Surgical Coding Specialist — Accurate, Impactful & Growth‑Oriented

ThedaCare; Neenah (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

ThedaCare is seeking a Clinic - III Coder to review CPT procedures and ICD-10-CM codes for professional services, including surgical procedures, with a high degree of accuracy. You will audit medical records, educate providers on documentation improvement opportunities, and address payer denials as part of a proactive compliance program.

Requirements include a coding certificate or an associate’s degree in medical business or coding/health information, a high school diploma, at least 3 years of

Qualifications

• High School diploma or GED preferred.
• Must be 18 years of age.
• Coding certificate or associate’s degree in medical business or coding/health information.
• Three years of experience in general medical or specialty coding.
• Dual certifications through AAPC and/or AHIMA.

Responsibilities

• Reviews and/or assigns proper CPT procedures and/or diagnosis codes (ICD-10-CM including HCC risk adjustment diagnosis) for professional services including specialty medical services, in and outpatient E/M, and surgical procedures with a high degree of accuracy.
• Educates providers on documentation improvement opportunities.
• Conducts and reports internal documentation audits to ensure ThedaCare compliance by providers and team members.
• Performs internal reviews in response to third party data summaries and/or investigations.
• Creates mitigation plan to reduce future risk.
• Manages and maintains coding inventory responsibilities, internal reporting and payer denials, and claim edits to ensure timely reimbursement for services provided.
• Researches policy and communicates with payers.
• Mentors and trains team members to skills matrix requirements.
• Provides orientation training to new team members.
• Performs world class service to our customers, responding timely and professionally to inquiries.

Education

Coding certificate or associate’s degree in medical business or coding/health information

Job description

ThedaCare is seeking a Clinic - III Coder to review CPT procedures and ICD-10-CM codes for professional services, including surgical procedures, with a high degree of accuracy. You will audit medical records, educate providers on documentation improvement opportunities, and address payer denials as part of a proactive compliance program.

Requirements include a coding certificate or an associate’s degree in medical business or coding/health information, a high school diploma, at least 3 years of