How to Become a Coding Compliance Specialist

Step 1: Understand the job description and responsibilities of a Coding Compliance Specialist

What does a Coding Compliance Specialist do?

A 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.

People's Opinions on Coding Compliance Specialist responsibilities

The Coding Compliance Specialist performs chart audits to provide documentation and analysis of the records reviewed to the rendering provider, Audit Manager, and Director Coding & Audit.

02/21/2020: Lima, OH

Make compliance and process related recommendations on medical coding issues.

02/19/2020: Somerset, NJ

Provide research, and other support services to ensure observance with official coding policies, regulations, requirements, and standards.

01/12/2020: Carson City, NV

Participate in process improvement efforts by maintaining a weekly issues log in accordance with the AFMS Coding Manual, to be received by the AFMS MCPO.

01/30/2020: Hopkinsville, KY

The Coding Compliance Specialist will be involved with activities of auditing and code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation).

12/31/2019: Medford, OR

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Step 2: Learn best tips to become a Coding Compliance Specialist

Best tips for those who want to become a Coding Compliance Specialist

Here are some tips to become a Coding Compliance Specialist.

Step 3: View best colleges and universities for Coding Compliance Specialist

Best colleges and universities for Coding Compliance Specialist

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College

Step 4: Think about whether is it worth to be a Coding Compliance Specialist

Is being a Coding Compliance Specialist Worth it?

People's Opinions on lifestyles

Must have two years of medical CPT/ICD coding experience and strong computer skills.

02/18/2020: Fort Lauderdale, FL

A minimum of 50% of the Coders time is devoted to coding Medical Services Supervisory/Management Responsibilities This is a non-management job that.

01/16/2020: Tucson, AZ

Provides support for coding denials… Hospital has an Education & ComplianceSpecialist (ECS) position available! The Education & ComplianceSpecialist will be responsible….

01/24/2020: Birmingham, AL

Maintaining compliance in turnaround time requirements as mandated by the TAT Standards of the facility and/or CIOX Health….

01/19/2020: Parkersburg, WV

Three years of recent experience with health care compliance, auditing, billing, coding, reimbursement and/or information management required.

01/04/2020: Johnstown, PA

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Step 5: Prepare relevant skills for being a Coding Compliance Specialist

What skills do you need to be a Coding Compliance Specialist?

Supporting level roles often require a broad range of skills to ensure jobs can be executed accurately and efficiently. Some of the more relevant day-to-day skills for this role include: Abstract Treatment Information, CPT Coding (Current Procedural Terminology), ICD, ICD-10 Coding, Medical Classification, Medical Coding, Medical Record Keeping, Staff Training, Compliance Monitoring. In this role, you should command of the following: Electronic health records (EHR) Software. Success in this function is highly dependant upon these skills, as well as others specific to each individual company.

People's Opinions on Coding Compliance Specialist skills

Eight plus years of experience with coding and/or billing in health care revenue cycle. This should include hospital and physician practice.

02/04/2020: Rock Island, IL

Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT).

12/03/2019: Colorado Springs, CO

Maintains high level of knowledge of current coding guidelines.

01/27/2020: Wilmington, NC

Knowledgeable on regulations around documentation and coding.

12/22/2019: Portland, OR

5 years’ experience as an outpatient coder or related coding experience.

12/02/2019: Las Vegas, NV

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Step 6: View average salary for Coding Compliance Specialist

How much does a Coding Compliance Specialist make?

The average salary range for a Coding Compliance Specialist is from $66,135 to $86,032. The salary will change depending on your location, job level, experience, education, and skills.

Salary range for a Coding Compliance Specialist

$66,135 to $86,032