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)
Must be 20 years old to apply. Pre-employment drug screen, physical and background check required.
Licensure/Certification:
One of the following certifications is required: Certified Coding Associate Credential (CCA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Medical Coder (CMC), or Certified Inpatient Coder (CIC). Valid driver’s license and auto insurance required.
Salary: Starting range is $50,000-$55,000 per year depending on education and experience.
Education Requirements:
High school diploma or general education degree (GED) from an accredited high school. Bachelor’s degree in Health/Hospital Administration, Business Administration or related human services field preferred.
Experience Requirements:
Four to seven years of medical coding experience. Experience working in hospital or healthcare field with specific role in medical coding and experience working within an Electronic Health Record.
The Medical Coding Specialist for Camber Children’s Mental Health (CCMH) is our subject matter expert on medical coding. This is a hybrid position and must reside in the Kansas City metro area. They will conduct audits and code reviews on all documentation of medical providers to ensure accuracy and optimum billing recoupment is met for Camber. They will collaborate with the medical providers, Utilization Review Department, and Accounts Receivable Department to ensure all legal requirements regarding coding procedures and practices are met and billing can be maximized in the most time efficient manner. The Medical Coder will support and foster a culture that is focused on integration of utilization review, risk management, and quality assurance into management in order to ensure the judicious use of the facility's resources and high-quality care.
Benefits:
CCMH provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Camber is a private, nonprofit organization and a subsidiary of KVC Health Systems. KVC Health Systems is the parent company of a family of nonprofit organizations working to make a difference in the lives of children, adults and families.
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