Coding Quality Auditor – Revenue Capture
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Job Description
HCC Coding Quality Auditor responsible for detailed diagnostic chart reviews and coding accuracy at Providence Medical Group Northwest Washington. Ensuring compliant billing and accurate coding practices.
Responsibilities:
- Conduct detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding.
- Review and abstract HCC codes to ensure they are coded accurately, to the highest specificity.
- Query providers to clinically validate or clarify diagnosis criteria.
- Review for compliant documentation resulting in compliant reporting/billing and RVU capture.
Requirements:
- Within 1 year of hire: Certified Professional Coder (CPC) Or Certified Coding Specialist (CCS)
- 2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVU’s.
- Experienced in reviewing patient account information, insurance explanation of benefits, computer screens, and financial records.
- Preferred: Bachelor's Degree Or equivalent educ/experience
- Within 1 year of hire: Certified Risk Adjustment Coder (CRC)
- Within 1 year of hire: Certified Professional Medical Auditor (CPMA) Or Certified Healthcare Compliance Auditor (CHCA)
- Experience in HCC coding.
Benefits:
- Comprehensive benefits package including health care benefits (medical, dental, vision)
- 401(k) Savings Plan with employer matching
- Life insurance
- Disability insurance
- Time off benefits (paid parental leave, vacations, holidays, health issues)
- Voluntary benefits
- Well-being resources
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