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)
This position has no direct reports
KNOWLEDGE, SKILLS AND ABILITIES
PHYSICAL DEMANDS
While performing the duties of this job, the employee is frequently required to do the following:
Much of the work consists of conveying and receiving information verbally. While performing the duties of this job the employee may be required to sit, stand and/or walk for long periods of time; use fingers, handle, or feel objects; reach with hands; talk and hear; climb or balance; stoop, kneel, bend, twist, and crouch. The employee must occasionally lift, carry, and/or move up to 25 pounds. The use of arms above or below the shoulder is sometimes required. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Requires manual dexterity and ability to quickly move hand(s), hand with arm, grasp, manipulate, or assemble.
WORKING CONDITIONS
Notes
Our Sales Support & Compliance Support Specialist is responsible for managing all brewery compliance in addition to playing a crucial role in assisting the sales team and ensuring the smooth operation of the sales process.
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