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Senior Internal Auditor


Job Description:

A passion for making lives better.

Mercy Health System and Rockford Health System have joined forces to become Mercyhealth, a vertically integrated, not-for-profit multi-regional health system serving northern Illinois and southern Wisconsin. At Mercyhealth, we serve with a passion for making lives better. We hire well qualified individuals because we want our patients to get exceptional care, close to home. We are growing and expanding services because we want to make lives better by providing greater access to top-notch medical care for the communities we serve. We purchase the latest technology and pursue advanced accreditations and certifications because our patients deserve the very best health care has to offer.

We are seeking a talented individual to join us as a Senior Internal Auditor for Mercyhealth, our wholly owned subsidiary that links Mercyhealth together by offering a complete continuum of health care services to our membership, including seniors, individuals, and area employers and their employees.

Senior Internal Auditor
Position located in Janesville, WI

  • Design and conduct financial and risk-based audits to assure MercyCare’s adherence with industry standards, federal and state regulatory requirements, MercyCare policies and procedures, current contracts, and national accreditation standards.
  • MercyCare administers a variety of insurance products, including Medicaid, government marketplace individual and small group health plans, Employee Retirement Income Security Act health plan, Federal Employees Health Benefit program, and commercial products regulated by the Wisconsin Office of the Commissioner of Insurance and Illinois Department of Insurance.
  • Create, manage, and administer the annual audit plan.
  • Perform audits ensuring financial and statistical accuracy with industry standards.
  • Design and conduct audits to test the adequacy of management and control of operations, ensuring compliance with established internal processes by examining records, reports, operating procedures, and documentation.
  • Prepare written reports (for the Director of Compliance and Audit and the Director of the area examined), summarizing audit findings on the accuracy and quality of work, and making recommendations for improvement and correction where identified.
  • Assist with MercyCare compliance activities identifying risk areas, and contribute with development and implementation of policies and procedures where indicated.
  • Assign projects to others as needed.
  • Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional associations.


  • Bachelor’s degree in accounting, health information management, or business administration (with concentration in other related areas preferred).
  • Licensure as at least one of these: Certified Internal Auditor, Certified Public Accountant, or Registered Health Information Administrator.
  • Keen adherence to Mercyhealth’s high standards related to quality, service, partnering, and cost.
  • At least 5 years audit experience in health care industry preferred.

In addition to opportunities to learn, grow, and advance, Mercyhealth offers health and dental insurance, vacation, matched retirement savings, and more. Apply online at:



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Compliance Coordinator Insurance Operations


Job Description:

A passion for making lives better.

Mercy Health System and Rockford Health System have joined forces to become Mercyhealth, a vertically integrated, not-for-profit multi-regional health system serving northern Illinois and southern Wisconsin. At Mercyhealth, we serve with a passion for making lives better. We hire well qualified individuals because we want our patients to get exceptional care, close to home. We are growing and expanding services because we want to make lives better by providing greater access to top-notch medical care for the communities we serve. We purchase the latest technology and pursue advanced accreditations and certifications because our patients deserve the very best health care has to offer.

We are seeking a talented individual to join us as a Compliance Coordinator – Insurance Operations for Mercyhealth, our wholly owned subsidiary that links Mercyhealth together by offering a complete continuum of health care services to our membership, including seniors, individuals, and area employers and their employees.

Compliance Coordinator – Insurance Operations

Position located in Janesville, WIPlan, organize, and execute compliance programs associated with insurance products marketed by MercyCare, including Medicare Advantage, Medicaid, Federal Employees Health Benefit program, Wisconsin Department of Employee Trust Funds, and the commercial products regulated by the Wisconsin Office of the Commissioner of Insurance and the Illinois Department of Insurance.

