Inpatient Coding Compliance Specialist

This is a fully remote position, open to applicants in Alabama, +22 more states.

📋 Description

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

• Mitigate institutional and individual provider legal and financial risks through training and internal audits.

• Provide education to providers on governmental regulations, Medicare and Medicaid guidelines, HIPAA, and Fraud and Abuse.

• Evaluate current conditions and suggest priorities and objectives for future clinic requirements.

• Detect coding and billing risk areas, perform targeted reviews, and execute corrective measures.

• Carry out regular internal audits of provider documentation.

• Work in partnership with physicians and internal personnel to enhance documentation, coding, and compliance abilities.

• Examine internal controls, policies, and procedures for adherence to University, State, and Federal regulations.

• Address external and internal issues and apply corrective actions.

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

• Advocate for compliance initiatives among clinical faculty and administration.

⛳️ Requirements

• Completion of a Bachelor's degree program.

• A minimum of four years of administrative experience applying compliance, coding, and auditing principles associated with insurance billing, collections, consulting, and other revenue cycle functions.

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

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

• For professional coding, a CPC or CCS or RHIT or RHIA or CPMA certification is necessary.

• Experience in formal coding instruction is preferred.

• Specialty coding experience in surgical or E/M coding is preferred.

• Understanding of Medicare/Medicaid guidelines, HIPAA, and Fraud and Abuse regulations.

• Capability to conduct coding and billing risk assessments, internal audits, and implement corrective actions.

• Ability to review internal controls, policies, and procedures for compliance with University, State, and Federal guidelines.

🏝️ Benefits

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

• A fully remote work arrangement.

• Commitment to equal employment opportunity and nondiscrimination.