How to Become a Coding Compliance Specialist
Step 1: Understand the job description and responsibilities of a Coding Compliance Specialist
What does a Coding Compliance Specialist do?
A Coding Compliance Specialist audits medical records to ensure compliance with the organization's coding procedures and standards. Reviews insurance payments and denials and recommends billing corrections. Being a Coding Compliance Specialist trains staff members on the coding process. May require an associate degree. Additionally, Coding Compliance Specialist requires CPC (Certified Professional Coder). Typically reports to a supervisor or manager. Coding Compliance Specialist's years of experience requirement may be unspecified. Certification and/or licensing in the position's specialty is the main requirement.
The Coding Compliance Specialist performs chart audits to provide documentation and analysis of the records reviewed to the rendering provider, Audit Manager, and Director Coding & Audit.
Make compliance and process related recommendations on medical coding issues.
Provide research, and other support services to ensure observance with official coding policies, regulations, requirements, and standards.
Participate in process improvement efforts by maintaining a weekly issues log in accordance with the AFMS Coding Manual, to be received by the AFMS MCPO.
The Coding Compliance Specialist will be involved with activities of auditing and code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation).
Step 2: Learn best tips to become a Coding Compliance Specialist
Best tips for those who want to become a Coding Compliance Specialist
Here are some tips to become a Coding Compliance Specialist.
Step 3: View best colleges and universities for Coding Compliance Specialist
Best colleges and universities for Coding Compliance Specialist
- Butler University
- Carroll College
- Cooper Union
- High Point University
- Princeton University
- Providence College
Step 4: Think about whether is it worth to be a Coding Compliance Specialist
Is being a Coding Compliance Specialist Worth it?
Must have two years of medical CPT/ICD coding experience and strong computer skills.
A minimum of 50% of the Coders time is devoted to coding Medical Services Supervisory/Management Responsibilities This is a non-management job that.
Provides support for coding denials… Hospital has an Education & ComplianceSpecialist (ECS) position available! The Education & ComplianceSpecialist will be responsible….
Maintaining compliance in turnaround time requirements as mandated by the TAT Standards of the facility and/or CIOX Health….
Three years of recent experience with health care compliance, auditing, billing, coding, reimbursement and/or information management required.
Step 5: Prepare relevant skills for being a Coding Compliance Specialist
What skills do you need to be a Coding Compliance Specialist?
Supporting level roles often require a broad range of skills to ensure jobs can be executed accurately and efficiently. Some of the more relevant day-to-day skills for this role include: Abstract Treatment Information, CPT Coding (Current Procedural Terminology), ICD, ICD-10 Coding, Medical Classification, Medical Coding, Medical Record Keeping, Staff Training, Compliance Monitoring. In this role, you should command of the following: Electronic health records (EHR) Software. Success in this function is highly dependant upon these skills, as well as others specific to each individual company.
Eight plus years of experience with coding and/or billing in health care revenue cycle. This should include hospital and physician practice.
Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).
Maintains high level of knowledge of current coding guidelines.
Knowledgeable on regulations around documentation and coding.
5 years’ experience as an outpatient coder or related coding experience.
Step 6: View average salary for Coding Compliance Specialist
How much does a Coding Compliance Specialist make?
The average salary range for a Coding Compliance Specialist is from $55,413 to $72,055. The salary will change depending on your location, job level, experience, education, and skills.
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Average salary for Coding Compliance Specialist jobs
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