Coding Specialist IV Clinical Practice Services

Serve as expert resource regarding all aspects of documentation coding and supervisor and team by guiding and directing specific employees in their day-to-day job functions. Train new and existing cross coverage for multiple specialty areas. Investigate and resolve issues pertaining to charge capture billing and reimbursement. Complete special projects as assigned. Act as supervisor in Supervisors absence.

All remote work must be performed within one of the MCW registered payroll states which currently includes: WI AL AZ DE FL GA IN MD MI MN MO NC TN TX & UT.

CHARGE PROCESSING

• Expert knowledge of multispecialty coding which may include surgical inpatient emergency and/or ambulatory coding; assignment or verification of CPT ICD-10 CM coding and modifiers based upon documentation.

• Guide and direct specific employees in their day-to-day job functions. Answer questions and resolve coding and billing issues.

• Identify report and resolve coding and reimbursement issues with physicians department administrators and other billing office staff including reimbursement staff.

• Resolve edits for electronic charges following established policies and procedures to ensure that all data elements (claim requirements CPT ICD-10 CM modifiers provider billing area etc.) are applied.

• Serve as a resource to staff for accurate assignment of CPT procedure and ICD-10-CM diagnosis coding of complicated multi-specialty services for appropriate reimbursement.

• Provide out of office coding coverage to multi-specialty areas.

ASSIST WITH TEAM SUPERVISION AND SPECIAL PROJECTS

• Primary contact for staff when issues or questions arise.

• Monitor team workflow assign and re-assign work to meet team and organizational goals.

• Quality review of staff work and workflows.

• Act as supervisor in Supervisors absence.

TRAINING STAFF

• Onboarding/training of new or existing coding specialist staff.

CLAIM DENIALS / BILLING ISSUES

• Identify report and resolve coding and reimbursement issues. Working with physicians department administrators and other billing office staff including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.

PROTOCOLS

• Develop and maintain all protocols related to their assigned areas.

• Assist others in the development of protocols for other areas.

SYSTEM TESTING

• Participate in system testing as needed.

Expert knowledge of CPT ICD-10 CM coding payer and governmental policies. Excellent oral and written communication skills. Detail oriented. Excellent presentation skills. Excellent project management and problem-solving skills. Ability to handle multiple issues at one time. Ability to establish and maintain effective working relationships with the team and departmental staff (including administrative staff and faculty). Ability to work independently. Excellent computer skills. Knowledge of EMRs and electronic charge workflows. Meet or exceed established production rate and performance standards.

Minimum Required Education:High school diploma.

Minimum Required Experience: 5 years of related coding experience.

Preferred Experience:Academic teaching institution professional billing experience.

Required Certification/Licensure(s): Coding certification (CPC CCS-P) and/or Health Information Management credential (RHIT RHIA).

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Work requires occasionally lifting moderate weight materials standing or walking continuously.

Occasional exposure to dust noise temperature changes or contact with water or other liquids. Work is performed in an environmentally controlled environment.

Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.

• Outstanding Healthcare Coverage including but not limited to Health Vision and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Employee & Family Assistance Program (EFAP)
• Pet Insurance
• On campus Fitness Facility offering onsite classes
• Additional discounted rates on items such as: Select cell phone plans local fitness facilities Milwaukee recreation and entertainment etc.

For a brief overview of our benefits see: Benefits Overview

For a full list of positions see: MCW Careers

At MCW all of our endeavors from our internal operations to our interactions with our partners are driven by our shared organizational values: Caring Collaborative Curiosity Inclusive Integrity Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds experiences and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world and we recognize that a healthy and thriving community starts from within. Our values define who we are what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all then MCW is the place for you. For more information please visit our institutional website.

The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty staff and students as well as ensuring equal educational opportunity employment and access to services programs and activities without regard to an individuals race color national origin religion age disability sex gender identity/expression sexual orientation marital status pregnancy predisposing genetic characteristic or military status. Employees students applicants or other members of the MCW community (including but not limited to vendors visitors and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.