  • Use CMS audit protocols to develop and implement internal auditing activities and checklists.
  • Develop, implement and track metrics for each operational area, and create a consistent and regular reporting mechanism and process.
  • Develop educational training modules to ensure staff is knowledgeable about Medicare Fraud, Waste and Abuse, and internal policies and procedures.
  • Work with compliance officer to investigate issues reported to the compliance hot line.
  • Assist compliance officer with activities related to oversight of first tier, downstream and related entities.
  • As resource for MercyCare partners, maintain current knowledge of Medicare regulations and guidelines.
  • Assist staff in interpreting, understanding and applying regulations to operational activities.
  • Work with operational areas to ensure appropriate documentation of policies and procedures.
  • Perform monitoring activities based on the compliance plan developed by compliance officer, under the auspices of the Mercy Health System Compliance Committee, and create management reports accordingly.
  • Perform multiple analytical reviews of various data sources to validate data reported to CMS and ensure compliance with Medicare program requirements.
  • Proactively audit data sources—including cross-claims analysis using pharmacy and medical claims data—to find anomalies, and then perform investigations to explain and report findings.
  • Prepare management reports based on audits, monitoring and compliance issues reported or received.
  • Create reports and files to comply with regulatory reporting requirements, such as Medicare Secondary Payer, debarment and suspension.
  • Review CMS-generated memos and other government-issued communications to remain current on regulatory activity and help operational areas adopt and implement new requirements.
  • Work with compliance officer to manage regulatory audits.
  • Coordinate the development, updating and filing of plan documents for commercial insurance products, following state and federal regulatory guidelines.

Required Qualifications:


  • Bachelor’s degree from four-year college or university.
  • At least 1 to 2 years relevant experience or training (or equivalent combination of education and experience).
  • Knowledge and experience working with healthcare claims data in multiple formats.
  • Proficient with various data-analysis tools and software, as well as database, Internet, spreadsheet and word processing software.
  • Adept at solving practical problems and dealing with a variety of concrete variables in situations where only limited standardization exists.
  • Proficient in interpreting a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Excellent communication and analytical/interpretive skills, with high degree of accuracy.
  • Keen adherence to Mercyhealth’s high standards related to quality, service, partnering, cost, analysis, design, problem solving, project management, and technical skills.


In addition to opportunities to learn, grow, and advance, Mercyhealth offers health and dental insurance, vacation, matched retirement savings, and more. Apply online at:



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Clinical Informaticist 2

Gundersen Health System



Works to optimize clinical work processes.  Responsible for coordinating aspects of analysis, design, development, implementation, maintenance, and evaluation of purchased or internally developed clinical information system applications.  Provides application support to assigned clinical systems.

Job Description:

1.Works with IS Department colleagues and all end users to provide timely, respectful, and comprehensive communication for the purpose of the customer.
2.Coordinates and participates in aspects of system analysis, planning, design, development, testing, and implementation of clinical information systems.
3.Coordinates and participates in efforts towards maintaining components of clinical information systems including revisions, testing, and integration of changes in components.
4.Prepares detailed program specifications and flowcharts, and coordinates system installations with the user department.
5.Provides application support, including problem analysis, user assistance queries, application issues/enhancement requests, systems upgrades and quality monitoring.

Required Qualifications:

Education and Learning:

Bachelor’s degree in Health Information Management or  Nursing from an accredited college of nursing, as recognized by the Accreditation Commission for Education in Nursing or Commission on Collegiate Nursing Education. or  Accounting or  Management of Information Systems (MIS) or  Computer Science or  Pharm.D. from an accredited School of Pharmacy
License and Certifications:

Some positions require Registered Nurse (RN) licensed to practice in the state of employment  or  Registered Health Information Administrator (RHIA)   or  Registered Health Information Technician (RHIT)   or  Certified Public Accountant (CPA)   or  Pharmacist – Wisconsin (Pharm.D.)

Instructions for Resume Submission:

Please visit our website and apply online at

Equal Opportunity Employer

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HIM Physician Coder

Estes Park Medical Center


Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement.  Provides education to the providers to ensure proper completion of Electronic Health Records and proper assignment of ICD-10-CDM, HCPCS and CPT codes.

