Medical Coder

Waukesha County's Department of Health & Human Services is recruiting for a talented Medical Coder. The Mental Health Coder is responsible for daily coding of behavioral health and substance use disorder services. The role is primarily for Outpatient records; however, opportunities for Inpatient coverage may be expected. The coder may also be involved with WCDHHS Community-Based program coding and/or associated HCPCS codes, including but not limited to, Comprehensive Community Service and Children's Long Term Care Support programs. The coder will lead with best practices for compliant and efficient coding procedures. The ideal candidate will be a critical thinker, quick learner, independent worker, and collaborative teammate. Tasks will include, but are not limited to:

• Working closely with providers to ensure documentation supports coding requirements and aligns with payer regulations
• Providing education and training to clinical staff on documentation best practices, coding updates, and compliance requirements
• Accurately coding services for mental health, psychiatric, and medical providers using ICD-10, CPT, and HCPCS codes
• Ensuring coding is consistent with payer guidelines, industry standards, and organizational policies
• Collaborating with the billing team to ensure claims are submitted accurately and promptly, reducing denials and maximizing revenue
• Assisting in reviewing and resolving coding-related denials or rejections from insurance companies, ensuring appropriate action is taken
• Monitoring trends in claims denials, providing insights and strategies to reduce recurring issues
• Conducting regular coding audits and compliance checks to identify areas for improvement and mitigate risks

Waukesha County offers a comprehensive compensation and benefits package including excellent health/dental/vision, life insurance, generous paid time off (vacation, 10 holidays, 3 floating holidays, ample accrued sick time that rolls over each year), an exceptional pension plan with employer match and lifetime retirement payment plus an optional tax advantaged 457 retirement savings plan. Amongst many other benefits, employees are recognized and valued through a pay for performance system. Successful candidates will be eligible for performance-based merit increases and non-base performance awards. Employee well-being is promoted through a balanced work-life culture and through an exceptional employee wellness program that offers a variety of programs and tools to help promote an employee's wellness and health, including an on-site health & wellness clinic.

Under direction, to accurately determine Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) and DSM-5 codes for all procedures/diagnoses for inpatient records and transcription in a behavioral health outpatient and inpatient settings; ensures that all coding assignments are accurate according to coding policies and based on the documentation provided in the medical record; responsible for providing feedback to physicians regarding coding and documentation; and to perform other duties as required.

1. Determines appropriate assignment of CPT, DSM-5, and ICD codes for physician, therapist, and facility services provided in an outpatient and inpatient settings.
2. Evaluates medical record for consistency and adequacy to prove medical necessity.
3. Researches, analyzes, and updates codes, as needed, in billing software in a timely manner to maintain prompt billing compliance.
4. Ensures all patient visits are coded in accordance with Centers for Medicare and Medicaid Services (CMS), CPT, DSM-5 and the Correct Coding Initiative (CCI) guidelines.
5. Performs chart audits for assigned providers and provides documentation and audit feedback to providers.
6. Performs insurance verifications to ensure accuracy of coding in electronic record.
7. Corrects codes, as needed, in billing software in a timely manner to maintain prompt billing compliance.
8. Conducts quality assurance audits and incorporates quality assurance information, findings and feedback into coding processes.
9. Identifies trends, recommends, and implements solutions for inaccuracies with coding; monitors for changes in trends related to the coding process affecting coding, charge entry, and billing.
10. Communicates with and assists in coding education of providers and support staff.
11. Provides orientation and training to new providers on coding and documentation guidelines and re-education as needed.
12. Serves as a resource to providers and support staff; interacts with all levels of personnel on coding issues.
13. Performs data reporting and statistical tracking.
14. Maintains a resource center regarding coding education for providers.
15. Participates in department meetings and interdisciplinary meetings.
16. Establishes and maintains effective working relationships with other employees, clients, other agencies, and the general public.
17. Performs emergency government duties as assigned in event of Waukesha County Emergency Government declaration.
18. Performs other duties as required.

1. Comprehensive knowledge of diagnosis and procedure codes in a behavioral hospital and clinic setting including ICD, CPT, DSM-5, and Health Care Procedural Code System (HCPCS).
2. Comprehensive knowledge of documentation and regulations of Joint Commission on the Accreditation of Health Care Organizations (JCAHO), Health Care Financing Administration (HCFA) and CMS.
3. Comprehensive knowledge of electronic and paper medical record systems.
4. Working knowledge of health information management and practice management systems.
5. Working knowledge of computerized department program software, Internet access, database spreadsheet and word processing programs.
6. Working knowledge of state and federal confidentiality statutes and requirements, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
7. Ability to concentrate with strong attention to details for extended periods of time.
8. Ability to ensure the confidentiality and rights of patients and confidentiality of health system and departmental documents.
9. Ability to perform in-depth medical coding audits.
10. Ability to demonstrate proficiency in meeting quality and quantity standards.
11. Ability to work with minimal supervision.
12. Ability to demonstrate effective organizational skills, multi-tasking, project and timeline planning, leadership and problem solving skills.
13. Ability to communicate effectively verbally and in writing.
14. Ability to work with and teach medical professionals coding rules and regulations.
15. Ability to adapt to rapidly changing priorities and deadlines.
16. Ability to prioritize work assignments to ensure timely completion.
17. Ability to coordinate generalized observations/symptoms to the correct code.
18. Ability to utilize word processing, database, and spreadsheet programs.
19. Ability to establish and maintain effective working relationships with other employees, clients, other agencies, and the general public.
20. Ability to effectively interact with sensitivity with persons from diverse cultural, socioeconomic, educational, racial, ethnic and professional backgrounds, and persons of all ages and lifestyles.

About Us:
Waukesha County prides itself on operating in a business-like manner and is recognized as a leader delivering high quality services with competence and skill. With our vision of "Leading the Way", we value teamwork and collaboration, ethics and diversity, communication, efficiency and cost savings, innovation, and the wellbeing of our staff and the citizens we serve. Employees are provided professional development opportunities and encouragement to learn and practice continuous improvement and LEAN principles as we regularly ask ourselves "Is there a better way?"

Location:
Located in the City of Waukesha, our campus offers an on-site cafe and fitness center, free parking, and easy access to interstate highway systems. Waukesha County offers a perfect blend of urban and rural living where one can enjoy the benefits of quiet rural lake communities or opt for nearby attractions that the greater Milwaukee area offers including vast beach and park systems, public markets, performing arts, music festivals, and sports including the Milwaukee Admirals, Brewers, Bucks, Wave, Marquette University Golden Eagles and the UW-Milwaukee Panthers Basketball programs.

EEO/AA:
Waukesha County is committed to equal opportunity and nondiscrimination in employment and adheres to all Federal, State and County Equal Employment Opportunity laws, policies, plans, rules, regulations and ordinances. The County recognizes and accepts its important leadership role in providing for equal employment/service opportunities for minorities, women, and persons with disabilities. It is the express policy of Waukesha County to promote equal employment opportunity among all who are employed by Waukesha County and who seek employment with Waukesha County.

For further information visit: https://www.waukeshacounty.gov

The County does not sponsor applicants for work visas.
Applicants must be currently authorized to work in the United States on a full-time basis.