Coding Compliance Specialist jobs in Saint Louis, MO
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)
Recently Added Coding Compliance Specialist jobs
- BJC
-
Saint Louis, MO
FULL_TIME
-
Additional Information About the Role
- Remote opportunity- must reside in the Greater St. Louis Metropolitan area!
- Previous auditing experience of evaluation and management and surgical procedures is preferred!
- Working knowledge of EXCEL and MS Publisher.
OverviewBJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region.
Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve.
The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO.
Preferred QualificationsRole Purpose
The Compliance Coordinator conducts and coordinates reviews of BJCMG primary care providers? documentation to ensure accuracy of services billed. This position prepares reports of findings to be presented to providers. This position also provides educational opportunities for new and existing primary care providers, giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. Additionally, the Compliance Coordinator collaborates with departments in providing appropriate education to staff as it relates to compliance and privacy of protected health information.
Responsibilities
- Conducts and coordinates routinely scheduled reviews of BJCMG primary care providers? documentation involved with professional fee billing, for accuracy of coding and physical presence; these reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG primary care providers; reviews medical record documentation to identify under-coded and up-coded services, prepare reports of findings, and meet with providers to provide education and training on accurate coding practices and compliance issues as a result of the review.
- Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for primary care providers.
- Interacts with primary care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review.
- Provides training, instruction, and support to primary care providers and coders, as appropriate, regarding coding compliance documentation, regulatory provisions, and third party payer requirements as a result of the review or as request by management.
- Assists team with requests from government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization?s compliance initiatives as requested by management related to primary care providers.
- High School Diploma or GED
- 2-5 years
- No Experience
- CCS/CPC
- Associate's Degree - Business/HC Admin/related
- RHIA/RHIT
- Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
- Disability insurance* paid for by BJC
- Pension Plan*/403(b) Plan funded by BJC
- 401(k) plan with BJC match
- Tuition Assistance available on first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays and personal time
- Adoption assistance
- 5 Days Ago
Minimum Requirements
Education
Experience
Supervisor Experience
Licenses & Certifications
Preferred Requirements
Education
Licenses & Certifications
Benefits and Legal Statement
BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
To learn more, go to www.bjctotalrewards.com/Benefits
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
- BJC
-
Saint Louis, MO
FULL_TIME
- Additional Information About the RoleRemote opportunity- must reside in the Greater St. Louis Metropolitan area! Experience with analyzing provider data and training on current billing guidelines to i...
- 16 Days Ago
- Mercy
-
Chesterfield, MO
FULL_TIME
- We’re a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts o...
- 17 Days Ago
- SoutheastHEALTH
-
Cape Girardeau, MO
OTHER
- Cape Girardeau, MO | Physician Coding | Days Job Summary Accurately assigns and sequences diagnostic and procedural codes utilizing current industry code sets to inpatient and outpatient records for u...
- 21 Days Ago
- Columbia Orthopaedic Group
-
Columbia, MO
FULL_TIME
- Job Summary: Columbia Orthopaedic Group seeks a Certified Medical Coder to join our team. We are looking for a professional who has a certification in medical coding. The successful individual will be...
- Just Posted
- Midwest Innovation Laboratory
-
St. Louis, MO
FULL_TIME,CONTRACTOR,PART_TIME
- Job Summary:We are seeking a detail-oriented and experienced Medical Biller for medical laboratory and multi specialty clinics to join our team. The Medical Biller will be responsible for accurately c...
- 1 Day Ago
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0 Coding Compliance Specialist jobs found in Saint Louis, MO area
- Delta Dental Of Missouri
-
Saint Louis, MO
- TITLE: Compliance Specialist JOB CODE: E01305 GRADE LEVEL: 26 FLSA JOB STATUS: Exempt DEPARTMENT: Corporate Compliance R...
- 4/24/2024 12:00:00 AM
- Keurig Dr Pepper
-
Saint Louis, MO
- Sr Quality Assurance Specialist This role works with all departments to ensure quality, food safety, environmental and s...
- 4/24/2024 12:00:00 AM
- Department Of The Treasury
-
Saint Louis, MO
- Duties WHAT IS THE TAX EXEMPT & GOVERNMENT ENTITIES (TE/GE) DIVISION? A description of the business units can be found a...
- 4/24/2024 12:00:00 AM
- Department Of The Treasury
-
Saint Louis, MO
- Duties WHAT IS THE LBI - LARGE BUSINESS AND INTERNATIONAL DIVISION? A description of the business units can be found at:...
- 4/24/2024 12:00:00 AM
- TRS Healthcare
-
Belleville, IL
- Planet Healthcare is seeking a travel nurse RN Telemetry for a travel nursing job in Belleville, Illinois. Job Descripti...
- 4/22/2024 12:00:00 AM
- Prokatchers Llc
-
Saint Louis, MO
- Job Title: Regulatory Affairs Specialist Location: 63103, St Louis, Missouri, United States Duration: 24 Months Job Desc...
- 4/22/2024 12:00:00 AM
- Department Of The Treasury
-
Saint Louis, MO
- Duties WHAT ARE THE APPEALS (AP), LARGE BUSINESS AND INTERNATIONAL (LB&I), SMALL BUSINESS SELF-EMPLOYED (SB/SE) AND TAX ...
- 4/22/2024 12:00:00 AM
- Department Of The Treasury
-
Saint Louis, MO
- Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
- 4/22/2024 12:00:00 AM
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