[Hiring] ProFee Inpatient Coding Specialist III @Children's Wisconsin

Role Description

The ProFee Inpatient Coding Specialist III will work in collaboration with Ancillary or specialty departments/locations/providers to code, review and release charges in a timely manner and to ensure correct coding, billing compliance and complete charge capture. Collaborates with providers and other departmental staff/leaders on coding or charge capture related questions/topics.

• 100% Remote
• Full time: Monday-Friday (40 hrs per week)

Qualifications

• Three years of experience coding Pro-Fee Inpatient E/M services for multi-specialty required
• NICU experience preferred
• Experience coding bedside procedures in the inpatient setting
• Experience working claim edits and denials
• Epic experience preferred

Requirements

• One of the following certifications:
  • CPC-Certified Professional Coder - American Board of Professional Coders
  • CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association
  • CCS-Certified Coding Specialist - American Health Information Management Association
  • RHIT-Registered Health Information Technician - American Health Information Management Association
• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required

Knowledge, Skills and Abilities

• Knowledge of ICD10, CPT and HCPCS coding guidelines
• Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance
• Prior use of an Electronic Health Record
• Excellent communication (oral and written) skills
• Ability to work independently, exercise independent judgment and solve problems effectively
• Specialty Coding knowledge

Essential Duties

• Assigns or verifies CPT, ICD-10 CM coding and modifiers based upon documentation
• Subject matter expert in one or more specialties and may also cover multiple surgical/medical specialties for abstraction, ambulatory and/or surgical/procedural coding
• Ensures compliance with official coding guidelines
• Resolves edits for various charges, following established policies and procedures to ensure that all data elements are applied
• Monitors charge capture volumes and work queues
• Acts as a resource for department leaders and administrators, clinical staff and other revenue cycle staff to assure consistent and accurate charge capture
• Works with clinic staff and Providers regarding missing or unclear information that is required for billing
• Queries Providers as needed and coordinates responses to Provider questions
• Uses coding knowledge to identify trends and educational opportunities for Providers and other staff
• Identifies opportunities to reduce denials
• Develops and maintains all protocols and processes related to assigned areas of responsibility
• Maintains understanding of all teaching Physician and Provider documentation policies
• May train other Coders on new departments or specialties

Company Description

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.