Coding Compliance Specialist jobs in Poughkeepsie, NY

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)

O
Certified Coding Specialist
  • ONS MSO LLC
  • Poughkeepsie, NY FULL_TIME
  • Who we are:

    Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Rooted in the 100-plus-year legacy of its founding partners, the network spans the Northeast with 128 physicians, over 1100 employees, and 28 locations from Connecticut, New York, and Massachusetts.

    At Orthopedic Associates of Dutchess County, we believe our employees are our greatest asset. We believe in hiring the best people and cultivating a winning team. Investing in our employees’ future success is investing in our future success. We hire both experienced medical staff as well as those just starting out in the field looking for an opportunity to learn a profession. We promote from within whenever possible because we know our staff are highly trained and guided towards success!

    What you’ll do:

    The Certified Professional Coder will receive, review, and enter all charge documents, including office and hospital-based services. The Certified Professional Coder is responsible for the input of all charges related to the assigned physician or professional service, into the practice management system and is responsible for reviewing billing and procedure codes to ensure all billing guidelines are followed correctly. The Certified Professional Coder is classified as a nonexempt employee and is eligible to overtime pay with prior approval and in accordance with the practice’s personnel policies.

    Responsibilities/Duties:

    • Bill and enter charges in a timely manner in a high-volume setting.
    • Ensure charge information provided is correct and accurate,
    • Review the coding at charge entry to ensure compliance with insurance guidelines, and accurate and timely reimbursement,
    • Append modifiers based on payer specifics, insurance and authorization requirements and referring physicians’ unique attributes and add specific data such as, CPT and ICD-10 codes and date of injury (DOI) when needed.
    • Verify all demographic and insurance information in patient registration to ensure accuracy for claim processing.
    • Accurately examine charges for completeness.
    • Correct claims as needed when denied by insurance carriers.
    • Enter surgical claims based on operative reports and physician recommendations to achieve optimal reimbursement.
    • Monitor communication systems to obtain charge information for hospital services, including all in-hospital stays, out-patient, emergency room and consult services.
    • Attend Orthopedic coding seminars to stay current with changes,
    • Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and other staff.
    • Review coding newsletters for changes or guidance with proper coding
    • Successfully complete other duties as assigned including but not limited to, missing encounter reports and missing DME/VISCO charge reports.
    • Cross train and provide backup coverage as needed.
    • Maintains a professional work demeanor when interacting with co-workers or communicating with patients, physicians, and administration,
    • Complete other duties as assigned by the Revenue Cycle Leadership

    Who you are:

    Qualifications:

    • Certified Medical coding Certificate
    • Minimum of 2 years previous Orthopedic Coding, charge entry
    • Knowledge of HCPC’s, ICD-10 and CPT medical coding
    • Knowledge of Global billing regulations
    • Knowledge of CCI edit rules as well as bundling and unbundling code requirements,
    • Ability to code claims from office notes.
    • Knowledge of Insurance reimbursement guidelines
    • Polite telephone etiquette and good communication skills (written and oral)
    • Computer literacy skills, including practice management software, EMR, Microsoft Office
    • Detail oriented and strong organizational skills
    • Self- starter, team player, analytic & problem-solving ability

    What we offer:

    • Excellent growth and advancement opportunities
    • Dynamic environment
    • Access to a diverse network of practitioners
    • Broad infrastructure of tools and programs to enhance the employee experience,
    • Competitive Compensation
    • Generous PTO
    • Benefits package: health, dental, vision, 401(k), etc.

    We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).

  • 7 Days Ago

S
Certified Coding Specialist
  • Spire Orthopedic Partners
  • Poughkeepsie, NY OTHER
  • Job Details Level: Experienced Job Location: MSO-OADC Poughkeepsie (1900) - Poughkeepsie, NY Position Type: Full Time Education Level: None Salary Range: $23.15 - $28.70 Hourly Travel Percentage: None...
  • 16 Days Ago

S
Certified Coding Specialist
  • Spire Orthopedic Partners
  • Poughkeepsie, NY OTHER
  • Job Details Level: Experienced Job Location: MSO-OADC Poughkeepsie (1900) - Poughkeepsie, NY Position Type: Full Time Education Level: None Salary Range: $23.15 - $28.70 Hourly Travel Percentage: None...
  • 1 Month Ago

