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)
Experienced Certified Medicare Part A & B Biller (MUST LIVE IN TREASURE VALLEY)
Align Business Solutions is seeking a highly motivated and detail-oriented Certified Biller to join our growing team. The ideal candidate will have extensive experience in medical billing and coding, with a strong focus on Medicare Part A and Part B regulations and procedures.
Responsibilities:
Accurately and efficiently prepare and submit claims for all Medicare Part A and Part B patients.
Analyze and resolve claim denials and rejections.
Maintain accurate and up-to-date patient billing records.
Perform Medicare Part A and Part B audits.
Stay current on all Medicare regulations and coding updates.
Communicate effectively and professionally with clients, patients, insurance companies, and other healthcare providers.
Contribute to the continuous improvement of our billing and coding processes.
Qualifications:
Certified Medical Biller (CMB) or Certified Professional Coder (CPC) certification.
3 years of experience in medical billing and coding, with a focus on Medicare Part A and Part B.
Trained and experienced in relevant clearinghouses.
Proficiency in ICD-10-CM and CPT, as well as HCPCS coding systems.
Excellent understanding of Medicare billing guidelines, compliance, regulations and reimbursement.
Proficient in electronic health records (EHR) systems.
Exceptional organizational and time management skills.
Ability to work independently and as part of a team.
Capable of being flexible and adaptable to changing environment and client dynamics.
Strong communication and interpersonal and problem solving skills.
Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of all responsibilities, skills, or qualifications required for the role.
Job Type: Full-time
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Work Location: In person
0 Coding Compliance Specialist jobs found in Boise, ID area