Providence Health & Services HCC Coding Specialist in Spokane Valley, Washington
Providence is calling a HCC Coding Specialist (Day Shift, 1.0 FTE) to Providence Medical Group in Spokane, Washington. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
In this position you will:
Review medical records and practice management code data. Determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy.
Coordinate changes in insurance regulations and assist with regular in-services to providers, clinical staff and business office. Update providers, clinical staff and business office staff on correct CPT, HCPC, and ICD-9 coding.
Investigate codes for insurance companies and provide them with the information necessary to determine more appropriate reimbursement levels.
Assist in keeping all charge tickets up-to-date with current CPT and ICD-9 codes.
Meet periodically with provider specialty groups to discuss any changes in coding or reimbursement, and provide ongoing education. Act as a resource to physicians, clinical staff and business office staff regarding questions.
Analyze monthly reimbursement reports for trends. Trouble shoot with business office staff for alternative billing options and effective reimbursement strategies.
Demonstrate knowledge and understanding of patient privacy rights. Maintain confidentiality of all medical, financial, or other sensitive materials and information in printed, electronic or verbal form, which may jeopardize the privacy of patients and/or employees. Access and use the minimum necessary patient identifiable information to perform job responsibilities and duties and only for authorized purposes.
Utilize your knowledge of agency billing and reimbursement regulations for KCMBS, DSHS, Medicare, HMO’s and PPO’s.
Be required to work with medical terminology, CPT, ICD-9 and HCPC coding.
Extensive knowledge of E&M requirements for chart auditing.
Required qualifications for this position include:
High School diploma or equivalent
Current Basic Life Saving (BLS) certification required within 90 days of hire
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 Administrator (RHIA)
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)
Certified Professional Coder – Outpatient Hospital (CPC-H)
Certified Professional Coder – Payer (CPC-P)
Preferred qualifications for this position include:
Associates degree or higher, Field of Study: Business or Finance
Previous HCC coding experience highly preferred
About the clinic you will serve.
Providence Medical Group is a group of primary care, specialty care and hospital-based medical providers who serve eastern Washington in clinic locations. Our providers and staff strive to create a distinctive health care experience for each patient – one focused on trust, respect, communication and teamwork.
We offer a full comprehensive range of benefits - see our website for details
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.
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.
Job Category: Coding
Location: Washington-Spokane Valley
Req ID: 161184