Job Description:

  • Perform coding work requiring independent judgment with speed and accuracy
  • Examining and verifying coding errors through audits
  • Required in-services
  • Communicating clearly and concisely, orally and in writing
  • Confidentiality
  • Ability to use the computer
  • Ability to work independently to accomplish assigned work in a timely manner
  • Ability to communicate with staff and the public, both in person and over the telephone, in a tactful manner and under difficult situations
  • Understanding and carrying out verbal and written directions
  • Follow Estes Park Medical Center policies and procedures
  • Works independently in the absence of supervision Personal Work Relationships:
  • Maintain strict Estes Park Medical Center confidentiality
  • Works daily with staff, vendors, and public for the purpose of giving and receiving factual information
  • Must plan one’s own work such that it is accomplished in the allocated time
  • Works in cooperation with other clinic staff and the public

Required Qualifications:

Knowledge of:

  • Federal laws and regulations affecting coding requirements
  • Principles, practices and methods of current coding certificate required
  • Modern office practices, etc.
  • Knowledge of billing practices required
  • Knowledge of medical records, EHR required
  • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), Colorado State Law and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
  • Must have good math skills and effective communication skills.

Preferred Qualifications:

Excellent interpersonal skills

Three years’ experience using ICD-10-CM, CPT, HCPCs or equivalency

Computer competency

Education Qualifications:

High School Diploma

Medical Coding Certificate – RHIT or CPC- certification is required

Compensation/Benefits: Instructions for Resume Submission:

Send resume to or visit our website at and apply.

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Inpatient Coding Technician – Senior

UW Health


Join our team and be part of the talent that makes UW Health the best work and academic environments.

Job Description:

The UWHC Coding Technician-Inpatient-Senior is an advanced level position which requires minimal supervision and a high level of independent decision making and problem solving skills. The Senior inpatient coder is responsible for coding all and any charts, regardless of payer, including mortality records. The incumbent codes records of all payers identified for interim billing as well as tentative DRG. Compliant coding queries are written and sent with only ad hoc consultation from others. The incumbent is well versed in Patient Safety Indicators, Pediatric Safety Indicators and mortality review and can assist in any quality metric questions which may arise. This individual assists with responding to external coding reviews from private payers as well as government contractors. This position is differentiated from the objective level by the skill and independence required to code complex inpatient scenarios. The inpatient senior level coder will interact with physicians and other clinicians with minimal supervision as it pertains to coding and documentation. The incumbent is expected to meet departmental productivity, quality and performance standards. This position has the potential to work remotely, so excellent problem-solving and electronic communication skills are required.

Work Schedule: 100% FTE, 40 hours per week. Specific schedule can be flexible.

UW Health offers a competitive compensation and benefits package. Work experience that is relevant to the position will be taken into consideration when determining the starting base pay.

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

Required Qualifications:

Formal training (or equivalent work experience) in anatomy, pathophysiology and medical terminology normally obtained in a one-year college-level course of study
Formal training (or equivalent work experience) in the use of ICD-9 and ICD-10 coding systems—normally obtained through college level course of study
Formal training (or equivalent work experience) in reimbursement/quality systems: IPPS, MS-DRG, POA

Work Experience
Two or more years of progressive inpatient hospital coding experience

Licenses & Certifications

R.H.I.T. and/or C.C.S.
Required Skills, Knowledge, and Abilities
Comprehensive knowledge or ICD coding systems
Knowledge of regulatory requirements of IPPS
Outstanding interpersonal skills
Effective verbal and electronic communication skills
Excellent written communication skills
Ability to quickly analyze a situation and problem solve
Demonstrated capacity to work independently

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Supervisor, Physician Coding – Experienced Coder

ProHealth Care


Choose ProHealth Care

ProHealth Care has been the health care leader in Waukesha County and surrounding areas for the past century, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Medical Group clinics, AngelsGrace Hospice, ProHealth Home Care & Hospice, West Wood Health & Fitness Center and Regency Senior Communities. Learn more at

Job Description:

Hours: Full-time, Monday – Friday 8:00a.m to 5:00p.m.

