Full time, 40 hours per week.
Join Crossing Rivers Health and be part of a team that values Joy, Unity, Integrity, Compassion, and Excellence. The Medical Coding and Prior Authorization Specialist role supports accurate clinical documentation and timely authorization of services, ensuring compliance and maximizing reimbursement while facilitating patient access to necessary care.
Key responsibilities include reviewing clinical documentation for accuracy and compliance, assigning diagnoses and billing codes for all patient encounters using ICD-10-CM, ICD-10-PCS, and CPT guidelines, managing prior authorization requests for surgical procedures, specialty services, therapies, and imaging, and collaborating with clinical and scheduling teams. The position also involves denial follow-up, appeals, trends reporting, education support, and continuous learning to stay updated on coding and authorization guidelines.
Candidates should be detail-oriented, ethical, reliable, organized, accountable, and possess strong communication skills.
- High School Graduate or GED required.
- Associate's Degree in Health Information Management, Medical Coding, or related field required.
- Registered Health Information Technician or related certification required within 6 months of hire.
- Preferred 2+ years of medical coding experience in a Critical Access Hospital or similar setting.
- Preferred experience in prior authorization and insurance verification.
- Proficient in Microsoft Office.
- Epic system experience preferred.
Competitive pay and excellent benefits package including medical, dental, vision, life insurance, short term disability, paid time off, and a retirement plan with company match.
Location
Wisconsin, US
Employment Type
Internship
Experience Level
Associate
Remote work allowed
No
Posted
3 months ago