Coding Compliance Specialist jobs in Oregon

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 Compliance Specialist
  • La Clinica Del Valle
  • Medford, OR FULL_TIME
  • Center for Learning and Innovation

    Full Time | Hourly


    We’re committed to compassionate care for all. Our patients. Our employees. You.

    At La Clinica, we love our patients and enthusiastically treat them with the same care, respect, and dignity that we would our friends, family, and neighbors because that's who they are. If this appeals to you, La Clinica might be the right place to build your career. We’re looking for the right team members to treat our patients with this level of care.

    We extend our commitment to compassionate care to our employees as well. We invest in our employees' lives through competitive pay, comprehensive benefits packages, easy access to wellness, personal and professional development workshops, and a focus on healthy work-life harmony. Check out our careers page to learn more about why our employees love working at La Clinica.

    The Coding Compliance Specialist’s primary job function is to maintain organizational compliance with coding and medical record documentation. The Coding Compliance Specialist is responsible to review the coding of professional service records for compliance with CMS, AMA and certified coding standards. This position will conduct internal chart audits, encounter form reviews, assists with teaching providers/staff coding, and reporting results. This position will support any third-party billing staff in areas related to coding and/or collections. Utilizes advanced knowledge of specialty coding to analyze patient medical records, ensuring that documentation by providers conforms to legal and procedural requirements.


    Accountabilities Include
    :

    Performs Essential Job Duties

    • Ensure that medical claims are submitted accurately and in a timely manner.
    • Review electronic health record to assign accurate ICD-10-CM and CPT/HCPCS codes based on coding principles and official guidelines.
    • Reviews patient records documentation to ensure that services provided are accurate and meet appropriate guidelines.
    • Monitors billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling and other questionable practices.
    • Utilizes advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements.
    • Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
    • Reviews and resolves the claim edit and charge review work queues.
    • Enter out-patient/hospital physician/non-physician practitioner services through review of medical records/encounter forms or EHR records. Will also review recipient identification to assure correct patient.
    • Provides feedback and education regarding identified deficiencies to providers and clinical staff.
    • Serves as a resource person to providers, clinical, and coding staff on problems related to coding.
    • Assists in developing, implementing, and processing a coding compliance education/training program for physicians, on-physician providers, and new providers.
    • Processes rebilling’s as requested/required by insurance rejections for coding errors.
    • Assures compliance with all regulatory agencies and payor sources.
    • Conducts quarterly compliance auditing and monitoring for all payors. Creates summary of findings to report to leadership with solutions to address issues with employees.
    • Communicates with providers and clinical coordinators/team leads regarding new regulatory guidelines for billing and documentation compliance.
    • Assures that providers and support staff understand their responsibility for accuracy of coding of encounters.
    • Leads or assists in developing education programs for providers around coding.
    • Acts as a liaison between physicians and clinical staff to resolve issues involving coding and documentation requirements and procedures.
    • Researches inquiries from providers and patients related to coding, reimbursements, and denials.
    • Responds to inquiries regarding CPT, HCPCS and ICD-10 coding.
    • Acts as a liaison between the medical coordinators, members of senior leadership, and the coding department.
    • Works with OCHIN billing service to remedy coding issues.
    • Interacts with department heads and other administrative staff regarding implementation of new codes and revision of charge documents.
    • Complies with patient records policies and procedures such that patient data is handled in a strictly confidential manner; protected from loss, tampering, destruction, or unauthorized disclosure.
    • Ensures the integrity of the HCPCS, CPT and ICD-10 codes are maintained in the electronic health record (EHR).
    • Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety and environmental standards.
    • Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
    • Maintains fee schedules and provider master file.
    • Participates in OCHIN Billing Workgroup. Acts on information and communicates changes as appropriate.
    • Maintains current coding credentials and knowledge of state and federal regulations applicable to coding.
    • Completes assigned trainings via La Clinica’s learning module system (Relias) by required due date.
    • Other duties as assigned.


    Equity Statement

    At La Clinica, we commit to engage everyone in a welcoming, respectful, and loving way and to maintain the dignity and value of all people above everything else. These standards align with our organization’s vision of absolute excellence, open-hearted community, and well-being for all.


    Customer Service
    :

    Develops and maintains professional, support-oriented working relationships with patients, employees, team members, and community partners. Demonstrates continuous improvement in achieving “developing” and “fully competent” levels of La Clinica’s Behavioral Standards.


    Follow La Clinica’s SERVE standards and they are the following:


    • Service: I provide, helpful service focused on the needs of others.
    • Empathy: I welcome and connect with you on a personal level.
    • Relationships: I create partnerships, working a way that benefits everyone.
    • Value: I recognize the importance of others and treat everyone with respect.
    • Excellence: I go above and beyond to deliver an exceptional experience.


    Qualifications
    :

    Must be able to interact with a variety of individuals at various levels under stressful circumstances while exercising sound judgement, tact, and diplomacy; work productively both independently and in a team setting; communicate with clarity, both verbally and in writing to groups and individuals.


    Education and/or Experience
    :

    Required:

    • Minimum: High School Diploma or GED equivalent.
    • Certification for successful completion of a coding exam.
    • Minimum one-year experience working with Electronic Health Record and specialty coding with one to three years’ experience directly related to the duties and responsibilities field.
    • Excellent interpersonal communication and problem-solving skills.
    • Skills to intervene and promote reconciliation, compromise and positive outcomes in difficult interactions.
    • Skilled at using electronic health records as applicable to area of work (EPIC, Wisdom).

    Preferred:

    • Additional education and training are desirable with two years medical office experience and training; billing experience and chart auditing experience preferred. Community health care experience preferred.
    • Basic knowledge of adult learning models.


