Coding & Documentation Compliance Specialist, CPC/CPMA

This is a fully remote position, open to applicants in California, +3 more states.

📋 Description

• Conduct a foundational documentation audit of 10–20 charts for each billing provider across various encounters.

• Deliver reports detailing findings along with error rates categorized by provider and service line.

• Execute continuous quarterly audits involving 10 charts per provider and targeted service-line evaluations.

• Implement a 100% pre-bill review during new code rollouts until the error rate falls below 5%.

• Subject providers with an error rate exceeding 10% to monthly reviews accompanied by targeted educational sessions until they drop below the threshold.

• Assess the suitability of unused or underutilized codes for the care model.

• Specify the documentation necessary before codes can be billed in compliance with regulations.

• Develop documentation guidelines for clinical staff and the billing team.

• Support MIPS success by identifying appropriate measures and ensuring documentation surpasses requirements.

• Recommend improvements to templates to enhance accuracy and ensure MIPS compliance.

• Report directly to the Senior Medical Director.

⛳️ Requirements

• CPC (AAPC) or CCS-P (AHIMA) certification is mandatory.

• CPMA is highly preferred, or equivalent demonstrated experience in chart auditing.

• A minimum of 5 years of experience in coding outpatient E/M, including direct auditing experience.

• Comprehensive understanding of Medicare telehealth regulations.

• Familiarity with MIPS reporting and quality measure documentation.

• Must be US-based with extensive Medicare experience.

• Background in obesity medicine, endocrinology, or primary care is preferred.

• Previous experience with OIG self-disclosure or responding to payer audits is preferred.

• Experience in creating documentation templates or clinician cheat-sheets is preferred.

🏝️ Benefits

• Remote work opportunity.

• Independent contractor arrangement.

• Flexible part-time schedule averaging around 15–20 hours per week.

• Collaborate with a physician-led, evidence-based weight management care model.

• Chance to influence documentation templates, improve workflows, and enhance clinician education.