Coding Quality Auditor

🔥 12 hours ago

☕ Washington – Remote

☕ Washington – Remote

💵 $37 - $57 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

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This company has sponsored H1B visas in the past.

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Providence

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1856

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

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 for accurate, highly specific coding • Query providers to clinically validate or clarify diagnosis criteria • Review documentation for compliant reporting, billing, and RVU capture • Serve as a coding expert • Work with the Quality Integrity Program manager and clinical documentation review team • Ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions, and regulatory oversight requirements

🎯 Requirements

• 2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVUs • Experience reviewing patient account information, insurance explanations of benefits, computer screens, and financial records • Within 1 year of hire: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) • Bachelor's degree preferred, or equivalent education/experience • Within 1 year of hire: Certified Risk Adjustment Coder (CRC) preferred • Within 1 year of hire: Certified Professional Medical Auditor (CPMA) or Certified Healthcare Compliance Auditor (CHCA) preferred • Experience in HCC coding preferred

🏖️ Benefits

• Retirement 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 • Health-related time off benefits • Voluntary benefits • Well-being resources • Inclusive workplace and equal opportunities for advancement