Coding & Compliance Specialist

  • MaineHealth
  • South Portland, ME, USA
  • Feb 03, 2021

Job Description


*On-site weekly requirements until training is complete*

The Coding Compliance Specialist position is chiefly responsible for auditing and educating all MMP physicians, APPs, and other supporting providers and ancillary staff in a multi-specialty settings.   Our mission is to create a positive rapport between the clinical staff and our department to help promote accurate coding practices. The Specialist reviews each encounter notes for accuracy, including evaluation and management coding; office procedural coding; diagnostic coding; as well as other relevant, non-clinical, compliance elements. 

Meet personally with new hires to provide clinical staff and providers with onboarding education to help establish a strong foundation of communication, rapport, and coding education and compliance knowledge. Continued education is provided throughout the year.  Responds promptly to coding inquiries from providers or others with precise and accurate results, as well as the ability to research and interpret regulations and coding changes. 

Coding Compliance Specialists should possess the ability to work independently as well as in a group setting.  Maintaining coding. This particular position involves Neurology, Nephrology, Urology, Pediatric Surgery, Cardiology and Primary Care. Compliance education and relevant certifications required.


Required Minimum Knowledge, Skills, and Abilities (KSAs)

1.            Certified Professional Coder (CPC or CPMA).

2.            CRC not required, but preferred.  

3.            HCC/Risk Diagnostic Coding knowledge preferred.

4.            Minimum 3 years related experience.

5.            High school diploma or equivalent.

6.            Working knowledge of CPT-4 and ICD-10 coding.

7.            Knowledge of coding policies and billing practices.

8.            Excellent communication, customer service, and interpersonal skills with the ability to communicate clearly in person, in writing, and on the phone

9.            Ability to read, interpret medical charts and perform a coding audit.

10.          Excellent organizational skills with the ability to accomplish multiple tasks.

11.          Proficient computer skills to include Excel, Word, PowerPoint and Go-To-Meetings.

12.          Ability to maintain confidentiality.

13.          Ability to work independently and as a team member with minimal direct supervision.

14.          Ability to maintain a professional manner at all times.