Billing Compliance Asst

Position Summary

The Billing Compliance Assistant is responsible for assisting in the monitoring of clinical documentation, CPT and ICD coding. This position initiates medical record review and recommends proper action.

Responsibilities

• Assess clinical documentation supporting medical services to ensure accurate and compliant billing of reported services.
• Review and monitor CPT and ICD coding for accuracy and compliance with applicable regulations and payer requirements.
• Perform retrospective audits for established providers and prospective audits for newly onboarded providers to ensure appropriate documentation, coding accuracy, and billing compliance.
• Assist with communicating and collaborating with clinical staff regarding documentation and coding requirements.
• Assist in the development and delivery of educational sessions related to coding, documentation, and payer-specific billing requirements for physicians and billing personnel.
• Prepare and maintain scheduled audits to ensure timely completion.
• Respond to departmental inquiries via email regarding clinical documentation review and coding assistance.
• Review and discuss results of pre-billing transaction reviews with the Billing Compliance Specialist and assist with the continued development and implementation of departmental compliance initiatives.
• Preforms other related duties.

Minimum Qualifications

• Bachelor's degree or equivalent in education and experience, plus three years of related experience.

Preferred Qualifications

• Knowledge of CPT, ICD 10, and medical terminology.
• Knowledge of computer program applications, EPIC billing system.

Other Requirements

• 2 years in Physician billing experience.
• Certifications as a Certified Professional Coder.
• Intermediate MS Office skills.
• Demonstrates confidence and professionalism when communicating with clinical and administration staff.
• Excellent verbal communication skills with the ability to clearly explain coding and documentation requirements.
• Strong written communication skills for reporting, documentation review, and educational materials.
• Ability to work independently while maintaining accuracy, attention to detail, and regulatory compliance.
• Strong analytical and problem-solving skills related to coding, documentation, and billing practices.
• Ability to work well with physicians, good organizational skills and ability to set priorities.