Coding and Compliance Specialist
JOB SUMMARY:
The position is responsible for coordinating provider coding and compliance activities and outcomes within Concentra Health Services, including but not limited to revenue optimization, level of service coding and diagnosis coding.
MAJOR DUTIES AND RESPONSIBILITIES:
PrimaryFunctions:
- Provider/Coder support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
- Perform compliance audits for designated provider/coder centers consistent with established audit protocol.
- Coordinate with Zone Medical Leadership in development of provider/coder training plans and for active support in the training process.
- Organize and schedule periodic training as indicated from audit results, denial and down coding trends, level of service reports, etc. and/or as requested by medical leadership or CBO management.
- Monitor Coding and State Workers’ Compensation changes to ensure that most current information is available.
- Provide coding support to CBO as requested.
- Other duties as may be assigned.
EDUCATION/CREDENTIALS:
High School
Associates degree or Bachelor’s degree or equivalent experience
CPC or CCS-P coding certification Required
JOB RELAVENT EXPERIENCE:
Five years progressive healthcare billing, coding and auditing experience including provider training and presentation.
JOB-RELATED SKILLS/COMPETENCIES:
Auditing
Basic computer skills – PowerPoint, Excel, Word
Strong process management skills
Familiarity with state specific workers’ compensation regulations
Training and presentation skills
Concentra is an Equal Opportunity Employer, including disability/veterans
• 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, M/F/Disability/Veteran.