Coding Compliance Specialist jobs in Tulsa, OK
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
Quality Improvement - Clinical Coding & Compliance Analyst 195-2013
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: Responsible for the review, analysis, reporting and follow-up of risk adjustment and clinical coding functions to support the accurate representation of the member’s clinical health status as well as the accuracy of internal systems to support clinical decisions. This role works collaboratively with multiple internal departments as well as with external providers. KEY RESPONSIBILITIES: Serve as clinical coding resource across the CommunityCare Health Network Division in support of both ongoing and future coding related initiatives. Adhere to all official coding rules and CMS guidelines for risk adjustment programs. Ensure accuracy, completeness, specificity, and appropriateness of diagnosis information. Surveillance of CPT, CMS, and other regulations and their impact related to coding and other business functions. For Risk Adjustment Validation Audits (RADV), conduct chart review of inpatient and outpatient medical records for Hierarchal Condition Category (HCC) coding. Summarizes audit findings and recommendations for coding and/or documentation improvement. Evaluate Medicare Wellness Visit documentation for accuracy and completeness in addressing gaps in care and expiring HCC’s. Present findings to providers on a regularly scheduled basis. Evaluate/prioritize results of new Medicare Advantage and Marketplace member self-reported health risk assessments for risk adjustment conditions that should be addressed. Create analyses, summary reporting, and coordinate with providers. Engage with other Health Network Division Department leaders for opportunities to optimize clinical documentation at the point of care delivery. Provide measurable, actionable solutions for best practices to improve documentation and coding accuracy. Develop a feedback loop for provider query and education. This will involve collaborative work with owner and non-owner providers. Analyze the in-home assessment program for opportunities to follow-up on members who decline the assessment or do not schedule care. Support work/data from the Benefits Interpretation Committee (BIC) and the quarterly coding review workgroup. Support clinical coding needs of ASO (self-insured employers) marketing, claims and configuration departments, and preventative services list maintenance. Work in collaboration with company fraud, waste, and abuse program on issues with specific providers or services as may arise. QUALIFICATIONS: Knowledge of risk adjustment payment models and risk adjustment coding preferred Familiarity with State and federal regulations governing healthcare Medicare Advantage and /or medical practice experience preferred Proficient in Microsoft Excel Successful completion of Health Care Sanctions background check Excellent verbal and written communication skills Ability to work independently under stringent deadlines EDUCATION/EXPERIENCE: Coding certification nationally recognized by AAPC or AHIMA required Bachelor’s degree preferred or equivalent experience Three (3) years relevant professional experience with medical coding (ICD 10-CM, CPT, HCPCS)
- 8 Days Ago
Medical Billing and Coding Specialist
- Peak Physical Therapy
-
Bartlesville, OK
FULL_TIME
- Job Summary: We are seeking a detail-oriented and experienced Medical Biller to join our team. As a Medical Biller, you will be responsible for accurately coding and billing medical claims, ensuring t...
- 25 Days Ago
Medical Billing and Coding Specialist
- Prophylaxis HealthCare
-
Bixby, OK
FULL_TIME
- We are looking for a certified coder to join our team! We currently have 4 people in the billing department and need to add one more person to help with the overflow. Check out our website for more in...
- 2 Months Ago
Compliance Specialist
- SeneGence
-
Tulsa, OK
FULL_TIME
- As a Compliance Specialist at SeneGence, you'll play a critical role in ensuring that our distributors adhere to the company's Policies and Procedures. You'll serve as a trusted point of contact for o...
- 25 Days Ago
Compliance Inspector
- 7G Environmental Compliance Management
-
Tulsa, OK
FULL_TIME
- Our CompanyAt 7G, we're the go-to partner for petroleum tank owners across the country. We tackle environmental challenges while consistently keeping things compliant. Our values are simple: excellenc...
- 16 Days Ago
Regulatory Compliance Specialist
- Osage Casino
-
Tulsa, OK
OTHER
- Overview To perform compliance assessments of every department to ensure day to day compliance with application regulations and controls. This list of duties and responsibilities is illustrative only ...
- 1 Day Ago
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0 Coding Compliance Specialist jobs found in Tulsa, OK area
Accounts Receivable Analyst
- Manpower
-
Tulsa, OK
- AR Analyst Job Overview: Reconcile complex financial accounts using SAP, resolving discrepancies with finesse. Resolve p...
- 4/19/2024 12:00:00 AM
Internal Revenue Agent - 12 Month Roster
- Department Of The Treasury
-
Tulsa, OK
- Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
- 4/19/2024 12:00:00 AM
Specialty System Technician
- Faith Technologies, Inc.
-
Tulsa, OK
- Faith Technologies, a division of Faith Technologies Incorporated (FTI), is an energy expert and national leader in elec...
- 4/19/2024 12:00:00 AM
Air Quality Specialist
- Laredo Petroleum, Inc.
-
Tulsa, OK
- The Air Quality Specialist position is responsible for assisting the Air Quality Advisor in maintaining compliance with ...
- 4/18/2024 12:00:00 AM
Securities Services Ops Specialist I
- BOK Financial Corp.
-
Tulsa, OK
- Req ID: 74791 Location: Tulsa -TUL Areas of Interest: Accounting; Wealth Management Operations Pay Transparency Salary R...
- 4/18/2024 12:00:00 AM
Treasury Analyst
- Strategic Business Consulting Services
-
Tulsa, OK
- About the job Treasury Analyst Position: Treasury Analyst Company Overview: Strategic Business Consulting Services has p...
- 4/17/2024 12:00:00 AM
Internal Revenue Agent/ Senior Revenue Agent (Examiner)- (6 Month Roster) - Amended
- Department Of The Treasury
-
Tulsa, OK
- Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL (LBI) DIVISION? A description of the business units can be found at:...
- 4/16/2024 12:00:00 AM
Supervisory Internal Revenue Agent (12 month roster) AMENDED
- Department Of The Treasury
-
Tulsa, OK
- Duties WHAT IS THE LBI - LARGE BUSINESS AND INTERNATIONAL DIVISION? A description of the business units can be found at:...
- 4/15/2024 12:00:00 AM
About Tulsa, Oklahoma
Tulsa is located in the northeastern corner of Oklahoma, 99 miles (159 km) northeast of Oklahoma City; situated between the edge of the Great Plains and the foot of the Ozarks in a generally forested region of rolling hills. The city touches the eastern extent of the Cross Timbers, an ecoregion of forest and prairie transitioning from the drier plains of the west to the wetter forests of the east. With a wetter climate than points westward, Tulsa serves as a gateway to "Green Country", a popular and official designation for northeast Oklahoma that stems from the region's green vegetation and r...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$60,655 to $80,575
Tulsa, Oklahoma area prices
were up 1.2% from a year ago
were up 1.2% from a year ago
What does a Coding Compliance Specialist do?
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