BayCare Health Systems
1035 Kepler Drive
Green Bay, WI 54311, USA
Come work where passion, quality, vision, professionalism, and synergy are valued! BayCare Clinic's mission is to provide measurably superior specialty medical services to our patients.
BayCare Clinic Corporate Headquarters is looking for a Coding Compliance Auditor in Green Bay, WI. We’re looking for a compassionate, thoughtful candidate who wants to contribute to a positive experience for all our patients. This role is full time between our core hours, Monday-Friday between 8:00 a.m. - 5:00 p.m. No Holidays! No Weekends! This is a remote position with limited on-site requirements, however, must be able to commute as needed on-site.
The Clinic:
BayCare Clinic is a successful, dynamic group comprised of 19 specialties. We are a physician‑owned entity with joint ownership in Aurora BayCare Medical Center, a 167‑bed hospital located in Green Bay, WI, offering us a built‑in referral base. Each of our specialty practices have clinical autonomy and are financially sound.
BayCare Clinic offers part‑time and full‑time employees a comprehensive benefits package including health, dental, disability and life insurance, as well as flexible spending options. We also offer a 401k retirement plan with a company match, generous PTO, and paid holidays.
The Team:
The unique skills and talents of each member of our team contributes to our synergy and our overall goal of providing our patients with excellent care. We believe in the power of a positive, collaborative culture, and we strive to provide a supportive and energizing work environment.
Every member of our team has a voice and is trusted to have ownership over their work. To encourage this, we provide regular opportunities for professional development, we seek out feedback and ideas, and we invite participation on a variety of projects.
The Job:
Conducts comprehensive coding audits including but not limited to the review of: pre‑bill and post‑bill charges; coder‑focused and provider‑focused audit samples; and random and focused samples.
Evaluates the validity of services, procedures, diagnoses, and drugs/supplies billed based on the supporting documentation.
Analyzes the results of internal and external audits for patterns and identifies opportunities for coder education and provider documentation feedback.
Analyzes coding issues that generate claim edits and insurance denials.
Assists in creating and maintaining department resources.
Prepares formal reports of audit results and denial feedback.
Make recommendations for Epic warnings and rules to maximize claim submission accuracy.
Stays current with official coding guidelines for CPT, HCPCS, and ICD‑10‑CM and CMS NCCI edits and policy.
Maintains thorough knowledge of payor reimbursement policies.
Complies and adheres to pertinent policies and procedures.
Respects and maintains confidentiality.
Works in a safe, compliant and ethical manner at all times.
Performs any and all other assigned responsibilities.
The Requirements:
A minimum of an Associate’s degree in Health Information Technology or equivalent is preferred.
Coding certification specific to outpatient professional coding required.
Certified professional Medical Auditor (CPMA) preferred.
3+ years of recent experience in specialty professional coding required.
1+ years of recent experience in a coding auditing role preferred.
Advanced knowledge of ICD‑10‑CM, CPT and HCPCS coding required.
Exceptional written and verbal communication skills
Proficiency in Microsoft Office (Outlook, Teams, Excel, Word) required.
Experience with Epic EMR and/or web‑based coding software and/or medical coding audit software preferred.
High degree of focus with exceptional attention to detail.
Advanced ability to identify coding quality issues.
Ability to work independently and exercise independent judgment and decision making.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr