ProFee Inpatient Coding Specialist III
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 ProFee Inpatient Coding Specialist III - will work in collaboration with Ancillary or specialty departments/locations/providers to code, review and release charges in a timely manner and to ensure correct coding, billing compliance and complete charge capture. - Collaborates with providers and other departmental staff/leaders on coding or charge capture related questions/topics. Location and schedule - 100% Remote - Full time: Monday-Friday (40 hrs per week) Experience - Three years of experience coding Pro-Fee Inpatient E/M services for multi-specialty required - NICU experience preferred - Experience coding bedside procedures in the inpatient setting - Experience working claim edits and denials - Epic experience preferred Licenses and Certifications - One of the following: CPC-Certified Professional Coder - American Board of Professional Coders, CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association, CCS-Certified Coding Specialist - American Health Information Management Association, RHIT-Registered Health Information Technician - American Health Information Management Association - Education: High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required. Knowledge, Skills and Abilities - Knowledge of ICD10, CPT and HCPCS coding guidelines - Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance - Prior use of an Electronic Health Record - Excellent communication (oral and written) skills - Ability to work independently, exercise independent judgment and solve problems effectively - Specialty Coding knowledge Essential Duties - Ability to work independently, exercise independent judgment and solve problems effectively - Specialty Coding knowledge - Assigns or verifies CPT, ICD-10 CM coding and modifiers based upon documentation - Subject matter expert in one or more specialties and may also cover multiple surgical/medical specialties for abstraction, ambulatory and/or surgical/procedural coding - Ensures compliance with official coding guidelines - Resolves edits for various charges, following established policies and procedures to insure that all data elements are applied - Monitors charge capture volumes and work queues and acts as a resource for department leaders and administrators, clinical staff and other revenue cycle staff to assure consistent and accurate charge capture - Works with clinic staff and Providers regarding missing or unclear information that is required for billing - Queries Providers as needed and coordinates responses to Provider questions - Uses coding knowledge to identify trends and educational opportunities for Providers and other staff - Identifies opportunities to reduce denials - Develops and maintains all protocols and processes related to assigned areas of responsibility - Maintains understanding all teaching Physician and Provider documentation policies - May train other Coders on new departments or specialties 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