ProFee Coding Specialist III

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

📋 Description

• Collaborate with ancillary or specialty departments, locations, and providers to code, review, and timely release charges.

• Ensure accurate coding, billing compliance, and comprehensive charge capture.

• Partner with providers and departmental staff and leaders on inquiries related to coding and charge capture.

• Assign or verify CPT, ICD-10-CM coding, and modifiers based on relevant documentation.

• Act as a subject matter expert in one or more specialties while covering multiple surgical or medical specialties for abstraction, ambulatory, and/or surgical/procedural coding.

• Ensure adherence to official coding guidelines.

• Resolve edits for various charges in accordance with established policies and procedures.

• Monitor charge capture volumes and manage work queues.

• Assist department leaders, administrators, clinical staff, and revenue cycle personnel with consistent and accurate charge capture.

• Collaborate with clinic staff and providers regarding any missing or unclear billing information.

• Query providers when necessary and coordinate responses to their questions.

• Identify coding trends and educational opportunities for both providers and staff.

• Discover opportunities to minimize denials.

• Develop and maintain protocols and processes for assigned areas.

• Maintain a thorough understanding of teaching physician and provider documentation policies.

• May provide training to other coders on new departments or specialties.

⛳️ Requirements

• Minimum of three years of experience coding Pro-Fee E/M services for multi-specialty is required.

• Inpatient experience is preferred.

• Experience coding bedside procedures within the inpatient setting is essential.

• Familiarity with claim edits and denials is necessary.

• Epic experience is preferred.

• One of the following certifications is required: CPC (Certified Professional Coder), CCS-P (Certified Coding Specialist Physician Based), CCS (Certified Coding Specialist), or RHIT (Registered Health Information Technician).

• High School diploma, GED, or HSED is required.

• Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines.

• Working knowledge of CCI edits, healthcare insurance guidelines, and other regulatory standards.

• Excellent oral and written communication skills are essential.

• Ability to work independently, exercise sound judgment, and effectively solve problems.

• Specialty coding knowledge is required.

🏝️ Benefits

• Full-time schedule, Monday through Friday, 40 hours per week.