Coding Compliance Specialist jobs in Bartlesville, OK

Coding Compliance Specialist researches and develops the pre-certification insurance policy standards and criteria used by case management and utilization reviewers that will ensure that requested medical services are appropriate and medically necessary. Collaborates with medical professionals to resolve questions about policy development and standards. Being a Coding Compliance Specialist assigns correct ICD, CPT, or other coding assignments for medical procedures that support policy standards in claims systems. Provides expertise and solutions to users regarding the appropriate coding for claims. Additionally, Coding Compliance Specialist has broad knowledge of medical coding systems. May require an associate degree in healthcare administration, a related field, or equivalent. Requires AAPC Certified Professional Coder (CPC). May alternatively require Certified Coding Specialist (CCS) certification. Typically reports to a manager. The Coding Compliance Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Coding Compliance Specialist typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Coding specialist
  • Cigna
  • Bartlesville, OK FULL_TIME
  • Job Description : Coding Education Specialist (AHIMA or AAPC certified) Must live in Mobile, Alabama area. We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions.

    If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success.

    What you must have in order to do the job :

    • Remote, Work from Home - must be located in Mobile, Alabama - required to work in the field / visit multiple provider offices each week
    • Coding certification required (at least one of the below) : Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) Certified Coding Specialist for Hospitals (CCS-H) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA)
    • At least two years of hospital inpatient / outpatient or medical office coding experience, preferably two years risk adjustment coding experience.
    • Extensive knowledge and adherence to ICD-10-CM / outpatient and CPT coding principles and guidelines.
    • Excellent understanding of medical terminology, disease process and anatomy and physiology.
    • Working knowledge of CPT / Evaluation and Management guidelines
    • Working Knowledge of CMS Risk Adjustment and HCC Coding Process
    • Strong computer skills (i.e. MS Office)
    • Prior audit / quality experience.
    • Prior experiences teaching / training others on correct coding guidelines and / or have the ability to present to large groups of Physicians / Providers.
    • Minimal travel may be required for this position and person needs to be available for day, evening and weekend training sessions and meetings.
    • High school diploma Core Responsibilities :
    • Develop relationships with clinical providers and staff
    • Ability to communicate coding and documentation guidelines and education
    • Conduct provider training on health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation
    • Customize presentations to educate providers and staff.
    • Understands, develops, tracks, monitors and reports on key program performance metrics for coding initiative
    • Conduct chart reviews for providers and review provider performance.T his is accomplished by doing virtual training sessions or traveling to the individual practices and performing side-by-side education.
    • Work closely with internal representative for needs and support
    • Evaluate documentation to ensure that diagnosis coding is supported and meets specificity requirement to support clinical indicators, HEDIS and STARS quality measures
    • Query providers regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the heath record
    • Analyze data to prioritize provider educational reviews. Implement education, where necessary, and provide formal training to providers and staff regarding coding and documentation standards
    • Participate in monthly Quality reviews
    • Assist, as needed, to meet departmental goals / deadlines
    • Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training / education, both for historical and / or real time data
    • Assists with research, analysis and response to inquiries regarding compliance, coding, and inappropriate coding
    • Compile data and present solutions regarding trends or patterns noticed in provider coding
    • Perform the minimum number of coding quality reviews consistent with established departmental goals
    • Take direction and guidance from Coding Supervisor and Population Health leadership
    • Maintain a 95% quality audit accuracy rate
    • Maintain strictest confidentiality based on HIPAA privacy policy Maintain current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, HCPCS
    • Capacity to attend provider meetings day / evening / weekends as needed within assigned areas
    • Work closely with matrix partners including Provider Engagement, Stars, Clinical and Population Health teams as well as vendors to ensure provider office communications are effective and efficient
    • Analyze data regarding trends or patterns identified in provider office diagnosis coding.
    • Track work, action plans, and progress in CRM tool
    • Assists with research, analysis and response to inquiries from all internal and external audit departments regarding compliance, coding and inappropriate coding
    • Leverage provided tool sets and reporting in day to day job role and educations
    • Maintain current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, HCPCS
    • Assure compliance by delivering quality services and meeting all contractual, state, and federal legal and regulatory requirements
    • Maintain CEU credits to ensure credentials are kept up to date.
    • Conduct preliminary audit review of Annual Wellness Visit forms and attestations on defined percentages by IPA or POD
    • Provide timely and appropriate feedback on Annual Wellness Visit forms and attestations to provider; maintain assigned portion of queue and ensure all transitions and hand-offs between coding and providers is covered If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download / 5Mbps upload.

    About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.

    We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.

    Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

    If you require reasonable accommodation in completing the online application process, please email : SeeYourself@cigna.com for support.

    Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

    The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco / nicotine users in states where that is legally permissible.

    Candidates in such states who use tobacco / nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.

