Quality Coding Analyst I

As a Quality Coding Analyst I, you will serve as an expert resource for multi-specialty documentation, coding and billing. Works as an extension to the Charge Capture Supervisory Team to monitor daily Charge Capture volumes and production, quality of documentation and coding. Assist in performing medical coding audits on 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 staff education, as well as team and/or clinical department educational sessions.

Responsibilities:

• Expert resource of multi-specialty 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 multi-specialty clinical areas, include government documentation and coding regulations. Assist lead/CS IV team in educational session, include coding/charge capture process and Epic related changes.
• 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 staff orientation to acquaint them with charge 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. 

Minimum Qualifications:

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

Minimum Required Education: Bachelors Degree

Minimum Required Experience: 6 years

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

Preferred Qualifications:

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

Why MCW?
 

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Pet Insurance
• On campus Fitness Facility, offering onsite classes.
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.

For a full list of positions see: www.mcw.edu/careers  

For a brief overview of our benefits see: https://www.mcw.edu/departments/human-resources/benefits

Eastern Wisconsin is a vibrant, diverse metropolitan area.  MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine.  MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community.