Coding Compliance Specialist jobs in Tucson, AZ

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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Billing/Coding/Credentialing Specialist
  • PEOPLES HEALTH CARE CONNECTION LLC
  • Tucson, AZ FULL_TIME
  • The Billing/Coding/Credentialing Specialist possesses medical billing knowledge and understanding in order to monitor and manage accounts, claims, claims resolution, accounts receivable, and posting of AHCCCS claims. This position must follow-up on outstanding accounts by monitoring and executing various billing functions. Various Financial and Productivity reports will be submitted daily, weekly, to various departments.

    Duties:

    • Submit billing in a timely manner daily to AHCCCS through the portal.

    • Create reports on billing levels on a weekly basis.

    • Assists with physical site upkeep. (Cleaning, sanitizing, emptying trash, vacuuming etc.)

    • Keep track and process accounts and incoming payments in compliance with financial policies and procedures. Send daily / weekly reports to CEO

    • Perform day to day financial transactions including verifying, classifying, computing, posting and recording accounts  receivable data.

    • Verify discrepancies and resolve client’s billing issues and reconcile all payments received from insurance companies and with the services provided. 

    • Work in multiple software systems to accomplish AR results.

    • Generate financial statements and reports detaining accounts receivable status.

    • Serve as the liaison to therapist and AHCCCS Prior Authorization Department

    • Tracking and organizing insurance information, following up on all claim denials.

    • Effectively communicating billing, insurance, and coverage criteria updates with staff and management.

    • Understanding of the insurance credentialing process.

    • Keep up with compliance, coverage criteria, ICD-10 information and update all employees as needed.

    • Assists with general office cleaning and maintaining the conference room area and other areas of the office.

    • *Other duties as assigned.

    Requirements:

    • High School Diploma or GED

    • 1 to 3 years’ experience in Medical Billing, Billing and Coding Certificate required in addition to experience billing AHCCCS AIHP, AZ Complete, UHC/Optum, Blue Cross Blue Shield and other insurances.

    • Confidentiality of Protected Health Information.

    • Proven ability to calculate post and manage accounting figures and financial records.

    • Data entry skills and knowledgeable in arithmetic and statistics.

    • Excellent verbal and written communication skills. Proficiency in English and Spanish preferred.

    • Customer service orientation and negotiation skills.

    • High degree of accuracy and attention to detail

    • BS degree in Finance preferred.  Some academic training in accounting required.

    Must have a Valid Arizona Driver License, Current Level 1 AZDPS Finger Print Clearance Card, CPR and First Aid Certification

    Recent Negative TB Test.  This is an in-person position only, no remote options. 


  • 20 Days Ago

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Billing/Coding/Credentialing Specialist
  • PEOPLES HEALTH CARE CONNECTION LLC
  • Tucson, AZ FULL_TIME
  • The Billing/Coding/Credentialing Specialist possesses medical billing knowledge and understanding in order to monitor and manage accounts, claims, claims resolution, accounts receivable, and posting o...
  • 21 Days Ago

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Billing/Coding/Credentialing Specialist
  • PEOPLES HEALTH CARE CONNECTION LLC
  • Tucson, AZ FULL_TIME
  • The Billing/Coding/Credentialing Specialist possesses medical billing knowledge and understanding in order to monitor and manage accounts, claims, claims resolution, accounts receivable, and posting o...
  • 21 Days Ago

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Surgical Coding Specialist-REMOTE
  • The US Oncology Network
  • Tucson, AZ FULL_TIME
  • Overview: Employment Type : Full Time Remote Position Benefits : M/D/V, Life Ins., 401(k) SCOPE: Under direct supervision, performs all medical record coding activities. Assigns appropriate diagnostic...
  • 27 Days Ago

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Compliance Specialist - Rate Filing
  • Wahve
  • Tucson, AZ FULL_TIME
  • Compliance Specialist - Rate Filing - REMOTE Put your Insurance Experience to work – FROM HOME! At Wahve, we value significant insurance experience and want to revolutionize the way people think about...
  • 27 Days Ago

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Service Technician
  • GEN-TECH Power Generation Specialist
  • Tucson, AZ FULL_TIME
  • Description GEN-TECH is a full-service Industrial Power Generator Company four locations across Arizona, Southern Nevada, Denver, CO, and Albuquerque, NM. We are a 32 year company that provides New Eq...
  • 1 Month Ago

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0 Coding Compliance Specialist jobs found in Tucson, AZ area

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Regulatory Affairs Specialist II
  • Spectrum Plastics Group, A DuPont Business
  • Tucson, AZ
  • JOB PURPOSE: Provide support for the regulatory department to ensure efficient and compliant business processes and envi...
  • 5/9/2024 12:00:00 AM

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Compliance Specialist
  • Bank 34
  • Tucson, AZ
  • Southwest Heritage Bank, formerly Commerce Bank of Arizona, is committed to providing our employees with a competitive, ...
  • 5/9/2024 12:00:00 AM

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Substitute Teacher
  • Bright Horizons
  • Tucson, AZ
  • **Our Center in Sun City is looking for a summer Substitute Teacher!** Imagine your future teaching with a world-class t...
  • 5/9/2024 12:00:00 AM

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Insurance Claims Specialist Tucson, AZ
  • Government Employees Insurance Company
  • Tucson, AZ
  • Claims Service Specialist – Tucson, AZ *In Office Position* Salary: $20.42 hourly/$41,145 annually Claim your career gro...
  • 5/9/2024 12:00:00 AM

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Registered Nurse RN Neuro PCU
  • Banner Health
  • Tucson, AZ
  • Primary City/State: Tucson, Arizona Department Name: Med/Surg Neuro T1 8EW Work Shift: Night Job Category: Nursing **$15...
  • 5/7/2024 12:00:00 AM

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Tucson - Program Support Specialist
  • Lutheran Social Services of the Southwest
  • Tucson, AZ
  • Lutheran Social Services of the Southwest is a non-profit organization with Corporate Offices in Phoenix and Tucson and ...
  • 5/6/2024 12:00:00 AM

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Environmental Specialist
  • Arizona G&T Cooperative
  • Tucson, AZ
  • Environmental Specialist I or II Arizona G&T Cooperatives is seeking candidates for the position of Environmental Specia...
  • 5/6/2024 12:00:00 AM

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Physical Therapist
  • CareStaff Partners
  • Tucson, AZ
  • CareStaff Partners is seeking a Physical Therapist (PT) for a critical travel or local contract position with a Outpatie...
  • 5/5/2024 12:00:00 AM

Tucson (/ˈtuːsɒn, tuːˈsɒn/) is a city and the county seat of Pima County, Arizona, United States, and home to the University of Arizona. The 2010 United States Census put the population at 520,116, while the 2015 estimated population of the entire Tucson metropolitan statistical area (MSA) was 980,263. The Tucson MSA forms part of the larger Tucson-Nogales combined statistical area (CSA), with a total population of 1,010,025 as of the 2010 Census. Tucson is the second-largest populated city in Arizona behind Phoenix, both of which anchor the Arizona Sun Corridor. The city is 108 miles (174 km)...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$60,999 to $81,033
Tucson, Arizona area prices
were up 2.5% 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