Medical Coding Specialist I or II – Pathology, Ophthalmology

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

📋 Description

• Leverage available encoder and grouper software, along with other coding resources, to accurately identify the relevant ICD-10-CM, CPT, and/or HCPCS codes, including specialty-specific codes and Evaluation and Management (E&M) codes.

• Maintain a comprehensive understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents, and National Coverage Documents (LCD/NCD) directives, as well as Medically Unlikely Edits (MUEs) and Medicare Teaching Physician Guidelines, ensuring adherence to applicable regulatory requirements and institutional guidelines when selecting appropriate codes and modifiers.

• Address payer denials and respond to inquiries from revenue cycle teams, making necessary charge corrections as needed.

⛳️ Requirements

• High School Diploma or equivalent along with medical coding education is required; alternatively, an active coding certification is mandatory in lieu of a medical coding education.

• An Associate's Degree in a healthcare-related field is preferred.

• A minimum of 1 year of progressive coding experience is preferred (For HCC-specific roles, experience must be specifically related to HCC).

• At least 2 years of progressive coding experience across multiple specialties, with a focus on HCC Risk Adjustment Coding, is preferred.

• Certification as a Professional Coder (CPC), or as a Certified Professional Coder Apprentice (CPC - A), or as a Certified Outpatient Coder (COC), or as a Certified Outpatient Coder Apprentice (COC - A), or as a Certified Inpatient Coder (CIPC), or as a Certified Coding Specialist (CCS), or as a Certified Coding Specialist Physician-Based (CCS-P), or as a Certified Coding Associate (CCA), all within 1 year is required. Additionally, obtaining a Certified Risk Adjustment Coder (CRC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) upon hire is preferred.

• Certification as a Certified Inpatient Coder (CIC) upon hire is also preferred.

🏝️ Benefits

• Health and dental insurance

• Paid time off

• Retirement plans

• Two-week paid parental leave

• Adoption assistance

• Flexible scheduling options that promote work-life balance

• Access to valuable resources through the UW Health Employee Wellbeing Department to support emotional, financial, and physical well-being

• Eligibility for tuition benefits