Certified Outpatient Coding Specialist

Job Summary

A company is looking for a Healthcare Services Concept Specialist (Certified Outpatient Coding SME).

Key Responsibilities:

• Review and update existing audit concepts based on periodic review cycles or client/regulatory changes
• Ensure training material updates and contribute to the development of new training materials
• Conduct research and document impacts on existing concepts while supporting Segment Specialists

Required Qualifications:

• 2-4 years of audit or Payment Integrity experience
• CPC, COC, RHIA, or RHIT certification and/or RN
• Relevant knowledge and experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding
• Knowledge of Medicare and commercial claims processing systems
• Ability to understand and apply complex policies and regulations