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Medical Coding Compliance Jobs in Ohio (NOW HIRING)

OrthoOhio

Coding Specialist - Full-time

Findlay, OH · On-site

Review and assign accurate medical codes for diagnoses, procedures, and services using ICD-10, CPT, and HCPCS guidelines. * Ensure coding compliance with federal, state, and payer regulations, as ...

Allmed Staffing Inc

Medical Coder

Cuyahoga Falls, OH · On-site

$18/hr

Medical Coder Allmed Benefits: Vision Insurance, Health Insurance, Dental Insurance and 401(k) Pay ... This role ensures proper coding compliance, supports accurate reimbursement, and maintains ...

Allmed Staffing Inc

Medical Coder

Cuyahoga Falls, OH

$18/hr

Medical Coder Allmed Benefits: Vision Insurance, Health Insurance, Dental Insurance and 401(k) Pay ... This role ensures proper coding compliance, supports accurate reimbursement, and maintains ...

Alpha Rae Personnel, Inc.

Medical Coders

Columbus, OH · On-site

$18 - $24/hr

... coding systems, ensuring compliance with applicable coding guidelines, regulations, and ... Candidates must be local. * 3-4 years of recent medical coding experience * One of the following ...

RevCycleAce LLC

Medical Coder

Delhi, OH · On-site

$18.25 - $24.25/hr

... coding, and claims submission to improve reimbursement and compliance. Team members collaborate ... The Medical Coder will review clinical documentation and assign accurate and compliant diagnosis ...

Prestige Billing Services, Ltd.

Medical Coder

Miamisburg, OH · Remote

$16.75 - $22.50/hr

Position: Medical Coder Reports to: Coding Manager and Executive Director Exempt/Non: Non-Exempt ... Participate in compliance activities Coding Duties: * Assign CPT and ICD 10-CM in accordance with ...

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Medical Coding Compliance information

What is medical coding compliance?

Medical coding compliance refers to the process of ensuring that medical coding practices adhere to federal, state, and organizational regulations and guidelines. This involves accurately translating medical diagnoses, procedures, and services into standardized codes for billing and documentation purposes. Compliance helps prevent fraud, reduce billing errors, and ensures that healthcare providers receive appropriate reimbursement while avoiding legal penalties. Professionals in this field stay updated on changing regulations, conduct audits, and provide training to staff to maintain high standards of accuracy and integrity.

What are the key skills and qualifications needed to thrive in medical coding compliance, and why are they important?

To thrive in Medical Coding Compliance, you need a thorough understanding of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and compliance standards, often backed by certifications like CPC, CCS, or CHC. Proficiency with electronic health record (EHR) systems, coding software, and compliance auditing tools is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for identifying discrepancies and educating staff. These skills ensure accurate coding, reduce legal risks, and maintain organizational compliance with healthcare regulations.

What are some common challenges faced in a medical coding compliance role, and how can they be addressed?

Medical Coding Compliance professionals often encounter challenges such as staying updated with frequent changes to coding regulations, ensuring consistent adherence to compliance standards across departments, and accurately interpreting complex clinical documentation. To address these, it’s crucial to participate in ongoing education, maintain close communication with healthcare providers, and utilize robust auditing tools. Collaborating with compliance officers and regularly attending training sessions can also help reinforce best practices and minimize errors.

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

AspectMedical Coding ComplianceMedical Coding Specialist
CertificationsCPMA, CPC, CCSCPC, CCS
Work EnvironmentCompliance departments, healthcare organizationsMedical offices, hospitals, clinics
Primary FocusEnsuring coding accuracy and regulatory adherenceAssigning codes to medical procedures and diagnoses
Employer & Industry UsageHealthcare compliance and auditing firms, hospitalsHealthcare providers, billing companies

Medical Coding Compliance professionals focus on ensuring that coding practices adhere to regulations and standards, often working in compliance or auditing roles. Medical Coding Specialists primarily assign codes to medical records for billing and documentation. While both roles require similar certifications, their responsibilities and work environments differ significantly.

What does a medical coding compliance specialist do?

A medical coding compliance specialist ensures that healthcare providers accurately code medical procedures and diagnoses according to industry standards and regulations. They review coding practices, monitor for compliance with legal and payer requirements, and implement policies to prevent fraud and errors, often using coding software and staying updated on coding guidelines.

What are popular job titles related to Medical Coding Compliance jobs in Ohio?

For Medical Coding Compliance jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Medical Coding Compliance jobs in Ohio look for?

The top searched job categories for Medical Coding Compliance jobs in Ohio are:

What cities in Ohio are hiring for Medical Coding Compliance jobs?

Cities in Ohio with the most Medical Coding Compliance job openings:

Medical Coding Compliance jobs near you
Infographic showing various Medical Coding Compliance job openings in Ohio as of August 2026, with employment types broken down into 2% As Needed, 92% Full Time, and 6% Part Time. Highlights an 100% In-person job distribution.

Coding Compliance Specialist

Prestige Billing Services, Ltd.

