Behavioral Health Medical Coding & Compliance Specialist
New
C
Community Reach CenterBehavioral Health
Westminster, Colorado (flexible remote working conditions will be considered)Full-TimeMiddle
Salary$65,000-$75,000/yr
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Job Details
- Experience
- Two years minimum experience healthcare auditing or utilization review (or 5 years in a like role if no Bachelor's)
- Required Skills
- Microsoft OfficeDocumentation
Requirements
- Certified Professional Coder (CPC) certification required.
- Minimum of two years of experience in healthcare auditing or utilization review.
- Bachelor's degree preferred (or 5 years of relevant experience in a like role).
- Strong professional knowledge of Microsoft Office Suite, including PowerPoint.
- Strong communication, organization, and time management skills.
- Knowledge of Colorado State laws, rules, and policies regarding mental health licensure.
- Knowledge of clinical documentation standards (CMS, State, Federal, AMA).
- CPMA, CPS, or CDEO certifications are a plus.
- Chart review experience, specifically in behavioral health, preferred.
- Bilingual (Spanish) skills are a plus.
Responsibilities
- Design and implement internal compliance audits to monitor documentation accuracy and adherence.
- Conduct audits as determined by the Manager or Director.
- Oversee preparation for and participate in external audits, ensuring appropriate access to PHI.
- Coordinate with Program Managers and Directors to address and monitor corrective action needs.
- Collaborate with Utilization and QI Managers to track and monitor client outcomes for quality improvement.
- Create and implement systems to ensure clinical documentation complies with internal policies, CMS, state/federal regulations, and AMA guidelines.
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