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Coding Compliance Manager Jobs in Texas (NOW HIRING)

The Compliance Manager is responsible for building, executing, and continuously improving Dozee ... Working knowledge of CPT coding (99453-99470), CMS PFS Final Rules, OIG Work Plan, MAC audit ...

The Compliance Manager is responsible for building, executing, and continuously improving Dozee ... Working knowledge of CPT coding (99453-99470), CMS PFS Final Rules, OIG Work Plan, MAC audit ...

The Compliance Manager is responsible for building, executing, and continuously improving Dozee ... Working knowledge of CPT coding (99453-99470), CMS PFS Final Rules, OIG Work Plan, MAC audit ...

Compliance Manager

Irving, TX ยท On-site

$66K - $145K/yr

Position Summary The Compliance Manager is responsible for overseeing All Payer Claims Database ... Understanding of healthcare claims processing and industry coding structures. * Ability to travel ...

New

... and municipal code requirements. Oversees development, implementation, and enforcement of ... compliance matters. Manages staff performance, training, and development for direct reports and ...

Manage, administer, and champion E&C policies and processes, including code of ethics and conduct, anti-bribery and anti-corruption policies, trade compliance/sanctions, related party transactions ...

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Coding Compliance Manager information

What are some common challenges a Coding Compliance Manager faces when implementing new coding guidelines within a healthcare organization?

One common challenge for Coding Compliance Managers is ensuring consistent understanding and adoption of new coding guidelines among diverse coding staff. Differences in experience levels and interpretations can lead to discrepancies, so frequent training and clear documentation are crucial. Additionally, balancing the need for accuracy with productivity targets can be difficult, especially when guidelines change frequently. Effective communication across departments and ongoing audits help address these challenges and promote compliance.

What are Coding Compliance Managers?

Coding Compliance Managers are professionals responsible for ensuring that healthcare organizations accurately assign medical codes to diagnoses and procedures, and that these codes comply with federal regulations and payer requirements. They oversee coding staff, develop policies, conduct audits, and provide education to ensure proper billing and minimize risks of fraud or non-compliance. Their role is critical for optimizing reimbursement and maintaining the integrity of patient records.

What is the difference between Coding Compliance Manager vs Medical Coder?

AspectCoding Compliance ManagerMedical Coder
CertificationsAHIMA/AAPC certifications, compliance trainingCertified Professional Coder (CPC), CCS
Work EnvironmentHealthcare facilities, compliance departmentsHospitals, clinics, physician offices
Primary FocusEnsuring coding compliance, auditing, policy developmentAssigning medical codes for billing and documentation

The Coding Compliance Manager oversees coding practices to ensure regulatory adherence, while the Medical Coder focuses on accurately translating medical records into codes. Both roles require coding certifications, but the Compliance Manager emphasizes policy, audits, and compliance management, whereas the Medical Coder concentrates on coding accuracy for billing purposes.

What are the key skills and qualifications needed to thrive as a Coding Compliance Manager, and why are they important?

To thrive as a Coding Compliance Manager, you need deep knowledge of medical coding standards (ICD-10, CPT, HCPCS), healthcare regulations, and typically a credential such as CPC, CCS, or RHIA. Familiarity with auditing software, EHR systems, and compliance management tools is crucial. Strong analytical thinking, attention to detail, and effective communication skills set high performers apart. These competencies ensure accurate coding, regulatory compliance, and reduced risk of financial penalties for healthcare organizations.
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Medical Coding/Compliance Auditor

Medical Coding/Compliance Auditor

VMG Health

Dallas, TX โ€ข On-site

Full-time

Posted 11 days ago


Job description

Description:

At VMG Health, weโ€™re more than just a team of experts; weโ€™re trusted partners in the business of healthcare. Backed by a team of over 300 professionals and a history of more than 70,000 engagements since 1995, we bring experience, deep and wide, to every project. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms. Our solutions-oriented approach to client needs is bolstered by our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clientsโ€™ valuation, strategic, and compliance needs.

