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Medical Coding Specialist

Group Health Cooperative of South Central Wisconsin

The Medical Coding Specialist is responsible for reviewing electronic encounter documents to ensure accuracy and compliance of codes provided by practitioners, assigning applicable codes to medical records, and supporting coding education and documentation criteria. The role involves reviewing insurance claims for coding errors, researching coding guidelines to support claim denials, and assisting the Medical Coding Manager with administrative tasks. Works under supervision of the Revenue Cycle and Insurance Operations Manager.

The incumbent adheres to organizational policies, completes assignments timely, promotes company mission and values, and maintains high quality work standards.

Requirements & Qualifications
  • High school diploma or equivalent required.
  • Completion of an accredited Medical Coding Specialist Program or equivalent education/work experience required.
  • Preferred 1 year medical coding experience; knowledge of insurance processing preferred.
  • Preferred 1 year experience interacting with practitioners on coding requirements.
  • Certification as CPC or CCS-P required.
  • Knowledge of CPT/HCPCS, ICD-10-CM, E/M coding, medical records, and documentation.
  • Knowledge of medical terminology, anatomy, physiology, disease processes.
  • Knowledge of Medicare and Medicaid rules and regulations.
  • Ability to use MS Office, electronic medical records, and electronic coding systems; EPIC experience highly desirable.
  • Excellent oral and written communication skills.
  • Strong customer service skills and ability to work with diverse populations.
  • Organizational, analytical, problem-solving skills.
  • Ability to maintain confidentiality and understand HIPAA requirements.
  • Ability to negotiate with individuals including practitioners.
  • Ability to adhere to OSHA standards and patient care protocols.
  • Ability to travel among GHC sites on short notice.

Location

Madison, Wisconsin, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

1 month ago

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