Compliance/Quality Specialist & Medical Coder

Responsibilities

• Monitor and interpret regulations from bodies such as HIPAA, OSHA, and the Joint Commission to ensure organizational adherence to legal and accreditation standards.
• Develop, implement, and maintain compliance policies and procedures to mitigate organizational risk.
• Conduct regular internal compliance and quality audits and support external audits conducted by agencies like CMS and DHS.
• Review and accurately code medical records using ICD-10, CPT, HCPCS, and DSM-V to maximize reimbursement and support healthcare operations.
• Ensure the quality of medical records by verifying completeness and accuracy within the Electronic Health Record (EHR) system.
• Collaborate with clinical staff and administration to develop and implement corrective action plans following compliance investigations.
• Provide guidance and educational support to physicians and clinical staff regarding documentation compliance and coding guidelines.

Requirements

• Associate’s degree in health information technology, medical coding, healthcare administration, or a related field.
• 3–5 years of experience in a compliance and/or quality role, preferably within a mental health or healthcare setting.
• Proficiency in medical coding systems including ICD-10, DSM-5, CPT, and HCPCS.
• Strong working knowledge of HIPAA, privacy rules, and legal/quality management principles.
• Proficiency with Microsoft Office and Electronic Health Record (EHR) software.
• Mandatory Reporter of Child/Dependent Adult Abuse Certification (or ability to obtain within six months of hire).

Preferred Qualifications

• Bachelor’s degree in healthcare administration, psychology, or social work.
• Professional certification in medical coding, compliance, or quality management.

Benefits

• Health, dental, and vision insurance (up to 79% employer paid).
• 401(k) with profit sharing and employer match.
• Paid time off, including 10 paid holidays, sick time, and wellness days.
• Public Service Loan Forgiveness (PSLF) eligibility.
• Employer-paid CEUs through Relias and staff development opportunities.
• Employee assistance program and PerkSpot discount program.

About the Company

Hillcrest Family Services is a non-profit organization dedicated to assisting adults and children in need. We strive to be a leading provider in supporting brain health and wellness, fostering an environment where compassion is commonplace and every individual is supported.