JOB SUMMARY: The primary purpose of the position is to review both procedural and diagnostic (ICD-10) coding to ensure appropriate billing and insurance regulations are met. This position will be staffed during clinic hours and is largely remote. Occasionally in-person meetings with providers will be required. Must live within reasonable traveling distance from Hudson, WI.CORE DUTIES AND RESPONSIBILITIES:Have in-depth understanding of coding and compliance rules and regulations.Responsible for reviewing provider documentation, coding and posting charges for healthcare services; including Primary Care, Lab/Pathology, Podiatry and more.Provide coding education and engage with assigned providers.Research and communicate governmental and payer-specific rules and regulations to ensure coding compliance.Identify and communicate best practices based on provider documentation, insurance payer medical policies and CMS guidelines.Review, code and post charges for hospital outpatient and inpatient services if applicable to service lines worked.Work CCI/LMRP edits, claims manager rules and coding related denials.Assist patients and staff with coding and pricing issues.Provide support for customer service issues.Perform chart audits to assess overall understanding of CMS guidelines and increase clinic reimbursement.Attend department meetings, educational seminars, and trainings.Other duties as assigned.SUPPLEMENTAL DUTIES AND RESPONSIBILITIES:Maintain confidentiality.Displays the ability to work independently and multi-task.Work effectively under pressure in a fast-paced environment.Possess strong analytical, grammatical, spelling a communication skills.Attend relevant training sessions, department and employee meetings.Abide by clinic protocols, ergonomic recommendations and OSHA standards.Maintain a neat and well-groomed professional appearance.WORKING CONDITIONS:Is subject to interruptions, imposed deadlines and frequent problem-solving activities.May be subject to hostile and emotionally upset patients, staff, and personnel from other agencies.Standard Office Environment- with the option to work from home.PHYSICAL DEMANDS:Abide by the ergonomic recommendations of the position.Must possess sight/hearing senses or use prosthetic devices that will enable these senses to function adequately.Sit for several hours.Subject to lifting and carrying supplies averaging 25 lbs. (i.e. cartons of paper, medical supplies, office supplies, etc.).Repetitive motions involving use of phone and keyboard.EDUCATION: Required: Certification Professional Coder (AAPC) or Certified Coding Specialist certification (HIMA).EXPERIENCE: Minimum: 2 years clinical coding experience with strong E/M coding background. Experience in podiatry and lab coding is preferred.Desired: 2-5 years in primary care and/or multi-specialtyKNOWLEDGE:Ability to work independently with minimal instruction in a team environment.Excellent verbal and written communication skills.Ability to prioritize and multi-task.Demonstrated PC skills in Word and Excel.Maintain positive working relationships.Knowledge of Oracle PowerChart and Cerner PM productions are a plus.
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