Senior Coding Compliance Specialist

About Sound Physicians

Headquartered in Tacoma, WA, Sound Physicians is a physician-founded, multi-specialty medical group operating in over 400 hospitals across 45 states. With a team of more than 4,000 physicians, APPs, CRNAs, and nurses, Sound specializes in emergency medicine, hospital medicine, critical care, anesthesia, and telemedicine. Our mission is to innovate and lead through a changing healthcare landscape with patients at the center of everything we do.

Benefits include:

• Medical, dental, and vision insurance

• Health care and dependent care flexible spending accounts

• 401(k) retirement plan with company match

• Paid time off (15 days/year) plus 10 company-paid holidays

Role Overview

The Senior Coding Compliance Specialist ensures provider compliance with billing and privacy regulations by conducting retrospective coding and documentation reviews. This role identifies coding inaccuracies, provides feedback for improvement, and collaborates with clinical leadership to mitigate risk and enhance compliance processes.

You will serve as a compliance lead, supporting education, audits, and program development while maintaining current knowledge of federal and state healthcare regulations, CMS, Medicaid, and Medicare Advantage requirements.

Key Responsibilities

• Conduct complex coding and documentation compliance reviews in inpatient, post-acute care, and telemedicine settings.

• Verify accuracy of CPT, ICD-10 CM, and HCPCS coding assignments.

• Review special cases based on audits, inquiries, or risk assessments.

• Prepare detailed written reports on compliance findings, including refund calculations when necessary.

• Perform follow-up reviews to evaluate the efficacy of implemented recommendations and provider education.

• Maintain knowledge of healthcare billing processes, regulatory requirements, and current coding initiatives.

• Serve as a knowledge resource for coding and documentation standards, providing guidance to providers and administrative staff.

• Maintain confidentiality and integrity in all compliance activities.

• Participate in committees, workgroups, and process improvement projects as assigned.

Knowledge, Skills, and Abilities

• Extensive knowledge of 2023 E/M Documentation Guidelines, ICD-10 CM, CPT, and HCPCS coding standards.

• Strong understanding of federal/state regulations, CMS, Medicaid, and Medicare Advantage.

• Ability to interpret physician documentation and extract accurate billable services.

• Experience in Critical Care, Acute Rehab, Nursing Facility, Telemedicine, and Post-Acute Care billing and coding operations.

• Strong analytical and problem-solving skills with the ability to perform root-cause analysis.

• Excellent oral, written, and interpersonal communication skills.

• Ability to manage multiple priorities in a fast-paced, complex environment.

• Proficiency with Windows-based software and Microsoft Office Suite in a networked environment.

Qualifications

• Bachelor’s degree in Health Sciences, Business, or related field preferred (or equivalent experience).

• Current coding credential from AHIMA and/or AAPC.

• Minimum of 5 years’ experience in coding operations, compliance, and billing across critical care, post-acute, and telemedicine settings.

• Strong knowledge of documentation, billing, and coding compliance requirements.

Core Values at Sound Physicians

• Detail-Oriented: Consistently delivers accurate work with sensitivity to confidential information.

• Responsive: Prioritizes timely communication and follow-up.

• Solution-Seeker: Uses judgment to address issues independently and escalate when necessary.

• Collaborative: Partners effectively across teams.

• Empathetic: Balances professionalism with compassion in employee and provider interactions.

• Continuously Improving: Seeks innovative ways to optimize workflows using technology and process improvements.

Equal Employment Opportunity:
Sound Physicians is committed to diversity, equity, and inclusion. Qualified applicants will be considered without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, or disability.

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