Coding Quality Analyst

Priority Health; Grand Rapids (MI); On-site; USD 60,000 - 85,000; Full time

Job summary

Priority Health in Grand Rapids seeks a qualified coding and revenue management professional to bridge physicians, rehab services, and billing offices. The role emphasizes coding quality reviews, education, and process improvements within patient financial services.

Responsibilities include meetings with providers, reviewing billing reports, and acting as a resource on regulatory and documentation issues to improve reimbursement outcomes.

Qualifications

• Bachelor's Degree in accounting, finance, health care administration, or related field or equivalent combination of education and experience.
• 2 years of relevant experience in various hospital functions (e.g., professional/facility coding, reimbursement, billing, and/or chargemaster maintenance).
• RHIA, RHIT, CCS, or Professional Coder certifications upon hire.

Responsibilities

• Meets with providers and coding employees regularly on billing, coding and reimbursement issues.
• Reviews monthly reporting from billing system with a focus on revenue cycle metrics, unbilled accounts, and adequate documentation.
• Acts as a liaison between the Coding department and Spectrum Health to enhance educational awareness of coding and documentation.
• Reviews coding patterns/trends and provides ongoing consultation to providers regarding coding and documentation issues.
• Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or process improvements.
• Presents information to physicians, administrators and other institutional leadership.
• Acts as an expert resource for administrators and physicians in regulatory, coding, billing compliance and financial functions.

Education

Bachelor's Degree in accounting, finance, health care administration, or related field or equivalent combination of education and experience

2 years of relevant experience in hospital functions (coding, reimbursement, billing, chargemaster)

Tools

RHIA/RHIT/CCS/Professional Coder certifications

Job description

Job Summary

Acts as a liaison between physician practices, rehab services, professional billing office, coding, payer relations, compliance and revenue management operations of patient financial services and Spectrum Health. Provides assistance to management and employees. Conducts coding quality reviews for the coding department, rehab services and physician practices.

Essential Functions

• Meets with providers and coding employees regularly on billing, coding and reimbursement issues applicable to their specialty.
• Reviews monthly reporting from billing system with a focus on revenue cycle metrics, unbilled accounts, and adequate documentation.
• Acts as a liaison between the Coding department and Spectrum Health to enhance educational awareness of coding and documentation. Participates and initiates process and quality improvement activities.
• Reviews coding patterns/trends and provides ongoing consultation to providers regarding coding and documentation issues.
• Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or process improvements.
• Presents information to physicians, administrators and other institutional leadership.
• Acts as an expert resource for administrators and physicians in regulatory, coding, billing compliance and financial functions.

Qualifications

Required

• Bachelor's Degree accounting, finance, health care administration, or related field or equivalent combination of education and experience
• 2 years of relevant experience progressive experience in various hospital functions (e.g., professional/facility coding, reimbursement, billing, and/or chargemaster maintenance)
• CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association Upon Hire required Or
• CRT-Registered Health Information Technician (RHIT) - AAPC American Academy of Professional Coders Upon Hire required Or
• CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Upon Hire required Or
• CRT-Professional Coder - AAPC American Academy of Professional Coders Upon Hire require

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1239 E Beltline Ave NE - Grand Rapids

Department Name

Medical Code Review - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

Flexible: 7 a.m. to 5 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.