Coder (Clinic - II)

ThedaCare • Neenah, WI

3d • Onsite

About The Position

Summary : The Coder (Clinic - II) performs coding review for primary care or specialty services for ThedaCare Physician Services to accurately reflect services rendered. Reviews and processes charges using industry standard methodologies (CPT, ICD-10-CM, HCPCS), abides by Standards of Ethical Coding (AAPC/AHIMA), and complies with official coding guidelines and other regulatory requirements. Audits medical record documentation for completeness and accuracy. Educates and/or collaborates with providers and other clinical staff when completion or clarity is needed.

Requirements

• High School diploma or GED preferred
• Must be 18 years of age
• Coding certificate or associate’s degree in medical business or coding/health information
• One year of experience in general medical or specialty coding
• Coding certification through AAPC or AHIMA (CPC, CPC-A or CCS or CCS-P)
• Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
• Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

Responsibilities

• Reviews and/or assigns CPT and/or diagnosis codes (ICD-10-CM, including HCC risk adjustment) for primary care and/or specialty clinic services (E&M, office procedures, inpatient hospital rounding, OB services, outpatient general practice procedures, etc.) with a high degree of accuracy.
• Performs documentation reviews with the use of department auditing tools, shares results with providers and auditing team, and identifies educational opportunities.
• Collaborates with providers, clinical team members, and/or other departments when completion or clarity is needed within the medical record to accurately complete coding functions.
• Manages and maintains coding inventory responsibilities related to payer denials and claim edits to ensure timely reimbursement for services provided.
• Researches payer policies.
• Manages and maintains operational coding functions to ensure charge capture of all billable services.
• Performs world class service to our customers, responding timely and professionally to inquiries.

Benefits

• Lifestyle Engagement e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
• Access & Affordability e.g. minimal or zero copays, team member cost sharing premiums, daycare

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees