Coding Compliance Specialist

Proliance SurgeonsSeattle, WA
21hRemote

About The Position

The Coding Compliance Specialist (Revenue Cycle Quality Analyst) supports accurate coding practices, reduces compliance risk, and strengthens overall coding quality across the organization. This role assists with coding audits, regulatory monitoring, coding education, policy development, and workflow improvements. The analyst helps ensure coding integrity by reviewing claims, identifying trends, validating audit findings, and supporting training efforts in alignment with payer rules, CMS guidelines, and internal standards.

Requirements

  • Bachelor’s degree or equivalent experience preferred
  • Certified Professional Coder (CPC, CCS, or equivalent) required
  • At least five years of medical coding experience (orthopedics preferred)
  • Solid understanding of CMS rules, payer policies, and regulatory standards
  • Working knowledge of ICD-10, CPT, HCPCS, and payer billing rules
  • Ability to interpret and apply Medicare and commercial payor guidance
  • Skilled in reviewing medical documentation and assessing coding accuracy.
  • Proficient in EMR systems and audit software
  • Strong analytical skills, problem-solving ability, and documentation skills
  • Ability to navigate complex coding scenarios and provide clear recommendations
  • Comfortable supporting education and explaining coding concepts simply
  • Excellent communication, organization, and time-management skills
  • Strong attention to detail and accuracy
  • Analytical mindset with solid critical-thinking skills
  • High level of integrity and compliance awareness
  • Clear and supportive communicator
  • Comfortable educating and partnering with coding staff and providers
  • Process-improvement oriented
  • Able to work independently and within a collaborative team environment
  • You will be required to provide your own internet
  • You will be required to maintain your own quiet workspace
  • The teammate is required to sit for long periods of time. Use of telephone and Computer is required.
  • Manual dexterity required for use of computer keyboard.
  • Requires working under stressful conditions or working irregular hours.

Responsibilities

  • Assist in internal coding audits and quality checks for providers and coding staff
  • Validate and document audit findings and support data-driven reporting
  • Identify trends, patterns, and risk areas
  • Track audit results and follow-up remediation activities
  • Monitor federal, state, and payer-specific coding and billing updates
  • Help maintain compliance with CMS, payer rules, ICD-10, CPT, and HIPAA
  • Research coding and compliance questions and escalate when needed
  • Identify risk trends and provide recommendations to improve compliance
  • Assist in updating compliance monitors, workflows, and audit protocols
  • Support the development and maintenance of policies and SOPs
  • Participate in coding and provider training sessions
  • Support annual compliance training coordination
  • Assist in preparing reports for compliance initiatives and regulatory readiness

Benefits

  • health coverage
  • 401k with match
  • profit share
  • PTO
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