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)
Title: Risk Adjustment Coding Specialist
Location: Administrative Office - Patient Accounts Department
City: Bellingham, WA
Position: Full time 40 hours, Monday-Friday 8:00am-5:00pm, non-exempt (hourly)
Compensation: The full wage scale is $24.25 - $33.95 per hour. Placement within the range is determined by an evaluation of the candidate’s background, education, and experience.
Bonus: Employees are eligible annually to participate in discretionary bonus programs, as determined by FCN, which include the Years-of-Service bonus program, the Quality Performance bonus program and Performance Recognition bonus programs.
Job Summary: Primary responsibility is to assess Risk Adjustment / HCC coding practices for Family Care Network Practitioners and billing staff ensuring that regulations are being followed
We are looking for a qualified, motivated individual who can:
Essential Knowledge, Skills and Abilities:
About FCN: As an independent, locally owned, provider-run network of family medicine providers, we are passionate about our community's well-being. We take the time to build strong, long-term relationships with our patients and our employees. We have 11 clinics and 3 urgent care centers in Whatcom and Skagit County, in a beautiful corner of northwest Washington where the mountains meet the sea. Family Care Network offers an innovative and rewarding work environment, with a strong patient focus and a fulfilling mission.
Benefits:
Our health benefit programs are designed to take care of you and your family, offering flexibility and quality care.
At FCN, we value the importance of time away from work for leisure, health and well-being. Staff members accrue a generous Paid Time Off (PTO) program for vacation and short-term healthcare needs as well as an Extended Illness Bank (EIB).
Our 401k retirement plan is designed to support you in preparing for retirement planning and includes individualized financial planning guidance. Eligibility for the FCN Retirement Plan programs is determined based upon years of service and required payroll hours.
We offer the following programs:
Required Education & Experience:
Physical Requirements: While performing the duties of this job, the employee is required to stand, walk, sit, use hand-to-finger coordination, handle or feel objects, tools or controls, reach with hands and arms, climb stairs, balance, stoop, kneel, crouch, and listen attentively. The employee must occasionally lift and/or move up to 30 pounds.
Immunization Requirements: All employees at Family Care Network (FCN) are expected to meet and maintain required immunizations as a contingency of employment. The immunization requirements are as follows: Influenza (annually), Tdap (after the age of 19), MMR, Varicella or a verified history of chickenpox disease, Two-step TST or IGRA (within the last 12 months), COVID-19 vaccine completed series and any additional immunizations determined necessary for the protection of staff and patients. Hepatitis B is also required for employees in positions with a high risk of bloodborne pathogen exposure, which includes the following: Providers, RNs, LPNs, MA-Cs, PSRs at all Urgent Care Locations, and all-laboratory staff. The Hepatitis B vaccine is strongly recommended for all other employees. FCN will cover the cost of required immunizations for any FCN employee. All employee immunizations will be administered by FCN staff except for the COVID-19 vaccine. The COVID-19 vaccine can be administered at a participating pharmacy or other healthcare location. Note: A medical or religious vaccine exemption/reasonable accommodation will be considered by submitting an FCN Exemption form for review and evaluation by the Chief Medical Officer.
Family Care Network is a Drug-Free, Equal Opportunity Employer.
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