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Coding Compliance Specialist Jobs (NOW HIRING)

Genoa Telepsychiatry

Coding Compliance | , |

Coding Compliance Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...

UnitedHealthcare

Coding Compliance | , |

Coding Compliance Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve ...

Privia Health

Coding Compliance Audit Specialist

$70K - $80K/yr

Under indirect supervision, the Coding Compliance Audit Specialist conducts baseline, routine, and focused audits by comparing medical record documentation with reported CPT, HCPCS, and ICD-10-CM ...

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How much do coding compliance specialist jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for coding compliance specialist in the United States is $29.05, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $35.10 per hour, depending on experience, location, and employer.

What are some common challenges coding compliance specialists face when ensuring accurate medical coding across teams?

Coding Compliance Specialists often encounter challenges such as keeping up with frequent changes in coding regulations, ensuring all team members consistently apply complex coding guidelines, and addressing discrepancies between clinical documentation and coding requirements. Effective collaboration with providers and coding staff is essential to clarify documentation and resolve issues quickly. Strong attention to detail and ongoing education help specialists maintain compliance and minimize errors, which are crucial for accurate billing and avoiding regulatory penalties.

What is a coding compliance specialist?

A coding compliance specialist enforces medical billing and coding regulations. As a coding compliance specialist, you are in charge of training medical staff on the different medical codes used in treatment and insurance billing. You also review medical records, clarify billing issues, and conduct audits, while maintaining patient privacy. Medical insurance companies, hospitals, and other healthcare facilities have coding compliance specialists on staff.

What are the key skills and qualifications needed to thrive as a coding compliance specialist, and why are they important?

To thrive as a Coding Compliance Specialist, you need in-depth knowledge of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and a relevant certification like CCS, CPC, or RHIA. Familiarity with electronic health record (EHR) systems and coding audit tools is essential for accurate data analysis and compliance reviews. Strong attention to detail, analytical thinking, and effective communication skills set top performers apart in this role. These competencies are crucial for ensuring coding accuracy, minimizing compliance risks, and supporting proper healthcare reimbursement.

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

AspectCoding Compliance SpecialistMedical Coder
Required CredentialsCertification (e.g., CPC, CCS), knowledge of coding standards, compliance regulationsCertification (e.g., CPC, CCS), proficiency in coding systems
Work EnvironmentHealthcare facilities, compliance departments, insurance companiesHospitals, clinics, physician offices
Employer & Industry UsageFocuses on ensuring coding accuracy and regulatory compliancePrimarily responsible for assigning medical codes for billing
Search & Comparison IntentUnderstanding compliance roles, regulatory standards, auditingMedical coding procedures, billing, and documentation

The main difference is that a Coding Compliance Specialist focuses on ensuring coding practices adhere to regulations and standards, often involving audits and compliance monitoring. In contrast, a Medical Coder primarily assigns medical codes for billing and documentation purposes. Both roles require similar certifications but serve different functions within healthcare organizations.

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Coding Compliance Specialist jobs near you
Infographic showing various Coding Compliance Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, and 4% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $60,418 per year, or $29 per hour.

PROFESSIONAL CODING COMPLIANCE SPECIALIST (ON-SITE)

Riverside Healthcare

Kankakee, IL • On-site

$28.83/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Job description

Overview
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 Duties
  • Completes 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 reviewed
  • Reviews 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 reference
  • Documents audit results in designated Excel log as soon as review is completed
  • Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management
  • Assists coding compliance lead in creating and publishing monthly provider newsletter
  • Collaborates 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 teams
  • Participates in developing and presenting provider and coder education programs as requested
  • Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
  • Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
  • Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
  • Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies

Responsibilities
Required Experience
  • Minimum 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 required

Required Licensure/Education
  • High school graduate or equivalent required.
  • AAPC/CPC (Certified Professional Coder) required
  • AAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hire
  • AAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended

Preferred Education
  • Associate degree in health-related field preferred
  • Formal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:
Compensation:
  • Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or trainin
  • Premium pay such as shift differential, on-call
  • Opportunity for annual increases based on performance

Benefits - .5 to 1.0 FTE:
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program

Benefits - .001 to .49 FTE:
  • Paid Leave Hours accrued as you work

Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
  • Chemicals: NA
  • Video Display Terminals: Average
  • Blood and Body Fluids: None
  • TB or Airborne Pathogens: None

Sensory requirements (speech, vision, smell, hearing, touch):
  • Speech: Needed for presentations/training, telephone communication, facilitate meetings.
  • Vision: Needed to read computer screens and printouts, memos, communications, documentation, and literature.
  • Smell: Electrical/fire safety.
  • Hearing: Needed for telephone communications, meetings, and equipment operating characteristics.
  • Touch: Needed to write, do computer entry, filing.

Activity/Lifting Requirements:
Percentage of time during the normal workday the employee is required to:
  • Sit: 55%
  • Twist: 0%
  • Stand: 20%
  • Crawl: 0%
  • Walk: 20%
  • Kneel: 0%
  • Lift: 0%
  • Drive: 0%
  • Squat: 0%
  • Climb: 0%
  • Bend: 5%
  • Reach above shoulders: 0%

The weight required to be lifted each normal workday according to the continuum described below:
  • Up to 10 lbs: Frequently
  • Up to 20 lbs: Occasionally
  • Up to 35 lbs: Occasionally
  • Up to 60 lbs: Occasionally
  • Up to 75 lbs: Not Required
  • Up to 100 lbs: Not Required
  • Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
  • Putting away supplies.
  • Lift above the head occasionally to place boxes on high storage shelves.
  • Carry boxes up and down the stairs - distances up to 100 feet.

Maximum consecutive time (minutes) during the normal workday for each activity:
  • Sit: 30
  • Twist: .5
  • Stand: 30
  • Crawl: 0
  • Walk: 2
  • Kneel: 0
  • Lift: 5
  • Drive: 30
  • Squat: 1
  • Climb: .5
  • Bend: .5
  • Reach above shoulders: .5

Repetitive use of hands (Frequency indicated):
  • Simple grasp up to 15 lbs.
  • Normal weight: continuous
  • Pushing &pulling Normal weight: 50-200#
  • Fine Manipulation: Computer Keyboard and mouse.

Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards:
  • Environmental Factors (Time Spent):
    • Inside hours: 8.0
    • Outside hours : 0
  • Temperature: Normal Range
  • Lighting: Average
  • Noise levels: Average
  • Humidity: Normal
  • Atmosphere:
  • Special Hazards:
  • Protective Clothing Required: Gloves when handling blood and body fluids.

Pay Range
USD $28.83 - USD $37.13 /Hr

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