Coding Specialist IV - Clinical Practice Services

Serve as expert resource regarding all aspects of documentation, coding, and billing.Supports supervisor and team by guiding and directing specific employees in their day-to-day job functions. Train new and existing staff.Provide cross coverage for multiple specialty areas. Investigate and resolve issues pertaining to charge capture, billing, and reimbursement. Complete special projects as assigned. Act as supervisor in Supervisors' absence.

All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AL, AZ, DE, FL, GA, IN, MD, MI, MN, MO, NC, TN, TX, & UT.

CHARGE PROCESSING

• Expert knowledge of multispecialty coding, which may include surgical, inpatient, emergency, and/or ambulatory coding; assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.

• Guide and direct specific employees in their day-to-day job functions. Answer questions and resolve coding and billing issues.

• Identify, report, and resolve coding and reimbursement issues with physicians, department administrators, and other billing office staff, including reimbursement staff.

• Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements - CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied.

• Serve as a resource to staff for accurate assignment of CPT procedure and ICD-10-CM diagnosis coding of complicated multi-specialty services for appropriate reimbursement.

• Provide out of office coding coverage to multi-specialty areas.

ASSIST WITH TEAM SUPERVISION AND SPECIAL PROJECTS

• Primary contact for staff when issues or questions arise.

• Monitor team workflow, assign and re-assign work to meet team and organizational goals.

• Quality review of staff work and workflows.

• Act as supervisor in Supervisor's absence.

TRAINING STAFF

• Onboarding/training of new or existing coding specialist staff.

CLAIM DENIALS / BILLING ISSUES

• Identify report and resolve coding and reimbursement issues. Working with physicians, department administrators, and other billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.

PROTOCOLS

• Develop and maintain all protocols related to their assigned areas.

• Assist others in the development of protocols for other areas.

SYSTEM TESTING

• Participate in system testing as needed.

Expert knowledge of CPT, ICD-10 CM coding, payer, and governmental policies. Excellent oral and written communication skills. Detail oriented. Excellent presentation skills. Excellent project management and problem-solving skills. Ability to handle multiple issues at one time. Ability to establish and maintain effective working relationships with the team and departmental staff (including administrative staff and faculty). Ability to work independently. Excellent computer skills. Knowledge of EMR's and electronic charge workflows. Meet or exceed established production rate and performance standards.

Minimum Required Education:High school diploma.

Minimum Required Experience: 5 years of related coding experience.

Preferred Experience:Academic teaching institution professional billing experience.

Required Certification/Licensure(s): Coding certification (CPC, CCS-P) and/or Health Information Management credential (RHIT, RHIA).

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Work requires occasionally lifting moderate weight materials, standing, or walking continuously.

Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.

Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Employee & Family Assistance Program (EFAP)
• Pet Insurance
• On campus Fitness Facility, offering onsite classes
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.

For a brief overview of our benefits see: Benefits Overview

For a full list of positions see: MCW Careers

At MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring - Collaborative - Curiosity - Inclusive - Integrity - Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website.

The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.