coding compliance specialist

Signature Healthcare

<div><div><div><div><div>POSITION SUMMARY:
Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible for coding and abstracting services for the full range of hospital services. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or surgical procedures outpatient services, and/or emergency room records using ICD 10 CM and CPT 4 coding classification systems. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.</div> 
</div>
</div></div> 
Location: Signature Healthcare &middot; Health Information Management 
Schedule: Full Time 40 Hours only, Days 1st Shift, flexible</div>

Outpatient Coding Specialist

Covenant Health

<div>Overview:<div></div><div> 
Coding Specialist, Centralized Coding, Outpatient</div><div>
Full Time, 80 Hours Per Pay Period, Day Shifts</div><div></div><div> 
Covenant Health Overview:</div><div>
Covenant Health is the region&rsquo;s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area&rsquo;s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area&rsquo;s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes &ldquo;Best Employer&rdquo; seven times.</div><div></div><div> 
Position Summary:</div><div>
This individual provides leadership, direction, and training for the coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record documentation and coding accuracy, developing and updating all departmental policies and procedures relative to coding, performing quality reviews of coding/abstracting, and focusing on problem solving issues related to denials. Provides assurance that billing practices are complete, accurate, and in compliance with state and federal guidelines.</div>
Responsibilities:
<ul><li>Oversees through monitoring and by reviewing and auditing the coding staff to ensure position accountabilities and performance criteria are adhered to.</li><li>
Develops and maintains departmental and hospital policies and procedures and implements new policies and procedures relative to coding.</li><li>
Educates and assists physicians and clarifies coding versus clinical issues.</li><li>
Works closely with Registration and Business Office personnel to resolve issues related to claims, coding, pre-cert, and denials appeals, and verifies that appropriate chargemaster rates are used.</li><li>
Reviews medical record documentation to ensure existing documentation supports diagnostic/procedure code billed per UB 92 or HCFA 1500 form.</li><li>
Provides education to coding staff and physicians in response to regulatory changes and identified areas of deficiency.</li><li>
Monitors claim rejections and systematically assesses specific types of denial as it relates to coding and documentation issues, outpatient registration, and the receipt of physician orders.</li><li>
Attends meetings and provides input as it relates to coding, medical documentation, and reimbursement issues specific to medical billing and regulatory requirements.</li><li>
Increases awareness of compliance as it relates to coding and documentation.</li><li>
Facilitates and coordinates education of coding staff in the areas of coding, documentation, case mix, and denials.</li><li>
Increases understanding of APCs, DRGs, case mix, and denials.</li><li>
Educates coding staff to proper documentation necessary to support a DRG/APC/Medical Necessity/ROM/SOI.</li><li>
13 Integrates documentation, coding, and proper oversight to ensure accurate reimbursement.</li><li>
Reviews records to verify if the correct code has been assigned.</li><li>
Assists with all insurance requested audits and provides information to supervisor related to inaccurate and/or missing documentation.</li><li>
Reviews DRG/APC classifications and educates to maximize level of care assignment for increased reimbursement.</li><li>
Keeps current on local, state, and federal regulations to ensure compliance.</li><li>
Keeps current on coding guidelines and communicates to Health Information Manager. Implements corrective actions as indicated to minimize financial risk.</li><li>
Works with Denials Elimination Group and deals with physician specific issues as it impacts denials.</li><li>
Ensures LCDs/NCDs are being adhered to by admissions and hospital personnel to ensure qualifying diagnosis covers tests/procedures.</li><li>
Analyzes denials and coordinates appeals.</li><li>
Ensures corrective action is taken to prevent denials from reoccurring.</li><li>
Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications:
<div>
Minimum Education:
</div><div>None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.</div><div></div><div> 
Minimum Experience:
</div><div>Five or more (5+) years coding experience.</div><div></div><div> 
Licensure Requirement:
</div>RHIA, Coding, or RHIT certification required. Registered Health Information Technologist preferred.</div>

