Providence HCC Coder Analyst in Seattle, Washington
Providence is calling a HCC Coder Analyst to support Providence Elderplace Finance and Business Services. This is a position that can work remotely in any area of the country, but there will be office space available in Seattle, Washington or Portland, Oregon. This is a part-time (0.8 FTE or 32 hours per week) position. Schedule is flexible.
We are seeking a HCC Coder Analyst - Elderplace Finance and Business Services that will be responsible for detailed diagnostic coding associated with Risk Adjustment and HCC coding. This impacts revenue and CMS compliance with the coordination of technically detailed coding applications that impacts operations, programmatic and information systems, as well as contracted providers. The Coder Analyst will have a comprehensive understanding of ICD-9, ICD-10 and other types of coding for ElderPlace PACE programs (both Portland & Seattle), contracted facilities, and providers. This includes the identification and researching of provider diagnostic coding issues; medical record review, documentation standards and identifying and offering education in relation to provider coding errors. This position will be in an advisory role in development of ElderPlace Payment Rules related to risk adjustment. The position may require some travel.
In this position you will have the following responsibilities:
Perform external/internal onsite audits for providers with billing and coding issues and provides follow-up education
Formulate recommendations for process improvement
Manage coding applications for ICD-9 and ICD-10.
Analyze medical database for the purpose of ensuring accurate payment; review services billed for compliance with accepted standards within the industry; initiates corrective actions
Act as the medical coding resource for ElderPlace for diagnostic coding issues
Develop educational programs as needed for internal and external entities either one on one or in large groups
Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
Analysis to identify, collect, assess, monitor and document encounter coding information as it pertains to Clinical Condition Categories
Assist with validation audits to evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS for reimbursement and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives
Required qualifications for this position includes:
Associate's Degree in Business -OR- related field
Current certification as a professional coder (RHIA, RHIT or CPC.)
Current certification as CRC -OR- must be obtained within one year of hire
Three (3) years of experience working in risk adjustment and HCC coding, which includes doing PACE HCC coding or Medicare Advantage HCC coding
Preferred qualifications for this position includes:
Bachelor's Degree in Business -OR- related field
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Coding
Other Location(s): Washington-Seattle
Req ID: 262786