Advocate Aurora Health
We help people live well. We’re proud to be part of Advocate Health.
Documentation & Risk Coding Analyst – Hospital Based
Location
Wisconsin
Posted
38 days ago
Salary
$38.2K - $57.3K / year
Professional Certificate4 yrs expEnglishPMP
Job Description
• Demonstrates full understanding and is compliant with regulatory requirements regarding coding of medical information including but not limited to external regulatory agencies such as Quality Improvement Organizations (QIOs), the Centers for Medicare & Medicaid Services (CMS), Medicare National Correct Coding Initiative edits and other payers.
• Partners with Coding, CDI, CMD and Quality professionals and others to advance documentation improvement practices.
• Reviews clinical documentation and diagnostic results from the EHR to ensure appropriate assignment of the ICD-10-CM/PCS and/or ICD-10-CM CPT/HCPCS codes to support organizational and Clinician Services initiatives.
• As indicated, queries providers when existing documentation is unclear or ambiguous following established organizational policy.
• Partners with Coding, CDI, CMD and Quality professionals, and others to advance documentation improvement practices.
• Demonstrates positive collaboration with team members within Clinician Services and other organizational stakeholders.
Job Requirements
- Minimum of 4 years of healthcare experience, including at least 2 years working as a clinician or in direct partnership with clinicians or recognized profession supporting clinicians (i.e. CDI, CMD or informatics), with demonstrated involvement in clinical documentation, coding, or documentation improvement initiatives.
- Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications.
- Demonstrated proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems.
- Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.
- Advanced knowledge of Epic.
- Clinical or operational credential required. May include licensure as a clinically practicing professional (e.g., RN, RT, LCSW) or Certification in healthcare operations or project management (e.g., PMP, LSSGB, HFMA-CRCR).
- Certification in mid-revenue cycle operations from a recognized professional organization such as AHIMA, AAPC, or HFMA is required.
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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