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)
Req#: R29356
Category(s): Information Technology/Health Information Management, Medical Coding
Full Time / Part Time: Per Diem
Shift: First
Summary:
This position is responsible for the accurate coding of either inpatient coding or outpatient coding. All tasks need to be performed following the Operating Principles of Baystate Health.
Schedule: 40hrs a week Monday thru Friday
Location: Training Onsite (remote after training)
Qualifications: 1 years of coding (minimum)
1) Assign ICD-10-CM and/or CPT codes to medical records
2) Adheres to all appropriate coding rules
3) Participates in educational coding meetings either onsite or offsite
4) Meets the minimum productivity and quality coding standards
5) Participates as team member of quality team
1) Minimum of 1-3 years as a coder or equivalent experience
1) Willing to pursue coding certification if uncertified.
2) Credentialed as a Certified Coding specialist(CCS) or certified coding specialist (CPC)
1) Thorough knowledge of ICD-10-CM codes, CPT codes, and HCPCS, as appropriate
2) Strong computer skills are a must
3) Ability to communicate effectively
THE ADVANTAGES OF WORKING WITH BAYSTATE!
We strive to be the place where we can help you build the career you deserve – apply today – YOU belong at Baystate!
OUR COMPENSATION PHILOSOPHY
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
Associate of Arts, Bachelor of Arts, GED or HiSET (Required)
Certifications:
Certified Coding Specialist – American Health Information Management Association
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
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