coding compliance specialist

Signature Healthcare

<div><div><div><div><div><p><b>POSITION SUMMARY:</b></p>
<p>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.</p></div><br>
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</div></div><br>
Location: Signature Healthcare &middot; Health Information Management<br>
Schedule: Full Time 40 Hours only, Days 1st Shift, flexible</div>

Outpatient Coding Specialist

Parkland Health

<div>Location: Virtual Employee<br>
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<b>ProFee Experience Needed</b><br>
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<b>Primary Purpose
</b><br>
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<b>The Primary Purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC),observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.</b><br>
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<b>MINIMUM SPECIFICATIONS
</b><br>
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<b>Education</b><br>
<ul><li><b>
High school diploma required.</b></li><li><b>
Must have successfully completed an approved coding program.</b></li><li><b>
OR Must be a graduate of a health Information Management program.</b></li><li><b>
Must have strong knowledge of Anatomy and Physiology and possess strong application skills.</b></li></ul><br>
<b>
Experience</b><br>
<ul><li><b>
Must have two (2) years of coding experience in a acute care setting or diverse clinical specialties.</b></li><li><b>
Physician office coding, charging and billing experience preferred</b></li></ul><br>
<b>
Equivalent Education and/or Experience</b><br>
<ul><li><b>
May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.</b></li></ul><br>
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Certification/Registration/Licensure</b><br>
<ul><li><b>
Because of the lag in SCCE, HCCA, NCRA, and AHIMA updating the status of certifications, current employees whose certification is granted through one of these associations are allowed up to seven (7) calendar days, after expiration, to provide proof of renewal. Although an additional seven (7) calendar days is allowed to provide proof of renewal, there cannot be a lapse in the certification's 'active' status.</b></li><li><b>
Must be certified through the American Health Information Management Association (AHIMA) as one of the following:</b></li><li><b>
Registered Health Information Management Technician (RHIT)</b></li><li><b>
Registered Health Information Management Administrator (RHIA)</b></li><li><b>
Certified Coding Specialist (CCS)</b></li><li><b>
Certified Coding Specialist ' Physician Based (CCS-P)</b></li><li><b>
Certified Coding Associate (CCA) certification</b></li><li><b>
OR Must be certified through the American Association of Procedural Coders (AAPC) as one of the following:</b></li><li><b>
Certified Professional Coder (CPC)</b></li><li><b>
Certified Professional Coder-Hospital (CPC-H)</b></li><li><b>
Certified Outpatient Coder (COC)</b></li></ul><br>
<b>
Required Tests for Placement</b><br>
<ul><li><b>
Score a minimum of 80% on a pre-employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.</b></li></ul><br>
<b>
Skills or Special Abilities</b><br>
<ul><li><b>
Advance coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations.</b></li><li><b>
Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing.</b></li><li><b>
Score a minimum of 80% on a pre-employment coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement.</b></li><li><b>
Must have knowledge of medical terminology, the human disease process, anatomy and physiology.</b></li><li><b>
Demonstrate proficiency in coding and encoder skills.</b></li><li><b>
Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC).</b></li><li><b>
Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred.</b></li></ul><br>
<b>
Responsibilities</b><br>
<ul><li><b>
Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy, analyzing questionable documentation to ensure to the accuracy of information and resolves identified issues.</b></li><li><b>
Assigns appropriate diagnosis and procedures codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to the Centers for Medicare &amp; Medicaid Services (CMS) requirements for both professional and hospital billing. May assist in training and reviewing the work of other coders for accuracy and efficiency.</b></li><li><b>
Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards.</b></li><li><b>
May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner.</b></li><li><b>
Updates, as appropriate, patient database with classification codes and resolves conflicts or inconsistencies to provide sufficient patient health information according to Parkland's standards.</b></li><li><b>
Stays abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrates knowledge gained into current work practices.</b></li><li><b>
Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.</b></li><li><b>
Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work-related encounters are productive.</b></li><li><b>
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.</b></li><li><b>
Maintains CE hours and renew annual coding credentials.</b></li><li><b>
Routine Screenings/Proof of Immunizations Exclusions: Virtual workforce employees as defined by Parkland's Virtual Work procedure, and as specified in their job descriptions, are not required to undergo routine screening for communicable diseases including TB, the flu vaccination, or the COVID-19 vaccination.</b></li></ul><br>
<b>
Job Accountabilities</b><br>
<ul><li><b>
Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.</b></li><li><b>
Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.</b></li><li><b>
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.</b></li></ul><br>
<b>
Requisition ID:</b> 986043</div>

