Coding Compliance Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Extract clinical data from electronic medical record systems.

• Analyze medical documentation to ensure accurate CPT billing selection in accordance with CMS coding guidelines.

• Review medical records for inconsistencies in documentation practices and suggest remediation solutions.

• Provide continuous outreach and education to both new and existing coders regarding coding and documentation requirements for Emergency Medicine and Hospital Medicine.

• Assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and services.

• Validate the accuracy of codes and ensure compliance with coding guidelines and regulations.

• Stay updated on coding standards, regulations, and payer policies.

• Achieve quality and productivity targets established by the Coding Manager.

• Ensure adherence to federal, state, and payer-specific coding requirements.

• Review coding discrepancies and provide constructive feedback to the coding leadership team.

• Conduct audits of coded records.

• Recommend enhancements and best practices in coding.

• Review medical records for new business to identify documentation opportunities and provide templating education.

• Utilize coding software and EHR systems.

• Remain informed about updates to coding systems and software.

• Act as an expert resource for coding and documentation requirements.

• Carry out other related duties as assigned.

⛳️ Requirements

• A Bachelor’s degree or equivalent is mandatory.

• Preferred qualifications include RHIA, CDI, CPC, CCS, or CCS-P certifications.

• 1-2 years of experience in a Hospital or Physician practice setting is desirable.

• Familiarity with Evaluation & Management coding is required.

• A background in emergency medicine or hospital medicine is preferred.

• EHR/EMR (Electronic Health Record/Electronic Medical Record) experience is essential.

• Chart Auditing/Optimization experience is a plus.

• Reliable internet access is necessary.

• Comprehensive knowledge of medical coding and billing systems and regulatory requirements.

• Understanding of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.

• Strong analytical capabilities.

• Excellent communication and interpersonal skills.

• Ability to work autonomously and address challenges effectively.

• Capability to learn proprietary software applications.

• Proficiency in collaborating with internal and external professionals across different geographic locations.

• Ability to manage multiple priorities and thrive in a fast-paced environment.

🏝️ Benefits

• Fully remote work arrangement.

• Opportunity to travel for in-person meetings and events.

• Equal opportunity employer.

• ADA-compliant employment practices.