TensorOps is hiring a Medical Coding Compliance Specialist to safeguard our coding and billing practices. In this role, you will ensure full compliance with federal and state regulations, as well as payer and coding guidelines. You'll be a key subject matter expert, conducting audits, analyzing trends, and educating clinical staff.
What You'll Do
- Conduct reviews of medical record documentation and coding for accuracy and adherence to guidelines like ICD-10-CM, CPT, and HCPCS.
- Analyze audit data to identify trends, compliance risks, and areas for improvement, recommending and implementing corrective actions.
- Develop and deliver educational programs and training for physicians and staff on coding best practices.
- Maintain expert knowledge of evolving regulations, CMS guidelines, and industry coding standards.
- Serve as a resource for internal and external questions on coding, billing, and documentation compliance.
- Document audit findings and present clear, concise reports to management.
- Investigate potential non-compliant activities or billing discrepancies to determine root causes.
- Work closely with billing, revenue cycle management, and clinical departments to ensure compliant workflows.
What We're Looking For
- A relevant, industry-recognized coding certification (e.g., CPC, CCS, CPMA or equivalent).
- A minimum of 5 years of experience in medical coding and auditing.
- Experience in professional services for Evaluation and Management coding, Chronic Care Management, and Risk Adjustment coding.
- Extensive knowledge of CPT, ICD-10-CM, and HCPCS coding systems, as well as Medicare and Medicaid regulations.
Nice to Have
- An associate or bachelor’s degree in health information management or a related field.
Team & Environment
This role is part of the Legal Department. You'll join a team that values and appreciates your contributions in a positive and collaborative environment.
Benefits & Compensation
- Compensation up to $85,000 annually, determined by experience and qualifications.
- Monday to Friday schedule.
- Competitive compensation and benefits package.
- Career growth opportunities and comprehensive training programs.
- Supportive and collaborative team environment.
- Comprehensive training programs.
- Paid time off and holidays.
- Employer-paid life insurance policy.
Work Mode
This is a fully remote position for candidates located within the United States.
TensorOps is an equal opportunity employer.
