Coding Specialist II
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Purpose
Perform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments.
Primary Functions
CHARGE PROCESSING
Assignment or verificaiton of CPT, ICD-10 CM coding and modifiers based upon documentation. (Inpatient/Emergency Department abstraction, abmulatory coding and/or surgical/procedural coding)
Resolve edits for electronic charges, following established policies and procedures to inusre that all data elements (claim requriements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.
Charge Entry as needed.
RECONCILIATION OF CHARGES:
- Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel to
assure consistent and accurate chage flow. Work with clinic staff and physicians regarding missing or unclear
information that is required for billing.
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.
PROVIDER EDUCATION
Maintain understanding all Teaching Physician and provider documentation policies.
Actively participate in new provider orientations.
Note and address trends in provider documentation that may impact coding and billing,
Preferred Schedule:
Position Requirements:
Knowledge – Skills – Abilities
Working knowledge of CPT and ICD-10 CM coding. Understanding of medical insurance guidelines and governmental policies. Progressive computer skills. Detail oriented. Ability to establish and maintain effective working relationships with the team and department staff (including administrative staff and faculty). Meet or exceed established production rate and performance standards.
Specifications
Appropriate experience may be substituted on equivalent basis
Minimum Required Education: High school graduate or equivalent
Minimum Required Experience: 2 year of related coding and/or health care experience
Preferred Experience: Office experience
Certification: Coding certification (CPC, CPC-A, CCS-P, or CCA) and health information management credential (RHIT or RHIA).
Why MCW?
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
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 full list of positions see: www.mcw.edu/careers
For a brief overview of our benefits see: https://www.mcw.edu/departments/human-resources/benefits
Eastern Wisconsin is a vibrant, diverse metropolitan area. MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine. MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community.
MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering a diverse 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 individual's 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.
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