Coding Quality & Compliance 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

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.