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Medical Coding Compliance Specialist
2 months ago
Employment Type:
Full time
Shift: Day Shift
Position Overview:
As a key member of the Medical Group Revenue Cycle team, this role is accountable for conducting thorough audits of medical records. Responsibilities include analyzing documentation, validating diagnoses and procedures, and ensuring accurate coding assignments in accordance with established guidelines.
Key Responsibilities:
1. Perform comprehensive audits of medical records to ensure compliance with coding standards.
2. Monitor the accuracy of coding and charge capture by centralized coders, adhering to the International Classification of Diseases 10th Revision (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) guidelines.
3. Collaborate with leadership to enhance Risk Adjustment capture through targeted education for providers and coders.
4. Conduct ongoing reviews of medical documentation and coding practices by healthcare practitioners.
5. Provide education to practitioners regarding coding, documentation, and compliance standards.
Qualifications:
1. High school diploma or equivalent is required.
2. A minimum of two (2) years of professional coding experience with a solid understanding of ICD-10, CPT, and HCPCS modifiers, along with knowledge of Medicare, Medicaid, and third-party billing regulations is essential.
3. Preferred candidates will have three (3) years of coding experience, including the ability to code from various medical reports and prior auditing experience.
4. Required certifications include Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Certified Risk Coder (CRC), or Certified Documentation Expert Outpatient (CDEO).
Skills and Competencies:
1. Strong verbal, written, and interpersonal communication skills, with the ability to engage effectively with diverse populations.
2. Proven ability to work collaboratively in a team-oriented environment, demonstrating a strong customer-service focus.
3. Capacity to manage sensitive patient and organizational information with confidentiality.
4. Dependability and consistent attendance are essential.
Technical Proficiency:
1. Familiarity with standard desktop and Windows-based computer systems, including basic email and navigation skills.
2. Ability to utilize software necessary for fulfilling job responsibilities, with experience in Athena and/or Epic preferred.
Work Environment:
1. Must thrive in a fast-paced billing environment, demonstrating flexibility to adapt to changing workloads and priorities.
Compensation:
Pay Range: $39.75
Diversity and Inclusion Commitment:
Trinity Health is dedicated to fostering a diverse and inclusive workforce, recognizing that varied experiences and perspectives enhance our ability to provide equitable care.
Trinity Health is an Equal Opportunity Employer, ensuring that all qualified applicants receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
