Professional Coding Quality Review Specialist - Full-time

Children's Wisconsin; West Allis (WI); Remote; USD 70,000 - 90,000; Full time

Job summary

Children's Wisconsin is seeking a Professional Coding Quality Review Specialist to ensure high coding quality standards. This full-time remote role requires coding certification and extensive experience in multi-specialty coding. Join a dedicated team focused on children's health.

Qualifications

• At least 5 years of experience in a multi-specialty physician practice.
• Advanced knowledge of ICD-10, CPT, and HCPCS coding guidelines.

Responsibilities

• Conduct audits of coding staff to ensure coding quality standards.
• Provide feedback and education to coding leaders and staff.

Skills

Communication

Judgment

Education

High School diploma or GED/HSED

Associate or Bachelor's Degree

Tools

Electronic Health Records

Epic

Job description

Professional Coding Quality Review Specialist - Full-time

Join to apply for the Professional Coding Quality Review Specialist - Full-time role at Children's Wisconsin.

Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services, and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Learn more about working at Children’s Wisconsin: https://www.instagram.com/lifeatcw/

Job Responsibilities

The Quality Assurance Specialist - Professional Coding is responsible for conducting audits of coding staff to ensure the highest coding quality standards are upheld, and that policies, procedures, and protocols are followed appropriately. This position will provide feedback and education to coding leaders and staff based on audits completed.

Minimum Requirements

• Coding certification (CPC, CCS, CCS-P, or RHIT)
• High School diploma or GED/HSED
• At least 5 years of experience in a multi-specialty physician practice, coding multiple medical/surgical specialties/subspecialties
• Advanced knowledge of ICD-10, CPT, and HCPCS coding guidelines, payer and governmental policies
• Working knowledge of CCI edits, healthcare insurance guidelines, and other regulatory guidance
• Prior experience with Electronic Health Records
• Excellent communication skills (oral and written)
• Ability to work independently and exercise judgment and decision-making

Preferred Qualifications

• Associate or Bachelor's Degree
• Epic experience

This is a full-time, remote position (Monday to Friday) that does not require travel to our Milwaukee Main Campus.

Additional Information

Children's Wisconsin is an equal opportunity employer committed to diversity and inclusion. We do not discriminate based on race, color, religion, sex, gender identity/expression, sexual orientation, national origin, age, disability, veteran status, or any other protected status.

Certifications/Licenses

Required: Coding certification (CPC, CCS, CCS-P, or RHIT)

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Quality Assurance
• Industry: Hospitals and Healthcare