Medical Coding Technician-Remote

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

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/A

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.

Mercyhealth offers competitive pay and a comprehensive benefits package including:

• 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

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