Coding Analyst

Providence; Spokane (WA); Remote; USD 44.000 - 68.000; Vollzeit

Zusammenfassung

Providence is seeking a Coding Analyst responsible for detailed diagnostic coding tied to Risk Adjustment and HCC coding that impacts revenue and CMS compliance. The role requires depth in ICD-9/ICD-10 coding across health plans, facilities, and providers, including issue research and education on coding errors.

You will advise on Health Plan Payment Rules related to risk adjustment and work with multiple departments to ensure accurate coding and timely delivery.

Qualifikationen

• 3 years experience as a certified coder within a healthcare provider organization or health insurance company.
• Accredited program for medical coding or equivalent healthcare coding experience.

Aufgaben

• Carry out detailed diagnostic coding for Risk Adjustment and HCC coding.
• Research provider coding issues through medical record review and documentation standards.
• Advise on Health Plan Payment Rules related to risk adjustment.
• Coordinate coding applications with health plan operations, providers, and departments.

Kenntnisse

Certified coder experience

Ausbildung

Bachelor's Degree or equivalent

1 year HCC coding experience

Jobbeschreibung

Description

The Coding Analyst is responsible for detailed diagnostic coding associated with Risk Adjustment and HCC coding. This impacts revenue and CMS compliance with the coordination of technically detailed coding applications that impacts operations, programmatic and information systems, as well as contracted providers. Coding analyst will have a comprehensive understanding of ICD-9, ICD-10 and other types of coding to Health Plan, contracted facilities, and providers. This includes the identification and researching of provider diagnostic coding issues; medical record review, documentation standards and identifying and offering education in relation to provider coding errors. Coding analyst will be in an advisory role in development of Health Plan Payment Rules related to risk adjustment.

MAJOR CHALLENGES:

• Maintaining credibility with Providers for coding rules and applications.
• Integrating coding applications into the changing environment of the Health Plans.
• Managing multiple priorities efficiently and effectively.
• Working and communicating effectively with all Plan departments and levels of personnel, providers, provider office staffs, hospital staff.
• Distributing the work load over the course of the year.
• Coordinating workload to meet multiple and varying deadlines.
• Staying current with frequently changing coding rules and regulations, accrediting bodies, et al and determining when these changes impact Health Plan operations.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Physician Management Group and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we Providence know that to inspire and retain the best people, we must empower them.

Required qualifications:

• Coursework/Training: Accredited program for medical coding. Or Experience in coding in a Healthcare setting may be considered.
• 3 years Experience as a certified coder within a healthcare provider organization or health insurance company.

Preferred qualifications:

• Bachelor's Degree. Or equivalent educ/experience
• 1 year Experience in HCC Coding.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.

PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 461770
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Admin Support
Department: 3042 REVENUE INTEGRITY HCC
Address: WA Spokane 20 W 9th Ave
Work Location: Mother Gamelin Ctr-Spokane
Workplace Type: Remote
Pay Range: $31.73 - $49.27
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.