[Hiring] Coding & Documentation Compliance Specialist @Shapely

Role Description

This is a remote position.

You'll be the person who makes sure what we document supports what we bill, and that we're capturing everything we legitimately earn. This is a hands-on coding and auditing role reporting to the Senior Medical Director — not a policy, billing-clerk, or general compliance position.

You'll work in two modes:

• Prospectively, you'll help us assess which codes are safe to use for a given visit type as well as what documentation needs to be present to use the code compliantly.
• Retrospectively, you'll audit charts to confirm the documentation holds up with high accuracy, and turn opportunities for improvement into templates, workflow fixes, and education.

What you'll do:

• Audit:
  • Conduct a baseline documentation audit (10–20 charts per billing provider) across encounters, and deliver a findings report with error rates by provider and service line.
  • Run ongoing quarterly audits (10 charts per provider) plus focused service-line reviews.
  • Perform 100% pre-bill review during new-code rollouts until the error rate is under 5%.
  • Place any provider above a 10% error rate on monthly review with targeted education until they're back under threshold.
• Code evaluation:
  • Evaluate appropriateness of unused or underused codes for our care model and define the documentation each requires before we bill it.
  • Write documentation guidance for our clinical staff and billing team.
• MIPS:
  • Assist with success with MIPS, including determining appropriate measures and ensuring our documentation exceeds requirements.
  • Provide suggestions on enhancing our templates to optimize accuracy and compliance with MIPS.

Qualifications

• CPC (AAPC) or CCS-P (AHIMA)
• CPMA strongly preferred, or equivalent demonstrated chart-audit experience
• 5+ years coding outpatient E/M, with direct auditing experience
• Strong knowledge of Medicare telehealth rules
• Experience with MIPS reporting and quality-measure documentation
• US-based, with strong Medicare experience

Requirements

• Obesity medicine, endocrinology, or primary care background (nice to have)
• Prior work with OIG self-disclosure or payer audit response (nice to have)
• Experience building documentation templates or clinician cheat-sheets (nice to have)