Description Western Wisconsin Health is looking for a full-time Medical Coding Specialist (1.0 FTE) to join the Health Information Management department. The Medical Coding Specialist is responsible for reviewing clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM and CPT-4 codes for billing, internal and external reporting, research, and regulatory compliance. Under the direction of the HIM Director, accurately code inpatient, observation, outpatient diagnostic, therapeutic, consultative, emergency department services, ambulatory surgery (same day surgery), and clinic encounters, as assigned. Obtain appropriate reimbursement levels for professional services by reviewing and coding clinical diagnoses and procedures for physician visits and other services, conditions and procedures as documented in the ICD-10-CM and Official Guidelines for Coding and Reporting and CPT Coding Guidelines. Resolve errors associated with billing software edits, identify and report error patterns, and assist in design and implementation of workflow changes to reduce billing errors and improve coding efficiencies as appropriate for area of coding responsibility. Analyze denial and rejection reports and appeals whenever appropriate. Provide information and direction relevant to coding, to the physicians. Submit charges in a timely manner. All of this is done to support the organization's mission while living our values.
RequirementsQUALIFICATIONS Western Wisconsin Health expects employees to understand and to incorporate the values of our organization in their day-to-day practice. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Qualifications: - High school or GED
- Successful completion (or in progress) of an AHIMA-approved/other accrediting entity-approved Coding Certificate Program
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- RHIA, RHIT, CCS, CCS-P or CCA credentialed
- Proof of Certification is required and must be keep current throughout employment
- Recent graduate must obtain certification within 6 months of hire
Preferred Qualifications: - Associate's Degree
- 2+ years progressive related experience
Other Qualifications: - Understanding of ICD-10-CM/PCS, HCPCS and CPT coding systems
- Working knowledge of CMS and other third party payer billing rules, 3M encoder software use, electronic medical record applications
- Working knowledge of Microsoft Office (Excel, Word, PowerPoint, Outlook)
- Exhibit excellent communication and organizational skills
- Ability to manage conflicting priorities and handle multiple tasks/projects concurrently
- Maintain the integrity of highly confidential business and patient information
- Display and promote high standards of ethical conduct and behaviors consistent with organizational standards
Work schedule: - 1.0 FTE - 80 hours per biweekly pay period
- Monday-Friday, 7:30am-4pm
- May require minimal overtime
- Work remotely after onsite training is complete
- May be required to be onsite for mandatory meetings, education, and computer downtime so must live within a reasonable distance
ABOUT WESTERN WISCONSIN HEALTH Western Wisconsin Health is an integrated hospital and family practice clinic located in Western Wisconsin, just 30 minutes from downtown St. Paul on I-94. Join an exciting and growing team with a focus on the future of health care delivery!