Coding & Documentation Compliance Specialist (CPC/CPMA)

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

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.

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.

• 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

• 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.

• 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

• 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

• 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

Originally posted on Himalayas