Requirements:

VMG Health is seeking a Coding/Compliance Auditor to perform all levels of documentation and coding reviews related to professional services as well as project management and report writing for VMGโ€™s Coding Audit and Compliance (CAC) team. The Coding/Compliance Auditor will also provide education and training internally to the audit team in unique practice specialties and externally to clients which will include clinical providers and/or ancillary and coding/billing staff. The current team consists of a Managing Director, Director, Manager, Auditors, Coders, and Administrative Coordinators who work as consultants for healthcare organizations, providers, law firms, and private equity groups. Services provided include medical coding, auditing, due diligence coding reviews, education and training, general compliance and research. This is an excellent opportunity for the right professional who is interested in building a career in medical coding and compliance with the support of an industry expert recognized team.

KEY TASKS & RESPONSIBLITIES

  • Work as a part of an audit team to professionally and successfully complete client projects meeting productivity and quality standards within timely deadlines.
  • Access necessary medical record documentation from clientโ€™s EMR systems.
  • Complete detailed analysis of medical records for chart content and documentation requirements.
  • Assign diagnostic codes based on abstract from patient medical record information according to the ICD-10-CM and CPT-4 Manuals and coding conventions and guidelines, as established by state and federal regulatory requirements.
  • Utilize audit reporting tools to record audit results and create reports of results to submit for quality assurance (QA) and feedback prior to submission to client.
  • Develop reports of audit results and corrective action plans based on audit findings.
  • Conduct education and training sessions for internal team and clients as directed/requested.
  • Educate and serve as a resource for providers regarding coding, documentation, and compliance matters.
  • Coordinate, research, and access resources for execution of key client projects.
  • Assist Managing Director, Director and Manager as requested/assigned to ensure key client projects are delivered on time, within scope, and within budget.
  • Support the development and clarification of project scope and objectives, engaging all relevant stakeholders, and confirming that the project is technically feasible.
  • Develop and Maintain relationships with clients and all key stakeholders.
  • Review QA audit reports and make corrections and/or adjustments identified.
  • Keep current with changes in government regulatory coding and compliance guidance and other third-party payers as needed.
  • Maintain awareness of changes in coding auditing principles and practices and related areas to maintain professional competence.
  • Utilize Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) for completion of assigned tasks.

QUALIFICATIONS


Required Minimum Education:

  • High School Diploma.
  • Bachelorโ€™s degree preferred.

Experience:

  • Minimum of 3 years of CPT and ICD-10 medical coding and auditing experience, including abstracting information from patient charts.
  • Extensive experience in E/M coding and auditing, including detailed analysis and assignment of CPT, HCPCS and ICD-10 codes for multispecialty practices.
  • CRC (Certified Risk Coder) coding certification and/or significant HCC coding experience required.
  • Demonstrated experience with regulatory guidelines, including teaching physician settings, incident-to billing, and split/shared services, is required.

License/Certifications:

  • Coding Credentials: AHIMA - Certified Coding Specialist-Physician (CCS-P) or AAPC โ€“ CPC required. CPMA Certification required.
  • AAPC - CPC-I Certified Professional Coding Instructor -or- AAPC - CPC-I Certified Professional Coding Instructor -or- CHCA Certification from AHCAE (Association of Health Care Auditors and Educators), preferred but not required.

Knowledge & Skills:

  • Delivered one-on-one and group education and training to providers, enhancing coding accuracy and compliance.
  • Consistently achieved high productivity and quality outcomes while working independently with minimal supervision.
  • Expertly manage multiple priorities and projects in fast-paced, dynamic environments, consistently meeting deadlines.
  • Demonstrate meticulous attention to detail in all aspects of coding, auditing, and documentation review.
  • Communicate complex information clearly and confidently in both individual and group settings.
  • Excel in organization, planning, problem-solving, and decision-making, with a strong focus on quality management and results.
  • Provide exceptional client service, building and maintaining strong professional relationships.
  • Foster teamwork and collaboration, always maintaining a professional and positive attitude.
  • Proficiency in utilizing AI-powered coding, auditing, and compliance tools to enhance accuracy, efficiency, and reporting.
  • Advanced skills in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) and other relevant technologies.