Inpatient Coding Compliance Specialist

This is a fully remote position, open to applicants in Alabama, +21 more states.

📋 Description

• Develop and uphold compliance programs aligned with the Office of Inspector General's work plan.

• Mitigate legal and financial risks for both the institution and individual providers through educational initiatives and internal audits.

• Provide education to providers regarding government regulations, Medicare and Medicaid guidelines, HIPAA, and issues related to fraud and abuse.

• Evaluate current circumstances and propose priorities and objectives for the future needs of the clinic.

• Identify risk areas in coding and billing, conduct targeted reviews, and implement necessary corrective measures.

• Perform regular internal audits of provider documentation.

• Work collaboratively with physicians and internal teams to enhance documentation, coding, and compliance practices.

• Review internal controls, policies, and procedures to ensure compliance with university, state, and federal regulations.

• Address both external and internal concerns and take corrective actions as needed.

• Communicate with Medicare/Medicaid carriers and third-party payers regarding relevant policies and procedures.

• Advocate for compliance initiatives among clinical faculty and administration.

• Carry out additional duties related to the role as required.

⛳️ Requirements

• Completion of a Bachelor's degree program.

• A minimum of four years of administrative experience applying compliance, coding, and auditing principles to insurance billing, collections, consulting, and other revenue cycle-related tasks.

• For technical coding, two of the four years must involve experience with DRGs and APR-DRGs.

• RHIA, RHIT, or CCS certification is required for technical coding.

• CPC, CCS, RHIT, RHIA, or CPMA certification is required for professional coding.

• Experience in formal coding instruction is preferred.

• For professional coding, experience in specialty coding for surgical or E/M coding is preferred.

• Candidates must reside in North Carolina, Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, or Washington.

🏝️ Benefits

• A sign-on bonus of $10,000 paid in four equal installments over 24 months at six-month intervals.

• A fully remote work arrangement.