Coding Compliance Specialist jobs in Wheeling, WV

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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Coding Specialist II
  • WVUHS Home Care, LLC
  • Morgantown, WV FULL_TIME
  • Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

    To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospital and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment, severity of illness and risk of mortality for each medical record. This position is an integral part of an overall compliance program effort as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives. Responsible for analyzing and resolving issues of missing charges and problem accounts by researching information regarding department reimbursement.

    MINIMUM QUALIFICATIONS:

    EDUCATION, CERTIFICATION, AND/OR LICENSURE:

    1. High School Diploma or Equivalent.

    2. Associates degree in Health Information Management with RHIT (Registered Health Information Technician) or RHIA(Registered Health Information Administrator)ORCCS (Certified Coding Specialist) or CCS-P (Certified Coding Specialist Physician Based)/ or CPC (Certified Professional Coder).

    EXPERIENCE:

    1. Two years of medical coding experience required.

    PREFERREDQUALIFICATIONS:

    EXPERIENCE:

    1. Two years of physician office coding experience strongly preferred

    CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

    1. Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.

    2. Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas.

    3. Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals.

    4. Assures the accuracy, quality, and timely review of data needed to obtain a clean bill.

    5. Contacts physicians or any persons necessary to obtain information required to accurately code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process.

    6. Monitors on an on-going basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed.

    7. Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts.

    PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    1. Must be able to sit for long periods of time.

    2. Must have visual and hearing acuity within the normal range.

    3. Must have manual dexterity needed to operate computer and office equipment.

    4. Must be Able to lift, push or pull 10-20 pounds.

    WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    1. Standard office environment.

    2. Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.

    3. May require travel.

    SKILLS AND ABILITIES:

    1. Must be able to concentrate and maintain accuracy during constant interruptions.

    2. Must possess independent decision-making ability.

    3. Must possess the ability to prioritize job duties.

    4. Must be able to handle high stress situations.

    5. Must be able to adapt to changes in the workplace.

    6. Must be able to organize and complete assigned tasks.

    7. Must possess excellent written and verbal communication skills.

    8. Must meet quality and productivity standards.

    9. Must possess the knowledge of anatomy, physiology and medical terminology.

    Additional Job Description:

    Scheduled Weekly Hours:

    40

    Shift:

    Exempt/Non-Exempt:

    United States of America (Non-Exempt)

    Company:

    SYSTEM West Virginia University Health System

    Cost Center:

    539 SYSTEM HIM Provider Based Coding Analysis

     

  • 3 Days Ago

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Coding Specialist I
  • Mon Health
  • Morgantown, WV FULL_TIME
  • Job Summary Comments With a patient centered culture, the Coding Specialist will provide a positive experience to our customers and patients through assigning diagnostic codes, procedure codes and cha...
  • 22 Days Ago

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Compliance Inspector
  • 7G Environmental Compliance Management
  • Morgantown, WV 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...
  • 12 Days Ago

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NDE Technician - Bridgeport, WV
  • CROSSBRIDGE COMPLIANCE GROUP
  • Bridgeport, WV OTHER
  • Job Details Job Location: Bridgeport, WV Salary Range: Undisclosed DescriptionThe NDE Technician will be performing calibrations, Nondestructive Tests, and evaluations for acceptance or rejection dete...
  • 12 Days Ago

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Construction Manager- Electrical Substation Project
  • Compliance Systems Management
  • Maidsville, WV FULL_TIME
  • Construction Manager (Electrical Substation Project) Location: Maidsville WV Duration: 2 1/2 week shut down Compensation: (negotiable) $60-75/hr Company Overview: Our client is a leading provider of e...
  • 12 Days Ago

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Assistant Director of Compliance - Athletics
  • West Virginia University
  • Morgantown, WV FULL_TIME
  • The department of Athletics at West Virginia University is currently accepting applications for an Assistant Director of Compliance. About the Opportunity This position will assist the Senior Associat...
  • 8 Days Ago

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0 Coding Compliance Specialist jobs found in Wheeling, WV area

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Internal Revenue Agent (Senior Revenue Agent (Examiner) -12 MONTH ROSTER
  • Department Of The Treasury
  • Wheeling, WV
  • Duties WHAT IS THE SBSE - SMALL BUSINESS SELF EMPLOYED DIVISION? A description of the business units can be found at: ht...
  • 4/22/2024 12:00:00 AM

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Construction Manager
  • CEG
  • Wheeling, WV
  • Construction Manager Locations: Columbus, Southern Ohio, Piketon, and Wheeling, WV CEG is seeking a Construction Manager...
  • 4/22/2024 12:00:00 AM

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Business Support and Digital Specialist - Business Support and Delivery
  • WesBanco Bank, Inc.
  • Wheeling, WV
  • Location This position is 100% remote within the Bank's footprint. Employee will work full time remote outside of a WesB...
  • 4/22/2024 12:00:00 AM

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Compliance Specialist / Adv Compliance Specialist
  • Marathon Petroleum
  • Canonsburg, PA
  • An exciting career awaits you At MPC, we’re committed to being a great place to work – one that welcomes new ideas, enco...
  • 4/19/2024 12:00:00 AM

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Internal Revenue Agent (Reviewer - Examiner) 12 MONTH ROSTER - AMENDED
  • Department Of The Treasury
  • Wheeling, WV
  • Duties WHAT IS THE WHISTLEBLOWER OFFICE (WBO) DIVISION? A description of the business units can be found at: https://www...
  • 4/19/2024 12:00:00 AM

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Travel Nurse RN - Home Health - $2,436 per week
  • Hiring Now!
  • Canonsburg, PA
  • Planet Healthcare is seeking a travel nurse RN Home Health for a travel nursing job in Canonsburg, Pennsylvania. Job Des...
  • 4/19/2024 12:00:00 AM

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Travel Nurse RN - Home Health - $2,380 per week
  • Hiring Now!
  • New Martinsville, WV
  • Planet Healthcare is seeking a travel nurse RN Home Health for a travel nursing job in New Martinsville, West Virginia. ...
  • 4/19/2024 12:00:00 AM

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Residential Counselor BK1
  • InVision Human Services
  • Finleyville, PA
  • Provides direct support to people served in a manner consistent with the InVision Customized Services' mission and philo...
  • 4/18/2024 12:00:00 AM

Wheeling is a city in Ohio and Marshall counties in the U.S. state of West Virginia. Located almost entirely in Ohio County, of which it is the county seat, it lies along the Ohio River in the foothills of the Appalachian Mountains. Wheeling was originally a settlement in the British colony of Virginia and later an important city in the Commonwealth of Virginia. Wheeling was the first state capital of West Virginia. Due to its location along major transportation routes, including the Ohio River, National Road, and the B&O Railroad, Wheeling became a manufacturing center in the late nineteenth...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$62,771 to $83,385
Wheeling, West Virginia area prices
were up 1.2% 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