Miamisburg, OH • Remote

Full-time

Re-posted 5 days ago

Key responsibilities

  • Conduct internal and external coding audits to evaluate accuracy, documentation quality, and compliance with coding standards and regulations

  • Research and interpret evolving coding regulations, payer policies, and industry guidance to develop and update coding policies, standards, and educational resources

  • Research coding, documentation, and regulatory requirements for prospective clients and develop compliance frameworks to support onboarding and implementation

Job description

Position: Coding Compliance Specialist
Reports To: Operations Director
Exempt/Non: Exempt, Full-Time
Education: CPC (Certified Professional Coder) required; CPMA (Certified Professional Medical Auditor) preferred; CCS (Certified Coding Specialist) preferred
Experience: Minimum of five (5) years of physician and/or facility coding experience
The Coding Compliance Specialist is responsible for ensuring coding accuracy, regulatory compliance, and adherence to federal, state, payer, and organizational coding standards. This position serves as the department's subject matter expert for coding compliance by conducting internal and external audits, researching evolving coding regulations, supporting payer audit activities, and developing organizational coding and compliance standards.
This role is a complementary role to the Coding Operations Specialist, which focuses on operational workflow and production. The Coding Compliance Specialist focuses on compliance-related coding review.
In addition to audit responsibilities, the Coding Compliance Specialist leads the research and development of coding and compliance frameworks for prospective clients by evaluating specialty-specific coding requirements, documentation standards, payer regulations, and operational considerations to support successful client onboarding and implementation.
This position is an individual contributor role and does not include direct supervisory or personnel management responsibilities.
Requirements (Skills amp; Background)
  • Demonstrated expertise in coding audits, regulatory compliance, and coding research
  • Thorough knowledge of ICD-10-CM, CPT, HCPCS, CMS regulations, payer policies, and official coding guidelines
  • Strong analytical, research, and problem-solving skills
  • Excellent written and verbal communication skills
  • Proficiency with electronic health records (EHR), coding software, and Microsoft Office application
Essential Duties and ResponsibilitiesCoding Compliance and Auditing
  • Conduct routine internal coding audits to evaluate coding accuracy, documentation quality, and compliance with ICD-10-CM, CPT, HCPCS, CMS, and payer guidelines
  • Review external audit findings and validate recommended corrections prior to releasing encounters from audit hold queues
  • Perform annual coding audits for designated clients to ensure ongoing coding accuracy and regulatory compliance
  • Document audit findings, identify coding and documentation trends, and recommend educational opportunities to improve coding quality
  • Monitor compliance with applicable federal regulations, payer policies, and organizational coding standards
  • Identify compliance risks and recommend corrective actions and process improvements
  • Track audit metrics and prepare audit summaries for leadership review
Regulatory Research and Standards Development
  • Research evolving CMS regulations, payer policies, coding updates, and industry guidance affecting coding and reimbursement
  • Develop, maintain, and update internal coding and compliance policies, standards, reference materials, and best practice guidelines
  • Create and revise coding appeal letter templates, compliance documentation, audit tools, certification letter templates, and supporting resources to promote departmental consistency
  • Translate regulatory changes into practical guidance and educational resources for coding staff
  • Maintain departmental coding reference libraries and compliance resources
  • Help identify payer denials that could be resolved through education of proper coding guidelines
New Client Compliance and Research
  • Research coding, documentation, regulatory, and payer requirements for prospective clients across multiple medical specialties
  • Develop specialty-specific coding and compliance frameworks to support the successful onboarding of new client contracts
  • Evaluate payer requirements, specialty coding guidelines, and documentation expectations to establish compliant operational workflows for new business opportunities
  • Collaborate with operational leadership during the implementation of new client coding processes
  • Assist in developing coding policies, workflows, and documentation standards for newly acquired clients
Audit and Payer Support
  • Collaborate with physicians and providers to prepare certification letters and supporting documentation for payer audits and medical record reviews
  • Support clients with payer coding and contractual issues by researching applicable regulations, identifying coding requirements, and presenting findings to facilitate appropriate resolution
  • Assist with coding-related audit responses, compliance inquiries, regulatory documentation requests, and payer appeals as needed
  • Serve as a coding compliance resource during external audits and client reviews
Coding Consultation and Education
  • Serve as the primary resource for coding staff regarding coding guidelines, compliance issues, payer policies, and documentation requirements
  • Provide coding guidance based on current regulatory standards and official coding references
  • Share audit findings, coding trends, and regulatory updates with the Operations Director to support ongoing education and quality improvement initiatives
  • Assist in developing educational materials and coding reference tools for internal staff
Core Competencies
  • Coding Compliance
  • Medical Coding Auditing
  • Regulatory Research
  • Policy and Standards Development
  • Documentation Review
  • Coding Quality Assurance
  • Critical Thinking
  • Analytical Problem Solving
  • Written and Verbal Communication
  • Collaboration and Consultation
  • Attention to Detail
  • Organization and Time Management
  • Professional Judgment
  • Adaptability
Physical Requirements
  • Ability to sit and work at a computer for extended periods
  • Ability to occasionally lift up to 20 pounds
Additional Responsibilities
  • Maintain confidentiality of protected health information in accordance with HIPAA regulations
  • Maintain required coding certifications and continuing education requirements
  • Participate in departmental meetings, compliance initiatives, and special projects as assigned
  • Support departmental and organizational compliance initiatives
  • Perform other duties as assigned

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