Coding & Compliance Specialist

UR Medicine Thompson Health; Town of Canandaigua (NY); On-site; USD 28,000 - 34,000; Full time

Job summary

Thompson Health is seeking a qualified professional to support hospital third party insurance billing, coding accuracy, and payer compliance. The role emphasizes auditing, reporting, and collaboration with providers and billing staff within the health system.

The candidate should have CPC-A with CPC/CPC-H preferred, 3-5 years’ healthcare billing experience, and strong EMR proficiency to generate actionable reports for management.

Qualifications

• CPC-A required
• CPC or CPC-H preferred
• 3-5 years healthcare experience, billing experience preferred
• Excellent communication and collaborative skills
• Proficient in EMR use and reporting

Responsibilities

• Coordinate medical record audits for coding, billing and payer compliance
• Develop reports and present findings to management/providers
• Communicate with patients, payer representatives and hospital staff
• Analyze coding trends and guide providers/billing staff accordingly
• Maintain strong organizational and detail-oriented workflow
• Interface with EMR vendors to create reports where needed

Skills

Customer service

Communication

Team building

Problem solving

Process improvement

Auditing

EMR experience

Reporting

Microsoft Office

Education

CPC-A

CPC or CPC-H

Tools

EMR systems

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

• Demonstrates skills in customer service, communication, team building and problem solving.
• Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations.
• Demonstrates skill in proactively resolving problems, recommending, and implementing process changes.
• Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System.
• Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations. Develops reports as directed. Reports findings to management and providers.
• Electronic Medical Record experience preferred
• Highly organized and detail oriented

Qualifications:

• CPC-A required, CPC or CPC-H preferred
• Excellent communication skills and ability to form collaborative partnerships across all service settings.
• Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist
• Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.
• Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate
• Strong medical terminology background
• Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint). Self-directed, self-starter and able to implement new program
• Accepts responsibility and follows through on projects and activities
• Ability to assimilate new information and technologies into daily work

Education:

• CPC-A required
• CPC or CPC-H preferred

Experience:

• 3-5 years of healthcare experience, preferred
• Billing Experience preferred
• Excellent public/patient relations and communication skills
• Skills in using computers including Excel and Word required

Pay Range: $20.00 - $25.00/hour

Starting Pay:Based on Experience

Thompson Health is an EOE encouraging individuals with disabilities, and veterans to apply.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.