Coding Quality Auditor – Revenue Capture

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🔥 2 minutes ago

☕ Washington – Remote

☕ Washington – Remote

💵 $37 - $57 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

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Providence

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1856

⚕️ Healthcare Insurance

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.

📋 Description

• 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