Director of Documentation Integrity and Coding

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes, modifiers and audit activities related to health plan operations, risk adjustment, payer audits and regulatory requirements. This role ensures accurate medical coding, documentation integrity, and adherence to federal, state, and payer-specific guidelines.

The ideal candidate will possess advanced CPC coding expertise, strong analytical skills, and extensive experience supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week.

Responsibilities:

• Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians and coders.
• Ensure provider documentation and coding practices comply with CMS, Medicare, Medicaid, commercial payer, and applicable federal and state regulatory requirements.
• Conduct coding compliance audits to identify...