Coding Compliance Specialist jobs in Vermont

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 Specialist
  • BlueCross BlueShield of Vermont
  • Berlin, VT FULL_TIME
  • Blue Cross and Blue Shield of Vermont is looking for a Coding Specialist to join our Payment Integrity team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.
    REMOTE WORK: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week.
    Coding Specialist Responsibilities:

    • Oversee maintenance of medical coding changes in our Payment Integrity programs
    • Research requests using multiple systems (including: Sales Force, Jira, NPS) to provide all available details to reviewer
    • Use SalesForce, Jira, and NASCO claim systems, to perform functions such as initial claim review, outcome reporting, and distribution based on triage
    • Correspond with providers regarding decisions about requested services and obtain medical records when necessary
    • Review and respond to issues and questions from internal and external customers, both verbally and in writing
    • Work collaboratively with other departments to obtain additional information to resolve inquiries

    Coding Specialist Qualifications:

    • Bachelor’s degree, or equivalent combination of education and experience, with a minimum of 3 years’ experience in medical coding; In-depth knowledge of CPT, ICD-9, ICD-10, HCPCS, DRG diagnosis and procedure coding
    • Formal coding certification (eg: CPC, AAPC) is a must
    • Experience with both professional and facility claims coding and in APC, HIPPS, or RUG coding and validation

    Coding Specialist Benefits:

    • Health insurance (including vision)
    • Dental coverage (free to employees)
    • Wellness Program
    • 401(k) with employer match automatic employer contribution
    • Life Insurance
    • Disability Insurance
    • Combined time off (CTO) – 20 days per year 10 paid holidays
    • Tuition Reimbursement
    • Student Loan Repayment
    • Dependent Caregiver Benefits

    *
    Complete job description attached to ADP posting

    Job Type: Full-time

    Pay: $54,000.00 - $63,000.00 per hour

    Expected hours: 40 per week

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Parental leave
    • Professional development assistance
    • Tuition reimbursement

    Schedule:

    • 8 hour shift
    • Day shift
  • 14 Days Ago

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Grants Compliance Specialist III
  • Innovative Emergency Mgmt
  • Montpelier, VT FULL_TIME
  • Position Summary: IEM is seeking a dedicated and detail-oriented, Full Time - Grants Compliance Specialist III (GCS III), to ensure the effective and compliant management of grants for IEM’s State Bro...
  • 19 Days Ago

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Grants Compliance Specialist II
  • Innovative Emergency Mgmt
  • Montpelier, VT FULL_TIME
  • Position Summary: IEM is seeking a dedicated and detail-oriented, Full Time - Grants Compliance Specialist II (GCS II), to ensure the effective and compliant management of grants for IEM’s State Broad...
  • 20 Days Ago

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Grants Compliance Specialist I
  • Innovative Emergency Mgmt
  • Montpelier, VT FULL_TIME
  • Position Summary: IEM is seeking a dedicated and detail-oriented, Full Time - Grants Compliance Specialist I (GCS I), to ensure the effective and compliant management of grants for IEM’s State Broadba...
  • 20 Days Ago

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Lawn Specialist
  • TruGreen - Lawn Specialist
  • South Burlington, VT FULL_TIME
  • TruGreen is Now Hiring Lawn Specialists!Earn Up to $22.00 per Hour - Comprehensive BenefitsAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A career...
  • 16 Days Ago

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Surveillance Investigator - Part-Time
  • Allied Universal® Compliance and Investigations
  • Rutland, VT PART_TIME
  • Surveillance Investigator - Part-Time Overview Allied Universal® Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance compa...
  • Just Posted

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Code Compliance Specialist
  • City of Santa Cruz, CA
  • Santa Cruz, CA
  • Salary : $6,072.00 - $8,544.00 Monthly Location : City of Santa Cruz, CA Job Type: Regular Full-Time Job Number: 24-076 ...
  • 4/26/2024 12:00:00 AM

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Compliance Specialist / Adv Compliance Specialist
  • Marathon Petroleum
  • Canonsburg, PA
  • An exciting career awaits you At MPC, we’re committed to being a great place to work – one that welcomes new ideas, enco...
  • 4/24/2024 12:00:00 AM

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Code Compliance Specialist 1 (NY HELPS)
  • StateJobsNY
  • Buffalo, NY
  • Current New York State employee with one year or more of qualifying permanent service as a Senior Safety and Health Insp...
  • 4/24/2024 12:00:00 AM

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Compliance Specialist / Adv Compliance Specialist
  • Marathon Petroleum Corporation (MPC)
  • Canonsburg, PA
  • An exciting career awaits you At MPC, we're committed to being a great place to work - one that welcomes new ideas, enco...
  • 4/24/2024 12:00:00 AM

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Compliance Specialist
  • Global Channel Management Inc.
  • Los Angeles, CA
  • About the job Compliance Specialist Compliance Specialist needs 3+ years of strong experience workforce contract Complia...
  • 4/22/2024 12:00:00 AM

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Senior Quality & Compliance Specialist
  • Bayer
  • Kihei, HI
  • At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for a...
  • 4/22/2024 12:00:00 AM

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Customs Compliance Specialist
  • Clean Harbors
  • Norwell, MA
  • The Transportation Compliance Specialist reports directly to the Director of Transportation Compliance and is responsibl...
  • 4/18/2024 12:00:00 AM

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Product Expert - Compliance
  • Haleon
  • Poznań, Greater Poland Voivodeship
  • Hello. We’re Haleon. A new world-leading consumer health company. Shaped by all who join us. Together, we’re improving e...
  • 4/9/2024 12:00:00 AM

Vermont is located in the New England region of the Northeastern United States and comprises 9,614 square miles (24,900 km2), making it the 45th-largest state. It is the only state that does not have any buildings taller than 124 feet (38 m). Land comprises 9,250 square miles (24,000 km2) and water comprises 365 square miles (950 km2), making it the 43rd-largest in land area and the 47th in water area. In total area, it is larger than El Salvador and smaller than Haiti. It is the only landlocked state in New England, and it is also the easternmost and the smallest in area of all landlocked sta...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Coding Compliance Specialist jobs
$62,899 to $83,556

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