Supervisor, Professional Coding Audit & Education

Children's Wisconsin; Milwaukee, Northern (WI, KY); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Children’s Wisconsin is seeking a Supervisor for the Professional Coding Auditor Team. You will lead audits, ensure accuracy, and maintain timeliness while applying CMS and payer guidelines.

Ideal candidates have 2+ years in coding leadership and strong experience with ICD-10-CM, CPT, and HCPCS, plus proficiency in EMR and Excel. A remote-capable, collaborative leader is preferred for this role.

Qualifications

• High School graduate or GED/HSED required.
• Coding certifications specific to outpatient professional coding required.
• Associate's Degree or Bachelor's Degree preferred.

Responsibilities

• Lead Audit activities to ensure accuracy, timeliness, and consistency.
• Collaborate with Revenue Cycle Leaders and clinical area leaders.
• Serve as SME for auditing activities and ensure knowledge of coding rules and guidelines.
• Coordinate and perform training for team members when needed.

Skills

Leadership

Coding

Auditing

EMR

Excel

Education

GED

Coding certifications

Associate's Degree

Bachelor's Degree

Job description

At Children’s Wisconsin, we believe kids deserve the best. 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.

Job Summary

Supervises the Professional Coding Auditor Team. Ensures that Audits are accurate and performed based on the Auditing timeline guidelines. Requires thorough knowledge of both medical coding and auditing. Should have extensive experience with auditing of medical coding along with advanced experience with electronic medical records and excel.

Essential Functions

Leads Audit activities to ensure accuracy, consistency, and timeliness in the Professional Audit team. Monitors key departmental metrics in quality, efficiency, and production. Collaborates with Revenue Cycle Leaders as well as leaders in the clinical areas. Serves as a subject matter expert for all auditing activities and demonstrates expert knowledge in evaluation and management coding as well as multiple relevant specialty areas. Maintains current knowledge of coding rules and guidelines and provides guidance on requirements established by CMS, payers, professional coding organizations and medical specialty professional organizations. Coordinates and performs training for team members as needed. Demonstrates knowledge of organization safety policies and procedures and actively maintains a safe and positive work environment. Works with Professional Coding Coordinator to ensure timely processing of scheduling of Provider training as well as Provider Audits. Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale. Recommends hiring, terminations, compensation changes, promotions, corrective action decisions, and terminations. Responsible for understanding and adhering to the Children’s Organizational Code of Ethics and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to Children's business. Performs people management responsibilities for employees which may include but are not limited to: employee engagement, recruitment, performance management and development.

People Management Responsibility

Performs people management responsibilities for employees which may include but is not limited to: employee engagement, recruitment, performance management and development.

Education

• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required
• Coding certifications specific to outpatient professional coding required
• Associate's Degree preferred or Bachelor's Degree preferred

Experience

• 2+ years of coding leadership experience demonstrating progressive responsibilities required
• Recent experience applying ICD-10-CM, CPT and HCPCs codes requiredRecent experience in performing Coding Audits for Providers or Coders required
• Three or more years of Coding Audit leadership experience demonstrating progressive responsibilities preferred

Knowledge, Skills and Abilities

Exhibits excellent customer service and professionalism when interacting with providers, staff, patients, families and co-workers to ensure all are treated with kindness and respect. Professional attitude and ability to relate to and interact with others throughout the organization. Demonstrates leadership skills, organizational skills, and conflict resolution skills. Must be able to work collaboratively in a team environment. Must be able to work effectively in a remote environment. Must have excellent attention to detail ability. Exhibits a commitment to continuous quality improvement. Responsible for understanding and adhering to the Children’s Organizational Code of Ethics and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to Children's business.

Licenses and Certifications

+ one of the following:

• - N/A CCS-Certified Coding Specialist
• - American Health Information Management Association CPC-Certified Professional Coder
• - American Board of Professional Coders CCS-P-Certified Coding Specialist Physician Based
• - American Health Information Management Association RHIA-Registered Health Information Administrator
• - American Health Information Management Association RHIT-Registered Health Information Technician
• - American Health Information Management Association

Children’s Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses

+ one of the following:

• - N/A CCS-Certified Coding Specialist
• - American Health Information Management Association CPC-Certified Professional Coder
• - American Board of Professional Coders CCS-P-Certified Coding Specialist Physician Based
• - American Health Information Management Association RHIA-Registered Health Information Administrator
• - American Health Information Management Association RHIT-Registered Health Information Technician
• - American Health Information Management Association

Dedicated solely to the health and well-being of children. We are the region's only independent healthcare system dedicated solely to the health and well-being of children. In Milwaukee and throughout the state, we provide kids and their families a wide range of care and support - everything from routine care for ear aches or sore throats to life saving advances and treatment options. Our academic partner, The Medical College of Wisconsin, brings many of the nation's most well-respected doctors to our team. Together we work to ensure that every child and family we serve receives nothing but the best. Learn more about our affiliation with the Medical College of Wisconsin and the power of academic medicine.