Coding Quality Analyst

Summary

Serves as an expert resource for multi-specialty documentation, coding and billing. Assist in performing medical coding audits on clinicians and/or coding staff as needed within multi-specialty physician practices to identify deficiencies and ensure coding remains compliant with coding guidelines as well as government and third-party payer regulations and guidelines. Responsible for new and existing clinician and coder education, as well as team and/or clinical department educational sessions.

All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AZ, DE, FL, GA, IL, IN, MD, MI, MN, MO, NC, TN, TX, and UT.

• Expert resource of multispecialty coding, charge capture and reimbursement which may include surgical, inpatient, emergency and/or ambulatory coding; assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.

• Participate in work groups to evaluate, produce and/or update policies and procedures related to internal process in relation to documentation, coding, and billing.

• Educate/train new and existing employees in multispecialty clinical areas, including government documentation and coding regulations. Assist lead/CS IV team in educational session, including coding/charge capture process and Epic related changes.

• Onboard/educate new and existing physicians and APP's on documentation and coding rules and regulations.

• Perform documentation and coding audits on clinicians and coding specialist staff for coding accuracy.

• Support Charge Capture Team in analyzing coding denial trends and troubleshooting solutions such as front-end system edits and/or front-end education to minimize reimbursement delays.

• Assist in the training of coworkers, coding staff, clinicians as appropriate to provide evaluation, education and/or orientation adhering to CPT, ICD-10CM and Government documentation and coding regulations.

• Subject Matter Expert for Encoder Pro.

• Participates in new employee orientation to acquaint them with the charge capture process.

• Maintain current knowledge of medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements and practices. Communicates changes to appropriate persons.

• Review payer policy publications, notices and websites for coding and policy information to assist in appeal writing or to support other action determinations.

• Responsible for the day-to-day prioritization and the execution of various projects.

• Perform other duties or projects as assigned.

• Other duties as assigned.

• Ability to interact with people effectively.

• Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments.

• Strong written and oral communication skills.

• Ability to take initiative and to exercise independent judgment, decision making and problem-solving skills.

• Proficient in Excel and Word, Medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools.

Appropriate experience may be substituted for education on an equivalent basis.

Minimum Required

Education:

Bachelor's Degree

Minimum

Required Experience:

6 years

Preferred Experience: Front end professional coding, Epic, Encoder Pro

Required Certification/Licensure(s): Coding certification (CPC, CCS-P) and/or Health Information Management credential (RHIT, RHIA).

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Work requires occasionally lifting moderate weight materials, standing, or walking continuously.

Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.

Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.

Target salary range for this position is between $74,500.00 and $94,900.00 annually. The final offered salary will depend on the applicant's education, experience, skills, and knowledge, as well as…