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)
Surgical Specialty Center of Baton Rouge is looking for a self sufficient, experienced and certified coding professional with 5 to 7 years of inpatient and outpatient coding experience in Orthopedics, ENT, Urology and General Surgery.
Position is remote - must reside in Louisiana.
Under direct supervision apply the appropriate diagnostic and procedural codes to individual medical records according to the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to the Official Coding Guidelines.
Utilize ICD-CM, PCS and CPT references to assign appropriate codes to all inpatient and outpatient medical records. Code completed medical records within 3 days of discharge.
Education: High School diploma or equivalent preferred. Successful completion of a certified coding program preferred.
Experience: Fiveto sevenyears of hospital coding with ICD-CM and CPT experience.
Licenses/Certificates: Registered Health Information Technician or Certified Coding Specialist (CCS) highly preferred.
Special Skills: Computer literacy, knowledge of medical terminology, anatomy and physiology, clinical medicine, surgical procedures, diagnostic tests, radiology, pathology, pharmacology, and the various medical specialties as required in areas of responsibility. Ability to work under pressure with time constraints and be flexible to meet coding demands.
Physical Requirements: Sits seven to eight hours a day, walks, bends, stoops, and carries up to 10 pounds of medical records at a time.
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