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)
JOB SUMMARY
Our ideal candidate for Compliance Specialist aspires to be a model of innovation, inclusion and empowerment who enables bold people and ideas to thrive. The Compliance Specialist will be a participatory leader: a results-oriented, relationship-building, self-aware team player who also possesses high integrity, politeness, and fostering trust by building relationships with tolerance, patience, and support to provide the best value in service of the citizens of Brownsville.
The Compliance Specialist is crucial to ensure adherence and compliance with federal, state, and local laws and regulations regarding the U. S Housing and Urban Development Programs; Community Development Block Grant (CDBG), HOME Investment Partnerships Program (HOME), Emergency Solutions Grant (ESG) and other federal and state assisted programs. Responsibilities include compliance monitoring, oversight, and project evaluation. The candidate will perform special projects and research related to the programs administered by the department. This position reports directly to the Compliance Manager.
COMPETENCIES:
Effective Communication
Trust
Time Management
Ethical Practice
Problem Solving skills
Attention to detail
Strong Analytical
KEY FUNCTIONS/KNOWLEDGE/SKILLS:
Education and Experience
Bachelor’s degree plus 6 months to a year of experience relatable (preferred), or associate’s degree plus 2 years of experience, or high school graduation or GED plus six years of experience.
Special Certifications and License
Valid Texas Driver’s License.
Independence and Judgement
Average judgment; must recognize and resolve problems such as bad grammar, type of procedure to apply, where to refer call or correspondence without specified destination, when to change or sharpen blade on mower, whether there is a problem/malfunction with a piece of equipment that needs attention, etc.; may involve freedom in selection of work methods among approved routines, setting of priorities, or sequencing of tasks within established schedules.
Initiative and Ingenuity
General guidelines: occasionally requires interpretation of available options to apply to non-standard situations; day-to-day work drives priorities.
Supervisory and Responsibility
Does not supervise.
Financial Responsibility
Does not deal with money.
Level and frequency of Outside Contacts
Frequent contact with the public or other organizations; interactions may require obtaining cooperation of people; courtesy and tact are required when dealing with moderately difficult or sensitive issues.
Physical Demands
Office job with little or occasional light physical effort.
Responsibility for Equipment and Property
Responsible for use of equipment/property such as office equipment, supplies, etc., which are used in office.
Working Conditions
Office job, no adverse conditions.
Other Requirements
The City of Brownsville requires all employees to successfully pass a Drug & Alcohol examination and a Background Check.
ADA Requirements
The City of Brownsville is an Equal Opportunity Employer. ADA requires the City to provide reasonable accommodations to qualified individuals with disabilities. Prospective and current employees are invited to discuss accommodations.
Benefits
The City of Brownsville participates in a generous retirement plan with retirement opportunities available at 5 or 20 years of continuous service. The City has an exceptional employee and family medical and dental insurance plan. Employees may also contribute to deferred compensation plans or supplemental insurance plans. Full time employees have the opportunity to accumulate 10 sick days, 10 annual days and 2 floating holidays per year. Additionally, the City of Brownsville observes 12 holidays annually.
EEOC Statements
The City of Brownsville does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors.
Clear All
0 Coding Compliance Specialist jobs found in Brownsville, TX area