Summary:

Perform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments.

Primary Responsibilities:

CHARGE PROCESSING

Assignment or verification of

CPT, ICD-10 CM

coding and modifiers based upon documentation. (Inpatient/Emergency Department abstraction, ambulatory coding and/or surgical/procedural coding). Resolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements•

CPT, ICD-10

CM, modifiers, provider, billing area, etc.) are applied. Charge Entry as needed.

RECONCILIATION OF CHARGES

Monitor charge flow and act as a liaison with managers, department administrators and other billing personnel to assure consistent and accurate change flow. Work with clinic staff and physicians regarding missing or unclear information that is required for billing.

CLAIM DENIALS / BILLING ISSUES

Identify, report, and resolve coding and reimbursement issues. Working with physicians, department administrators and other billing office staff, including reimbursement staff. Identify opportunities to reduce denials and enhance revenue.

PROTOCOLS

Develop and maintain all protocols related to their assigned areas.

PROVIDER EDUCATION

Maintain understanding all Teaching Physician and provider documentation policies. Actively participate in new provider orientations. Note and address trends in provider documentation that may impact coding and billing. Knowledge

Skills

•

Abilities:

Working knowledge of CPT and

ICD-10 CM

coding. Understanding of medical insurance guidelines and governmental policies. Progressive computer skills. Detail oriented. Ability to establish and maintain effective working relationships with the team and department staff (including administrative staff and faculty). Meet or exceed established production rate and performance standards.

Qualifications:

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

Minimum Required Education:

High school graduate or equivalent

Minimum Required Experience:

2 years of related coding and/or health care experience Required Certification/Licensure(s): Coding certification (CPC, CPC-A, CCS-P, or CCA) and/or Health Information Management credential (RHIT or RHIA).

Preferred Experience:

Office experience Physical Requirements Work requires occasionally lifting moderate weight materials, standing, or walking continuously. Work Environment Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment. Sensory Acuity Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects. #LI-RT1 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 Employee & Family Assistance Program (EFAP) 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 brief overview of our benefits see: Benefits Overview For a full list of positions see: MCW Careers At MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring

Collaborative
Curiosity
Inclusive
Integrity
Respect.

We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website. MCW as an Equal Opportunity Employer and Commitment to

Non-Discrimination:

The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. About Us Together, we can build a healthier world. A student, an educator, a scientist and a community leader — alone, they can do many things. Together, the question isn't what they can do, but what can't they. The Medical College of Wisconsin (MCW) brings together the most inquisitive, passionate minds in science, medicine, education and community engagement to tackle today's toughest challenges in health and society. Academic medicine is at the center of where scientists, physicians and students work hand-in-hand with the community to ask the most important questions and fuel the cycle of innovation that shapes the future of medicine. Medical College of Wisconsin The tireless pursuit of knowledge and the power of academic medicine is at the core of everything we do at MCW. Bringing together the world's top scientists and clinicians, inspired students and invested communities, we are driven to solve the most complex challenges in health and society. 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