CODING SPEC-CLINIC

Atrium Health

<div>Department:
13376 Enterprise Revenue Cycle - Individualized Clinician Services Primary Care and Medical Specialties 
Status:
Full time 
Benefits Eligible:
Yes 
Hours Per Week:
40 
Schedule Details/Additional Information:
Will support:
<ul><li>Primary Care Southeast region</li></ul>
Schedule:
<ul><li>Monday - Friday 1st shift 40 hours a week EST .</li></ul>
Certification Required:
<ul><li>AHIMA RHIA or</li><li>
AHIMA RHIT, or</li><li>
AHIMA CCS or</li><li>
AHIMA CCS-P or</li><li>
AAPC (CPC)</li><li>
Additional specialty credential preferred.</li></ul>
Remote opportunity:
Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY
Pay Range
$35.50 - $53.25 
Major Responsibilities:<ul><li>
Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&amp;M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions.</li><li>
Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start.</li><li>
Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams.</li><li>
Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits.</li><li>
Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials.</li><li>
Collaborate across departments&mdash;including CMOs, Clinical Informatics, Risk Adjustment, and Population Health&mdash;to enhance documentation practices and system optimization.</li><li>
Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy.</li><li>
Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy.</li><li>
Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA&rsquo;s Standards of Ethical Coding, while maintaining expert knowledge of evolving policies.</li><li>
Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance.</li></ul>
Licensure, Registration, and/or Certification Required:<ul><li>
Registered Health Information Administrator (RHIA) or</li><li>
Registered Health Information Technician (RHIT) certification, or</li><li>
Coding Specialist (CCS) certification, or Coding Specialist &ndash;Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or</li><li>
Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC).</li><li>
Additional specialty credential preferred.</li></ul>
Education Required:<ul><li>
Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge. High school diploma or GED required.</li></ul>
Experience Required:<ul><li>
Typically requires 4 years of experience in expert-level professional coding.</li></ul>
Knowledge, Skills &amp; Abilities Required:<ul><li>
Advanced Coding Expertise: In-depth knowledge of ICD, CPT, and HCPCS coding guidelines, ensuring accurate and compliant coding practices.</li><li>
Medical Terminology &amp; Anatomy: Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.</li><li>
Epic &amp; Reporting Solutions: Advanced knowledge of Epic and other reporting tools to analyze data, generate reports, and optimize workflow efficiencies.</li><li>
Critical Thinking &amp; Analytical Skills: Highly proficient in problem-solving and analytical thinking with strong attention to detail.</li><li>
Interpersonal Communication: Excellent verbal and written communication skills, with the ability to educate and collaborate effectively with physicians, APCs, clinical leadership, and coding teams.</li><li>
Advanced Computer Skills: Proficiency in Microsoft Office Suite, electronic coding applications, and email communication.</li><li>
Organizational &amp; Prioritization Skills: Ability to efficiently manage multiple tasks, set priorities, and meet deadlines in a fast-paced environment.</li><li>
Independent Decision-Making: Ability to work independently, exercise sound judgment, and make informed decisions regarding coding and compliance.</li><li>
Collaboration &amp; Initiative: Strong ability to take initiative, contribute to process improvements, and work collaboratively within a team environment.</li></ul>
Physical Requirements and Working Conditions:<ul><li>
Follow organizational and divisional remote work policy and guidelines.</li><li>
Operates all equipment necessary to perform the job.
</li><li>Handles a fast paced and creative work environment moving independently from one task to another.</li><li>
Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis.</li></ul>
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
#REMOTE
#LI-REMOTE
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more &ndash; so you can live fully at and away from work, including:
Compensation<ul><li>
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training</li><li>
Premium pay such as shift, on call, and more based on a teammate's job</li><li>
Incentive pay for select positions</li><li>
Opportunity for annual increases based on performance</li></ul>
Benefits and more<ul><li>
Paid Time Off programs</li><li>
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability</li><li>
Flexible Spending Accounts for eligible health care and dependent care expenses</li><li>
Family benefits such as adoption assistance and paid parental leave</li><li>
Defined contribution retirement plans with employer match and other financial wellness programs</li><li>
Educational Assistance Program</li></ul> 
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation&rsquo;s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
The Clinician Coding Liaison is a remote role serving as a key resource for clinicians in their coding and documentation education, trend analysis, and issue resolution. This position collaborates with Chief Medical Officers (CMOs), operational leaders, and Physician Billing (PB) coding leadership to address coding challenges, identify payer-specific trends, and ensure compliance with evolving regulations. Responsibilities include providing proactive education and feedback to Advocate Health (AH) employed Physicians, Advanced Practice Professionals (APPs), and Medical Group and Clinic Leadership to enhance documentation accuracy, charge capture, and compliance. Acting as the primary point of contact for coding and documentation inquiries, this role triages issues, identifies root causes, and facilitates problem resolution in partnership with relevant teams. Additionally, the liaison works closely with Clinician Coding Liaison team members, Production Coding, and Coding Support teams to improve coding accuracy, documentation specificity, and overall billing practices while monitoring payer-specific rules and coverage trends. For the purposes of this role, the term &quot;Clinicians&quot; refers to all billing providers</div>

