Medical Coding Specialist

Group Health Cooperative of South Central Wisconsin • Madison, WI

89d

About The Position

The Medical Coding Specialist is responsible for reviewing electronic encounter documentation to verify that practitioner-submitted codes are accurate, adhere to coding protocols, and comply with all applicable guidelines. This role also involves assigning appropriate codes to medical records to ensure their accuracy and completeness. Additionally, the Specialist supports practitioners and their staff by providing education on coding practices and documentation requirements and may contribute to coding-related research projects. The position includes reviewing insurance claims to identify potential coding errors and researching coding standards to address denials based on coding issues. As needed, the Specialist may assist the Medical Coding Manager with administrative duties. This position operates under the general supervision of the Medical Coding Supervisor.

Requirements

• High school graduation or equivalent.
• Graduation from an accredited Medical Coding Specialist Program or equivalent combination of education and/or relevant work experience.
• Minimum of one (1) year of medical coding experience preferred.
• Certification as a CPC or CCS-P is required.
• Knowledge of CPT/HCPCS, ICD-10-CM, E/M, medical records, and documentation.
• Experience with EPIC is highly desirable.
• Knowledge of medical terminology, basic anatomy, physiology, and disease process.
• Knowledge of Medicare and Medicaid rules and regulations.
• Minimum of one (1) year of experience interacting with practitioners regarding coding requirements preferred.
• Knowledge of or ability to learn various computer programs such as MS Office Suite.
• Excellent oral and written communication skills.
• Excellent customer service skills and ability to work with a diverse patient population.
• Ability to identify coding needs and code accurately.
• Excellent organizational, analytical, and problem-solving skills.
• Ability to maintain personnel related and patient confidentiality.
• Knowledge of or ability to learn HIPAA requirements.
• Ability to negotiate with individuals, including practitioners.
• Ability to adhere to OSHA standards and other patient care protocols.
• Ability to see at near and mid-range.
• Ability to use a keyboard regularly.
• Ability to travel among GHC sites on short notice.
• Manual dexterity, including the ability to perform fingering and handling with both hands.
• Ability to intermittently sit, stand, bend, stoop, and stretch.

Nice To Haves

• Knowledge of insurance processing preferred.
• Experience with EPIC highly desirable.

Responsibilities

• Review electronic encounter documentation for accuracy and compliance with coding protocols.
• Assign appropriate codes to medical records.
• Provide education on coding practices and documentation requirements to practitioners and their staff.
• Contribute to coding-related research projects.
• Review insurance claims to identify potential coding errors.
• Research coding standards to address denials based on coding issues.
• Assist the Medical Coding Manager with administrative duties as needed.

Benefits

• Health and dental insurance.
• Paid short-term disability.
• Paid long-term disability.
• Life insurance.
• Flexible spending account.
• Employee assistance programs.
• Tuition reimbursement.
• Pet insurance.
• Eyewear discounts.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees