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Job Title:

Reimbursement Auditing Specialist (Remote in Wisconsin)

Cost Center:

101651059 Coding-Audit Appeals Educ

Scheduled Weekly Hours:

40

Employee Type:

Regular

Work Shift:

Mon-Fri; day shifts (United States of America)

Job Description:

_**Wisconsin residents only eligible to apply**_

JOB SUMMARY

The Reimbursement Auditing Specialist assists personnel in various areas of Revenue Integrity/Revenue Cycle as needed to properly code clinic, inpatient, outpatient, emergency room, nursing home, homecare/hospice, dialysis, OR/ambulatory surgery, supply and Durable Medical Equipment (DME) and regional center services. This individual is required to have knowledge and coding expertise of various CMS specialties and subspecialties within the Marshfield Clinic Health System. This Reimbursement Auditing Specialist reviews surgical and medical record documentation to assure complete/accurate charging for all properly documented services. This individual will utilize their leadership, analytical, and problem solving skills to complete audits, identify and resolve coding issues, and educate staff for training purposes or to optimize coding/billing results.

JOB QUALIFICATIONS

EDUCATION

_For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation._

**Minimum Required:** Successful completion of the following courses per department protocol, within one year of hire: American Medical Association (AMA) Current Procedural Terminology (CPT), current International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), and medical terminology.

**Preferred/Optional:** Associate degree in Medical Billing and Coding, Health Information Management, or a related field.

EXPERIENCE

**Minimum Required:** Three years of coding experience.

**Preferred/Optional:** Three years progressive surgical coding/auditing experience.

CERTIFICATIONS/LICENSES

_The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position._

**Minimum Required:** Coding certification from the American Academy of Professional Coders, American Health Information Management Association, or other approved coding certification.

**Preferred/Optional:** None

_**Wisconsin residents only eligible to apply**_

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.

Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program** **.

Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.