Coding Quality Analyst I

Position Description:


Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW . change making for a healthier Wisconsin.
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.
Knowledge - Skills - Abilities
Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments.
Ability to take initiative and to exercise independent judgment, decision making and problem-solving skills.
Proficient in Excel and Word, Medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools.
Ability to interact with people effectively. Strong written and oral communication skills.

Preferred Schedule:


Position Requirements:


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
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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 OK
Tuition Reimbursement
Paid Parental Leave
For a full list of positions see:
mcw.edu/careers
For a brief overview of our benefits see:

/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. For more information, please visit our institutional website at
/mcw.edu/departments/office-of-diversity-and-inclusion.

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 a diverse 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.
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