I
Compliance Specialist
  • Independent Living Inc
  • Newburgh, NY FULL_TIME
  • DescriptionAre you detailed oriented, have great time management skills and a great leader? If so, the Compliance Specialist maybe the job for you!As a Compliance Specialist, you will be responsible f...
  • 3 Days Ago

U
HCC Coding Specialist, Crystal Run Health
  • UnitedHealth Group
  • Middletown, NY FULL_TIME
  • Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at ...
  • 15 Days Ago

A
Private Investigator
  • Allied Universal® Compliance and Investigations
  • Poughkeepsie, NY FULL_TIME
  • Private Investigator Overview Allied Universal® Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance company, provides rewa...
  • 22 Days Ago

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0 Coding Compliance Specialist jobs found in Poughkeepsie, NY area

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Bilingual Financial Professional
  • New York Life Insurance Company
  • New Windsor, NY
  • Job Description Job Description Are you a leader who has the following traits? • Competitive • Entrepreneurial • Coachab...
  • 3/28/2024 12:00:00 AM

E
Financial Analyst
  • Experis
  • Kingston, NY
  • Jefferson Wells has a long-term project opportunity for a Financial Analyst with experience in governmental accounting a...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Reviewer - Examiner) 12 MONTH ROSTER - AMENDED
  • Department Of The Treasury
  • Poughkeepsie, NY
  • Duties WHAT IS THE WHISTLEBLOWER OFFICE (WBO) DIVISION? A description of the business units can be found at: https://www...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Examiner) - DIRECT HIRE (12 MONTH REGISTER) AMENDED
  • Department Of The Treasury
  • New Windsor, NY
  • Duties WHAT ARE THE APPEALS (AP), LARGE BUSINESS AND INTERNATIONAL (LB&I), SMALL BUSINESS SELF-EMPLOYED (SB/SE) AND TAX ...
  • 3/27/2024 12:00:00 AM

D
AMENDED - Internal Revenue Agent (Tax Computation Specialist - Examiner) 12 MONTH ROSTER
  • Department Of The Treasury
  • New Windsor, NY
  • Duties WHAT IS THE LARGE BUSINESS & INTERNATIONAL (LB&I) DIVISION? A description of the business units can be found at: ...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Reviewer - Examiner) Temp NTE 1 Yr., MBE, MBMP 12 MONTH ROSTER (Amended)
  • Department Of The Treasury
  • New Windsor, NY
  • Duties WHAT IS THE SMALL BUSINESS/SELF EMPLOYED (SBSE) DIVISION? A description of the business units can be found at: ht...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Reviewer - Examiner) 12 MONTH ROSTER - AMENDED
  • Department Of The Treasury
  • New Windsor, NY
  • Duties WHAT IS THE WHISTLEBLOWER OFFICE (WBO) DIVISION? A description of the business units can be found at: https://www...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent / Senior Revenue Agent (Examiner)-12 Month Roster AMENDED
  • Department Of The Treasury
  • New Windsor, NY
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL DIVISION? A description of the business units can be found at: https...
  • 3/27/2024 12:00:00 AM

Poughkeepsie (/pəˈkɪpsi/ pə-KIP-see), officially the City of Poughkeepsie, is a city in the state of New York, United States, which is the county seat of Dutchess County. As of the 2010 census it had a population of 32,736. Poughkeepsie is in the Hudson Valley midway between New York City and Albany, and is part of the New York metropolitan area. The name derives from a word in the Wappinger language, roughly U-puku-ipi-sing, meaning "the reed-covered lodge by the little-water place", referring to a spring or stream feeding into the Hudson River south of the present downtown area. Poughkeepsie...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$69,003 to $91,666
Poughkeepsie, New York area prices
were up 1.5% from a year ago

Coding Compliance Specialist in Somerset, NJ
Make compliance and process related recommendations on medical coding issues.
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Coding Compliance Specialist in Jacksonville, FL
·        Perform specialized audits of patient medical records to ensure compliance with organization’s coding procedures and standards and provide feedback to analyst/educator and management.
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Coding Compliance Specialist in Lebanon, PA
Provide monitoring and auditing functions as determined by the Regional Director of HIM Services, the HIM Coding Compliance Committee, TH Of NE Compliance Audit Plan, and as otherwise directed.
January 19, 2020