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Inpatient Coding Quality Reviewer Jobs in Wisconsin

Intermountain Health

PB Coding Coordinator

Madison, WI · On-site

$31.01 - $48.84/hr

Review medical record documentation and assign appropriate CPT, HCPCS, ICD-10, and modifiers ... Performs quality assurance audits within specialty team. * Ensures compliance with coding ...

Clune Construction Company, L.P.

WI · On-site

$70 - $100/hr

Working knowledge of applicable construction codes and project specifications. * Ability to review ... Support QA/QC leadership in ensuring inspection procedures and documentation requirements are ...

Tweet/Garot Mechanical

Quality Manager

Wrightstown, WI · On-site

Conduct performance reviews, provide ongoing feedback, and support professional development and ... Experience with AWS D1.1 welding codes, ASME standards, or other welding and fabrication quality ...

Ascension

Inpatient Pharmacist

Milwaukee, WI · On-site

$56.54/hr

Review, validate, and optimize medication orders for clinical appropriateness. You will proactively ... Supervise and elevate our pharmacy technicians, ensuring rigorous quality control and unwavering ...

Ascension

Inpatient Pharmacist

Milwaukee, WI · On-site

Review, validate, and optimize medication orders for clinical appropriateness. You will proactively ... Supervise and elevate our pharmacy technicians, ensuring rigorous quality control and unwavering ...

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Inpatient Coding Quality Reviewer information

What is an inpatient coding quality reviewer?

Inpatient Coding Quality Reviewers are healthcare professionals responsible for evaluating the accuracy and completeness of medical coding for inpatient hospital records. They review coded data to ensure compliance with official coding guidelines, payer requirements, and hospital policies. Their work helps ensure proper reimbursement, minimizes errors or denials, and maintains the integrity of patient records. Inpatient Coding Quality Reviewers often provide feedback and training to coding staff, and they may also participate in audits and quality improvement initiatives.

What skills and qualifications are needed to be an inpatient coding quality reviewer?

To thrive as an Inpatient Coding Quality Reviewer, you need in-depth knowledge of ICD-10-CM/PCS coding, medical terminology, and a credential such as RHIA, RHIT, or CCS. Familiarity with coding audit software, electronic health record (EHR) systems, and encoder tools is typically required. Strong analytical skills, attention to detail, and effective written communication help you stand out in this role. These skills ensure accurate coding, compliance with regulations, and optimal reimbursement for healthcare organizations.

What challenges do inpatient coding quality reviewers face, and how are they addressed?

Inpatient Coding Quality Reviewers often face challenges such as interpreting complex medical documentation, staying updated with frequently changing coding guidelines, and ensuring consistency across large volumes of records. These challenges are typically addressed through ongoing training, collaborative case discussions with the coding team, and regular use of coding reference tools and software. Additionally, reviewers may participate in quality improvement meetings and work closely with clinical staff to clarify documentation, fostering a supportive and communicative work environment.

What is the difference between Inpatient Coding Quality Reviewer vs Inpatient Coder?

AspectInpatient Coding Quality ReviewerInpatient Coder
CertificationsAHIMA CCS or AHIMA RHIT, CPC-HAHIMA CCS or AHIMA RHIT, CPC-H
Work EnvironmentReviewing medical records, ensuring coding accuracy, quality assuranceAssigning codes to inpatient records, coding documentation
Employer & Industry UsageHospitals, health systems, coding audit companiesHospitals, healthcare facilities, coding service providers

The Inpatient Coding Quality Reviewer focuses on auditing and ensuring the accuracy of inpatient coding, often working in quality assurance roles. In contrast, the Inpatient Coder actively assigns codes to medical records. Both roles require similar certifications and work in hospital or healthcare settings, but their primary responsibilities differ: review versus coding.

What does an inpatient coding quality reviewer do?

An inpatient coding quality reviewer evaluates medical records and coded data to ensure accuracy and compliance with coding standards such as ICD-10. They identify errors, provide feedback, and may recommend training or process improvements to maintain high coding quality, often using coding software and working closely with coding staff and healthcare providers.

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Cities in Wisconsin with the most Inpatient Coding Quality Reviewer job openings:

Inpatient Coding Quality Reviewer jobs near you

Medical Coding Specialist II - Profee Radiology

UWHealth

Middleton, WI • On-site, Remote

Full-time

Medical, Dental, Retirement, PTO

Re-posted 29 days ago

Job description

Work Schedule: 
This is a full-time, 1.0 FTE position that is 100% remote. This will have flexible shifts scheduled Monday - Friday and will be discussed in the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. 
 

To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states.  
 

Approved Remote Work States Listing

Be part of something remarkable


Join the #1 hospital in Wisconsin!

We are seeking a Medical Coding Specialist II to:

  • Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes.
  • Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.

At UW Health, you will have:

  • An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance.
  • Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance.
  • Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and physical well-being.
  • Tuition benefits eligibility - UW Health invests in your professional growth by helping pay for coursework associated with career advancement.

Qualifications

  • Medical coding education Required or In lieu of a medical coding education, an active coding certification Required
  • High School Diploma or equivalent Preferred
  • Associate's Degree in a healthcare related field Preferred

Work Experience

  • 1 year of progressive coding experience (For HCC-specific roles, experience must be specific to HCC) Required
  • 2 years progressive coding experience in multiple specialties, HCC Risk adjustment Coding Preferred

Licenses & Certifications

  • Certified Professional Coder (CPC) Upon Hire Required or
  • Certified Outpatient Coder (COC) Upon Hire Required or
  • Certified Inpatient Coder (CIC) Upon Hire Required or
  • Certified Coding Specialist (CCS) Upon Hire Required or
  • Certified Coding Specialist Physician-Based (CCS-P) Upon Hire Required or
  • Certified Coding Associate (CCA) Upon Hire Required or
  • Certified Risk Adjustment Coder (CRC) Upon Hire Required or
  • Registered Health Information Technician (RHIT) Upon Hire Required or
  • Registered Health Information Administrator (RHIA) Upon Hire Required
  • Registered Health Information Technician (RHIT) Preferred or
  • Registered Health Information Administrator (RHIA) Preferred

Our Commitment to Social Impact and Belonging

UW Health is committed to fostering a workplace that creates belonging for everyone and is an Equal Employment Opportunity (EEO) employer. Our respect for people shines through patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. It is the policy of UW Health to provide equal opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
 

Job Description

UW Medical Foundation Benefits

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