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20 jobs similar to Medical Coding Compliance Specialist

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US

  • Ensure the organization's medical coding and billing practices comply with regulations and guidelines.
  • Perform independent audits and provide training for medical staff.
  • Act as a subject matter expert on coding and documentation standards.

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care.

  • Perform coding audits and reviews on a variety of professional fee record types.
  • Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
  • Assist in the design and presentation of educational seminars to clients and staff.

UASI has over 40 years of experience and enduring partnerships with our valued clients, and is proud of the stability they’ve built and the long-term success of their dedicated team.

  • Perform inpatient coding audits and review services remotely.
  • Identify coding trends and recommend corrective actions.
  • Provide in-service education to clients on coding trends.

UASI helps healthcare organizations with coding and auditing services. They have been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023 and 2024 and pride themselves on stability and long-term success.

$69,885–$97,302/hr
US

  • Develops curriculum and materials for documentation training programs.
  • Assesses coder comprehension.
  • Conducts quality assurance reviews.

Northwestern Medicine is a leader in the healthcare industry, set apart by a patient-first approach. They offer competitive benefits, including tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits, aiming to take care of their employees.

US

  • Accurately abstracts information and assigns appropriate CPT, ICD-9/10, and HCPCS codes.
  • Communicates professionally with providers, practice management, and other stake holders.
  • Identifies trends and educational opportunities to ensure proper coding, documentation, and accuracy of billing.

UofL Health is a fully integrated regional academic health system. With more than 14,000 team members, they are focused on one mission: to transform the health of communities they serve through compassionate, innovative, patient-centered care.

US

  • Performs Current Procedural Terminology (CPT) and International Classification of Diseases coding.
  • Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.
  • Trains physicians and other staff regarding documentation, billing and coding.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace.

US

  • Conduct thorough reviews of medical records for accurate coding compliance.
  • Identify opportunities for documentation improvement to enhance code accuracy.
  • Educate healthcare providers on proper coding practices and HEDIS measures.

Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.

  • Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement.
  • Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
  • Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. The Coherenauts who succeed here are empathetic and believe diverse, inclusive teams make the most impactful work.

US 2000w PTO

  • Acts as the clinical coding subject matter expert and lead coding resource across the organization.
  • Acts as a resource and provides education to providers on clinical coding standards.
  • Coordinates and leads the Alliance Coding Workgroup.

Central California Alliance for Health is a regional non-profit health plan that provides accessible, quality health care. The company has over 500 employees and fosters a respectful, diverse, professional, and fun culture where employees are empowered to do their best work.

US

  • Accurately assigns and sequences ICD-10-CM and CPT-4 codes for various patient visits.
  • Interacts with physicians to clarify/verify questions and resolve coding/documentation issues.
  • Conducts internal coding studies and/or provides resource information to other departments.

Cooper University Health Care is an integrated healthcare delivery system serving residents and visitors throughout Cape May County. They are committed to providing competitive rates, compensation programs and comprehensive employee benefits.

US

Primarily responsible for the accurate assignment of CPT, HCPCS, modifiers, and diagnosis codes. Utilizes expert knowledge and application of CPT, HCPCs, and ICD-10 coding guidelines to ensure accuracy of coding and charge capture. Communicates effectively with providers or other teams to resolve CPT, ICD-10, HCPCs, or modifier discrepancies and resolve complex coding-related denials.

Cook Children's is a not-for-profit organization comprised of a flagship medical center, a physician network, and other health-related services throughout Texas.

$52,519–$70,915/hr
US

  • Abstracts and codes physician professional services and diagnosis codes.
  • Trains physicians and other staff regarding documentation, billing and coding.
  • Ensures charges are captured by performing various reconciliations.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace.

US

  • Ensure adherence to payer requirements and internal compliance standards.
  • Support audit readiness, reduce denials, and improve claim resolution.
  • Maintain payer setup and readiness including fee schedules.

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients.

In this role, you’ll ensure the accurate coding of medical procedures and diagnoses across our diverse range of services including inpatient, outpatient, ambulatory, and specialty care. You’ll play a key role in supporting compliance, optimizing reimbursements, and ensuring all documentation aligns with federal and state regulations.

Diana Health is a network of modern women’s health practices working in partnership with hospitals to reimagine the maternity and women’s healthcare experience.

$60,000–$80,000/yr
US Unlimited PTO 17w maternity 9w paternity

  • Review and abstract professional medical records, including provider notes, encounters, and supporting documentation.
  • Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers accurately, following national and payer-specific coding guidelines.
  • Maintain coding quality metrics (accuracy, productivity, and compliance) as defined by leadership.

Sprinter Health is reimagining how people access care by bringing it directly into their homes. They have supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS.

$60,243–$91,083/yr

As a Coder II, you will review and process complex specialty clinic professional charges for Dignity Health Medical Foundation. Codes complex office, surgical and hospital professional charges for assigned providers Provide education to physicians and providers on coding and documentation, as needed.

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California.

$54,579–$81,853/hr
US

  • Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types
  • Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures.
  • Collaborates with Orders Management Unit (OMU) and other coding divisions for NCD/LCD edit resolution.

Northwestern Medicine is committed to cultivating a patient-first approach within a positive workplace and is a leader in the healthcare industry. They offer competitive benefits and aim to care for their employees during their quest for better healthcare.

$67,558–$97,968/hr
US

  • Creates and delivers education to the Coding Team, Clinical Documentation Nurses, Physicians, and other licensed providers to improve the quality of documentation.
  • Collaborates with the CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.
  • Analyzes dashboard and audit data to derive conclusions and construct action plans.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace.

$71,100–$97,800/yr

  • Identify documentation and coding improvement opportunities.
  • Provide guidance around operational and clinical best practices in the risk adjustment methodology.
  • Perform analysis of performance indicators and put together a formal presentation for reporting out to providers.

Humana Inc. is committed to putting health first – for our teammates, our customers and our company by providing insurance and healthcare services.

US

  • Apply coding classification standards and guidelines to medical record documentation for accurate coding.
  • Submit necessary provider queries to resolve documentation discrepancies.
  • Abstract and assigns the appropriate ICD-10-CM and CPT codes for all diagnoses and procedures performed in the outpatient and surgical settings as applicable.

Ovation Healthcare partners with 375+ hospitals and health systems across 47 states. For 45+ years, Ovation Healthcare has supported hospitals and health systems through a portfolio of shared services designed to provide scale and efficiency to hospital business operations.