Medical Coding Specialist

1 month ago


Janesville, Wisconsin, United States Mercy Health System Full time
Job Summary

We are seeking a skilled Medical Coding Technician to join our team at Mercy Health System. As a Medical Coding Technician, you will be responsible for performing coding reviews and claim audits to resolve coding edits and denial issues. You will also provide education to partners and ensure compliance with coding guidelines.

Key Responsibilities
  • Review and analyze documentation to identify discrepancies between code selection and documentation.
  • Resolve pre-bill claim edits and maintain a close working relationship with departmental staff.
  • Research and provide education to partners on CMS policies related to outpatient coding, inpatient coding, and professional fee coding.
  • Solve complex billing and claim denial issues related to coding.
  • Demonstrate extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare & Medicaid Services (CMS), and contracted payers.
Requirements
  • High School graduate or equivalent.
  • Three years of experience coding professional or hospital services in an outpatient or clinic setting preferred.
  • Certified in professional or hospital coding (CPC, CPC-H) or other equivalent coding certification required.
Skills and Abilities
  • Problem solving skills.
  • Excellent written, oral, interpersonal, and communication skills.
  • Analytical skills.
  • Extensive research skills.


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