At Virginia Garcia Memorial Health Center, this role supports compliance with medical coding and documentation standards while helping maintain accurate billing, reimbursement, and patient records.
The Coding Compliance Specialist reviews professional service records for compliance with CMS, AMA, and certified coding standards. The position conducts internal chart audits, reviews encounter forms, supports coding education for providers and staff, and assists third-party billing teams with coding- and collections-related issues.
Key responsibilities include reviewing electronic health records, resolving claim edits and charge review queues, monitoring billing performance, preparing audit findings, supporting denials analysis, and helping ensure the integrity of HCPCS, CPT, and ICD-10 coding in the EMR. The role also works closely with clinical leadership, billing staff, and OCHIN to address billing and coding issues.
Qualifications
- High school diploma or GED
- Successful completion of a coding exam
- Current certification such as CPC, CPC-H, CCS, CCSP, ART, or RHIT
- Minimum 1 year of experience with electronic health records and specialty coding
- At least 2 years of directly related experience
- Billing experience and chart auditing experience preferred
- Community health experience desirable
- Valid Oregon driver's license, reliable transportation, safe driving record, and insurance coverage required
Knowledge and skills
- Knowledge of auditing concepts and patient chart review
- Ability to analyze complex medical records and identify billable services
- Advanced knowledge of medical coding procedures, systems, and regulatory issues
- Knowledge of medical terminology, anatomy and physiology, ICD-9-CM, ICD-10-CM, and CPT-4 coding
- Strong analytical, problem-solving, reporting, and communication skills
- Proficiency with Microsoft Word, Excel, PowerPoint, and database software
- Spanish/English bilingual or bicultural proficiency preferred
- Ability to handle PHI in compliance with HIPAA
Location
Oregon, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 months ago