Coding & Documentation Compliance Specialist (CPC/CPMA)

Posted Yesterday
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Hiring Remotely in USA
Remote
Senior level
Fitness • Healthtech • Pharmaceutical • Telehealth
The Role
Conducts prospective and retrospective outpatient coding and documentation audits, evaluates code appropriateness, defines compliant documentation requirements, and supports MIPS reporting. Performs baseline, quarterly, focused, and pre-bill audits; tracks provider error rates; develops documentation guidance, templates, workflow improvements, and clinician education. Requires strong Medicare, telehealth, outpatient E/M coding, chart-audit, and quality-measure expertise.
Summary Generated by Built In

This is a remote position.

Remote (US-based) · Independent contractor · ~15–20 hrs/week ongoing · Reports to the Senior Medical Director

About Shapely

Shapely is transforming the weight loss industry through an innovative physician-led approach that makes weight loss care affordable for everyone. With evidence-based care, industry-leading support, and a seamless integrated app, we help thousands of patients across California, Florida, New York, and Texas access GLP-1 therapies and comprehensive weight management, all covered by insurance, including Medicare. Most of our patients are over 65.

Our care model is longitudinal and includes MDs/DOs, NPs, PAs, and RDNs. We bill fee-for-service and also participate in MIPS.

The role

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 teh coe 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



Requirements

Required

  • 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

Nice to have

  • Obesity medicine, endocrinology, or primary care background

  • Prior work with OIG self-disclosure or payer audit response

  • Experience building documentation templates or clinician cheat-sheets



Skills Required

  • CPC certification from AAPC or CCS-P certification from AHIMA
  • CPMA certification or equivalent demonstrated chart-audit experience
  • 5+ years of outpatient E/M coding experience
  • Direct coding and chart-auditing experience
  • Strong knowledge of Medicare telehealth rules
  • Experience with MIPS reporting and quality-measure documentation
  • US-based work authorization and strong Medicare experience
  • Background in obesity medicine, endocrinology, or primary care
  • Experience with OIG self-disclosure or payer audit response
  • Experience building documentation templates or clinician cheat sheets
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The Company
Year Founded: 2023

What We Do

Shapely is a physician-led telehealth platform offering affordable, insurance-covered weight loss treatment, including GLP-1 medications, nutrition, and other health services, with a focus on personalized care.

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