Coding Compliance Specialist jobs in Maryland

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)

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Coding Compliance Specialist
  • Johns Hopkins Medicine
  • Hanover, MD FULL_TIME
  • Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

    What awaits you:

    • Work-life balance - This is a remote role!
    • Medical, Dental, and Vision Insurance.
    • 403B Savings Plan w/employer contribution.
    • Paid Time off & Paid holidays.
    • Employee and Dependent Tuition assistance benefits.
    • Health and wellness programs and MORE!

    Who you are:

    As a Medical Appeals Coding Specialist for Johns Hopkins Health Plans, you are the subject matter expert when it comes to your understanding of physician billing and coding regulations related to CPT/ICD-10/HCPCS coding.

    What you’ll do:

    • As you receive appeals from providers, you review them and use our resources to make sure benefits are applied correctly through the system
      • You work with provider team to fix incorrect coding issues
    • Overturn or uphold decisions based upon your review of appeals content from providers
    • Monitor annual code changes implemented by governing bodies
    • Work with department management and staff as a resource and to provide guidance on coding issues.

    What you’ll bring:

    • CPC or AAPC Certification is required
    • 1 years’ experience in coding/auditing
    • 5 years’ medical claims ore related insurance experience
    • Requires an AA degree in Business, Health Care Administration or related field
      • Bachelor’s degree preferred.
    • Strong familiarity with the following:
      • Knowledge of healthcare regulatory requirements, medical plans and the ability to effectively communicate (oral and written)
      • Reimbursement methodologies and guidelines

    Who we are:

    Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

    Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.

    Johns Hopkins Health System and its affiliates are drug-free workplace employers.

  • 16 Days Ago

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CODING COMPLIANCE AUDITOR
  • University of Maryland Medical System
  • Baltimore, MD FULL_TIME
  • Job DescriptionI. General SummaryAccurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research ...
  • 15 Days Ago

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Medical Billing and Coding Compliance Manager
  • MedVanta
  • Bethesda, MD FULL_TIME
  • MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO). Our services are specifically designed for musculoskeletal (MSK) providers and go ...
  • 20 Days Ago

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CODING COMPLIANCE AUDITOR TEAM LEAD
  • University of Maryland Medical System
  • Baltimore, MD FULL_TIME
  • Job DescriptionUnder direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing func...
  • 1 Month Ago

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Remote- Inpatient Coding Auditor Compliance Edits
  • Palm Bridge Solutions
  • Blank, MD FULL_TIME
  • Remote Inpatient Coding Auditor - Compliance Edits Position Overview: We are thrilled to announce an opportunity for a Remote Inpatient Coding Auditor with a focus on Compliance Edits at our new, stat...
  • 3 Days Ago

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Certified Coding Specialist
  • Johns Hopkins Medicine
  • Annapolis, MD PART_TIME
  • No Nights and Weekends! The Certified Professional Coder (CPC) at Odenton is a billing staff position with responsibility for specified coding and billing department duties within ENTAA Care, a practi...
  • 20 Days Ago

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Material Compliance Specialist
  • MacLean-Fogg
  • Mundelein, IL
  • Material Compliance Specialist Mundelein, IL, 1000 Allanson Road, Mundelein, Illinois, United States of America Req #337...
  • 3/29/2024 12:00:00 AM

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HIPAA Compliance Expert
  • Eagle Consulting Partners, Inc.
  • Cleveland, OH
  • At Eagle Consulting Partners, we provide cybersecurity, compliance, and IT risk management consulting to Small and Mediu...
  • 3/28/2024 12:00:00 AM

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Financial Compliance Specialist
  • Virginia Tech University
  • Blacksburg, VA
  • The Office of Sponsored Programs at Virginia Tech, a central university department under the Office of Research and Inno...
  • 3/28/2024 12:00:00 AM

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Personal and Work Life Core Compliance Expert
  • Ladgov Corporation
  • Montgomery, AL
  • Major Duties and Responsibilities Provide family-focused education and support services. Conduct initial and crisis asse...
  • 3/28/2024 12:00:00 AM

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Compliance Specialist
  • APTIM
  • West Union, WV
  • At APTIM, we come to work each day knowing that we are making an impact on the world. Our work spans from safeguarding a...
  • 3/28/2024 12:00:00 AM

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Compliance Specialist
  • King City Gardens
  • Cincinnati, OH
  • Qualifications -Stipulation of employment is passing an OHIO BCI and FBI background check in accordance with ORC/OAC 379...
  • 3/28/2024 12:00:00 AM

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Compliance Specialist
  • VP Racing Fuels
  • San Antonio, TX
  • Job Description Job Description Company Overview: VP Racing Fuels is the world’s leader in fuel technology. From a singl...
  • 3/27/2024 12:00:00 AM

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EMEA Trade Compliance Specialist
  • Arrow Electronics, Inc.
  • Sevenum, Limburg
  • Position: EMEA Trade Compliance Specialist Job Description: As Arrow Global Components (AGC), a part of Arrow Electronic...
  • 3/11/2024 12:00:00 AM

Maryland (US: /ˈmɛrələnd/ (listen) MERR-əl-ənd) is a state in the Mid-Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east. The state's largest city is Baltimore, and its capital is Annapolis. Among its occasional nicknames are Old Line State, the Free State, and the Chesapeake Bay State. It is named after the English queen Henrietta Maria, known in England as Queen Mary. Sixteen of Maryland's twenty-three counties border the tidal waters of the Chesapeake Bay estuary and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$66,059 to $87,756

Coding Compliance Specialist in Altus, OK
With little or no supervision, plans, conducts and coordinates the daily operations of one of the Coding and Documentation Quality Assurance (CDQA) sub-teams.
December 14, 2019
Coding Compliance Specialist in Terre Haute, IN
Leads the initiatives and responsibilities of the Enterprise-Wide Coding implementation work groups applicable to their sub-team.
December 16, 2019
Coding Compliance Specialist in Portland, OR
This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS Coding Guidelines and Official ICD9 / ICD10 Coding Guidelines.
December 23, 2019