Medical Coding Specialist – Outpatient

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🔥 0 minutes ago

🌽 Illinois, Wisconsin – Remote

🌽 Illinois – Remote 🧀 Wisconsin – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Sauk Prairie Healthcare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1956

💼 Consulting

🏥 Healthcare

🤝 Non-profit

Consulting • Healthcare • Non-profit

Sauk Prairie Healthcare is a nonprofit 501(c)(3) acute care hospital and clinic network serving the Sauk Prairie region since 1956. The organization operates a 37-bed hospital with multiple surgical specialties, primary care clinics, an emergency department, and ancillary services including orthopedics, joint replacement, women's health, rehabilitation, and a wellness/fitness center called Wellspring. Sauk Prairie Healthcare provides community-focused patient care, health education (webinars and guides), volunteer and foundation programs, and sees tens of thousands of patients annually across its service area.

📋 Description

• Review medical reports and physician documentation for clinic and hospital outpatient services • Apply diagnostic and procedural codes to patient health information for claims processing, data retrieval, and analysis • Focus primarily on Emergency Department and Urgent Care coding while assisting in other areas • Assign ICD and CPT codes for ambulatory outpatient facility and professional services • Enter professional codes for Emergency Room and Urgent Care providers • Audit electronic medical records for patient, insurance, diagnosis, and procedure-code accuracy • Review and resolve NCCI and OCE edits • Communicate with clinical department directors and medical billing staff to clarify coding guidelines and resolve claim edits • Identify and communicate missed revenue opportunities to ambulatory departments • Work with business analysts to create new charge codes as needed • Investigate and timely appeal denied insurance claims • Abstract pertinent information from patient records using the hospital information system • Query physicians for documentation or code-assignment clarification • Identify coding concerns or trends and involve Revenue Cycle leadership when needed • Provide education on coding changes • Attend continuing education programs and review educational resources to maintain current knowledge and coding recertification • Assist with developing coding policies and procedures • Assist with training new employees and job shadowing • Perform other related work assignments as required

🎯 Requirements

• Wisconsin or Illinois residency required • Successful completion of an AHIMA- or AAPC-recognized professional coding course and/or an associate degree in a healthcare-related program • No prior experience required • Must obtain AHIMA or AAPC credentials within six months of hire and maintain the credential thereafter • Acceptable certifications include RHIT, RHIA, CCA, CCS, CPC-H, CPC, CIC, or COC • Ability to use ICD and CPT coding protocols • Ability to audit electronic medical records and resolve NCCI and OCE edits • Ability to clarify documentation and code assignments with physicians • Ability to investigate and appeal denied claims • Ability to abstract information from patient records using a hospital information system • Ability to provide coding-change education and participate in continuing education and recertification

🏖️ Benefits

• Competitive health and dental insurance options • Flexible paid time off to balance work and life • Retirement plan with immediate vesting and employer match • Discounted membership to our state-of-the-art fitness facility • Generous tuition reimbursement • Employer provided life and disability insurance • Free parking at facility