Coding Specialist II

Henry Ford Health

<div><div><p>GENERAL SUMMARY:</p><p>
Under established coding principles and procedures reviews, analyzes, and validates the diagnostic and/or procedural codes applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Complex Specialist accurately abstracts information from the electronic health record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, and regulation and accreditation guidelines.</p>
<div><p>EDUCATION/EXPERIENCE REQUIRED:</p><ul><li>High school diploma or G.E.D. equivalent required.</li><li>Minimum of two (2) years coding experience required.</li><li>Additional specialty coding certification or five (5) years coding experience required.</li><li>Prior experience in a healthcare revenue cycle position required.</li><li>Specialty coding experience preferred.</li><li>One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred</li></ul><p></p><p><br>
CERTIFICATIONS/LICENSURES REQUIRED:</p><ul><li>
Certification as a Registered Health Information Technician (RHIT), CPC, or CCS certification required.</li></ul>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Coding Complex Specialist/Full Time/Remote

<div><div><p>GENERAL SUMMARY:</p><p>
Under established coding principles and procedures reviews, analyzes, and validates the diagnostic and/or procedural codes applied from front-end coding and clinical teams for reimbursement and billing purposes. The CBO Coding Complex Specialist accurately abstracts information from the electronic health record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, and regulation and accreditation guidelines.</p><br>
<p></p>
<div><p>EDUCATION/EXPERIENCE REQUIRED:</p><ul><li>
High school diploma or G.E.D. equivalent required.</li><li>
Minimum of two (2) years coding experience required.</li><li>
Additional specialty coding certification or five (5) years coding experience required.</li><li>
Prior experience in a healthcare revenue cycle position required.</li><li>
Specialty coding experience preferred.</li><li>
One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.</li><li>
Must have through knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.</li><li>
Strong organizational and time management skills required to effectively prioritize work.</li><li>
Ability to communicate effectively with colleagues, supervisor, and manager.</li><li>
Ability to work independently.</li><li><p>
Ability to work remotely.</p></li><br>
<p></p><li>
Proficient in medical terminology.</li><li>
Proficient in ICD-10 CM, CPT and HCPCS coding.</li><li>
Able to recognize patterns and trends and escalate to supervisors to support root- cause analysis.</li><li>
Able to assist other team members.</li><li>
Supports the standards set forth in the HFHS Code of Conduct by adhering to legal and ethical guidelines.</li></ul><p></p><p><br>
CERTIFICATIONS/LICENSURES REQUIRED:</p><ul><li>
Certification as a Registered Health Information Technician (RHIT), CPC, or CCS certification required.</li></ul>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Zeal Integrated Health

<p><b>Overview</b><br/>We are seeking a detail-oriented and experienced Billing Specialist to join our team. The ideal candidate will have a strong background in medical billing and coding, with proficiency in various coding systems. This role is essential in ensuring accurate billing processes and maintaining compliance with medical regulations. The Billing Specialist will work closely with healthcare providers and insurance companies to facilitate smooth billing operations.</p><p><b>Duties</b></p><ul><li>Process and manage medical billing for various services rendered by healthcare providers.</li><li>Utilize coding to ensure accurate claim submissions.</li><li>Review patient records for completeness and accuracy before billing.</li><li>Handle medical collections and follow up on outstanding claims or payments.</li><li>Maintain organized medical records and ensure compliance with relevant regulations.</li><li>Collaborate with healthcare staff to resolve billing discrepancies or issues.</li><li>Utilize EMR and EHR systems effectively for documentation and billing purposes.</li><li>Stay updated on changes in medical terminology, coding practices, and insurance policies.</li></ul><p><b>Requirements</b></p><ul><li>Proven experience in medical billing, coding, or a related field is essential.</li><li>Familiarity with general medical terminology is required.</li><li>Experience with EMR and EHR systems is highly desirable.</li><li>Strong attention to detail and organizational skills are a must.</li><li>Excellent communication skills for interacting with healthcare providers and patients.</li><li>Previous experience in a medical office setting is preferred.</li><li>Ability to work independently as well as part of a team in a fast-paced environment. If you are passionate about ensuring accurate medical billing processes and possess the necessary skills, we encourage you to apply for this rewarding opportunity as a Billing Specialist.</li></ul><p>Job Type: Full-time</p><p>Pay: $18.00 - $21.00 per hour</p><p>Benefits:</p><ul><li>Health insurance</li><li>Paid sick time</li><li>Paid time off</li></ul><p>Work Location: In person</p>

