Professional Coding Specialist Team Lead - Full-Time - Remote!

At Children’s Wisconsin, we believe kids deserve the best.

Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/

The Professional Coding Specialist Lead serves as the expert resource regarding all aspects of coding and charge capture. Supports the Coding Leaders and team by guiding and directing employees in their day to day job functions. Trains new and existing team members. Provides coverage for various specialty areas. Investigates and resolves issues pertaining to coding and charge capture.

Major Responsibilities

• Expert knowledge of multispecialty coding which may include office-based, surgical, hospital-based, emergency, ambulatory, ancillary and/or mental and behavioral health coding including assignment or verification of CPT, ICD-10 CM, HCPC, and modifiers based upon documentation.

• Reviews and resolves edits for various types of charges to insure that all data elements are applied.

• Guides and serves as a resource for employees as they perform their daily job functions. Serves as the initial resource for questions and acts as a resource to staff in relation to accurate assignment of CPT, ICD-10CM, and HCPC codes.

• Monitors charge capture volumes and work queues and acts as a resource for department leaders and administrators, clinical staff and other revenue cycle staff to assure consistent and accurate charge capture. Works with clinic staff and Providers regarding missing or unclear information that is required for billing.

• Primary staff contact for issues. Monitors workflow, assigns or re-assigns work to meet team goals.

• Uses coding knowledge to identify trends and educational opportunities for Providers and other staff. Serves as a resource to staff for accurate assignment of CPT procedure and ICD-10-CM diagnosis coding for single or multi-specialty services for appropriate reimbursement.

• Works with Coding Department leaders in an active effort to reduce denials and eliminate re-work.

• Develops and maintains protocols and processes related to assigned areas of responsibility.

• Participates in system related testing as needed.

• Maintains understanding all teaching Physician and Provider documentation policies.

• Trains and on-boards new team members or those learning a new area or specialty of coding.

• Works with the Auditing team to identify opportunities and develop education for Coders.

Minimum Job Requirements

Licensure, Registration and/or Certification
Coding certification (CPC, CCS, CCS-P, or RHIT).

Education
High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED).

Experience
Requires 5 years of experience in in a multi-specialty physician practice, coding multiple medical/surgical specialties/subspecialties.

Knowledge / Skills / Abilities

• Exhibits guiding behaviors that reflect Children’s values and support our mission and vision.

• Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer and governmental policies.

• Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance.

• Prior use of an Electronic Health Record.

• Excellent communication (oral and written) skills.

• Ability to work independently, exercise independent judgment and solve problems effectively.

• Specialty Coding Knowledge.

• Evaluation and Management Coding Knowledge.

We would prefer candidates with EPIC experience, but it is not required.

Schedule : This is a fully remote M-F position during regular day-time hours. We do not anticipate travel to the Milwaukee area.

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses:

Job Type: Full-time