Legacy Health · 1 day ago
Coding Compliance Analyst
Legacy Health is a healthcare organization committed to improving lives within the community. The Coding Compliance Analyst will develop, implement, and monitor systems ensuring compliance with Medicare and other payor documentation guidelines, while providing training and support to physicians and staff.
Hospital & Health Care
Responsibilities
Works closely with Regulatory department to support adherence to compliance policies relating to professional coding
Provides new physician orientation related to regulatory compliance, documentation and coding guidelines
Analyzes physician practices to identify charge opportunities and ensure all billable services are captured
Provides in-services to providers and staff on proper coding and documentation
Oversees the set-up of new CPT Codes
Updates and reviews fee tickets annually and ensures system files are updated accordingly
Identifies need for and enlists consultant services as needed
Participates in reimbursement analysis to determine if denials relate to CPT or diagnostic coding
Defines criteria for payor specific reimbursement for correct payment analysis
Investigates payor response to new CPT/HCPCS codes
Analyzes and documents the patient account cycle for each physician or physician line of business for timely and accurate processing
Provides onsite initial and ongoing CPT and ICD-9 training to providers and staff
Acts as a resource to physicians for CPT and diagnostic coding questions
Performs regular audits to ensure compliance with coding and documentation guidelines. Provides feedback to physicians, both written and verbally, regarding coding and documentation accuracy
Qualification
Required
RHIT, RHIA, CCS, CCS-P or CPC certification required for this role
Associate's degree in business or healthcare, or equivalent experience, required
Minimum of two years healthcare experience required
Strong communication skills, both verbal and written
Ability to speak in front of large and small groups
Proven ability to develop training programs, provide training and oversee work processes
Excellent organizational skills and the ability to handle large volumes of work
Demonstrated understanding of insurance reimbursement and payment methodology
Competent in Microsoft Excel and Word software
Preferred
CPT/ICD9 experience in a multi-specialty setting preferred
Database experience preferred
Company
Legacy Health
Good health for our people, our patients, our communities and our world.
Funding
Current Stage
Late StageLeadership Team
Recent News
Fierce Healthcare
2025-06-06
2025-05-31
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