Coding Quality Analyst – Clinical Practice Services

This is a fully remote position, open to applicants in Wisconsin.

📋 Description

• Act as a knowledgeable resource for multispecialty documentation, coding, charge capture, and reimbursement processes.

• Assign or validate CPT, ICD-10-CM codes and modifiers according to the provided documentation.

• Conduct medical coding audits for clinicians and coding personnel to uncover deficiencies and ensure regulatory compliance.

• Create and present educational sessions and training programs for clinicians, coders, employees, teams, and clinical departments.

• Engage in workgroups to assess, develop, and revise documentation, coding, and billing policies and procedures.

• Onboard and instruct physicians and APPs on coding and documentation rules and regulations.

• Assist the Charge Capture Team by analyzing trends in coding denials and resolving reimbursement delays.

• Serve as a subject matter expert for Encoder Pro.

• Participate in new employee orientation sessions focused on the charge capture process.

• Keep up-to-date with medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements, and industry practices.

• Review payer policy publications, notices, and websites to aid in writing appeals and other necessary actions.

• Prioritize and manage daily projects while also fulfilling other assigned responsibilities.

⛳️ Requirements

• Bachelor’s Degree; relevant experience may be accepted as an equivalent to educational qualifications.

• At least 6 years of professional experience.

• Coding certification (CPC or CCS-P) and/or a Health Information Management credential (RHIT or RHIA).

• In-depth knowledge of multispecialty medical coding, charge capture, reimbursement, professional medical coding, contracting, and payment processing.

• Proficient in Excel and Word applications.

• Familiarity with medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools.

• Excellent written and verbal communication skills.

• Capacity to exercise independent judgment, decision-making, problem-solving, and take initiative.

• Preferred experience with front-end professional coding, Epic, and Encoder Pro.

• Ability to work remotely within one of MCW’s registered payroll states.

🏝️ Benefits

• Exceptional Healthcare Coverage, encompassing Health, Vision, and Dental services.

• Flexible Spending options available.

• 403B Retirement Package.

• Competitive Vacation and Paid Holidays.

• Tuition Reimbursement programs.

• Paid Parental Leave.

• Employee & Family Assistance Program (EFAP).

• Pet Insurance options.

• Access to an on-campus Fitness Facility, including onsite classes.

• Additional discounted rates on select cell phone plans, local fitness facilities, and Milwaukee recreation and entertainment.