Inpatient Coding Compliance Specialist

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

📋 Description

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

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

• Provide education to providers on government regulations, CMS guidelines, HIPAA, and issues related to fraud and abuse.

• Assess current conditions and propose priorities and objectives for the clinic's future requirements.

• Identify risk areas in coding and billing, carry out targeted reviews, and implement corrective measures.

• Execute regular internal audits of provider documentation.

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

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

• Address both external and internal inquiries and execute corrective actions as necessary.

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

• Advocate for compliance initiatives among clinical faculty and administrative staff.

• Perform additional related tasks as required by the position.

⛳️ Requirements

• Bachelor’s degree.

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

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

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

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

• Familiarity with government regulations, CMS guidelines for academic medical centers, HIPAA, and issues related to fraud and abuse.

• Experience in formal coding instruction is preferred.

• Preferred specialty coding experience in surgical or E/M coding for professional coding roles.

🏝️ Benefits

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

• Fully remote work arrangement.

• Commitment to equal employment opportunity and non-discrimination.