ProFee Coding Specialist III

🕒 Yesterday

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 11%

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Children's Wisconsin

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1883

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Children's Wisconsin is a healthcare organization that is dedicated to the well-being of children. The organization provides comprehensive care that addresses the physical, social, and mental health needs of children. They create child-friendly environments to ease stress, offer specialized medical services, and provide resources that extend care beyond the clinic to homes and schools. With facilities like hospitals, specialty clinics, and urgent care centers, Children's Wisconsin focuses on innovation and community partnerships to enhance the health and happiness of children.

📋 Description

• Collaborate with ancillary or specialty departments, locations, and providers to code, review, and release charges timely • Ensure correct coding, billing compliance, and complete charge capture • Collaborate with providers and departmental staff and leaders on coding and charge capture questions • Assign or verify CPT, ICD-10-CM coding, and modifiers based on documentation • Serve as subject matter expert in one or more specialties and cover multiple surgical or medical specialties for abstraction, ambulatory, and/or surgical/procedural coding • Ensure compliance with official coding guidelines • Resolve edits for various charges according to established policies and procedures • Monitor charge capture volumes and work queues • Support department leaders, administrators, clinical staff, and revenue cycle staff with consistent and accurate charge capture • Work with clinic staff and providers regarding missing or unclear billing information • Query providers as needed and coordinate responses to provider questions • Identify coding trends and educational opportunities for providers and staff • Identify opportunities to reduce denials • Develop and maintain protocols and processes for assigned areas • Maintain understanding of teaching physician and provider documentation policies • May train other coders on new departments or specialties

🎯 Requirements

• Three years of experience coding Pro-Fee E/M services for multi-specialty required • Inpatient experience preferred • Experience coding bedside procedures in the inpatient setting • Experience working claim edits and denials • Epic experience preferred • One of the following certifications: CPC (Certified Professional Coder), CCS-P (Certified Coding Specialist Physician Based), CCS (Certified Coding Specialist), or RHIT (Registered Health Information Technician) • High School graduate, GED, or HSED required • Knowledge of ICD-10, CPT, and HCPCS coding guidelines • Working knowledge of CCI edits, healthcare insurance guidelines, and other regulatory guidance • Excellent oral and written communication skills • Ability to work independently, exercise independent judgment, and solve problems effectively • Specialty coding knowledge

🏖️ Benefits

• Full-time schedule, Monday-Friday, 40 hours per week

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