    Last updated : 2024-03-08

  • 18 Days Ago

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Medical Billing and Coding Specialist
  • Peak Physical Therapy
  • Bartlesville, OK FULL_TIME
  • Job Summary: We are seeking a detail-oriented and experienced Medical Biller to join our team. As a Medical Biller, you will be responsible for accurately coding and billing medical claims, ensuring t...
  • 3 Days Ago

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Medical Billing and Coding Specialist
  • Prophylaxis HealthCare
  • Bixby, OK FULL_TIME
  • We are looking for a certified coder to join our team! We currently have 4 people in the billing department and need to add one more person to help with the overflow. Check out our website for more in...
  • 1 Month Ago

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Compliance Specialist
  • SeneGence
  • Tulsa, OK FULL_TIME
  • As a Compliance Specialist at SeneGence, you'll play a critical role in ensuring that our distributors adhere to the company's Policies and Procedures. You'll serve as a trusted point of contact for o...
  • 3 Days Ago

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Regulatory Compliance Specialist
  • HF Sinclair Corporation
  • Tulsa, OK FULL_TIME
  • Basic FunctionHF Sinclair Midstream is seeking a Regulatory Compliance Specialist. This position is open to location. The Regulatory Compliance Specialist conducts and supports compliance of DOT/PHMSA...
  • 15 Days Ago

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Compliance & Reporting Specialist
  • Oklahoma Complete Health
  • TULSA, OK FULL_TIME
  • You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll hav...
  • 1 Month Ago

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0 Coding Compliance Specialist jobs found in Bartlesville, OK area

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IT Program Manager - Workday Security Compliance - REMOTE
  • Sentara Healthcare
  • Independence, KS
  • City/State Virginia Beach, VA Overview Work Shift First (Days) (United States of America) Be a part of an excellent heal...
  • 3/29/2024 12:00:00 AM

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Senior Meat Cutter
  • Sam's Club
  • Owasso, OK
  • What you'll do at Position Summary... As a Senior Meat Cutter you will drive sales in your area to deliver to our member...
  • 3/27/2024 12:00:00 AM

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General Dentist - Bartlesville, OK
  • My Dentist
  • Bartlesville, OK
  • General Dentist - Bartlesville, OK My Dentist in Bartlesville, Oklahoma is looking for a General Dentist to join this es...
  • 3/26/2024 12:00:00 AM

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Quality Assurance - Special Process Subject Matter Expert - Material Testing
  • Precision Castparts Corp
  • Coffeyville, KS
  • 1 The Subject Matter expert is responsible for leading and developing policies, best practices, and training/competency ...
  • 3/26/2024 12:00:00 AM

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Quality Assurance - Special Process Subject Matter Expert - Non-Destructive Testing
  • Precision Castparts Corp
  • Coffeyville, KS
  • 1 The Subject Matter expert is responsible for leading and developing policies, best practices, and training/competency ...
  • 3/26/2024 12:00:00 AM

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Quality Assurance - Special Process Subject Matter Expert - Heat Treat and Pyrometry
  • Precision Castparts Corp
  • Coffeyville, KS
  • 1 The Subject Matter expert is responsible for leading and developing policies, best practices, and training/competency ...
  • 3/26/2024 12:00:00 AM

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Quality Assurance - Special Process Subject Matter Expert - Chemical Processing
  • Precision Castparts Corp
  • Coffeyville, KS
  • 1 The Subject Matter expert is responsible for leading and developing policies, best practices, and training/competency ...
  • 3/26/2024 12:00:00 AM

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Residential Program Coordinator II (PC II)
  • A New Leaf, Inc.
  • Owasso, OK
  • Job Description Job Description Description: Job Summary: The Residential Program Coordinator II (PCII) coordinates resi...
  • 3/25/2024 12:00:00 AM

Bartlesville is a city mostly in Washington County in the U.S. state of Oklahoma. The population was 35,750 at the 2010 census, with a 2015 estimate of 36,595 according to the U.S. Census Bureau. Bartlesville is 47 miles (76 km) north of Tulsa and 18 miles (29 km) south of the Kansas border. It is the county seat of Washington County. The Caney River runs through Bartlesville. Bartlesville is the primary city of the Bartlesville Micropolitan area, which consists of Washington County and had a population of 52,021 in 2015. A small portion of the city is in Osage County. The city is also part o...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$60,443 to $80,295
Bartlesville, Oklahoma area prices
were up 1.2% from a year ago

Coding Compliance Specialist in Somerset, NJ
Make compliance and process related recommendations on medical coding issues.
February 19, 2020
Coding Compliance Specialist in Jacksonville, FL
·        Perform specialized audits of patient medical records to ensure compliance with organization’s coding procedures and standards and provide feedback to analyst/educator and management.
February 04, 2020
Coding Compliance Specialist in Lebanon, PA
Provide monitoring and auditing functions as determined by the Regional Director of HIM Services, the HIM Coding Compliance Committee, TH Of NE Compliance Audit Plan, and as otherwise directed.
January 19, 2020