Coding Compliance Specialist

BASIC FUNCTION:
Under 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.

JOB REQUIREMENTS:
High School Diploma or GED.
CPC, CRC Coding Certification (AAPC) or CCS, CCSP (AHIMA)
2 years medical coding experience
Experience with process management
PC experience and skills to include Microsoft Office
Verbal and written communication skills
Analytical skills
Ability to travel 60% to 80% of the time to physicians office / clinics.

PREFERRED JOB REQUIREMENTS:
Associate or Bachelor's degree
Experience in health insurance or health care setting
Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business

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HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Other, Government Programs Job Type Full-Time Regular Location TX - El Paso, TX - Austin, TX - Richardson, TX - Houston


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