Aurora Health Care
Clinical Quality Coder Lead - Hospital Based
Aurora Health Care, Allenton, Wisconsin, United States, 53002
Clinical Quality Coder Lead – Hospital Based
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This range is provided by Aurora Health Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base Pay Range $40.30/hr - $60.45/hr
Major Responsibilities
Ensure compliance with regulatory coding standards, including CMS, QIOs, NCCI edits, and payer-specific requirements, while adhering to AHIMA’s Standards of Ethical Coding.
Review clinical documentation and diagnostic results in the EHR to assign accurate ICD-10-CM/PCS and CPT/HCPCS codes that support organizational and Clinician Services initiatives.
Query providers when documentation is unclear, following established policies to ensure coding accuracy and completeness.
Collaborate with cross‑functional teams—including Coding, CDI, CMD, and Quality—to advance documentation improvement practices and align with enterprise goals.
Participate in special projects that support documentation, compliance, and operational excellence.
Promote a professional, team‑oriented service culture, modeling collaboration and accountability across Clinician Services and partner departments.
Identify improvement opportunities through analysis and review, partnering with leadership and team members to implement enhancements.
Demonstrate technical proficiency in using EHR systems, coding software, and official coding resources to support accurate and efficient documentation.
Maintain confidentiality of patient records, and report any non‑compliant practices to Documentation and Risk leadership or compliance officers.
Engage in continuous learning, staying current with evolving coding guidelines, terminology, and best practices through training, publications, and credential maintenance.
Licensure, Registration, And/Or Certification Required
Prior clinical experience as a licensed and/or certified qualified healthcare practitioner in location/area of practice.
MD or APP or RN or must have CRCR/CMD certification within 12 months of hire.
RHIA or HIT or CCS or CCS-P or CPC;
Specialty credential required within one year of employment.
Education Required
Completion of advanced training in revenue cycle management through a recognized or accredited program, equivalent in scope and rigor to post‑secondary education. High school diploma or GED required.
Experience Required
5 years of experience in expert‑level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians. Advanced level of ICD‑10‑CM/PCS and/or ICD‑10‑CM/CPT/HCPS for a large complex health care system or medical group.
Knowledge, Skills & Abilities Required
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.
Ability to deal and work effectively with multiple departments and in matrix organizational structures. Proven ability to influence others not directly reporting to them. Strong oral and written communication skills.
Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.
Highly proficient in problem‑solving and strong attention to detail.
Advanced knowledge of Epic.
Physical Requirements And Working Conditions
Follow organizational and divisional remote work policy and guidelines.
Operates all equipment necessary to perform the job.
Handles a fast paced and creative work environment moving independently from one task to another.
Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis.
This position may require travel, therefore, will be exposed to weather and road conditions.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
#REMOTE
Seniority level Not Applicable
Employment type Full-time
Job function Other
Hospitals and Health Care
Referrals increase your chances of interviewing at Aurora Health Care by 2x
Get notified about new Medical Coder jobs in Allenton, WI.
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Get AI-powered advice on this job and more exclusive features.
This range is provided by Aurora Health Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base Pay Range $40.30/hr - $60.45/hr
Major Responsibilities
Ensure compliance with regulatory coding standards, including CMS, QIOs, NCCI edits, and payer-specific requirements, while adhering to AHIMA’s Standards of Ethical Coding.
Review clinical documentation and diagnostic results in the EHR to assign accurate ICD-10-CM/PCS and CPT/HCPCS codes that support organizational and Clinician Services initiatives.
Query providers when documentation is unclear, following established policies to ensure coding accuracy and completeness.
Collaborate with cross‑functional teams—including Coding, CDI, CMD, and Quality—to advance documentation improvement practices and align with enterprise goals.
Participate in special projects that support documentation, compliance, and operational excellence.
Promote a professional, team‑oriented service culture, modeling collaboration and accountability across Clinician Services and partner departments.
Identify improvement opportunities through analysis and review, partnering with leadership and team members to implement enhancements.
Demonstrate technical proficiency in using EHR systems, coding software, and official coding resources to support accurate and efficient documentation.
Maintain confidentiality of patient records, and report any non‑compliant practices to Documentation and Risk leadership or compliance officers.
Engage in continuous learning, staying current with evolving coding guidelines, terminology, and best practices through training, publications, and credential maintenance.
Licensure, Registration, And/Or Certification Required
Prior clinical experience as a licensed and/or certified qualified healthcare practitioner in location/area of practice.
MD or APP or RN or must have CRCR/CMD certification within 12 months of hire.
RHIA or HIT or CCS or CCS-P or CPC;
Specialty credential required within one year of employment.
Education Required
Completion of advanced training in revenue cycle management through a recognized or accredited program, equivalent in scope and rigor to post‑secondary education. High school diploma or GED required.
Experience Required
5 years of experience in expert‑level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians. Advanced level of ICD‑10‑CM/PCS and/or ICD‑10‑CM/CPT/HCPS for a large complex health care system or medical group.
Knowledge, Skills & Abilities Required
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.
Ability to deal and work effectively with multiple departments and in matrix organizational structures. Proven ability to influence others not directly reporting to them. Strong oral and written communication skills.
Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.
Highly proficient in problem‑solving and strong attention to detail.
Advanced knowledge of Epic.
Physical Requirements And Working Conditions
Follow organizational and divisional remote work policy and guidelines.
Operates all equipment necessary to perform the job.
Handles a fast paced and creative work environment moving independently from one task to another.
Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis.
This position may require travel, therefore, will be exposed to weather and road conditions.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
#REMOTE
Seniority level Not Applicable
Employment type Full-time
Job function Other
Hospitals and Health Care
Referrals increase your chances of interviewing at Aurora Health Care by 2x
Get notified about new Medical Coder jobs in Allenton, WI.
#J-18808-Ljbffr