Job Description

Position Summary

The Medical Coder plays a key role in ensuring accurate and compliant coding and documentation for both professional staff and facility services. This position supports the integrity of our billing processes by applying current coding standards and maintaining compliance with all state and federal regulations

*This position requires on-site training at our office in Wausau, Wisconsin.

Essential Job Functions and Responsibilities

• Reviews documentation and accurately assigns codes and charges for all professional and ASC facility services based on provider documentation and levels of service
• V erifies accuracy of all data entry, including CPT/HCPCS codes, ICD-10-CM diagnosis codes, modifiers, units of service, place of service, NDC codes, provider and referring provider details, and required attachments (such as admission/discharge dates, authorizations, or claim notes).
• Ensure diagnoses are sequenced in accordance with ICD-10-CM guidelines and payer policies.
• Reviews and implements changes from quarterly CCI edits.
• Maintains current knowledge of billing and coding regulations, payer requirements, and compliance standards by routinely reviewing OIG fraud alerts, payer newsletters, regulatory updates, and professional publications.
• Provides training to new staff and providers to ensure appropriate coding and documentation compliance.
• Communicates coding and billing updates to providers and staff as needed.
• Performs other related duties as assigned.

Minimum Qualifications

• Education
  • High School diploma required.
  • Advanced training/certification in billing, coding and insurance required, or equivalent experience.
• Licensure/Certification
  • Certified Gastroenterology Coder (CGIC™) certification required within two years of employment.
• Experience
  • Minimum of one year of medical coding experience preferred.

Competencies Required

• Knowledge
  • Working knowledge of medical and insurance terminology, CPT, HCPCS, and ICD-10 coding.
• Skills
  • Strong interpersonal, communication, and listening skills for effective interaction with providers, patients, and team members.
  • Proficiency in EMR and Practice Management systems, as well as Microsoft Word, Excel, and Internet-based applications.
  • Demonstrates professionalism and respect in all forms of communication and correspondence.
  • Attention to detail, submitting work with confidence in its accuracy.
• Abilities
  • Ability to Maintain strict confidentiality of patient and fiscal information
  • Ability to work effectively in a fast-paced, team-oriented environment while managing multiple priorities
  • Ability to a ccurately gather, review, and prepare information in a timely manner.
  • Ability to provide in-service education to billing and clinical staff to support compliance efforts

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