Coding and Compliance Specialist

About the role

Trinity Health Of New England is seeking an experienced Coding Compliance Specialist to support and enhance our Health Information Management (HIM) Compliance Program. This role is responsible for supporting key areas of the organization related to an area of expertise. Uses data, research analysis, critical thinking & problem-solving skills to support colleagues & leadership in achieving organization’s strategic objectives. Serves as a peer influencer & may direct a project or project team by applying industry experience & specialized knowledge.

Responsibilities

• Provides high level technical competency & subject matter expertise analyzing coding and documentation review for professional services, including code selection of evaluation and management codes and procedural services.
• Conducts comprehensive audits of professional coders and providers to ensure accuracy, compliance, and alignment with CPT, ICD 10, HCPCS, HCC and payer‑specific guidelines.
• Analyze documentation and coding patterns to identify risks related to compliance, revenue integrity, and regulatory requirements.
• Provides clear, actionable feedback to providers, coders, and leadership to improve documentation quality and coding accuracy.
• Maintains current knowledge and credentials through ongoing education and interpretation of regulatory and industry changes.
• Develops and delivers targeted education and training programs based on audit findings, regulatory updates, and identified knowledge gaps.
• Provides training and onboarding to new providers.
• Adheres to coding quality & productivity standards as established by Revenue Excellence; responsible