of Working Mother magazine's 100 Best Companies for Working Mothers
• A Top 50 Company and Top 10 Nonprofit for Executive Women