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Medical Coding Compliance Specialist

Theoria Medical

Theoria Medical is seeking a Medical Coding Compliance Specialist to support coding accuracy, regulatory compliance, and clinical documentation integrity across the organization.

This role focuses on coding audits, identifying compliance risks, supporting corrective action plans, delivering education and training, and collaborating with billing, revenue cycle, provider, and operational teams.

Theoria Medical serves the post-acute sector with multispecialty physician services across skilled nursing facilities nationwide.

Requirements & Qualifications
  • Minimum of 5 years of experience in medical coding and auditing
  • One or more of the following certifications required:
    • Certified Professional Coder (CPC)
    • Certified Coding Specialist (CCS)
    • Certified Professional Medical Auditor (CPMA)
    • Equivalent industry-recognized certification
  • Associate’s or bachelor’s degree in Health Information Management or related field preferred
  • Experience with E/M coding, Chronic Care Management (CCM), and Risk Adjustment coding preferred
  • Strong knowledge of CPT, ICD-10-CM, and HCPCS coding systems
  • Strong understanding of Medicare and Medicaid regulations and compliance standards
  • Excellent analytical, problem-solving, written, verbal, and presentation skills
  • High attention to detail and strong organizational skills
  • Ability to maintain confidentiality and professionalism with sensitive patient information
Benefits & Perks
  • Paid time off
  • 401(k) with employer matching and participation
  • Medical, vision, and dental insurance for eligible candidates
  • Short- and long-term disability insurance for eligible candidates
  • Employer-paid life insurance policy
  • Technology and tools designed to streamline workflows and improve efficiency

Location

Michigan, US

Employment Type

Full-time

Experience Level

Senior

Remote work allowed

Yes

Posted

3 weeks ago

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