Coding Compliance Senior Specialist - Remote

Overview

The Coding Compliance Senior Specialist is responsible for ensuring compliance with healthcare coding and billing regulations while assisting the Trinity Health leadership team in achieving operational efficiency through data analysis and reporting.

In Short

• Responsible for data capture, analysis, and reporting.
• Auditing and monitoring enterprise information for compliance.
• Assists in training and onboarding new colleagues.
• Conducts risk assessments for compliance programs.
• Provides education on coding and compliance topics.
• Monitors changes in laws and regulations.
• Develops risk mitigation strategies.
• Ensures compliance with healthcare regulations.
• Requires a Bachelor’s degree in healthcare or equivalent experience.
• Minimum six years of healthcare organization experience.

Requirements

• In-depth knowledge of Medicare and third-party payer regulations.
• Experience in health care compliance programs.
• Knowledge of CPT, HCPCS, ICD-10 coding and billing regulations.
• AHIMA, AAPC, or equivalent certification required.
• Thorough understanding of healthcare legal and regulatory practices.
• Experience with government audits and investigations.
• Knowledge of Hospital Outpatient Prospective Payment System.
• Detailed knowledge of the Medicare Claims Processing Manual.
• Possess and maintain relevant licensure or certification.
• Master's degree in law, business, or healthcare preferred.

Benefits

• Diversity and inclusion commitment.
• Equal opportunity employer.
• Access to extensive healthcare services.
• Community benefit programs investment.
• Supportive work environment.