Coding Quality Auditor - Revenue Capture

Providence St. Joseph Health

Everett, WA

JOB DETAILS
SKILLS
Auditing, Best Practices, Billing, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Clinical Study Publications, Clinical Validation, Community and Social Services, Diversity, Documentation, Health Insurance, Healthcare, Hospital, Medical Billing, Medical Coding, Regulatory Compliance, Reimbursement, Relative Value Unit (RVU), Revenue Management, Risk, Social Work
LOCATION
Everett, WA
POSTED
3 days ago

Under the supervision of the Coding Manager, Revenue Capture, the HCC Coding Quality Auditor is responsible for detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding. The incumbent reviews and abstracts HCC codes to ensure they are coded accurately, to the highest specificity, queries providers to clinically validate or clarify diagnosis criteria, and reviews for compliant documentation resulting in compliant reporting/billing and RVU capture.

Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Group Northwest Washington and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Providence Regional Medical Center Everett received the Health Grades Distinguished Hospital Award for Clinical Excellence four years in a row.

Required Qualifications:

  • Within 1 year of hire: Certified Professional Coder (CPC) Or
  • Within 1 year of hire: 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 Qualifications:

  • 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
  • Within 1 year of hire: Certified Healthcare Compliance Auditor (CHCA)
  • Experience in HCC coding.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate''s placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Company

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Providence St. Joseph Health

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