
Healthcare Insurance
Providence is a not-for-profit health system committed to providing a wide range of medical services, including primary care, urgent care, pediatrics, maternity care, cancer treatment, and specialized services like neurosurgery and orthopedics. They offer both in-person and virtual care through clinics and a mobile app, ensuring patients can access healthcare conveniently. With a mission rooted in compassion, dignity, and justice, Providence emphasizes serving those who are vulnerable and strives for excellence in healthcare delivery. They are involved in research and innovation, including genomic profiling and clinical trials to improve patient outcomes.
40 minutes ago
🏄 California – Remote
🌲 Oregon – Remote
+1 more states
💵 $28 - $57 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
🧐 Analyst
🦅 H1B Visa Sponsor

Healthcare Insurance
Providence is a not-for-profit health system committed to providing a wide range of medical services, including primary care, urgent care, pediatrics, maternity care, cancer treatment, and specialized services like neurosurgery and orthopedics. They offer both in-person and virtual care through clinics and a mobile app, ensuring patients can access healthcare conveniently. With a mission rooted in compassion, dignity, and justice, Providence emphasizes serving those who are vulnerable and strives for excellence in healthcare delivery. They are involved in research and innovation, including genomic profiling and clinical trials to improve patient outcomes.
• Responsible for updating and creating Coding Policies and associated edit configurations within the PHP claims editing system • Reply to provider and member appeals providing appropriate CPT, CMS, specialty society, Coding Policy, and documentation rationale for Coding Policy edits • Monitor changes to codes, coding guidelines and regulations, and coding edits from external agencies • Assist with implementation of such changes to the claims adjudication and editing software • Serve as a coding subject matter expert to other departments within PHP for questions about CPT, HCPCS, and ICD-10 codes
• Coding certification through AAPC (CPC) or AHIMA (CCS) upon hire • 5 years of experience directly related to CPT coding from chart extraction with a health care provider, a health insurance company, or a capitated managed care company • 5 years of excellent writing and grammar skills required • 5 years of demonstrated experience in detailed coding applications, as well as Microsoft Office capabilities, such as Excel, Word, and Access • Bachelor's Degree or experience in a Healthcare or Health Plan setting coding and auditing will also be considered (preferred)
• Comprehensive benefits package including health care benefits (medical, dental, vision) • Retirement 401(k) Savings Plan with employer matching • Paid time off including paid parental leave, vacations, holidays, and health issues • Disability insurance • Life insurance • Wellness resources and much more
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