Supervises the daily coding activities and all assigned coders to ensure the timely and accurate submission of codes to maximize reimbursement and minimize delays in revenue cycle operations. Ensures the compliance and adherence to coding guidelines, Medicare regulations, third party payers and charging requirements.

The Supervisor, Coding should have certification and at least 4 years of physician coding experience along with demonstrated leadership skills. The role is responsible for 16 employees (both remote and in office) including: monitoring workflow, quality assurance, audits, and staying up to date with regulatory changes with CMS-EME and CPT codes. The role may require travel from time to various ProHealth Care sites for provider education/training and meetings. This is a hands on supervisor role which will be expected to jump in and help perform coding work when needed and act as a subject matter expert for staff.

Required Qualifications:


  • High School Diploma or equivalent required. Associate degree or higher strongly preferred.
  • At least 4 years of physician coding experience.
  • CPC or CCS certification required.
  • Demonstrated leadership skills.
  • Demonstrated strong time management and prioritization skills.

Preferred Qualifications: Education Qualifications: Compensation/Benefits: Instructions for Resume Submission:

ProHealth Care, one of the largest employers in Waukesha County, offers work that is challenging and rewarding. The organization is dedicated to providing the highest quality service to our patients and their families and treats each individual with respect – the way they should be treated. We have high expectations for those who join our team of nearly 5,000 employees. In return, we offer exceptional career opportunities in a dynamic, health care system where the contributions of every team member are valued.

For complete details and to apply please click on the following link, then click “Search and Apply for Job Opportunities” and search by the position title or Requisition #:

Direct URL link to posting to Apply Online:

Waukesha County:

ProHealth Care is located in Waukesha County (pop. 380,985) part of beautiful Southeastern Wisconsin. Waukesha can be found 15 miles west of exciting downtown Milwaukee, 60 miles east of Madison, 100 miles south of Green Bay and 100 miles northwest of Chicago, and hosts a variety of recreation opportunities combined with an array of cultural and sporting events.

ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. EOE-Minorities/Females/Disabled/Vets.

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Release of Information Clerk/Analyst

Bay Area Medical Center


Bay Area Medical Center is a 99 bed hospital located in Marinette, WI.  Marinette is located on the east side of Wisconsin on beautiful Lake Michigan.  We are just one hour north of Green Bay.  We are opening a brand new, state-of-the-art facility in Summer of 2018.

Job Description:

Completes all  tasks related to release of medical information including maintaining request logs, updating status of requests and retrieving charts.  Knowledge of HIPAA rule is necessary to perform this role.  Aides in the achieving the departmental objectives.

Essential Functions:

  1. Logs all requests for information in Meditech and/or Epic timely and accurately.
  2. Responds to requests for information timely and accurately.
  3. Assures release requests and consent forms are valid prior to information being sent.
  4. Alerts HIM Director of possible litigation cases.
  5. Assists all customers with any issues; including filing patient concerns.
  6. Must be able to complete the physical, sensory and mental requirements of the position.
  7. Follows all facility and department policies.

Required Qualifications:

Knowledge of HIPAA and ability to determine validity of requests for information is strongly preferred.  One year of experience with releasing medical records is required.  Experience in the medical field with a good working knowledge of computer systems, medical terminology, typing ability (25 wpm) and filing.  Must have the ability to work in a team environment, effective communication skills and a commitment to customer satisfaction.  Customer service skills are essential.  Serves all customers without prejudice.  Professionalism, accuracy, dependability and confidentiality are essential.  Position requires close attention to detail, good organizational skills and independent decision making.

Preferred Qualifications: Education Qualifications:

High school graduate or equivalent.


