ProFee Inpatient 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 ensure timely coding, review, and release of charges.

• Guarantee accurate coding, adherence to billing compliance, and comprehensive charge capture.

• Work closely with providers, departmental personnel, and leaders to address coding and charge capture inquiries.

• Assign or confirm CPT, ICD-10-CM coding, and modifiers based on the provided documentation.

• Act as a subject matter expert in one or more specialties, covering various surgical, medical, ambulatory, and procedural coding areas.

• Ensure compliance with official coding standards.

• Address charge edits in accordance with established policies and procedures.

• Track charge capture volumes and manage work queues.

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

• Collaborate with clinic staff and providers to rectify missing or ambiguous billing information.

• Engage with providers and coordinate responses to their inquiries.

• Recognize coding trends and identify opportunities for education.

• Highlight opportunities to minimize denials.

• Develop and uphold protocols and processes related to assigned responsibilities.

• Maintain knowledge of teaching physician and provider documentation policies.

• Provide training to other coders on new departments or specialties as necessary.

⛳️ Requirements

• Minimum of three years of experience coding Pro-Fee Inpatient E/M services across multiple specialties is required.

• NICU experience is preferred.

• Experience in coding bedside procedures within the inpatient environment.

• Familiarity with managing claim edits and denials.

• Epic experience is preferred.

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

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

• Knowledge of ICD-10, CPT, and HCPCS coding guidelines is essential.

• Working understanding of CCI edits, healthcare insurance guidelines, and other regulatory instructions.

• Prior experience using an Electronic Health Record system.

• Exceptional oral and written communication abilities.

• Capacity to work independently, exercise sound judgment, and effectively resolve issues.

• Proficiency in Specialty Coding.

🏝️ Benefits

• Full-time schedule of Monday to Friday, totaling 40 hours per week.

• 100% remote work opportunity.