ZipRecruiter

Log In

1

Coding Integrity Specialist Jobs in Wisconsin (NOW HIRING)

ThedaCare

Coding Auditor

Appleton, WI · On-site

$26.50 - $30.25/hr

The Coding Auditor performs coding quality audits of records to ensure appropriateness and accurate ... Integrity Specialists (ACDIS) PHYSICAL DEMANDS: * Ability to move freely (standing, stooping ...

Medical College of Wisconsin

Coding Specialist II

Milwaukee, WI · On-site

$18.50 - $23.75/hr

Perform coding and related duties using established billing office policies in an accurate and ... Caring - Collaborative - Curiosity - Inclusive - Integrity - Respect. We are committed to fostering ...

Medical College of Wisconsin

Coding Specialist II

Milwaukee, WI · On-site +1

$18.50 - $23.75/hr

Perform coding and related duties using established billing office policies in an accurate and ... Caring - Collaborative - Curiosity - Inclusive - Integrity - Respect. We are committed to fostering ...

next page

Showing results 1-20

All JobsCoding Integrity Specialist JobsCoding Integrity Specialist Jobs in Wisconsin

Coding Integrity Specialist information

How does a Coding Integrity Specialist typically collaborate with clinical staff and other departments?

Coding Integrity Specialists frequently work closely with clinical staff, billing teams, and compliance departments to ensure accurate medical coding and adherence to regulatory guidelines. They often clarify documentation with healthcare providers, participate in cross-departmental meetings, and provide education on coding best practices. This collaborative approach helps reduce errors, prevent claim denials, and maintain high standards for data integrity across the organization.

What is the difference between Coding Integrity Specialist vs Medical Coder?

AspectCoding Integrity SpecialistMedical Coder
CertificationsAHIMA or AAPC coding credentials, compliance trainingAHIMA or AAPC coding credentials, certification often preferred
Work EnvironmentHealthcare organizations, compliance departmentsHospitals, clinics, billing companies
Job FocusEnsuring coding accuracy, compliance, auditingAssigning medical codes for billing and documentation

The Coding Integrity Specialist and Medical Coder roles both require coding certifications and work within healthcare settings. However, the Coding Integrity Specialist primarily focuses on auditing, compliance, and maintaining coding accuracy, while Medical Coders are responsible for assigning codes for billing purposes. The Specialist role emphasizes oversight and integrity, whereas the Coder role centers on code assignment.

What is a coding integrity specialist job description?

A coding integrity specialist reviews medical coding to ensure accuracy, compliance, and proper documentation. They analyze coding practices, identify errors or inconsistencies, and may use coding software and guidelines such as ICD, CPT, or HCPCS. The role often requires attention to detail, knowledge of healthcare regulations, and certification in medical coding.

What are the key skills and qualifications needed to thrive as a Coding Integrity Specialist, and why are they important?

To thrive as a Coding Integrity Specialist, you need comprehensive knowledge of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and typically a certification like CCS or CPC. Proficiency with coding auditing software, electronic health record (EHR) systems, and compliance tools is essential. Attention to detail, analytical thinking, and strong communication skills are crucial soft skills for ensuring accuracy and collaborating with healthcare teams. These skills ensure accurate coding, regulatory compliance, and optimized reimbursement for healthcare organizations.

How much does a coding compliance specialist make?

A coding compliance specialist typically earns between $50,000 and $80,000 annually, depending on experience, certifications, and location. They ensure coding accuracy and compliance with industry standards, often working with healthcare or data management systems.

What are Coding Integrity Specialists?

Coding Integrity Specialists are professionals who ensure the accuracy and compliance of medical coding within healthcare organizations. They review clinical documentation and coding processes to make sure that diagnoses, procedures, and services are coded correctly according to regulatory requirements and industry standards. Their work helps organizations receive appropriate reimbursement, avoid coding errors, and maintain compliance with healthcare laws. Coding Integrity Specialists often collaborate with medical coders, auditors, and healthcare providers to resolve discrepancies and provide education on best practices.

What pays more, CCS or CPC?

In the context of coding and billing roles, CPC (Certified Professional Coder) typically offers higher salaries than CCS (Certified Coding Specialist) due to its broader scope and demand in outpatient and physician-based coding. Both certifications require coding skills and knowledge of medical terminology, but CPCs often work in more diverse settings with higher earning potential.

What does an integrity specialist do?

An integrity specialist ensures that coding and data practices adhere to ethical standards, legal requirements, and organizational policies. They review code for compliance, detect and prevent misconduct, and may use tools like audits and monitoring systems to maintain data and coding integrity.
What are popular job titles related to Coding Integrity Specialist jobs in Wisconsin? For Coding Integrity Specialist jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Coding Integrity Specialist jobs in Wisconsin look for? The top searched job categories for Coding Integrity Specialist jobs in Wisconsin are:
What cities in Wisconsin are hiring for Coding Integrity Specialist jobs? Cities in Wisconsin with the most Coding Integrity Specialist job openings:
Coding Integrity Specialist jobs near you
Infographic showing various Coding Integrity Specialist job openings in Wisconsin as of July 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 93% In-person, and 7% Remote job distribution.
Revenue Integrity Specialist

