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Coding Audit & Education Coordinator (Professional) - REMOTE

Role overview

Summary

This role is for a Coding Audit & Education Coordinator at Children's Wisconsin, focusing on ensuring accurate coding practices across multiple specialties. You will support the Professional coding team by conducting research, developing educational materials, and collaborating with various teams to enhance coding accuracy and reduce denials.

Qualifications

  • 4 years of experience in a multi-specialty physician practice, coding multiple medical/surgical specialties/subspecialties.
  • High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED).
  • Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer and governmental policies.
  • One of the following certifications: CPC, CCS, CCS-P, or RHIT.
  • Excellent communication (oral and written) skills.

Responsibilities

  • Conduct research on appropriate coding of services for all specialties using reputable professional coding sources.
  • Develop educational materials based on research of new or existing services provided by the Professional Coding team.
  • Identify opportunities to reduce preventable Professional Coding denials and collaborate with teams to implement plans.
  • Maintain understanding of Teaching Physician and Provider documentation policies.

Key facts

Hard skills

Other skills

  • Verbal Communication Skills
  • Analytical Skills
  • Problem Solving

About the company

Children's Wisconsin logo

Children's Wisconsin

  • Hospitals & Health Systems
  • Large
  • 1,001–5,000
Children's Wisconsin is one of the nation's top pediatric hospitals. We have over 500 pediatric-trained doctors who see kids of all ages for everything from serious procedures to routine checkups. And we complement our nationally-ranked clinical care with robust community support programs that keep kids safe and healthy.

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Job description

At Children’s Wisconsin, we believe kids deserve the best.

Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/

The Coding Audit and Education Coordinator (ProFee) is responsible for conducting research on the appropriate coding of services for all specialties, using reputable professional coding sources. Research will be needed when new service lines are being considered, when new procedure or diagnosis codes are released or when we need to review current coding practices. This position will help the Professional coding team ensure that we are coding with accuracy and are able to provider providers with accurate coding guidance.

  • 100% Remote
  • Full time - 40 hours per week
  • Monday-Friday
  • No Evenings or weekends

Education:

  • High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required
  • Associate's Degree preferred or
  • Bachelor's Degree preferred


Experience:

  • 4 years of experience in a multi-specialty physician practice, coding multiple medical/surgical specialties/subspecialties required

Licenses and Certifications:

  • + one of the following:
  • CPC-Certified Professional Coder - American Board of Professional Coders
  • CCS-Certified Coding Specialist - American Health Information Management Association
  • CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association
  • RHIT-Registered Health Information Technician - American Health Information Management Association


Knowledge, Skills and Abilities:


  • Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer and governmental policies.
  • Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance.  
  • Prior use of an Electronic Health Record.
  • Ability to accurately research Coding Topics using a variety of resources.
  • Excellent communication (oral and written) skills
  • Ability to work independently, exercise independent judgment and solve problems effectively.

Essential Functions:

  • Serves as an expert in the area of multispecialty coding which may include surgical, inpatient, emergency and/or ambulatory coding and include assignment of CPT, ICD-10 CM coding and modifiers based upon documentation.
  • Performs research using reputable professional coding sources for all new services performed by Providers that the Professional Coding team supports.
  • Develops educational materials based on research of new or existing services that are provided.
  • Maintains understanding all Teaching Physician and Provider documentation policies.
  • Acts in conjunction with teams throughout the organization to evaluate policies and workflows related to Professional coding.
    Identifies opportunities to reduce preventable Professional Coding denials and works with other teams to implement plans to reduce denials.
  • Develops Professional coding Internal Coding guidelines and works with others to develop and maintain internal guidelines.
  • Works with Professional Coding leaders to offer feedback on processes and assists in the development of new processes as needed.

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.

Certifications/Licenses:

+ one of the following: - N/A, CCS-Certified Coding Specialist - American Health Information Management Association, CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association, CPC-Certified Professional Coder - American Board of Professional Coders, RHIT-Registered Health Information Technician - American Health Information Management Association

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