Benefits include:

Short-term disability
Long-term disability
Life Insurance
Pro-rated PTO
Wellness Benefits

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Health Information Technician 1

University of Wisconsin Oshkosh Student Health Center


This position is responsible for the operational management of health information services, medical coding/billing, and reception services for the Student Health Center. Knowledge of overall clinic operations, office policies and procedures, medical report preparation methods and procedures, state and federal regulations related to electronic medical records, HIPAA and privacy regulations, and proficiency with electronic medical records (EMR) software are essential to coordinate these functions.

Candidate should possess strong attention to detail, and high language, reasoning, and critical thinking abilities. Knowledge of medical terminology, statutes, administrative rules and regulations concerning the confidentiality of health care information, medical ethics, health facility organization, coding, billing, financial account reconciliation and insurance processes is required. Independent decision making abilities are required to identify problems and seek and implement solutions. Must be able to exercise sound judgement and discretion in a variety of complex situations, function well in a fast-paced environment, and be able to work on and prioritize many tasks simultaneously while responding in a compassionate, calm manner to meet the needs of patients, co-workers, and others.

After training, proficiency is required with PeopleSoft Student Information System, PyraMed Electronic Medical Record software and the Forward Health Portal. Candidate should be skilled in the regular use of Microsoft Word, spreadsheet and database software, and the use of internet, electronic mail, and EHR software. Strong oral and written communication skills, excellent organizational skills, careful attention to detail and the ability to work independently while handling a variety of tasks simultaneously are required.

Job Description:

Medical Record Duties (35%)

1. Maintain confidentiality and HIPAA compliance for all health records and related correspondence and/or communication. Monitors state and federal mandates regarding medical record confidentiality, reporting requirements and procedures for release of information and revises operational standards as needed.

2. Assign diagnosis and/or procedure codes, utilizing standard classification systems such as the International Classification of Diseases (ICD) in collaboration with providers.

3. Requests medical information from other health agencies/medical providers via phone, fax, and mail as needed in compliance with state and federal regulations and ensures all documentation is scanned into the EMR.

4. Follow statutory guidelines and other regulations to independently evaluate and respond appropriately to requests from individuals, families, legal representatives, insurance companies, healthcare providers or government agencies for the release of patient health information.

5. Working knowledge of college health service EMR to perform billing, coding and cashiering for patient visits.

6. Manually checks enrollment in Student Information System if not automatically populated in the EMR.

7. Labels Patient Alerts in the EMR as individual circumstances require.

8. Provides training and direction to health care staff regarding medical record completion, management and confidentiality requirements. Assists staff with EMR functionality and troubleshooting, technical support and reporting.

9. Updates clinical dictionaries in EMR software as needed.

10. Assist providers, medical informatics associate, and director in collecting health-related information.

11. Evaluates active medical files for both completeness and quality of documentation and monitors and manages accuracy of entries and updates to web portal scheduling software. Contacts providers and other health care staff as needed to remedy identified record deficiencies.

12. Mentors and delegates responsibilities to Student Employees as needed.

Front Office Organization, Medical Reception and Appointment Scheduling: (35%)

1. Answers telephones and assists walk-in patients requesting care. Assesses the nature and urgency of the patients’ medical need and notifies health care professionals of possible emergencies on telephone or in waiting room. Schedules patient per set scheduling guidelines determining the most appropriate visit type and timing of appointment to ensure optimal patient care.

2. Responds quickly and appropriately to emergency situations, e.g., cardio-pulmonary arrest, patient hostility, fire, patient and staff evacuation, etc. Participates in scheduled drills according to established policies and procedures.

3. Checks in patients and interprets SHC policies for students, faculty, staff, and visitors regarding fees, no shows, check-in times, etc. Responds to general inquiries regarding services, hours, patient care, and patient billing. Instructs patients on how to complete patient data forms, history forms, and consent forms both on paper and via web portal.

4. Determines eligibility for service, validates student ID, obtains and updates address, telephone, birth date, FPOS status and other pertinent records utilizing EMR and explains payment options to patients.

