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Coding Reviewer Jobs in Wisconsin (NOW HIRING)

CorroHealth Inc

WI · On-site

$25 - $28.50/hr

Provides second-level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies. * Researches, analyzes and responds to inquiries regarding compliance ...

Bellin

Denials Coding Specialist

Green Bay, WI · On-site +1

This role reviews inpatient medical records to assess coding accuracy, supports appeal processes, and ensures appropriate ICD-10-CM coding and DRG assignment to reflect the patient's severity of ...

CorroHealth Inc

WI · On-site

The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare and ICD-10-CM guidelines ...

ASPIRUS HEALTH

FACILITY OUTPATIENT CODER - CODING

Wausau, WI · On-site

$20 - $26.75/hr

Reviews and collects various health information data elements for patient care, statistical ... Coding accreditation and/or certification in coding by a recognized professional organization is ...

Aspirus Health

FACILITY OUTPATIENT CODER - CODING

Wausau, WI · On-site

$20 - $26.75/hr

Reviews and collects various health information data elements for patient care, statistical ... Coding accreditation and/or certification in coding by a recognized professional organization is ...

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Coding Reviewer information

What is a coding reviewer?

Coding Reviewers are professionals responsible for evaluating, analyzing, and verifying code written by other developers to ensure it meets established standards and best practices. They check for errors, maintainability, security vulnerabilities, and adherence to coding guidelines. Their feedback helps improve code quality, reduce bugs, and facilitate team collaboration. Coding Reviewers often participate in code walkthroughs, pull request reviews, and may also mentor junior developers.

How does a coding reviewer typically collaborate with software development teams during the review process?

Coding Reviewers work closely with developers by examining code for quality, consistency, and adherence to best practices before it is merged into the main codebase. They often provide constructive feedback through code review tools or meetings, helping developers understand and resolve issues. Effective collaboration also involves clear communication to ensure that suggested changes are well-understood and implemented, fostering continuous improvement and knowledge sharing within the team.

What are the key skills and qualifications needed to thrive as a coding reviewer, and why are they important?

To thrive as a Coding Reviewer, you need in-depth knowledge of medical coding standards (such as ICD-10, CPT, and HCPCS), healthcare regulations, and relevant clinical terminology, typically supported by a certification like CPC or CCS. Familiarity with electronic health records (EHR) systems, coding audit tools, and healthcare compliance software is essential. Strong attention to detail, analytical thinking, and effective communication skills help Coding Reviewers identify errors and provide clear feedback. These skills ensure accurate billing, regulatory compliance, and optimized revenue cycles in healthcare organizations.

What is the difference between Coding Reviewer vs Medical Coder?

AspectCoding ReviewerMedical Coder
CredentialsCertification in coding (e.g., CPC, CCS)Certification in coding (e.g., CPC, CCS)
Work EnvironmentReviewing medical codes, often in healthcare settingsAssigning medical codes from patient records
Industry UsageUsed in hospitals, clinics, insurance companiesUsed in hospitals, clinics, billing companies
Primary RoleReview and validate coding accuracyAssign and input medical codes

Both Coding Reviewers and Medical Coders require similar certifications and work in healthcare environments. Coding Reviewers focus on verifying the accuracy of codes assigned by others, ensuring compliance and correctness. Medical Coders are responsible for assigning the initial codes based on medical records. While their roles are interconnected, Coding Reviewers primarily audit and validate, whereas Medical Coders handle the coding process itself.

What cities in Wisconsin are hiring for Coding Reviewer jobs?

Cities in Wisconsin with the most Coding Reviewer job openings:

Coding Reviewer jobs near you
Infographic showing various Coding Reviewer job openings in Wisconsin as of September 2026, with employment types broken down into 62% Full Time, 19% Part Time, 6% Temporary, and 13% Contract. Highlights an 87% In-person, and 13% Remote job distribution.

Coding and Compliance Analyst

Marshfield, WI • On-site

Family Health Center
See more jobs at Family Health Centerexternal

Full-time

Re-posted 2 days ago

Job description

* This is a hybrid position to be located in WI with travel required. *


JOB SUMMARY

The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines.  This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs.  The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs).  The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable standards and payer requirements.

ESSENTIAL JOB FUNCTIONS

  1. Reviews provider documentation, medical records, and associated charges to ensure correct assignment of ICD-10, CPT, HCPCS codes, and modifiers according to payer, CMS, HRSA, and FQHC-specific guidelines.
  2. Conducts regular audits of coding, billing, and claims to ensure accuracy, completeness, and compliance with CPT, CDT, HCPCS, ICD-10, and payer-specific guidelines. 
  3. Monitors claims submissions, pre-bill edits, denials, and payor feedback and identify coding and billing errors or trends and recommend corrective actions and coordinate follow-up audits as needed.
  4. Assists in developing, updating, and maintaining coding and billing compliance policies, procedures, training materials as guidelines or payor rules change.
  5. Collaborates proactively with providers, clinical teams, and billing staff to ensure accurate documentation, compliant coding practices, and adherence to Medicaid coverage and reimbursement requirements.
  6. Analyzes denied or underpaid claims to identify root causes, including coding errors, documentation gaps, or payer-specific policy issues, and collaborate with interdepartmental teams to implement targeted process improvements that strengthen billing compliance and optimize revenue integrity.
  7. Monitors and interprets payer updates, coding changes, and reimbursement policy revisions from CMS, HRSA, Medicaid, and commercial payers; evaluates their impact on FQHC operations and communicates relevant updates, guidance, and action steps to affected departments to ensure compliance and optimized reimbursement.
  8. Monitors coding practices for compliance with FQHC Prospective Payment System (PPS) and encounter-based billing guidelines.
  9. Performs charge reviews comparing itemized bills to medical record documents to ensure appropriate charges.
  10. Conducts regular staff training sessions for providers, billers, and clinical staff on documentation, coding updates, and compliance best practices.
  11. Prepares audit reports and presents findings to leadership and compliance officer.
  12. Maintains strict adherence to scheduled work hours with regular and reliable attendance.
  13. Performs other duties as assigned.

EDUCATION AND EXPERIENCE

  1. Minimum of 3-5 years of experience in medical billing, coding, and/or compliance within a healthcare setting is required; FQHC experience preferred.
  2. Proficiency with EHR and practice management systems (e.g., Epic Systems, NextGen Healthcare, eClinicalWorks).
  3. Associate’s or degree in Health Information Management, Healthcare Administration, or related field preferred.

CERTIFICATIONS / LICENSES

  1. Certified Professional Coder (CPC), awarded by American Academy Professional Coders (AAPC) required.
  2. Additional credentials such as Certified Compliance Professional (CCP) preferred.
  3. Valid Wisconsin Driver’s License required with an acceptable motor vehicle record (MVR), per FHC guidelines.


Equal Employment Opportunity