Certified Coding Specialist

Job Summary

A company is looking for a Data Integrity Specialist who will ensure the accuracy and compliance of risk adjustment coding for claim submissions.

Key Responsibilities

• Ensure compliance with CMS Risk Adjustment Methodology rules and regulations
• Perform pre-claim audits and validate clinical documentation for accuracy and completeness
• Conduct retrospective audits to identify trends and areas for improvement in coding and documentation

Required Qualifications

• Minimum of 4 years experience in ICD-10 Auditing
• Current coding certification (CRC, CPC, or CPC-H required)
• High school diploma required; Bachelor's Degree in Healthcare, Finance, or Business preferred
• Advanced knowledge of ICD-10-CM, CPT, HCPCS coding, and medical terminology
• Proficient in Microsoft Office Suite and coding compliance standards