Children's Wisconsin
Location
Burlington, Massachusetts
The specialist is responsible for coding, reviewing, and releasing charges for Pediatric Urology and ENT to ensure billing compliance and complete charge capture. They collaborate with providers and departmental leaders to resolve coding questions and maintain official guidelines.
Requires a high school diploma and at least 3 years of Profee coding experience, along with a professional certification such as CPC, CCS-P, CCS, or RHIT. Proficiency in ICD-10, CPT, and HCPCS guidelines is essential, with Epic experience preferred.
Knowledge of ICD10, CPT and HCPCS coding guidelines. Working knowledge of CCI edits, healthcare insurance guidelines and other regulatory guidance. Prior use of an Electronic Health Record. Epic experience preferred. Excellent communication (oral and written) skills. Ability to work independently, exercise independent judgment and solve problems effectively. Licenses and Certifications: Certification: one of the following: CPC-Certified Professional Coder - American Board of Professional Coders CCS-P-Certified Coding Specialist Physician Based - American Health Information Management Association CCS-Certified Coding Specialist - American Health Information Management Association RHIT-Registered Health Information Technician - American Health Information Management Association Essential Functions: Assigns or verifies CPT, ICD-10 CM coding and modifiers based upon documentation. Subject matter expert in one or more specialties and may also cover multiple surgical/medical specialties for abstraction, ambulatory and/or surgical/procedural coding. Ensures compliance with official coding guidelines.
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