As a Coding Quality Analyst, you will serve as an expert resource for multi-specialty documentation, coding and billing. Assist in performing medical coding audits on clinicians and/or coding staff as needed within multi-specialty physician practices to identify deficiencies and ensure coding remains compliant with coding guidelines as well as government and third-party payer regulations and guidelines. Responsible for new and existing clinician and coder education, as well as team and/or clinical department educational sessions.
All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AZ, DE, FL, GA, IL, IN, MD, MI, MN, MO, NC, TN, TX, and UT.
Primary Responsibilities
• Expert resource of multispecialty coding, charge capture and reimbursement which may include surgical, inpatient, emergency and/or ambulatory coding; assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Participate in workgroups to evaluate, produce and/or update policies and procedures related to internal process in relation to documentation, coding, and billing.
• Educate/train new and existing employees in multispecialty clinical areas, include government documentation and coding regulations. Assist lead/CS IV team in educational session, include coding/charge capture process and Epic related changes.
• Onboard/educate new and existing physicians and APP’s on documentation and coding rules and regulations.
• Perform documentation and coding audits on clinicians and coding specialist staff for coding accuracy.
• Support Charge Capture Team in analyzing coding denial trends and troubleshooting solutions such as front-end system edits and/or front-end education to minimize reimbursement delays.
• Assist in the training of coworkers, coding staff, clinicians as appropriate to provide evaluation, education and/or orientation adhering to CPT, ICD-10CM and Government documentation and coding regulations.
• Subject Matter Expert for Encoder Pro.
• Participates in new employee orientation to acquaint them with the charge capture process.
• Maintain current knowledge of medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements and practices. Communicates changes to appropriate persons.
• Review payer policy publications, notices and websites for coding and policy information to assist in appeal writing or to support other action determinations.
• Responsible for the day-to-day prioritization and the execution of various projects.
• Perform other duties or projects as assigned.
• Other duties as assigned.
Knowledge – Skills – Abilities
• Ability to interact with people effectively.
• Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments.
• Strong written and oral communication skills.
• Ability to take initiative and to exercise independent judgment, decision making and problem-solving skills.
• Proficient in Excel and Word, Medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools.
Qualifications
Appropriate experience may be substituted for education on an equivalent basis.
Minimum Required Education: Bachelor’s Degree
Minimum Required Experience: 6 years
Preferred Experience: Front end professional coding, Epic, Encoder Pro
Required Certification/Licensure(s): Coding certification (CPC, CCS-P) and/or Health Information Management credential (RHIT, RHIA).
Target salary range for this position is between $74,500.00 and $94,900.00 annually. The final offered salary will depend on the applicant’s education, experience, skills, and knowledge, as well as considerations of internal equity and market alignment.
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