Clinician Coding Liaison - Primary Care

MUSC Health

<div>
 
 Job Description Summary
 
 
 
 Under the supervision of the Coding Audit and Education Manager, the Coding Educator is responsible for delivering targeted, audit-based education to coding professionals and providers to improve coding accuracy, compliance, and documentation quality. Working closely with Coding Auditors, this role translates audit findings into actionable education, promotes consistent application of coding guidelines, policies, and regulatory requirements. The Coding Educator plays a key role in strengthening coding integrity, reducing risk, and supporting revenue cycle performance.
 
 
 
 Entity
 
 
 
 Medical University Hospital Authority (MUHA)
 
 
 
 Worker Type
 
 
 
 Employee
 
 
 
 Worker Sub-Type
 
 
 
 Regular
 
 
 
 Cost Center
 
 
 
 CC002307 SYS - Hospital Coding
 
 
 
 Pay Rate Type
 
 
 
 Hourly
 
 
 
 Pay Grade
 
 
 
 Health-28
 
 
 
 Scheduled Weekly Hours
 
 
 
 40
 
 
 
 Work Shift
 
 
 
 
 Job Description
 
 
 
 
 Key Responsibilities:
 
 
 
 <ul>
 <li>
 Partner with Coding Auditors to review audit findings and identify education needs for coders and providers.
 </li>
 <li>
 Develop and deliver audit-based follow-up education to individual coders, coding teams, and providers based on identified trends, errors, and compliance risks.
 </li>
 <li>
 Provide one-on-one and group education sessions to reinforce correct coding practices, documentation requirements, and guideline updates.
 </li>
 <li>
 Create and maintain educational materials, tip sheets, job aids, and training presentations related to ICD-10-CM/PCS, CPT, HCPCS, and payer-specific requirements.
 </li>
 <li>
 Educate providers on documentation improvement opportunities that support accurate code assignment and compliance.
 </li>
 <li>
 Stay current with official coding guidelines, regulatory changes, payer policies, and industry best practices, and communicate updates to coding staff and providers.
 </li>
 <li>
 Collaborate with Revenue Cycle, Compliance, CDI, and clinical departments to address coding and documentation issues.
 </li>
 <li>
 Participate in coding meetings, education committees, and performance improvement initiatives as assigned.
 
 
 </li>
 </ul>
 
 Additional Job Description
 
 
 
 Education: Bachelor's degree or equivalent required
 
 
 Experience: Minimum of 4 years coding specific experience
 
 
 Licensuree/Certification: One of the following coding certifications required: CPC, COC, CCS, RHIA, RHIT
 
 
 
 If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
 
 
 
