QI Coding Compliance Specialist

The QI Coding Compliance Specialist reviews clinical documentation and applies appropriate billing and diagnostic codes using acceptable guidelines. They develop and implement tracking mechanisms for coding trends and patterns and consult with the Medical Director and Regional Practice Administrators regarding regulatory compliance issues related to coding. The Certified Coder is responsible for physician consultation, auditing, training, planning and other coding services covering most specialties, including but not limited to, Family Practice, Internal Medicine, Pediatrics, OB/GYN, Surgery, GI, Emergency Medicine, Sleep, Neurology, Neurosurgery, Anesthesia, Ophthalmology, Oncology, ENT, Epilepsy, Orthopedics, etc.

They are also responsible for physician coding reviews/audits, developing training tools, training staff members on any changes in coding regulations, serving as consultant to clinics and managers for coding questions, assisting with creation of templates, fee tickets, and other forms as necessary, participation in coding workshops/in-services/seminars and other duties as requested. A high degree of verbal and written communication and professionalism required.

Desired candidate works well alongside existing QI team under direction of medical director. Other information: Bachelor Degree preferred. Clinical background a plus.

Formal education in medical records procedures ideal. Extensive knowledge of medical terminology with an in-depth understanding of ICD10CM and CPT Coding principles focusing on evaluation and management services. Fundamental knowledge of current standard billing practices as defined by AMA, as well as, the ability to interpret clinical data.

Knowledge of Continuous Quality Improvement principles in a healthcare setting. Outstanding written and oral communication skills. Computer skills required.

This job will be authorized 80.00 hours bi-weekly.