Coding Quality Analyst Priority Health

Corewell Health Corporate; Grand Rapids (MI); On-site; USD 75,000 - 110,000; Full time

Benefits offered by this job

On-demand pay (Payactiv)

Discount directory with deals

Identity theft protection

Traditional retirement options with 3–

Job summary

Corewell Health seeks a dedicated professional to act as a liaison among physician practices, rehab services, professional billing, coding, payer relations, compliance and revenue management operations. The role supports management, conducts coding quality reviews, and drives improvements in documentation and revenue integrity.

The candidate should have a related Bachelor’s degree and 2+ years in hospital coding/reimbursement, plus RHIA/RHIT/CCS or equivalent certifications.

Qualifications

• Bachelor's degree in accounting, finance, health care administration, or related field.
• 2 years of relevant experience in hospital coding, reimbursement, or billing.
• Progressive experience in various hospital functions (e.g., professional/facility coding, reimbursement, billing, chargemaster maintenance).
• RHIA, RHIT, CCS, and Professional Coder certifications listed in job requirements.

Responsibilities

• Meet with providers and coding staff on billing, coding and reimbursement issues.
• Review monthly reporting from billing system focusing on revenue cycle metrics and unbilled accounts.
• Act as liaison between Coding and Spectrum Health to improve coding/documentation education.
• Proactively identify problems and opportunities and implement process improvements.
• Present information to physicians and leadership and serve as an expert resource on regulatory, coding, and financial functions.

Skills

Billing and coding knowledge

Regulatory compliance

Communication with physicians

Process improvement

Education

Bachelor's degree in accounting/finance/health care administration or related field

RHIA

RHIT

CCS

Professional Coder (AAPC)

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
• CRT-Registered Health Information Technician (RHIT) - AAPC American Academy of Professional Coders
• CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association
• CRT-Professional Coder - AAPC American Academy of Professional Coders

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.

• 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

Learn more here.

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 8 a.m. to 5 p.m. Days Worked Monday to Friday Weekend Frequency N/A

CURRENT COREWELL HEALTH TEAM MEMBERS –

This career site is for Non-Corewell Health team members only.

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.

People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency.

Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.