 The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
 
 
 Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
</div>

Coding Educator-2

Medical College of Wisconsin

<div><h3 class="jobSectionHeader">Summary</h3>
Serves as an expert resource for multi-specialty documentation, coding and billing. Assist in performing medical coding audits on clinicians and/or coding staff as needed within multi-specialty physician practices to identify deficiencies and ensure coding remains compliant with coding guidelines as well as government and third-party payer regulations and guidelines. Responsible for new and existing clinician and coder education, as well as team and/or clinical department educational sessions.
All remote work must be performed within one of the MCW registered payroll states, which currently includes: WI, AZ, DE, FL, GA, IL, IN, MD, MI, MN, MO, NC, TN, TX, and UT.
<h3 class="jobSectionHeader">Primary Responsibilities
</h3><ul><li>Expert resource of multispecialty coding, charge capture and reimbursement which may include surgical, inpatient, emergency and/or ambulatory coding; assignment or verification of CPT, ICD-10 CM coding and modifiers based upon documentation.</li><li>
Participate in workgroups to evaluate, produce and/or update policies and procedures related to internal process in relation to documentation, coding, and billing.</li><li>
Educate/train new and existing employees in multispecialty clinical areas, include government documentation and coding regulations. Assist lead/CS IV team in educational session, include coding/charge capture process and Epic related changes.</li><li>
Onboard/educate new and existing physicians and APP&rsquo;s on documentation and coding rules and regulations.</li><li>
Perform documentation and coding audits on clinicians and coding specialist staff for coding accuracy.</li><li>
Support Charge Capture Team in analyzing coding denial trends and troubleshooting solutions such as front-end system edits and/or front-end education to minimize reimbursement delays.</li><li>
Assist in the training of coworkers, coding staff, clinicians as appropriate to provide evaluation, education and/or orientation adhering to CPT, ICD-10CM and Government documentation and coding regulations.</li><li>
Subject Matter Expert for Encoder Pro.</li><li>
Participates in new employee orientation to acquaint them with the charge capture process.</li><li>
Maintain current knowledge of medical terminology, procedure codes, modifiers, diagnosis codes, coding requirements and practices. Communicates changes to appropriate persons.</li><li>
Review payer policy publications, notices and websites for coding and policy information to assist in appeal writing or to support other action determinations.</li><li>
Responsible for the day-to-day prioritization and the execution of various projects.</li><li>
Perform other duties or projects as assigned.</li><li>
Other duties as assigned.</li></ul><h3 class="jobSectionHeader">
Knowledge &ndash; Skills &ndash; Abilities</h3><ul><li>
Ability to interact with people effectively.</li><li>
Expert knowledge of medical billing and collections revenue cycle as it specifically relates to professional medical coding, reimbursement, contracting and processing payments.</li><li>
Strong written and oral communication skills.</li><li>
Ability to take initiative and to exercise independent judgment, decision making and problem-solving skills.</li><li>
Proficient in Excel and Word, Medical terminology, CPT, HCPCS, ICD-10CM coding, CMS coding requirements, and coding tools.</li></ul><h3 class="jobSectionHeader">
Qualifications</h3>
Appropriate experience may be substituted for education on an equivalent basis.
Minimum Required Education: Bachelor&rsquo;s Degree
Minimum Required Experience: 6 years
Preferred Experience: Front end professional coding, Epic, Encoder Pro
Required Certification/Licensure(s): Coding certification (CPC, CCS-P) and/or Health Information Management credential (RHIT, RHIA).
#LI-RT1<h3 class="jobSectionHeader">
Physical Requirements</h3>
Work requires occasionally lifting moderate weight materials, standing, or walking continuously.<h3 class="jobSectionHeader">
Work Environment</h3>
Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.<h3 class="jobSectionHeader">
Sensory Acuity</h3>
Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.
Target salary range for this position is between $74,500.00 and $94,900.00 annually. The final offered salary will depend on the applicant&rsquo;s education, experience, skills, and knowledge, as well as considerations of internal equity and market alignment.
<h3 class="jobSectionHeader">Why MCW?</h3><ul><li>
Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options</li><li>
403B Retirement Package</li><li>
Competitive Vacation and Paid Holidays offered</li><li>
Tuition Reimbursement</li><li>
Paid Parental Leave</li><li>
Employee &amp; Family Assistance Program (EFAP)</li><li>
Pet Insurance</li><li>
On campus Fitness Facility, offering onsite classes</li><li>
Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.</li></ul>
For a brief overview of our benefits see: Benefits Overview
For a full list of positions see: MCW Careers 
 
At MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring &ndash; Collaborative &ndash; Curiosity &ndash; Inclusive &ndash; Integrity &ndash; Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website.<h3 class="jobSectionHeader"> 
MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination:</h3>
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.</div>