    Language Skills
    :

    Must have the ability to communicate with clarity, both verbally and in writing; read, analyze, and interpret complex documents, regulations, policies, and procedure manuals; and create professional business documents. Preferred bilingual English/Spanish.


    Equity Statement:

    At La Clinica, we commit to engage everyone in a welcoming, respectful, and loving way and to maintain the dignity and value of all people above everything else. These standards align with our organization’s vision of absolute excellence, open-hearted community, and well-being for all.

    For more information, please visit our website at: https://laclinicahealth.org/patients/approach/

    Applications will be reviewed by the appropriate Department for interview; those selected must be able to provide proof of legal right to work in this country. La Clinica is a drug free work environment. Equal Opportunity Employer. La Clinica complies with the Americans with Disabilities Act. If you consider yourself disabled and desire assistance in the application process, please contact the Human Resources Department.

  • 9 Days Ago

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Coding Compliance Analyst-Remote Position (OR/WA Only)
  • Legacy Health
  • Oregon, OR FULL_TIME
  • Overview Remote Position (OR/WA Only) This is a remote position – incumbents, who reside in Oregon or Washington only. There may be occasional situations that require work to be performed on-site at a...
  • Just Posted

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Medical Coding/Billing Specialist
  • Valley Clinics Internal Medicine
  • Corvallis, OR FULL_TIME
  • Valley Clinics is looking to hire another full time, in office, Medical Coding/Billing Specialist! We are looking for someone who is: CPC Certified, preferably from AAPC. Familiar with CPT, HCPCS, and...
  • 18 Days Ago

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Inpatient Coding Specialist - Facility
  • Exela Technologies
  • Remote, OR FULL_TIME
  • Job Description Job Description Why Exela? Help us revolutionize the way that business around the world gets done. As a member of Team Exela, you’ll join a passionate, creative, and knowledgeable grou...
  • Just Posted

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Medical Coding Specialist
  • Robert Half
  • Portland, OR CONTRACTOR,TEMPORARY
  • ***This position is fully remote, but you must have your CPC certificate or CCS certificate to be considered for the role*** Robert Half is currently seeking a Certified Medical Coder to play a crucia...
  • 1 Day Ago

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Medical Coding/Billing Specialist
  • VALLEY CLINICS, PC
  • Corvallis, OR FULL_TIME
  • Valley Clinics is looking to hire another full time, in office, Medical Coding/Billing Specialist! We are looking for someone who is: CPC Certified, preferably from AAPC.Familiar with CPT, HCPCS, and ...
  • 1 Month Ago

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HIPAA Compliance Expert
  • Eagle Consulting Partners, Inc.
  • Cleveland, OH
  • At Eagle Consulting Partners, we provide cybersecurity, compliance, and IT risk management consulting to Small and Mediu...
  • 3/28/2024 12:00:00 AM

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Financial Compliance Specialist
  • Virginia Tech University
  • Blacksburg, VA
  • The Office of Sponsored Programs at Virginia Tech, a central university department under the Office of Research and Inno...
  • 3/28/2024 12:00:00 AM

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Personal and Work Life Core Compliance Expert
  • Ladgov Corporation
  • Montgomery, AL
  • Major Duties and Responsibilities Provide family-focused education and support services. Conduct initial and crisis asse...
  • 3/28/2024 12:00:00 AM

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Compliance Specialist
  • Storm2
  • Boston, MA
  • Role: Compliance Specialist Industry: InvestTech Location: Boston, hybrid Storm2 are partnered with a VC backed InvestTe...
  • 3/27/2024 12:00:00 AM

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Compliance Specialist
  • Trilogy Health Services
  • Louisville, KY
  • JOIN TEAM TRILOGY: Weekly pay, health and dental after your first month, student loan repayment, a competitive 401(k) ma...
  • 3/27/2024 12:00:00 AM

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Compliance Specialist
  • Collabera
  • Cincinnati, OH
  • Job Description Job Description Urgent Hiring for Compliance Specialist at Cincinnati, OH at $20/hr. Job Description: In...
  • 3/27/2024 12:00:00 AM

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Compliance Specialist
  • Deringer-Ney Inc.
  • Hartford, CT
  • Title: Compliance Specialist Job Summary: Oversee compliance requests and requirements to ensure that statutory, regulat...
  • 3/26/2024 12:00:00 AM

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EMEA Trade Compliance Specialist
  • Arrow Electronics, Inc.
  • Sevenum, Limburg
  • Position: EMEA Trade Compliance Specialist Job Description: As Arrow Global Components (AGC), a part of Arrow Electronic...
  • 3/11/2024 12:00:00 AM

Oregon (/ˈɒrɪɡən/ (listen) ORR-ih-gən) is a state in the Pacific Northwest region on the West Coast of the United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. The parallel 42° north delineates the southern boundary with California and Nevada. Oregon is one of only four states of the continental United States to have a coastline on the Pacific Ocean. Oregon was inhabited by many indigenous tribes before Western traders, explorers, and settlers arrived. An autonomous government ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$64,415 to $85,572

Coding Compliance Specialist in Altus, OK
With little or no supervision, plans, conducts and coordinates the daily operations of one of the Coding and Documentation Quality Assurance (CDQA) sub-teams.
December 14, 2019
Coding Compliance Specialist in Terre Haute, IN
Leads the initiatives and responsibilities of the Enterprise-Wide Coding implementation work groups applicable to their sub-team.
December 16, 2019
Coding Compliance Specialist in Portland, OR
This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS Coding Guidelines and Official ICD9 / ICD10 Coding Guidelines.
December 23, 2019