Certified Medical Coding Specialist HYBRID

The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.Essential DutiesCompletes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewedReviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings and use as referenceDocuments audit results in designated Excel log as soon as review is completedImmediately reports adverse audit trends, potential areas of risk, and compliance concerns to managementAssists coding compliance lead in creating and publishing monthly provider newsletterCollaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teamsParticipates in developing and presenting provider and coder education programs as requestedAssists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirementsAssists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requestedServes as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requestedAssists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacanciesRequired ExperienceMinimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience requiredRequired Licensure/EducationHigh school graduate or equivalent required. AAPC/CPC (Certified Professional Coder) requiredAAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hireAAPC/CRC (Certified Risk-Adjustment Coder) strongly recommendedPreferred EducationAssociate degree in health-related field preferredFormal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education