HCC Coding Quality Auditor

Providence; Everett (WA); On-site; USD 70,000 - 95,000; Full time

Job summary

Join a culture focused on patient-centered care and collaboration, where your expertise helps maintain regulatory compliance and high-quality documentation across our care teams in Northwest Washington.

Qualifications

• 2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVU's.
• Experience in reviewing patient account information, insurance explanation of benefits, computer screens, and financial records.
• Within 1 year of hire: CPC or CCS certification.

Responsibilities

• Perform detailed diagnostic chart reviews of clinical documentation and coding for Risk Adjustment and HCC coding.
• Query providers to clinically validate or clarify diagnosis criteria.
• Review for compliant documentation resulting in compliant reporting/billing and RVU capture.

Skills

Medical billing and coding

RVU review

Healthcare coding compliance

Education

Bachelor's Degree or equivalent

Job description

Join a culture focused on patient-centered care and collaboration, where your expertise helps maintain regulatory compliance and high-quality documentation across our care teams in Northwest Washington.