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)
JOB PURPOSE |
This position is responsible for assisting the Compliance Lead in making sure all serialized items are properly received and handled in inventory, building work orders, and acquisitions, transfers, and dispositions in both company and ATF logbooks, to and from proper locations. Responsible for building all serialized work orders. The Compliance Specialist may at times provide additional support to positions in need. The Compliance Specialist will report any issues or discrepancies to their lead or supervisor, to be handled immediately.
DUTIES AND RESPONSIBILITIES |
QUALIFICATIONS |
Required Education and Experience
Knowledge and Skills
Soft Skills
WORKING CONDITIONS |
Scheduled shifts are Monday through Friday. Occasional overtime may be optional or mandatory. All work is performed in an operational warehouse environment.
PHYSICAL REQUIREMENTS |
Team members are constantly standing, walking, carrying, twisting, bending, seeing, stooping, balancing, hearing, as well as handing paperwork and heavy PC computer usage. Team members will be lifting objects weighing from less than 20 pounds to 60 pounds.
DIRECT REPORTS |
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N/A
Must be at least 18 years old.
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