Coding Compliance Specialist & Medical Auditor

DaMar Staffing; Westwego (LA); Remote; USD 65,000 - 85,000; Full time

Job summary

DaMar Staffing seeks a Coding Compliance Specialist to support coding, audit, and compliance across clinical services. You will ensure accurate code assignment, adhere to FQHC billing and reimbursement regulations, and contribute to risk mitigation through provider education and ongoing audits.

The role involves travel to InclusivCare locations for onsite audits, education, and operational support, with focus on HIPAA and payer policy compliance.

Qualifications

• AAPC Coding Certification required.
• 3+ years of professional medical coding experience required.
• FQHC or community health center experience recommended.
• Knowledge of ICD-10-CM, CPT, HCPCS, and FQHC billing guidelines.
• Proficiency with EHR and practice management systems including Athena.

Responsibilities

• Conduct routine and targeted provider coding audits to ensure compliance with FQHC billing requirements, Medicare, Medicaid, and commercial payer policies.
• Analyze audit findings and communicate results to Providers, including corrective action recommendations and education as needed.
• Serve as a liaison to Providers regarding coding updates, documentation standards, and regulatory changes; present to physician groups.
• Review all coding-related denials to identify trends, root causes, and systemic risks; recommend preventive strategies.
• Review Athena coding rejections and validate relevance to FQHC encounters; eliminate non-applicable edits.
• Collaborate with Billing Specialists to identify coding risks, compliance concerns, and documentation gaps.
• Ensure appropriate use of CPT, HCPCS, ICD-10-CM, and FQHC-specific codes; prepare compliance and denial trend reports.
• Travel to InclusivCare locations to support onsite audits, provider education, or operational needs.
• Ensure HIPAA compliance and compliance with federal and state regulations.

Skills

Medical coding knowledge

Regulatory compliance

Data analysis

Communication skills

Problem solving

Education

AAPC Coding Certification

Tools

Athena

Microsoft Excel

Microsoft Word

Job description

DaMar Staffing seeks a Coding Compliance Specialist to support coding, audit, and compliance across clinical services. You will ensure accurate code assignment, adhere to FQHC billing and reimbursement regulations, and contribute to risk mitigation through provider education and ongoing audits.

The role involves travel to InclusivCare locations for onsite audits, education, and operational support, with focus on HIPAA and payer policy compliance.