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)
Sentara Medical Group is now hiring a Risk Adjustment Coding & Documentation Specialist in Charlottesville, VA!
This is a full-time position, Monday-Friday, no nights, holidays, or weekends.
This role consists of educating primary & specialty care providers and staff on appropriate HCC coding & documentation, via virtual sessions and in-person site visits. Duties include retrospective auditing to ensure compliance with appropriate HCC coding & documentation guidelines .
Candidate should be geographically located within the Charlottesville/Blue Ridge area in order to visit practice sites within the region.
Hybrid work model employed – office space available with expectation 1-2 days/week in office; initial onboarding & training will be in-office.
Previous HCC coding experience STRONGLY PREFERRED
Qualifications:
Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
Keywords: HCC Coding, Risk Adjustment, Monster, Talroo-Allied Health, #Indeed
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0 Coding Compliance Specialist jobs found in Virginia Beach, VA area