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)
Position overview
Essential Duties and Responsibilities:
Working relations:
Works closely with Supply Chain and R&D departments. Collaborate with all departments to ensure suppliers maintain compliance and customers receive required documentation.
Qualifications:
Physical characteristics:
Must be able to stand, walk, sit for extended periods. Some bending or stooping may be necessary, at times. Exposure to cold and wet environments for extended periods is required. Must be able to communicate effectively with cross-functional teams and external stakeholders, both verbally and in writing.
Other duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Benefits
Raw Seafoods, Inc. and its affiliates is and will continue to be an equal opportunity employer. We recruit, hire, assign and promote without regard to race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, disability, marital & veteran status or any legally recognized protect personal characteristics.
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0 Coding Compliance Specialist jobs found in New Bedford, MA area