Document Review Specialist Position Available In Williamson, Tennessee

• Job Summary
• The Documentation Review Specialist conducts quality audits and reviews of medical records to ensure accurate coding and billing practices for professional services.

This role verifies that provider documentation supports submitted codes and meets payer and regulatory standards. The Specialist partners with internal stakeholders to identify compliance risks, deliver education, and promote consistent documentation practices across the organization.

• Essential Functions
• + Audits medical records to validate the accuracy of CPT, HCPCS, ICD-10, and HCC coding for professional services, including evaluation and management, procedural, and ancillary services.

+ Confirms medical record documentation meets required standards, including signatures, attestations, authorizations, ABNs, and consents, to support billing compliance. + Prepares clear, detailed audit reports using designated audit management tools, documenting findings and identifying trends or issues. + Collaborates with Compliance and Physician Practice leaders to share audit results and assist in developing targeted provider and staff education. + Serves as a subject matter resource on coding guidelines, billing regulations, and documentation standards. + Maintains up-to-date knowledge of payer rules, CMS regulations, and National and Local Coverage Determinations (NCDs and LCDs). + Participates in quality assurance by submitting bi-annual samples of audit work and maintaining an accuracy rate of 95% or higher. + Assists in the creation and maintenance of educational materials and documentation tools to support compliance. + Supports special projects as assigned in alignment with organizational compliance initiatives. + Ensures confidentiality and secure handling of provider, patient, and billing information in accordance with HIPAA and organizational policies. + Performs other duties as assigned. + Complies with all policies and standards.

• Qualifications
• + H.S. Diploma or GED required + Associate Degree in Health Information Management, Healthcare Administration, Nursing, or a related field preferred + 3-5 years of experience in professional coding, auditing, or clinical documentation review required + Experience working in a healthcare compliance, billing, or revenue cycle role preferred
• Knowledge, Skills and Abilities
• + Knowledge of current CPT, HCPCS, ICD-10, and HCC coding guidelines and billing regulations.

+ Familiarity with Medicare, Medicaid, and commercial payer documentation and reimbursement requirements. + Strong analytical, auditing, and documentation review skills with a high attention to detail. + Excellent written and verbal communication skills with the ability to clearly explain findings and recommendations. + Proficiency with Microsoft Office and audit management or electronic health record (EHR) systems.

• Licenses and Certifications
• + Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification required + Additional compliance or auditing certifications (e.

g., CPMA, CDEO) preferredEqual Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.