Coding Compliance Specialist jobs in Trenton, NJ

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)

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Compliance Specialist
  • Gentell
  • Morrisville, PA FULL_TIME
  • Description

     

    Compliance Specialist

    Responsibilities (Specific tasks, duties, essential functions of the job)

    • Obtain proper medical records in a timely fashion, corresponding as necessary with outside medical offices to fulfill documentation requests. Thoroughly review documentation for accuracy, compliance with Medicare guidelines, and physical or e-signatures.
    • Assemble documentation required for insurance denials, compliance reviews, and audits and manage correspondence between Gentell and affiliated companies and CMS regulatory agencies such as Noridian, CGS, and third parties.
    • Review decisions of medical records reviews and prepare any necessary redeterminations.
    • Track progress and results of audits and report to administrative staff.
    • Assist with tracking data and creating reports for the analysis of compliance issue patterns.
    • Establish and maintain compliance audit spreadsheets and wound dissemination spreadsheets using Excel. Conduct and distribute plan updates and patient/order information specifically to/or for Medicare, DME and/or healthcare sector contacts.
    • Ensure that company field staff and servicing facility information is accurately represented on patient files.
    • Perform other tasks and responsibilities as assigned.


    Requirements

     Knowledge, Skills, and Abilities

    • Understanding of Medicare program and DME LCD guidelines.
    • Knowledge of surgical and debrid ed wound care is a plus.
    • Familiarity with Medicare audit rules and state and federal laws and regulations.
    • Experience in patient records, database and document management.
    • Experience in successful Medicare submissions is preferred.
    • Friendly and efficient relational style while working with company field staff, facility personnel, and internal and external vendors.
    • Must have a strong level of attention to detail and ability to manage high volumes of data.
    • Reliable, resilient work ethic; strong planning and problem-solving skills; efficient; team player.
    • Ability to follow through to resolve outstanding issues.

    Qualifications (Experience and Education)

    • Bachelor’s Degree or equivalent combination of education and 3 years of work experience
    • 3 years of experience in medical records, preferably in a long-term care facility
    • Proficiency in Brightree and Fastcare preferred.
    • Knowledge of Microsoft Office Suite, with excellent proficiency in Excel and Word.
    • Experience using computer hardware, peripherals, dispensing, template and ticketing systems and other standard computer software programs.
    • Robust verbal and written communication skills.
    • Eagerness to demonstrate a positive, courteous, and friendly attitude that projects an inviting, positive image of Gentell and its affiliated companies, Wound Care Concepts and Absolute

    Wound Solutions.

    • Experience working with C-Suite executives, managers and internal/external vendors.

    Job Type: Full-timeSalary: $48,000.00 - $60,000.00 per yearBenefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday
    • No weekends

    Ability to commute/relocate:

    • Morrisville, PA 19067: Reliably commute or planning to relocate before starting work (Required)

    Experience:

    • Medical records: 3 years (Required)
    • Brightree: 1 year (Preferred)
    • working with C-suite Executives: 2 years (Preferred)

    Work Location: In person 



  • 8 Days Ago

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Medical Billing and Coding Specialist (Remote in NJ)
  • MEDLOGIX, LLC
  • Hamilton, NJ FULL_TIME
  • Certified Professional Coder / Bill Review Expert Location: Remote. Need to be in the Hamilton NJ office for training. Responsibilities: Review medical bills related to MVA injuries sustained for NJ a...
  • 2 Months Ago

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Regulatory and Accreditation Compliance Specialist
  • Doylestown Hospital
  • Doylestown, PA FULL_TIME
  • Job Detail Job Title: Regulatory and Accreditation Compliance Specialist Req: 2023-0912 Location: Hospital Department: Quality Initiatives Schedule: Job Description: Serves as a professional resource ...
  • 12 Days Ago

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CL Licensing and Compliance Specialist
  • NJM Insurance Group
  • Trenton, NJ FULL_TIME
  • Personal, compassionate service is what we’re known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy some of the ...
  • Just Posted

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Housing Support and Compliance Specialist
  • Lutheran Social Ministries of New Jersey
  • Burlington, NJ FULL_TIME
  • We have an awesome opportunity for a full-time Housing Support and Compliance Specialist for our Housing Communities. We are looking for someone with housing and compliance experience. This may be the...
  • 22 Days Ago

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Compliance Specialist - Plainsboro, NJ
  • DSM-Firmenich
  • Plainsboro, NJ FULL_TIME
  • Compliance Specialist Princeton, NJ, US On-Site CL 13 As a Compliance Specialist, you will be responsible for overseeing various aspects of the production process including quality control and adheren...
  • 1 Month Ago

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0 Coding Compliance Specialist jobs found in Trenton, NJ area

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Compliance Specialist
  • The Harrison Group, Inc.
  • Havertown, PA
  • Job Description Job Description JOB DESCRIPTION: COMPLIANCE SPECIALIST The Compliance Specialist will work closely with ...
  • 3/18/2024 12:00:00 AM

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Clinical Trials, Billing, Budget and Compliance Specialist
  • University of Pennsylvania
  • Philadelphia, PA
  • University Overview The University of Pennsylvania, the largest private employer in Philadelphia, is a world-renowned le...
  • 3/18/2024 12:00:00 AM

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Internal Revenue Agent (Examiner) - Direct Hire - Incentive eligible-AMENDED
  • Department Of The Treasury
  • Trenton, NJ
  • Duties WHAT ARE THE APPEALS (AP), LARGE BUSINESS AND INTERNATIONAL (LB&I), SMALL BUSINESS SELF-EMPLOYED (SB/SE) AND TAX ...
  • 3/18/2024 12:00:00 AM

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Internal Revenue Agent - 12 Month Roster
  • Department Of The Treasury
  • Trenton, NJ
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
  • 3/18/2024 12:00:00 AM

A
Business Support Specialist - Compliance & Onboarding
  • Atlas Data Systems
  • Berkeley Heights, NJ
  • Job Title: Business Support Specialist Team: Compliance & Onboarding Location: Hybrid, 2 days in-office at Berkeley Heig...
  • 3/17/2024 12:00:00 AM

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Compliance Specialist
  • Hackensack Meridian Health
  • Neptune, NJ
  • Overview: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients liv...
  • 3/17/2024 12:00:00 AM

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Trade Compliance Specialist *Onsite Only*
  • Soho Studio/TileBar
  • Riverside, NJ
  • Soho Studio/ TileBar is a direct importer and retailer of mosaics, natural stone, and porcelain tile. We are driven by c...
  • 3/17/2024 12:00:00 AM

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Compliance Specialist
  • Synergy Orthopedics
  • Plymouth Meeting, PA
  • Job Description Job Description Skills and Qualifications: Experience working with a healthcare organization preferred A...
  • 3/14/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 8.155 square miles (21.122 km2), including 7.648 square miles (19.809 km2) of land and 0.507 square mile (1.313 km2) of water (6.21%). Several bridges across the Delaware River – the Trenton–Morrisville Toll Bridge, Lower Trenton Bridge and Calhoun Street Bridge – connect Trenton to Morrisville, Pennsylvania, all of which are operated by the Delaware River Joint Toll Bridge Commission. Trenton is located near the exact geographic center of the state, which is 5 miles (8.0 km) located southeast of Trenton. The city is so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$69,882 to $92,834
Trenton, New Jersey 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.
February 19, 2020
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.
February 04, 2020
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