Providence Health & Services HCC Risk Adjustment Coder in Spokane Valley, Washington
Providence is calling a HCC Risk Adjustment Coder (PMG Revenue Integrity, Day Shift, Full Time) to Physician Management Group in Spokane, Washington. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
In this position you will:
Analyze payment policy and coding applications that have financial and operational impact associated with risk adjustment coding
Complete diagnostic coding audits for external payers, CMS, OHP, etc.
Responsible for the modification of Payment Rules related to risk coding following research of industry standards and other regulatory sources
Manage coding applications for ICD-9, ICD-10, and other applicable coding systems that apply to medical claims
Analyze medical claims database for the purpose of assuring accurate payment; review services billed for compliance with accepted standards within the industry; initiates corrective actions
Act as the medical coding resource for Health Plans for diagnostic coding issues. Develop educational programs as needed for internal and external entities either one on one or in large groups
Required qualifications for this position include:
Current certification as a professional coder is required (RHIA, RHIT or CPC)
Current certification as CRC is required or must be willing to obtain CRC within 1 year of hire
3 years experience as a RHIA, RHIT or CPC certified coder within a healthcare provider organization or health insurance company
Demonstrated experience in project completion, educational program development and/or group presentation
Preferred qualifications for this position include:
- Bachelor's Degree OR experience in a Healthcare setting
About the clinic you will serve.
Providence Medical Group is a group of primary care, specialty care and hospital-based medical providers who serve eastern Washington in clinic locations. Our providers and staff strive to create a distinctive health care experience for each patient – one focused on trust, respect, communication and teamwork.
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 Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. 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
Location: Washington-Spokane Valley
Req ID: 263479