Coding Quality Analyst

Optum

<div>Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As a Coding Compliance Analyst, you will be responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding.
Schedule (FT, 40 hours): Will work 8-hr shifts, Monday-Friday. Must be flexible with schedule changes depending on business need. Typical business hours range from 6am - 6pm. (Preferably EST or CST).
Role is fully remote.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:<ul><li>
Participates in the identification and resolution of areas requiring additional intervention through established Coding/Billing and Corporate Compliance work plans</li><li>
Develops and implement clinic-wide training programs geared towards educating clinical and non-clinical support staff regarding compliance related topics and/or deficiencies identified through documentation/coding and billing compliance audits</li><li>
Develops and delivers clinic-wide memorandums/educational materials pertaining to relevant revenue integrity initiatives</li><li>
Identifies trends that result in lost revenue and educates provider as appropriate</li><li>
Assist in the review and update of annual Revenue Integrity &amp; Education work plan and audit schedule</li><li>
Performs formal review of annual CPT/Diagnosis/HCPCS changes and prepares educational documents by specialty highlighting significant changes</li><li>
Trains providers, staff, and others in small and large group sessions</li><li>
Meet deadlines, productivity targets as defined in the Coding/Billing Compliance work Plan</li><li>
Communicates effectively at all levels in the organization, including clinical and non-clinical support staff, managers, physicians, and medical leadership</li><li>
Conducts random and scheduled internal audits of physician billing and medical records documentation to ensure: Correct Coding (CPT, ICD-10, HCPCS, Modifiers), Accurate Data Entry, Accurate Charge Preparation/Processing, Compliance with governmental and third-party billing regulations</li><li>
Conducts quarterly audits of Coding staff to ensure correct coding and to identify training opportunities</li><li>
Utilizes Microsoft Excel / Word, to document and report audit results to the appropriate personnel, including physicians/providers and Medical Leadership</li><li>
Works collaboratively with clinical department physicians, mid-level providers, and other staff to ensure appropriate and compliant documentation, coding, and billing practices</li><li>
Develops and tracks progress of internal audit schedules</li><li>
Serves as an internal compliance resource for Patient Accounts, Clinical departments, and for coding and documentation questions</li><li>
Utilizes the Internet, intranet, internal reference library, available workshops and/or seminars and other sources to stay current with government and local third-party payer coding, specialty specific and reimbursement rules, and requirements</li><li>
Measures and reports coding trends as compared to national standards; or claim/documentation reviews. Documents and reports result to all appropriate parties</li><li>
Monitors and productivity reports and other data as requested by manager</li><li>
Participate in all governmental and third-party insurance audits</li><li>
Assist in developing Revenue Integrity and Education Policies and Procedures</li><li>
Comply with all established departmental policies, procedures, and objectives</li><li>
Maintains all Professional certifications</li><li>
Attends a variety of meetings as required or directed</li><li>
Performs other similar and related duties as required or directed</li><li>
Must be able to work as a team and independently as needed</li><li>
Regular, reliable, and predicable attendance is required</li></ul>
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:<ul><li>
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays</li><li>
Medical Plan options along with participation in a Health Spending Account or a Health Saving account</li><li>
Dental, Vision, Life&amp; AD&amp;D Insurance along with Short-term disability and Long-Term Disability coverage</li><li>
401(k) Savings Plan, Employee Stock Purchase Plan</li><li>
Education Reimbursement</li><li>
Employee Discounts</li><li>
Employee Assistance Program</li><li>
Employee Referral Bonus Program</li><li>
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
High School Diploma/GED (or higher)</li><li>
Certified Professional Coder (CPC, CCS-P, CEMC, CPMA or COC)</li><li>
1+ years of experience utilizing standard scoring (CMS) methodologies to report findings to providers</li><li>
1+ years of experience employing clinical references with the auditing process</li><li>
1+ years of experience with Apply CPT and ICD-10 coding convention to documentation guidelines</li><li>
1+ years of experience with Apply CMS and other payer constraints to final code and documentation determination</li><li>
1+ years of demonstrated experience in a physician/professional billing environment</li><li>
1+ years of demonstrated experience with third party payer guidelines</li><li>
Ability to obtain CPMA within 1 year of employment</li></ul>
Preferred Qualifications:<ul><li>
Experience with ICD-10, CPT and HCPCS coding</li><li>
Experience with auditing physician medical records utilizing E+M guidelines</li><li>
Experience with Microsoft Office Suite (Excel, Word, Power Point) or successful completion of related courses. Must show proficiency in current billing software within six (6) months</li><li>
Demonstrated experience in the application of medical terminology, anatomy and physiology or successful completion of related college courses</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO #GREEN</div>

Coding Compliance Analyst

UCHealth

<div>Coord Quality Coding Inpatient 
 
Location: UCHealth Admin Lowry, US: CO: Denver 
 
Department: UCHlth Inpatient Coding 
 
Work Schedule: Full Time, 80.00 hours per pay period (2 weeks)
 
 
Shift: Days
 
 
Pay: $33.82 - $50.73 / hour. Pay is dependent on applicant's relevant experience. 
 
