Coding Compliance Specialist: CPC Auditor & Educator

DaMar Staffing; Kankakee (IL); On-site; USD 63,835,000 - 106,392,000; Full time

Job summary

Riverside Medical Group is seeking a Professional Coding Compliance Specialist to audit provider documentation and coding for accuracy, completeness, and regulatory compliance. You will review ICD-10-CM and CPT/HCPCS, discuss findings with providers, and help develop provider education materials and monthly newsletters.

You will collaborate with the coding compliance team to maintain current guidelines, orient new staff, and support education programs to improve coding quality and compliance

Qualifications

• Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience.
• High school graduate or equivalent.
• AAPC/CPC required.
• AAPC/CPMA strongly recommended at hire; required within two years of hire.
• AAPC/CRC strongly recommended.
• Associate degree in health-related field preferred.

Responsibilities

• Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed.
• Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation to support findings and use as reference.
• Documents audit results in designated Excel log as soon as review is completed.
• Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management.
• Assists coding compliance lead in creating and publishing monthly provider newsletter.
• Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teams.
• Participates in developing and presenting provider and coder education programs as requested.
• Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
• Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
• Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
• Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies

Skills

ICD-10-CM

CPT/HCPCS

E/M assignment

Education

High school graduate

AAPC CPC

AAPC CPMA

AAPC CRC

Associate degree preferred

Job description

Riverside Medical Group is seeking a Professional Coding Compliance Specialist to audit provider documentation and coding for accuracy, completeness, and regulatory compliance. You will review ICD-10-CM and CPT/HCPCS, discuss findings with providers, and help develop provider education materials and monthly newsletters.

You will collaborate with the coding compliance team to maintain current guidelines, orient new staff, and support education programs to improve coding quality and compliance