Medical Coding Specialist II - Profee Pediatrics/Multi Specialty

UW Health•Middleton, WI

3d•$28 - $42•Remote

About The Position

We are seeking a Medical Coding Specialist I/II - Profee Pediatrics/Multi Specialty to utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. The role requires maintaining an understanding and applying knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers. Additionally, the specialist will resolve payer denials and respond to inquiries from revenue cycle teams, processing charge corrections as appropriate.

Requirements

High School Diploma or equivalent and medical coding education Required or In lieu of a medical coding education, an active coding certification Required

Nice To Haves

Associate's Degree in a healthcare related field Preferred
1 year of progressive coding experience (For HCC-specific roles, experience must be specific to HCC) Preferred
2 years progressive coding experience in multiple specialties, HCC Risk adjustment Coding Preferred
Certified Professional Coder (CPC) within 1 year Required or Certified Professional Coder Apprentice (CPC - A) within 1 year Required or Certified Outpatient Coder (COC) within 1 Required or Certified Outpatient Coder Apprentice (COC - A) within 1 year Required or Certified Inpatient Coder (CIPC) within 1 year Required or Certified Coding Specialist (CCS) within 1 year Required or Certified Coding Specialist Physician-Based (CCS-P) within 1 year Required or Certified Coding Associate (CCA) within 1 year Required
Certified Risk Adjustment Coder (CRC) Upon Hire Preferred
Registered Health Information Technician (RHIT) Upon Hire Preferred
Registered Health Information Administrator (RHIA) Upon Hire Preferred
Registered Health Information Technician (RHIT) Preferred
Registered Health Information Administrator (RHIA) Preferred
Certified Inpatient Coder (CIC) Upon Hire Preferred

Responsibilities

Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes.
Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.
Resolve payer denials and respond to inquiries from revenue cycle teams, processing charge corrections as appropriate.