Coding Compliance Specialist jobs in Portland, ME

ESSENTIAL FUNCTIONS

• Maintain current knowledge of coding guidelines and applies knowledge to determine if coding and documentation meets regulatory guidelines and audit standards
• Perform audits of medical record documentation for coding accuracy based on CPT, HCPCS, ICD-10 guidelines, private payer and CMS guidelines as well as InterMed Policies as appropriate; Escalate identified documentation/coding errors for review by clinical coding educator
• Select samples of medical records for internal and external audit and document results, based on Coding Compliance Plan
• Adjust coding as necessary, documenting rationale for coding decisions, comparing auditor findings against those generated from the provider, identifying and recording discrepancies, and recording the rationale for changes in coding decisions
• Research coding guidelines and documentation requirements
• Coordinate communication of coding audit results in collaboration with the clinical coding educator
• Develop coding education materials in collaboration with the clinical coding educator
• Maintain documentation of audits performed, such as to medical record samples, coding error rationale, accuracy scores and due dates in accordance with the Coding Compliance plan
• Monitor for changes and updates to payer and CMS policies related to coding and documentation
• Work collaboratively, seeking additional opinion(s) when needed
• Other duties as assigned

JOB REQUIREMENTS

• Associates Degree, or equivalent experience, required
• Certified Professional Coder (CPC) required; Certified Officer of Compliance (COC) or Certified Risk Coder (CRC) preferred
• Knowledge of the revenue cycle, medical terminology
• Knowledge of billing, coding, insurance practices, and the ‘language’ associated with each
• Excellent interpersonal as well as written and verbal communication skills
• Strong Microsoft Office Suite (Including Word, Excel and Powerpoint) and EMR (eClinicalWorks) skills
• At least four years of revenue cycle experience required

InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.