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Title
Text copied to clipboard!Coding Compliance Analyst
Description
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We are looking for a detail-oriented and knowledgeable Coding Compliance Analyst to join our healthcare compliance team. This role is essential in ensuring that all medical coding practices adhere to federal regulations, payer policies, and internal standards. The ideal candidate will have a strong background in medical coding, auditing, and compliance, with a deep understanding of ICD-10, CPT, and HCPCS coding systems.
As a Coding Compliance Analyst, you will be responsible for conducting audits of medical records to ensure accurate coding and documentation. You will work closely with coding staff, physicians, and compliance officers to identify areas of risk and implement corrective actions. Your role will also involve educating staff on coding guidelines and regulatory changes, as well as assisting in the development of policies and procedures to support compliance efforts.
This position requires excellent analytical skills, attention to detail, and the ability to interpret complex regulations. You should be comfortable working independently and as part of a team, and possess strong communication skills to effectively convey findings and recommendations.
Key responsibilities include performing routine and focused coding audits, analyzing audit results, preparing detailed reports, and participating in compliance training initiatives. You will also monitor coding trends and provide feedback to improve accuracy and efficiency.
The successful candidate will hold a certification such as CPC, CCS, or RHIA/RHIT, and have at least 3 years of experience in medical coding and compliance. Familiarity with electronic health records (EHR) systems and audit tools is also important.
This is a critical role in maintaining the integrity of our billing practices and ensuring compliance with healthcare laws and regulations. If you are passionate about healthcare compliance and have a strong coding background, we encourage you to apply.
Responsibilities
Text copied to clipboard!- Conduct regular and focused coding audits
- Ensure compliance with federal and payer-specific regulations
- Collaborate with coding and clinical staff to resolve discrepancies
- Develop and deliver coding compliance training
- Analyze audit findings and recommend corrective actions
- Maintain up-to-date knowledge of coding guidelines
- Assist in policy and procedure development
- Prepare detailed audit reports and summaries
- Monitor coding trends and identify risk areas
- Support internal and external audit processes
Requirements
Text copied to clipboard!- Certification such as CPC, CCS, RHIA, or RHIT
- Minimum 3 years of experience in medical coding and compliance
- Strong knowledge of ICD-10, CPT, and HCPCS coding systems
- Familiarity with EHR systems and audit tools
- Excellent analytical and problem-solving skills
- Strong written and verbal communication abilities
- Ability to work independently and collaboratively
- Attention to detail and high level of accuracy
- Understanding of healthcare regulations and billing practices
- Experience in developing and delivering training materials
Potential interview questions
Text copied to clipboard!- Do you hold a current coding certification (CPC, CCS, RHIA, or RHIT)?
- How many years of experience do you have in medical coding compliance?
- Can you describe your experience with coding audits?
- What EHR systems are you familiar with?
- Have you ever developed or delivered coding compliance training?
- How do you stay updated on changes in coding regulations?
- Describe a time you identified a compliance risk and how you addressed it.
- What audit tools have you used in your previous roles?
- How do you ensure accuracy in your coding reviews?
- Are you comfortable working with cross-functional teams?
