Coding and Compliance Specialist
From our Dallas corporate headquarters to our clinics and worksite locations, Concentra colleagues remain focused on our driving purpose: to provide superb patient and employer experience by delivering the highest quality healthcare in an efficient, affordable, caring manner. We do this by putting all customers (internal and external) first and by displaying:
- A healing focus
- A selfless heart
- A tireless resolve
The Coding and Compliance Specialist audits and reviews to support the following activities: charge entry, level of service, procedure and diagnosis coding for Clinician/colleague education. In addition, the role will provide education and training to employed and contracted Clinicians on appropriate documentation, charge capture and Level of Service code selection. The audit findings are scheduled and presented to the clinician, by the auditor, via telephone or video platforms.
- Perform compliance audits for designated clinicians/centers consistent with established audit protocols and Nationally recognized guidelines. Meet the production and QA standards as set out in Concentra Coding and Compliance policies.
- Organize and schedule training that is indicated from audit results, denial and down coding trends, and/or as requested by medical leadership, center leadership or Central Billing Office leadership
- Assist CBO with reconsideration, appeals process and coding support as requested
- Provide clinician support, education and training related to the quality of documentation, level of service, procedure and diagnosis coding consistent with established coding guidelines and standards
- Assist Medical Leadership in development of clinician training plans and for active support in the training process under guidance of coding leadership
- Monitor Coding and State Workers’ Compensation changes to ensure that most current information is available
- This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
- High School Diploma or GED equivalent
- Requires at least one credential through AHIMA or AAPC (CPC, COC, CCS, CCS-P, CEMC, CPMA, etc.). The credential(s) must be up-to-date and verifiable through these organizations.
- Customarily has at least three or more years of experience working as a certified Coder
- Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
- Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
- Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
- The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
- Auditing expertise
- Moderate computer skills with programs such as PowerPoint, Word, Excel, Access and similar databases
- Working knowledge of routine and non-routine concepts, practices and procedures within billing, coding and auditing
- Strong understanding and application of Evaluation and Management Guidelines
- Strong process management skills
- Attention to detail
- Excellent written, oral communication
- Able to work independently and as part of a team
- Able to multi-task
- Ability to meet multiple deadlines
- Training and presentation skills
- Familiarity with state specific workers' compensation regulations
- Auditing experience
- 401(k) with Employer Match
- Medical/Vision/Prescription/Dental Plans
- Life Insurance/Disability
- Paid Time Off/Holidays
- Colleague Referral Bonus Program
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra is an Equal Opportunity Employer, including disability/veterans