Coding Compliance Specialist
Albuquerque New Mexico HQ (5701 Balloon Fiesta Parkway)
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Job SummaryUnder supervision, this position is responsible for researching and analyzing the medical records when there is a discrepancy in coding. Validating the coding and supporting the department in the reporting of findings. This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS coding guidelines and official ICD9 / ICD10 coding guidelines. Reviews insurance payments and denials and recommends coding corrections.Ability to travel 20 – 30% of the time in and out of state.
Job Requirements:
- High School Diploma or GED.
- CPC Coding Certification/CPC, CCS, CCSP.
- 2 years medical coding experience.
- Experience with process management.
- PC experience and skills to include Microsoft Offic.
- Verbal and written communication skills.
- Analytical skills.
- Ability to travel 20% - 30% of the time in and out of state.
Preferred Job Requirements:
- Associate or Bachelor’s degree.
- CRC.
- Experience in health insurance or health care setting.
- Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business.
*CA
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HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$39,900.00 - $88,800.00 ApplyJob Profile
Ability to travel Ability to travel 20-30% of the time
Benefits/PerksCareer growth Curated development plans Employee Referral Process Inclusive workplace Professional development Purpose-driven company
Tasks- Audit for compliance
- Recommend coding corrections
- Research medical records
- Review insurance payments
- Validate coding
Analytical Business Coding Coding compliance Communication Compliance Health care Health Insurance Insurance Management Medical Coding Microsoft Office PC Process Management Reporting Risk Adjustment Supervision Verbal communication Written communication
Experience2 years
EducationAssociate degree Bachelor Bachelor's degree Business GED High school diploma
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9