[Hiring] Coding Analyst @Providence

Role Description

The Coding Analyst is responsible for detailed diagnostic coding associated with Risk Adjustment and HCC coding. This impacts revenue and CMS compliance with the coordination of technically detailed coding applications that impacts operations, programmatic and information systems, as well as contracted providers. Coding analyst will have a comprehensive understanding of ICD-9, ICD-10 and other types of coding to Health Plan, contracted facilities, and providers. This includes:

• Identification and researching of provider diagnostic coding issues
• Medical record review
• Documentation standards
• Identifying and offering education in relation to provider coding errors
• Advisory role in development of Health Plan Payment Rules related to risk adjustment

MAJOR CHALLENGES:

• Maintaining credibility with Providers for coding rules and applications
• Integrating coding applications into the changing environment of the Health Plans
• Managing multiple priorities efficiently and effectively
• Working and communicating effectively with all Plan departments and levels of personnel, providers, provider office staffs, hospital staff
• Distributing the work load over the course of the year
• Coordinating workload to meet multiple and varying deadlines
• Staying current with frequently changing coding rules and regulations, accrediting bodies, et al and determining when these changes impact Health Plan operations

Qualifications

• Coursework/Training: Accredited program for medical coding or experience in coding in a Healthcare setting may be considered
• 3 years experience as a certified coder within a healthcare provider organization or health insurance company

Requirements

• Bachelor's Degree or equivalent education/experience
• 1 year experience in HCC Coding (preferred)

Benefits

• 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