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)
Recently Added Coding Compliance Specialist jobs
Quality Improvement - Clinical Coding & Compliance Analyst 195-2013
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: Responsible for the review, analysis, reporting and follow-up of risk adjustment and clinical coding functions to support the accurate representation of the member’s clinical health status as well as the accuracy of internal systems to support clinical decisions. This role works collaboratively with multiple internal departments as well as with external providers. KEY RESPONSIBILITIES: Serve as clinical coding resource across the CommunityCare Health Network Division in support of both ongoing and future coding related initiatives. Adhere to all official coding rules and CMS guidelines for risk adjustment programs. Ensure accuracy, completeness, specificity, and appropriateness of diagnosis information. Surveillance of CPT, CMS, and other regulations and their impact related to coding and other business functions. For Risk Adjustment Validation Audits (RADV), conduct chart review of inpatient and outpatient medical records for Hierarchal Condition Category (HCC) coding. Summarizes audit findings and recommendations for coding and/or documentation improvement. Evaluate Medicare Wellness Visit documentation for accuracy and completeness in addressing gaps in care and expiring HCC’s. Present findings to providers on a regularly scheduled basis. Evaluate/prioritize results of new Medicare Advantage and Marketplace member self-reported health risk assessments for risk adjustment conditions that should be addressed. Create analyses, summary reporting, and coordinate with providers. Engage with other Health Network Division Department leaders for opportunities to optimize clinical documentation at the point of care delivery. Provide measurable, actionable solutions for best practices to improve documentation and coding accuracy. Develop a feedback loop for provider query and education. This will involve collaborative work with owner and non-owner providers. Analyze the in-home assessment program for opportunities to follow-up on members who decline the assessment or do not schedule care. Support work/data from the Benefits Interpretation Committee (BIC) and the quarterly coding review workgroup. Support clinical coding needs of ASO (self-insured employers) marketing, claims and configuration departments, and preventative services list maintenance. Work in collaboration with company fraud, waste, and abuse program on issues with specific providers or services as may arise. QUALIFICATIONS: Knowledge of risk adjustment payment models and risk adjustment coding preferred Familiarity with State and federal regulations governing healthcare Medicare Advantage and /or medical practice experience preferred Proficient in Microsoft Excel Successful completion of Health Care Sanctions background check Excellent verbal and written communication skills Ability to work independently under stringent deadlines EDUCATION/EXPERIENCE: Coding certification nationally recognized by AAPC or AHIMA required Bachelor’s degree preferred or equivalent experience Three (3) years relevant professional experience with medical coding (ICD 10-CM, CPT, HCPCS)
- 13 Days Ago
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...
- 2 Days Ago
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...
- 30 Days Ago
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...
- 30 Days Ago
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...
- 24 Days Ago
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...
- 1 Month Ago
Filters
- Current Active Filter
- Bartlesville, OK
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Coding Compliance Specialist jobs found in Bartlesville, OK area
Senior Procurement Specialist Procurement Dubai
- Gulf Marketing Group (gmg Group)
-
Independence, KS
- ABOUT US:With a diversified portfolio of leading sports and over 500 stores globally, inspiring, and empowering active l...
- 4/24/2024 12:00:00 AM
Environmental Services Specialist
- William Newton Hospital
-
Cedar Vale, KS
- Job Type Part-time Description Job Summary: Cleans all areas of the hospital according to policies and procedures. Parti...
- 4/24/2024 12:00:00 AM
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...
- 4/23/2024 12:00:00 AM
NA Engineering Team Manager- Trade & Installers
- US0767 Prysmian Cables and Systems Usa LLC
-
Independence, KS
- Prysmian is the world leader in the energy and telecom cable systems industry. Each year, the company manufactures thous...
- 4/22/2024 12:00:00 AM
FT Data Entry Specialist - Work From Home>
- Sharecare
-
Owasso, OK
- [Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay - As a Data Entry Specialist you'll: Access var...
- 4/20/2024 12:00:00 AM
Instrumentation and Controls Engineer
- CF Industries Employee Services LLC
-
Claremore, OK
- At CF Industries, our mission is to provide clean energy to feed and fuel the world sustainably. Our employees are focus...
- 4/8/2024 12:00:00 AM
Regional Medical Affairs Lead, North Central
- CSL Vifor
-
Coffeyville, KS
- At CSL Vifor, we use our skills to offer solutions in iron deficiency, nephrology, and cardio-renal therapies, so we can...
- 3/25/2024 12:00:00 AM
Site Procurement and Material Control Manager
- CF Industries Employee Services LLC
-
Claremore, OK
- At CF Industries, our mission is to provide clean energy to feed and fuel the world sustainably. Our employees are focus...
- 3/25/2024 12:00:00 AM
About Bartlesville, Oklahoma
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
$60,078 to $79,808
Bartlesville, Oklahoma area prices
were up 1.2% from a year ago
were up 1.2% from a year ago
What does a Coding Compliance Specialist do?
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