Certified Compliance Specialist
Job Summary
To ensure compliance with coding standards, the full-time remote Certified Compliance Specialist will conduct coding quality audits of inpatient records, monitor data quality, and provide feedback for education needs in alignment with CMS guidelines.
Key responsibilities
- Perform monthly quality audits of professional billing coders to ensure accurate coding and documentation
- Analyze coded records for compliance with federal, state, and third-party insurer regulations, identifying trends and risk areas
- Collaborate with various departments and serve as a subject matter expert for coding-related inquiries
Required qualifications
- High School Diploma required
- Four years of coding review experience in compliance, auditing, and coding principles
- Certification as a Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) required
- Knowledge of ICD-10-CM and CPT/HCPCS coding guidelines
- Experience with Epic and MS Office applications preferred
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