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Mercyhealth Medical Coding Specialist, Coding in Janesville, Wisconsin

Department/Skill highlights

  • Location: Mercyhealth Hospital & Trauma Center - Janesville

    Mercyhealth is committed to offering our partners a best place to work and continually evaluates new programs and benefits. We have been recognized locally, regionally and nationally for helping our workers achieve a work/life balance through benefit offerings and innovative programs.

    Our unique workplace Culture of Excellence is built upon:

  • Employee engagement, empowerment and growth

  • Teamwork toward our common goal – providing exceptional health care services with a passion for making lives better

  • An atmosphere of caring and quality that cascades throughout the organization

    Essential Duties and Responsibilities

  • Reviews, analyzes, and interprets provider documentation with regards to procedure and diagnosis code selection.

  • Performs audits of provider coding and documentation to make recommendations for improvements and enhancements.

  • Maintains a close working relationship with assigned providers and medical office, frequently querying the provider when coding discrepancies arise.

  • Researches any coding inquiries the provider or medical staff may have, and presents findings to them.

  • Reviews hospital, clinical, and surgical documentation and the assigned diagnosis and procedure codes, releasing charges within the Epic system. Identifies discrepancies between the provider code selection and the medical record documentation; makes appropriate corrections, and presents findings and education to the provider.

  • Demonstrates extensive knowledge of official coding guidelines established by the American Medical Association (AMA), the Center for Medicare & Medicaid Services (CMS) and contracted payers.

  • Has a thorough understanding of the differences between professional coding in a clinic setting as compared to professional coding in a hospital setting (outpatient and inpatient), and demonstrates a high skill level in the practical application of that knowledge.

  • Works with billing partners in developing efficient coding processes and researching denials.

  • Responds to customer concerns through coding reviews requested by other departments.

  • Conducts provider coding orientation and education sessions and documents all information presented.

  • Maintains an in-depth knowledge of Epic ambulatory and hospital modules.

  • Works as a team to achieve productivity goals.

    Education and Experience

  • High School graduate or equivalent

  • Two years of experience coding professional services in multiple specialties

    Certification/Licensure

  • Certified Professional Coder (CPC) or other equivalent coding certification required

    Special Physical Demands

    The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.

    While performing the duties of this job, the partner is regularly required to talk and hear. Eyesight to identify numbers, folders, colors, and computer printouts. Speech to communicate one-on-one and over the telephone. Manual dexterity to operate keyboards, mouse and telephones. Prolonged sitting; use hands to finger, handle, or feel and reach with hands and arms. The partner is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The partner must occasionally lift and/or move up to 25 pounds.

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