Billing Specialist

Keystone Health

<div><p>At Keystone Health, we aspire for you to feel empowered and fulfilled as you work towards our shared mission of delivering heartfelt care. Earn a living where your heart truly belongs.</p><p></p><p>
The Patient Financial Services Department is seeking a full time Billing and Coding Integrity Specialist to join the team.</p><p></p><p><b>
This role is fully on‑site and is not eligible for remote work.
</b></p><p></p><p>Under the direction of the Director of Patient Financial Services the specialist is responsible for implementing and promoting consistent revenue integrity practices that will improve compliance, accurate billing, and charge capture at the point of service to ensure optimal reimbursement for Keystone Health. The specialist is responsible for auditing and monitoring appropriate coding guidelines and regulations. Recommending any corrective action and assists with implementing the corrective action. This position is also responsible for providing billing/coding training and education to providers and staff and maintaining a current knowledge of coding/billing regulations and guidelines.</p><p></p><p><b>
EDUCATION and/or EXPERIENCE:</b><b> </b>High School graduate or GED equivalency required. Minimum of two years&rsquo; experience in a similar position in a health care setting is preferred.
</p><p></p><p><b>LICENSES and CERTIFICATION:</b> AAPC Billing and Coding Certification required.</p><p></p><p>
Keystone Health is an Equal Opportunity Employer</p></div>

Billing & Coding Integrity Specialist

Addison Group

<p><b>Job Overview</b><br/>We are seeking a dynamic and detail-oriented Medical Billing Specialist to join our healthcare team. In this vital role, you will be responsible for managing the entire billing process, ensuring accurate coding, timely submission of claims, and effective follow-up on outstanding accounts. Your expertise will help optimize revenue cycle management while maintaining compliance with industry standards. This position offers an exciting opportunity to contribute to efficient healthcare delivery through precise medical billing practices.</p><p><b>Responsibilities</b></p><ul><li>Prepare and submit insurance claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, and ICD-10 codes.</li><li>Review medical records and documentation to ensure accuracy and completeness for billing purposes.</li><li>Verify patient insurance coverage and eligibility before submitting claims.</li><li>Follow up on unpaid or rejected claims through effective medical collection strategies.</li><li>Maintain detailed records of billing activities within Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems.</li><li>Collaborate with healthcare providers to clarify diagnoses or procedures requiring accurate DRG (Diagnosis-Related Group) coding.</li><li>Ensure compliance with healthcare regulations and industry standards related to medical coding and billing.</li></ul><p><b>Requirements</b></p><ul><li>Proven experience in medical office settings or healthcare billing environments.</li><li>Strong knowledge of medical terminology, medical records management, and billing procedures.</li><li>Familiarity with DRG, CPT coding, ICD-9, ICD-10, and ICD coding systems.</li><li>Experience working with EMR/EHR systems for documentation and billing purposes.</li><li>Excellent attention to detail and organizational skills to manage multiple claims efficiently.</li><li>Ability to interpret complex medical documentation and translate it into accurate billing codes.</li><li>Effective communication skills to coordinate with providers, insurance companies, and patients. Join our team as a Medical Billing Specialist and play a crucial role in ensuring smooth financial operations while supporting quality patient care!</li></ul><p>Pay: $34.39 - $59.37 per hour</p><p>Benefits:</p><ul><li>Dental insurance</li><li>Health insurance</li><li>Retirement plan</li></ul><p>Work Location: In person</p>

Medical Billing Specialist

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10000 coding compliance specialist jobs Near Me

Outpatient Coding Specialist

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Coding Complex Specialist/Full Time/Remote

Billing Specialist

Billing & Coding Integrity Specialist

Medical Billing Specialist