• Full-time virtual, telecommuting, work from home environment
• Exposure to a variety of coding scenarios to broaden experience and knowledge
• Make a direct impact on members while collaborating and educating multiple stakeholders across the healthcare delivery system on medical coding best practices
• Base compensation range of $55,000 - $69,000 + robust total rewards package

• Review, edit and adjudicate claims that are pended and/or assigned in HealthLink based on CES logic/application, regulatory and internal policies.
  • Research and resolve assigned claim pends, review and monitor daily trends.
  • Research and respond to Customer Relationship Management (CRMs) inquires routed for coding expertise.
  • Review and resolve appeals in OnBase or HealthLink by reviewing documentation and making determination.
• Serve as a subject matter expert to advise internal and external parties on correct and compliant coding regulations and requirements for professional and facility coding and billing practices.
  
  • Edit, adjudicate, and resolve claim pends assigned from CES logic.
  • Monitor and analyze coding patterns to identify potential risks and assist with special projects to address trends, financial impacts, and potential improvements to system and performance and operational capabilities.
• Develop and update claim coding policies, procedures, and supporting documentation.
• Monitor industry standards and regulatory updates, analyzing and communicating impacts or changes that may be required to Quartz operations and lines of business.

• Certification as a professional/facility hospital coder (CPC, COC, RHIT, or CCS)
• Associate degree or equivalent work experience required
• 3+ years of experience in professional and/or facility coding, preferably in the health insurance field
• Strong working knowledge of professional and facility regulatory guidelines, fee and reimbursement and claims practices (CPT, HCPCS, ICD9/ICD10, OPPS, IPPS)
• Strong understanding of government-regulated medical payment policies and programs (CMS, Medicare, Medicaid, DHS, etc.)
• Experience communicating and working effectively with healthcare providers
• Intermediate proficiency with Microsoft Office is required; Epic software and/or claim or coding compliance or edit software (CES) knowledge is desirable
• Analytical problem-solving skills, with the ability to work independently to successfully investigate complex issues and collaboratively to resolve them

This position can work 100% remotely or from one of our offices in Madison, WI or Onalaska, WI in a hybrid or full-time on-site arrangement, if preferred. Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.

We offer an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. Quartz is a federal contractor and supports a safe, drug-free workplace. All employment offers are contingent upon successful completion of a pre-employment criminal background check and drug screening.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.