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)
- Review and analyze medical records and patient information to assign appropriate medical codes using ICD-10 and ICD-9 coding systems
- Ensure accuracy and completeness of coded data for billing and reimbursement purposes
- Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies
- Stay up-to-date with changes in coding guidelines, regulations, and industry best practices
- Maintain confidentiality of patient information and adhere to HIPAA regulations
- Utilize electronic medical record systems and coding software to perform coding tasks efficiently
- Minimum of 2 years of experience as a Coding Specialist or similar role in a healthcare setting
- Proficiency in medical coding, including knowledge of ICD-10 and medical terminology
- Familiarity with medical billing processes and procedures
- Strong attention to detail and accuracy in coding assignments
- Excellent analytical and problem-solving skills
- Ability to work independently and meet deadlines in a fast-paced environment
- Knowledge of medical office systems and electronic health record (EHR) software
Please note that this is not an entry-level position. Qualified candidates must have prior experience in medical coding.
If you are a detail-oriented individual with a strong knowledge of medical coding practices, we would love to hear from you. Apply now to join our team of dedicated Coding Specialists.
Job Type: Full-time
Pay: $22.00 - $23.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
Work setting:
Work Location: In person
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