Advanced Medical Coding Specialist

2 weeks ago


Middleton, Wisconsin, United States UW Health Full time
Position Overview

Work Schedule:

This is a full-time, 1.0 FTE role that allows for 100% remote work. Candidates selected for this position can operate remotely from various states, with specifics to be discussed during the interview.

To qualify for remote work, you must reside in an approved remote work state for UW Health. A comprehensive list of these states is available for your reference.

Join a Leading Healthcare Institution

We are looking for a Advanced Medical Coding Specialist:
  • Employ encoder and grouper software along with other coding tools to accurately identify the appropriate ICD-10-CM, CPT, and/or HCPCS codes, including specialty-specific codes and Evaluation and Management (E&M) codes.
  • Maintain and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents, and National Coverage Documents (LCD/NCD) directives, as well as Medically Unlikely Edits (MUEs) and Medicare Teaching Physician Guidelines, ensuring compliance with regulatory requirements and institutional standards for code selection and modifiers.
  • Oversee the resolution of pre-bill claim edits (OCE, CCI, MUE, Medical Necessity, etc.) across all Hospital Billing clinical areas, striving to produce the most accurate claims prior to submission to Billing or payers.
Educational Requirements:

Minimum -
  • High School diploma or equivalent
AND
  • Medical Coding Education
Preferred - Associate degree in a healthcare-related discipline.

Experience Requirements:

Minimum - One year of progressive coding experience.

Preferred - Two years of progressive coding experience across multiple specialties, including HCC Risk Adjustment Coding.

Licenses and Certifications:

Minimum - Certification as a Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA) is required, or Certified Risk Adjustment Coder (CRC) must be obtained within one year of hire for HCC.

Preferred - Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).

Commitment to Diversity, Equity, and Inclusion

UW Health is dedicated to fostering a diverse, equitable, inclusive, and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity is reflected in patient care interactions and daily operations as we embrace the unique perspectives and qualities each employee and faculty member contributes. Applications from Black, Indigenous and People of Color (BIPOC) individuals, LGBTQ+ and non-binary identities, women, persons with disabilities, military service members, and veterans are strongly encouraged. EOE, including disability/veterans.

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UW Hospital and Clinics benefits.

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