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)
Job Title: Compliance Specialist
Reports To: Director of Administration
Status: Full-time, Exempt,
Location: Remote position considered, candidate should be willing to travel to sites within First Children Services locations as needed.
Job Summary:
Join our team as a Compliance Specialist at First Children Services! In this role, you will assist in ensuring our organization remains compliant with all relevant regulations and standards. Your responsibilities will include conducting internal audits, maintaining health and safety standards, assisting with external audits, and supporting the credentialing process for licensed/certified staff.
If you have a keen eye for detail, strong analytical skills, and a commitment to upholding compliance standards, we want to hear from you!
Essential Duties and Responsibilities:
Environments and Demands:
Education and Experience:
Job Benefits:
Exceptional Company Culture
Competitive Salary and current 10k sign-on bonus
University Partnership for free CEUs, certificates and reduced rates for degrees
Medical/Dental/Vision, 401K, and more
PTO and paid holidays
Opportunities for Advancement
If you're ready to contribute to a culture of compliance excellence, apply now to join our team as a Compliance Specialist!
First Children Services is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status
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0 Coding Compliance Specialist jobs found in Reading, PA area