Coding Specialist

The Coding Specialist will read and interrupt provider documentation of patient encounters to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual – C Modification (ICD-10-CM), and the Current Procedural Terminology manual (CPT).

 

ESSENTIAL JOB FUNCTIONS

1. Evaluates and works closely with providers to receive and interpret accurate medical documentation to optimize reimbursement for procedures and services.

2. Ensures that the ICD-10/ICD-10 and CPT codes and other documentation are accurately entered into the computer system to generate a statement or claim.

3. Protects the security of medical records to ensure that confidentiality is maintained.

4. Reports any coding issues to Revenue Cycle Manager and helps to resolve the issues.

5. Review denials, make appropriate corrections and file appeals on any coding related discrepancies.

6. Works collaboratively with coders in other departments for coding procedures.

7. Ensures the codes are entered correctly due to insurance company requirements for providers to receive reimbursement for their services.

8. Conduct periodic audits to ensure accuracy and competitiveness to market benchmark standards.

9. Support scheduling team as a resource for questions, inquires, as needed.

10. Attends workshops, webinars, etc. to stay abreast of current issues, trends and changes in the laws and regulations governing medical coding and documentation.

11. Perform other projects/tasks as requested.

This list is not inclusive of all duties and responsibilities that may be assigned. They are only listed as typical. Any other duties and responsibilities assigned will be of a similar nature requiring the same relative skill and capabilities.

 

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

EDUCATION and/or EXPERIENCE

· Associate degree in medical coding, health care business services or a related field is required. Will consider equivalent experience.

· 2+ years of work experience in a billing or coding role is required.

· Credentialed as A Certified Professional Coder (CPC) or related field is preferred.

· Knowledge in Epic software is preferred.

· Experience with auditing is preferred.

 

KNOWLEDGE, SKILLS & ABILITIES – COMPETENCIES

· Possesses a clear understanding of medical terminology, medical billing practices and billing reimbursement.

· Demonstrates knowledge in the appeals process across all payers.

· Adherence to strict confidentiality standards and compliance as to scope of role, record keeping, PHI and HIPPA.

· Possesses strong communications and organizational skills.

· Models a professional disposition and communication style.

· Demonstrates attention to detail.

· Specific safety certification/recertification may be required per the organization.

 

PHYSICAL/MENTAL DEMANDS and WORK ENVIRONMENT

The nature of the job requires sitting, walking for periods of time. While performing the essential functions of the job one may occasionally bend/stoop, squat, reach above shoulder, crouch, kneel balance, push/pull. Some lifting/carrying up to 35 lbs. is required. The use of hands for repetitive simple grasping, firm grasping, fine manipulating is required. While performing the job, one will encounter frequent close paperwork, use of computer monitor, need for color vision, visual monotony. Must utilize hearing for continuous conversations, frequent telephone use, background noise. Frequent stress may occur. The job requires frequent independent decision-making.

This job description is not a guarantee of employment. It is understood that employment is “at will,” and the employer or the employee may terminate employment at any time.

To perform this position successfully, an individual must be able to perform the essential job duties satisfactorily (with or without accommodation). Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions.

Additional Notes:

Full-time FTE (.8 – 1.0)

Position is based in Wausau WI. Potential to be a hybrid role, working virtually/remote while residing within the Wausau WI area – it is required to be able to come in to the office to complete needed tasks/responsibilities (i.e. work denials) and attend team and company meetings.

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Wausau, WI 54401: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• How did you hear of this Coder position with Surgical Associates?

Education:

• Associate (Preferred)

Experience:

• billing or coding: 2 years (Preferred)
• coding, health care business services, or related: 2 years (Preferred)
• EPIC: 1 year (Preferred)

License/Certification:

• Certified Professional Coder (CPC) credentialing (Preferred)

Work Location: One location

 

Apply Now

 

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Equal Opportunity Employer

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