Coding Compliance Specialist researches and develops the pre-certification insurance policy standards and criteria used by case management and utilization reviewers that will ensure that requested medical services are appropriate and medically necessary. Collaborates with medical professionals to resolve questions about policy development and standards. Being a Coding Compliance Specialist assigns correct ICD, CPT, or other coding assignments for medical procedures that support policy standards in claims systems. Provides expertise and solutions to users regarding the appropriate coding for claims. Additionally, Coding Compliance Specialist has broad knowledge of medical coding systems. May require an associate degree in healthcare administration, a related field, or equivalent. Requires AAPC Certified Professional Coder (CPC). May alternatively require Certified Coding Specialist (CCS) certification. Typically reports to a manager. The Coding Compliance Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Coding Compliance Specialist typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)
About us
We are a skilled home healthcare business.
Our work environment includes:
Job Overview:
We are seeking a certified billing and coding specialist to join our home healthcare team. As a certified billing and coding specialist, you will be responsible for accurately assigning medical codes to patient records for billing and reimbursement purposes. Your expertise in medical coding and knowledge of medical terminology will be essential in ensuring accurate documentation and compliance with industry regulations.
Responsibilities:
- Review and analyze medical records to identify relevant diagnoses and procedures
- Assign appropriate medical codes using ICD-9 or ICD-10 coding systems
- Ensure accuracy and completeness of coded information
- Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies
- Stay up-to-date with changes in coding guidelines and regulations
- Maintain confidentiality of patient information and adhere to HIPAA guidelines
- Assist with medical billing and collection processes as needed
Experience:
- Proficient in medical coding systems, including ICD-9 and ICD-10
- Strong knowledge of medical terminology, anatomy, and physiology
- Familiarity with medical billing processes and insurance claim submission
- Experience working in a home healthcare setting is preferred
- Excellent attention to detail and accuracy in coding assignments
- Strong analytical and problem-solving skills
Job Type: Full-time
Pay: $22.00 - $26.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
Work setting:
Ability to Relocate:
Work Location: In person
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