Coding Analyst - Revenue Capture

Providence St. Joseph Health - Everett, WA

Full-time - Mid Level

Everett, WA

10,001+ employees

Management of Companies and Enterprises

About the position

The Coding Analyst - Revenue Capture is responsible for detailed diagnostic coding related to Risk Adjustment and Hierarchical Condition Category (HCC) coding, which is crucial for revenue generation and compliance with CMS regulations. This role involves a comprehensive understanding of various coding systems, including ICD-9 and ICD-10, and requires the analyst to identify and resolve coding issues, conduct medical record reviews, and provide education on coding standards to healthcare providers. The position also plays an advisory role in the development of Health Plan Payment Rules associated with risk adjustment.

Responsibilities

• Perform detailed diagnostic coding associated with Risk Adjustment and HCC coding.
• Identify and research provider diagnostic coding issues.
• Conduct medical record reviews and ensure documentation standards are met.
• Offer education related to provider coding errors.
• Advise on the development of Health Plan Payment Rules related to risk adjustment.

Requirements

• 3 years of experience in coding within a healthcare provider organization or health insurance company.
• 3 years of experience as a RHIA, RHIT, or CPC certified coder.
• Demonstrated experience in project completion and educational program development.

Nice-to-haves

• Bachelor's Degree or equivalent experience in a healthcare setting.

Benefits

• 401(k) Savings Plan with employer matching
• Health care benefits (medical, dental, vision)
• Life insurance
• Disability insurance
• Paid parental leave
• Vacation and holiday time off
• Voluntary benefits
• Well-being resources