5. Creates group appointments and bursar charges for special events such as flu clinics, TB clinics, sports physicals, etc.

6. Monitors reception and patient waiting area to maintain an appropriate atmosphere.

7. Prepares the front office for the day’s business, including starting computers, and turning over phones.

8. Plans front office work schedules and assigns work to ensure coverage of all duties. Responsible for communicating with all areas of clinic regarding daily clinic business, changes, etc., and works closely with medical providers to ensure smooth and efficient operation during peak periods of activity.

9. Maintains protocols and policies for front office.

10. Does not supervise other staff, however may provide work direction to student employees.

Insurance Coding, Billing & Financial Recordkeeping Duties: (25%)

1. Possesses knowledge of ICD-10 and CPT coding for software, billing, and insurance purposes.

2. Verifies accuracy of medical ICD-10 and CPT codes on encounter forms.

3. Enters new and revised ICD-10 and CPT codes in the EMR.

4. Invoices charges on patient visit encounters within the EMR Billing Workplace, and responds to questions regarding patient accounts.

5. Audits coding and accuracy of charges in the EMR Patient Workplace (chart).

6. Submits and verifies the accuracy of claims for Family Planning Only Services (FPOS) through the Forward Health Portal.

7. Posts FPOS payments received. Attempts to recover maximum allowable charges for services. Posts payments and adjustments to student accounts through the Insurance Payment Workplace.

8. Updates pricing of goods and services as well as the EMR financial schedules.

9. Develops and prepare statistical and financial reports.

10. Sets semester eligibility and plan updates in Student Information System.

11. Counts cash and reconciles cash/checks and Titan Card dollar with EMR reports. Completes applicable deposit forms and daily deposit.

12. Processes daily payments as needed, corrects billing and coding errors.

13. Verifies accuracy of Bursar reports from the UWO Student Financials Department and the EMR Bursar report.

Miscellaneous Duties: (5%)

1. Handles sensitive information with discretion and confidentiality, responding to inquiries and complaints from patients, staff and the public.

2. Attends meetings, in-services, job related seminars, and other continuing education classes.

3. Participates in and contributes to quality assurance/improvement activities such as performing random audits of medical record documentation, monitoring the quality of patient care by reviewing patient documentation against clinical pathways or performing special projects as assigned.

4. Organize, update, and save documents to shared drive.

5. Helps orient and train new employees.

6. Perform opening and closing day procedures.

7. Compile utilization statistics.

8. Other duties as required.

Departmental Core Competencies:

1. Demonstrates empathy, caring, and understanding of students and their needs when seeking health care.

2. Continually seeks methods and opportunities to improve the quality of care delivered to students.

3. Anticipates, identifies and adopts to change willingly. Supports others in identifying potential solutions to work problems. Provides leadership in the areas of medical records and privacy of PHI (Protected Health Information).

4. Applies ethical and legal principles to the collection, use, and dissemination of medical information.

5. Develops skills and behaviors to manage multiple tasks and maximize work performance individually and as a team member.

6. Maintains appropriate standards of safety, hygiene and infection control for the Student Health Center environment.

7. Demonstrates the ability to sensitively, effectively and professionally interact with persons from diverse cultural, socioeconomic and professional backgrounds.

8. Interacts effectively and professionally with staff and all university departments assisting with students’ academic/athletic health care requirements.

Required Qualifications:

1. Minimum three (3) years of office experience, preferably in a medical setting.

2. Level of knowledge equivalent to that ordinarily acquired through completion of two year medical record technician course or credentialed as a Registered Health Information Technician (RHIT).

3. Experience with public speaking.

Preferred Qualifications:

1. Level of knowledge equivalent to that ordinarily acquired through completion of a four year health information management course or credentialed as a Registered Health Information Administrator (RHIA).

Instructions for Resume Submission:

Please visit the UW Oshkosh Human Resources website ( to apply for this job.

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