Coding & Compliance Specialist

Monday - Friday, 8:00 AM - 4:30 PM

Responsibilities

• Demonstrates skills in customer service, communication, team building, and problem solving.
• Demonstrates competency in all areas of hospital third-party insurance billing, including federal and state regulations.
• Demonstrates skill in proactively resolving problems, recommending, and implementing process changes.
• Demonstrates skill in communicating with patients, payer representatives, and associates throughout the Health System.
• Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations.
• Develops reports as directed and reports findings to management and providers.

Requirements

• CPC-A required; CPC or CPC-H preferred.
• Excellent communication skills and ability to form collaborative partnerships across all service settings.
• Proficient in the use of Electronic Medical Records (EMR); ability to create reports independently and interface with EMR vendor to develop reports where none currently exist.
• Extensive knowledge of RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care), and billing.
• Ability to analyze coding and actively question and guide providers and/or billing staff as appropriate.
• Strong medical terminology background.
• Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint).
• Self-directed, self-starter, and able to implement new programs.
• Accepts responsibility and follows through on projects and activities.
• Ability to assimilate new information and technologies into daily work.
• 3-5 years of healthcare experience preferred; billing experience preferred.
• Excellent public/patient relations and communication skills.
• Skills in using computers, including Excel and Word, required.

Education

• Associate’s degree preferred.

Pay

$20.00 - $25.00/hour (starting pay based on experience).