Coding Analyst
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Job Description
Coding Analyst performing risk adjustment and HCC diagnostic coding for Providence healthcare plans. Reviewing records, researching coding issues, educating providers, and advising on payment rules.
Responsibilities:
- Perform detailed diagnostic coding associated with Risk Adjustment and HCC coding
- Coordinate technically detailed coding applications affecting revenue, CMS compliance, operations, programs, information systems, and contracted providers
- Identify and research provider diagnostic coding issues
- Review medical records and documentation standards
- Identify provider coding errors and provide education
- Advise on the development of Health Plan Payment Rules related to risk adjustment
- Maintain credibility with providers regarding coding rules and applications
- Integrate coding applications into changing Health Plan environments
- Manage multiple priorities and varying deadlines
- Communicate and coordinate effectively with Plan departments, personnel, providers, provider office staff, and hospital staff
- Stay current with changing coding rules, regulations, and accrediting-body requirements
Requirements:
- Coursework/training in an accredited medical coding program, or coding experience in a healthcare setting may be considered
- 3 years of experience as a certified coder within a healthcare provider organization or health insurance company
- Comprehensive understanding of ICD-9, ICD-10, and other coding types
- Bachelor's degree or equivalent education/experience preferred
- 1 year of HCC coding experience preferred
- Knowledge of medical record review and documentation standards
- Ability to research provider diagnostic coding issues
- Ability to identify provider coding errors and offer related education
Benefits:
- Retirement 401(k) Savings Plan with employer matching
- Medical, dental, and vision health care benefits
- Life insurance
- Disability insurance
- Paid parental leave
- Vacation time
- Paid holidays
- Paid time off for health issues
- Voluntary benefits
- Well-being resources
- Inclusive workplace where diversity is valued
- Additional compensation may be available for shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities
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