Coding Quality Analyst

Position Description:

Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW ... changemaking for a healthier Wisconsin. In the role of Coding Quality Analyst, you will be working in Clinical Practice Services. You will serve as an expert resource for multi-specialty documentation, coding, and billing. You will work as an extension to the Charge Capture Supervisory Team to monitor quality of documentation and coding. Assist in performing medical coding audits on clinicians and/or 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. You will also be responsible for new and existing clinician and coder education, as well as team and/or clinical department educational sessions.

All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AZ, FL, IL, IN, MD, MI, MN, MO, NC, TN,TX, and UT.

Responsibilities:

• Expert resource of multispecialty coding, charge capture and reimbursement which may include surgical, inpatient, emergency and/or ambulatory coding; assignment or verificaiton of CPT, ICD-10 CM coding and modifiers based upon documentation.
• Participate in workgroups 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 multispecialty 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.
• Onboard/educate new and existing physicians and APP's on documentation and coding rules and regulations.
• Perform documentation and coding audits on clinicians and coding specialist staff for coding accuracy.
• 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 employee orientation to acquaint them with the charge capture 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

Ability to interact with people effectively. Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments. Strong written and oral communication skills. 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.

Preferred Schedule:



Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs.

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

#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
• 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 full list of positions see: www.mcw.edu/careers

For a brief overview of our benefits see: https://www.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 https://www.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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