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)
Lives Change Here! We are GROWING…Columbia River Mental Health Services provides comprehensive behavioral health and recovery services that transform the lives of children, adults and families in the communities of SW Washington. We are the largest and oldest not-for-profit provider of mental/chemical dependency treatment in southwest Washington with 200 employees and a history dating back to 1942.
Our Mission: Providing behavioral health and recovery services that transform the lives of children, adults, and families in the communities of SW Washington.
Starting Pay Range - $22.18 to $24.42/hour
Summary:
The Medical coding & compliance specialist is responsible in making certain that the documentation within the chart meets compliance with WAC, RCW, and other state and federal guidelines and that the codes assigned within the electronic health record (EHR) meet legal, federal and insurance regulations so that payments to services are easily obtained in a timely manner. The Medical Coding & Compliance Specialist will conduct routine audits of charts, which may include reviewing codes, documentation, and ensuring the evidence-based practices identified are showing properly within the note. The specialist will attend department and leadership team meetings and offer trainings to staff about how to properly document interactions and assist CPCO and billing staff in review of charts and codes for services offered.
Essential Job Responsibilities:
Non-essential Job Functions:
Education, Licensing and Experience:
Competencies, Knowledge, Skills and Abilities:
Why Work Here?
CRMHS offers AMAZING benefits aside from health and wellness (medical/dental/vision etc.) Work life balance benefits: 12 paid holidays per year, including 3 paid floating holidays, and 24 days of PTO days accrued in the first year, and continues to grow from there! Career development: $325 annual allowance for career development and education with an additional 40 hours of paid time off for career development/education! And so much more!
PER COMPANY POLICY - ALL HEALTHCARE EMPLOYEES MUST BE EITHER COVID-19 VACCINATED / HAVE A MEDICAL/RELIGIOUS EXEMPTION.
IF EXTENDED AN OFFER OF EMPLOYMENT WITHIN OUR COMPANY, CANDIDATE MUST PROVIDE PROOF TO BE COMPLIANT (COVID VACCINE CARD/MEDICAL OR RELIGIOUS EXEMPTION) IN ORDER TO COMPLETE THE HIRING PROCESS.
EQUAL EMPLOYMENT OPPORTUNITY
Columbia River Mental Health Services is proud to be an equal opportunity workplace. We are committed to diversity and inclusion, and we seek applicants from all backgrounds to join our teams. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status, gender identity, or any other factor protected by law. We encourage our employees to bring their authentic selves to work and do not tolerate discrimination at the workplace.