Precision Medical Coding & Prior Authorization Specialist

Crossingrivers; Prairie du Chien (WI); On-site; USD 42,000 - 64,000; Full time

Job summary

Crossing Rivers Health is seeking a Medical Coding & Prior Authorization Specialist to support accurate clinical documentation and timely service authorizations. The role involves coding diverse encounters using ICD-10-CM/ICD-10-PCS/CPT, reviewing documentation for accuracy, and managing prior authorizations for procedures, imaging, and therapies.

Responsibilities include collaborating with providers and staff to obtain necessary documentation, resolving coding and authorization denials, and

Qualifications

• High School Diploma required.
• Associate’s Degree in Health Information Management or Medical Coding required.
• RHIT or related Medical Coding certification within 6 months of hire.

Responsibilities

• Review clinical documentation to ensure coding accuracy and compliance.
• Assign ICD-10-CM/ICD-10-PCS/CPT codes for diverse encounters.
• Manage prior authorization requests for procedures and therapies; verify payer criteria.
• Collaborate with providers and staff to obtain necessary documentation.
• Identify and resolve coding or authorization denials and discrepancies.

Skills

Accountability

Accuracy

Communication

Detail oriented

Organized

Reliability

Honesty & integrity

Education

High School Diploma

Associate’s Degree in Health Information Management/Medical Coding

RHIT or related Medical Coding certification within 6 months

Tools

Microsoft Office

Epic

Job description

Crossing Rivers Health is seeking a Medical Coding & Prior Authorization Specialist to support accurate clinical documentation and timely service authorizations. The role involves coding diverse encounters using ICD-10-CM/ICD-10-PCS/CPT, reviewing documentation for accuracy, and managing prior authorizations for procedures, imaging, and therapies.

Responsibilities include collaborating with providers and staff to obtain necessary documentation, resolving coding and authorization denials, and