ProHealth Care has been the health care leader in Waukesha County and surrounding areas for the past century, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Medical Group clinics, AngelsGrace Hospice, ProHealth Home Care & Hospice, West Wood Health & Fitness Center and Regency Senior Communities. Learn more at ProHealthCare.org
Hours: Monday through Friday 7:30 am to 4:30 pm (flexibility required)
Full Time / Part Time: Full Time Benefits
In this role, the Ambulatory Clinical Documentation Improvement (CDI) Specialist and Coding Educator will, review the physician documentation within the electronic health records for accurate and complete documentation of all relevant diagnoses, procedures, HCPCS, and E/M Level of Service.
Incumbent will demonstrate a willingness to maintain awareness of the business of medicine and transitional healthcare changes, including but not limited to value-based purchasing, bundled payments, accountable care organizations, and the CMS Risk Adjustment Model (measures the disease burden that includes several HCC categories, correlated to diagnosis codes).
Must also be devoted to ongoing and continuous learning in clinical medicine – including a practical understanding of ICD-10 with the ability to educate physicians and coders on relevant updates and happenings in the business of medicine; including updates from CMS carriers effecting physicians such as billing, documentation, and coding guidelines and policies.
- Bachelor’s degree in a related healthcare field OR equivalent combination of education and experience.
- Certification required: CPC by AAPC OR CCA-P OR RHIA OR RHIT by AHIMA OR registered nursing background and coding certification.
- At least 5 years of experience in healthcare professional billing and coding or clinical field.
- At least 5 years of certified coding experience or clinical experience.
- At least 2 years of experience in education and training of coders and physicians regarding coding and documentation guidelines preferred.
- Experience and proficiency with Microsoft Office applications to include: Outlook, Word, PowerPoint, Excel and SharePoint.
- Ability to have flexible work hours to facilitate face-to-face meetings with physicians at their clinics.
- Proven success with developing and maintaining statistics, metrics, and performance improvement activities.
ProHealth Care, one of the largest employers in Waukesha County, offers work that is challenging and rewarding. The organization is dedicated to providing the highest quality service to our patients and their families and treats each individual with respect – the way they should be treated. ProHealth Care supports a Just Culture, one that encourages an open learning environment and maintaining safe systems. We have high expectations for those who join our team of nearly 5,000 employees. In return, we offer exceptional career opportunities in a dynamic, health care system where the contributions of every team member are valued.
ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
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