This position is 100% remote. Eligible, out-of-state candidates may be considered.
 
 
Summary: 
Responsible for coding data integrity by reviewing diagnosis and procedure code assignments, and validating MS-DRG, APC, or RVU designations. 
 
Responsibilities: 
Conducts internal quality reviews, in accordance with the Coding Compliance Plan. Reviews government, commercial and other external audits. Performs internal audits as requested by other departments. Monitors and reports issues/trends. 
 
Presents coding education to staff, leadership and others throughout the Health System. Provides training as necessary. Assists with developing and guiding SMEs responsibilities.
 
 
Responds to coding questions submitted throughout the Health System. Reviews physician queries for appropriateness, and related correspondence. 
 
Reviews coded claims data in response to denials and customer service requests. Provides thorough rationale and explanation for proper code assignments. 
 
Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action. 
 
Requirements: 
<ul><li>
High School diploma GED.</li><li>
Coding-related certification from AHIMA or AAPC.</li><li>
3 years of relevant experience.</li></ul> 
Employees are our number one asset. 
 
UCHealth promotes a culture that invests in professional success and personal well-being through a comprehensive total rewards program. * 
 
Recognition 
<ul><li>
Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure. The bonus accumulates annually each October and is paid out in October during the third year of employment.</li><li>
Performance-based pay increase: The Annual Merit Pay Increase recognizes work performance that meets or consistently exceeds performance standards documented through UCHealth's established evaluation process and accounts for increased experience, skills and cost of living.
</li><li>Market reviews: All UCHealth positions are reviewed annually to ensure UCHealth base pay aligns with market standards. Base pay rates are adjusted as needed to stay market competitive.
</li></ul> 
Health and well-being 
<ul><li>
Medical, dental and vision coverage.</li><li>
Access to 24/7 mental health and well-being support for employees and dependents.</li><li>
Discounted gym memberships and fitness resources.</li><li>
Free Care.com membership.</li><li>
Voluntary benefits such as accident insurance, critical illness insurance, group legal plan, identity theft protection, pet insurance, auto and home insurance, and employee discount programs.</li><li>
Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence.</li><li><ul><li>
New employees receive an initial PTO load with first paycheck.</li></ul></li><li>
Employer-provided basic life and accidental death and dismemberment coverage with buy-up coverage options.</li><li>
Employer-provided short-term disability and long-term disability with a buy-up coverage option.</li></ul> 
Retirement and savings 
<ul><li>
403(b) plan with employer matching contribution.</li><li>
Additional 457(b) plan may be available.</li><li>
Flexible spending accounts for health care and dependent day care; health savings account available when enrolled in high-deductible (HD) medical plan.</li></ul> 
Education and career growth 
<ul><li>
UCHealth provides access to academic degrees and certificate programs to promote professional and personal growth.</li><li><ul><li>
Up to 100% of tuition, books and fees paid for by UCHealth for specific educational degrees.
</li><li>Other programs may qualify for up to $10,000/year pre-paid by UCHealth or up to $5,250/year in the form of tuition reimbursement.
</li></ul></li><li>Access to LinkedIn Learning, which offers thousands of virtual courses and seminars, and internal professional development opportunities.
</li><li>Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness.</li></ul> 
<ul><li>Eligibility for some programs is based on an employee's scheduled work hours.
</li></ul> 
We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.
 
 
UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified. 
 
UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when the do not impose an undue hardship on the organization. 
 
Who We Are (uchealth.org)</div>

Coord Quality Coding Inpatient

Search 10000+ Coding compliance specialist jobs near you this March. New roles added regularly across leading industries. Apply today.