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Providence Health & Services Coding Auditor and Education Specialist in Spokane Valley, Washington


Providence is calling a Coding Auditor and Education Specialist PSJH to Providence Health & Services in Spokane, WA.

We are seeking a Coding Auditor and Education Specialist PSJH to audit medical records to ensure compliance with the organization's coding procedures and standards. Reviews insurance payments and denials and recommends billing corrections. Serves as a coding expert, working with the Coding Supervisor/Manager and the Clinical Documentation Improvement Program (CDIP) Data Integrity Liaison to ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions and regulatory oversight agencies.

In this position you will have the following responsibilities:

  • Assess, develop resources/materials, and conducts training to assure accurate coding of Health Information Management (HIM) coded medical records

  • Be responsible for monitoring and overseeing the coding integrity program

  • Develop competencies and quality assessment tools for education/compliance requirements

  • Conduct chart audits for physician documentation requirements & internal coding; provide associate/physician & education as appropriate

  • Review and revise departmental policies and provides education to coding staff regarding changes

  • Assist with the development and implementation of policies, procedures, standards and initiatives

  • Serve as Epic super-user and recommends system modifications to improve the organization’s coding functions

  • Develop and revise educational objectives and curriculum applicable to all Epic coding processes

  • Assist with developing goals, standards, and objectives that directly support the strategic plan and vision of the organization

  • Provide positive feedback in a constructive manner

  • Develop and maintain good working relationships with peers, physicians and other staff members

  • Work in a high volume environment while maintaining high quality standards

  • Adhere to established company compliance, policies, procedures and protocols


Required qualifications for this position include:

  • High School diploma or equivalent

  • 5 years experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVU’s.

  • Certification: Required Certified Professional Coder (CPC credential) or Registered Health Information Technician (RHIT) or holds at least one of the following coding credentials from the American Academy of Professional Coders (AAPC) and/or American Health and Information Management Association (AHIMA):

  • Registered Health Information Management Technician (RHIT)

  • Certified Coding Specialist (CCS)

  • Certified Coding Associate (CCA)

  • Certified Coding Specialist – Physician Based (CCS-P)

  • Certified Professional Coder (CPC)

  • Certification: Current BLS – Healthcare Provider (must be AHA accredited) or obtained within 90 days of hire

  • Extensive knowledge of CMS E&M documentation requirements

  • The ability to research and audit provider charges to ensure they are properly processed

  • Experience with provider and clinic staff feedback and education

  • Extensive knowledge of: medical terminology, CPT, ICD-10 and HCPCS coding

  • Experienced in reviewing patient account information, insurance explanation of benefits, computer screens, and financial records

  • Proficient with computer and data processing

  • Strong analytical, problem solving and written and oral communication skills

  • Advanced knowledge of coding principles for disease management process, Medicare Risk Adjustment scores and Medicare fee for scenarios

  • Demonstrated ability to mentor and motivate staff, identify and implement process improvement

  • Ability to effectively communicate to patients, customers, co-worker or leaders via written or verbal communication

  • Exhibit a high level of professionalism in all communication with all customers, both internal and external

Preferred qualifications for this position include:

  • Associates degree or higher

  • Previous experience teaching documentation guidelines to Providers

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

Our Mission

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.

About Us

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.

Schedule: Full-time

Shift: Day

Job Category: Coding

Location: Washington-Spokane Valley

Req ID: 212967