Revenue Integrity Specialist

Upland Hills Health

Dodgeville, WI

Full-time

Retirement, PTO

Posted 7 days ago

Upland Hills Health rating

6.0

Company rating: 6.0 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

Position Title: Revenue Integrity Specialist

Location: Upland Hills Health - Dodgeville Hospital Campus

Role amp; Department: Revenue Integrity Specialist in the Revenue Cycle Department

Hours amp; Shift: Full-time (1.0 FTE) Day Shift Position, Monday through Friday
Position Summary: The Revenue Integrity Specialist serves as a bridge between billing operations, payor contract compliance, and reimbursement analysis. This role supports accurate and compliant charge capture, billing correctness while supporting denial prevention, revenue optimization, and team education. This role works closely with billing lead, contract specialist, and finance to protect and optimize organizational revenue.

Role Responsibilities:
Charge Capture Integrity:
  • Responsible for assigned Pricing, Revenue Code, Account, Charge Review, Router Review and Claim Edit Work queues and the continual monitoring, reduction, and transfer of AR associated with the assigned areas.
  • Monitors daily census of room rates for Med/Surg and OB floor.
  • Follows up on all incomplete and inaccurate charges and makes prompt corrections.
  • Responsible for the timely and accurate processing of patient and research charges and corrections to hospital account record as necessary.
  • Works closely with Materials Management and Surgical staff to ensure appropriate charging and pricing for new supply products
  • Applies analytical skills to daily work to identify trends or root causes and provides recommendations to improve processes across the revenue cycle (missing or delayed charges, lag time, claim denials, etc.)
  • Creates temporary reports with findings of build issues to run on a daily basis until Epic tickets can be fixed.
  • Coordinates with patient financial services on compliance issues regarding national correct coding initiative rules, Medicare outpatient code editor rules and Medicare and Medicaid fraud and abuse rules and charge practices.
Revenue Integrity:
  • Estimate set up and workflow support.
  • Maintains Revenue Integrity manual and workflows.
  • Monitors quarterly WHA updates to Top 75 procedure list and forwards to Patient Access as required by regulations.
  • Identify trends in billing errors, denials, and underpayments and recommend corrective actions.
  • Assist the billing department with questions relating to revenue codes, modifiers, etc.
  • Support revenue cycle improvement initiatives.
  • Provides back-up support for State Reporting.
  • Provides back-up support for the HB Statement processing and acceptance.
  • Provides back-up support to the Revenue Integrity Analyst as it relates to Charge Capture Integrity.
  • Additional duties as assigned.
Denial Prevention amp; Revenue Optimization:
  • Analyze claim denials related to documentation, coding, billing or contract interpretation.
  • Collaborate with billing lead and contract specialist to reduce payor-specific denial trends.
  • Collaborate with registration, coding, clinical, authorization, and billing teams to improve claim accuracy.
  • Assist with appeals by validating documentation, coding and contract language.
  • Develop and implement corrective actions, including workflow changes, to prevent repeat denials.
  • Maintain current knowledge of payor rules, medical policies, and contract requirements.
  • Provide education and feedback to internal teams on payor-specific denial trends and prevention strategies.
  • Prepare denial prevention reports, dashboards, and performance metrics.
  • Act as a subject matter expert for denial prevention best practices.
Qualifications:
  • Bachelor’s Degree in Business, or related Medical Field, or equivalent combination of experience and education preferred.
  • Required: Associate Degree in Business, or related Medical Field, or equivalent combination of experience and education.
  • Knowledge of CPT and Medicare and Medicaid and other regulatory billing guidelines preferred.
  • Experience with medical terminology, CPT coding systems preferred
  • Ability to collaboratively coordinate, set priorities, operate with minimal direct supervision.
  • Effective analytical ability in order to analyze, recommend solutions to and solve complex problems.
  • Excellent interpersonal, organizational, and communication skills as well as the ability to problem solve
  • Competency with Microsoft Excel, Word, PowerPoint, and Software programs.
  • 3 years’ experience in hospital reimbursement environment to include charge capture and billing preferred
  • Strong knowledge of insurance claim workflows and denial types.
  • Ability to obtain any certifications needed to perform the position.
Employee Benefits:
  • Comprehensive benefits packages available for both part and full-time employees!
  • Paid Time Off (PTO) benefits begin to accrue on day one!
  • Retirement Plan with matching dollars available!
  • Two wellness center facilities that employees are eligible to use free of charge amp; a minimal fee for spouses!
  • Many Employer Sponsored Events held throughout the year to celebrate our employees!

Why Upland Hills Health: Upland Hills Health (UHH) consistently ranks as a very high performing health care institution in Southwestern Wisconsin. Located just 40 minutes from Madison, WI and as well from Dubuque, IA, the area is surrounded by wonderful communities and beautiful scenery. For over 100 years, Upland Hills Health has been dedicated to the promise of offering the highest standard of healthcare. Our community-minded staff emphasizes providing quality, comprehensive healthcare while offering a comfortable, neighborly welcome to everyone who walks through our doors. Here, neighbors care for neighbors!

Posting date: May 21, 2026

What Upland Hills Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply