Coding Analyst

This is a fully remote position, open to applicants in Washington.

📋 Description

• Conduct thorough diagnostic coding pertinent to Risk Adjustment and HCC coding.

• Oversee technically intricate coding applications that influence revenue, CMS compliance, operations, programs, information systems, and contracted providers.

• Detect and investigate provider diagnostic coding discrepancies.

• Examine medical records and uphold documentation standards.

• Recognize provider coding mistakes and facilitate educational opportunities.

• Provide guidance on the formulation of Health Plan Payment Rules relevant to risk adjustment.

• Maintain trustworthiness with providers concerning coding regulations and applications.

• Incorporate coding applications into evolving Health Plan settings.

• Handle multiple priorities and varied deadlines efficiently.

• Communicate and collaborate effectively with Plan departments, personnel, providers, provider office staff, and hospital staff.

• Keep abreast of evolving coding regulations, guidelines, and requirements set by accrediting bodies.

⛳️ Requirements

• Completion of coursework/training in an accredited medical coding program, or coding experience in a healthcare environment may be considered.

• A minimum of 3 years of experience as a certified coder in a healthcare provider organization or health insurance company.

• In-depth knowledge of ICD-9, ICD-10, and other coding systems.

• A Bachelor's degree or equivalent education/experience is preferred.

• At least 1 year of experience with HCC coding is preferred.

• Familiarity with medical record review and documentation standards.

• Capability to investigate provider diagnostic coding issues.

• Skill in identifying provider coding errors and providing related education.

🏝️ Benefits

• Retirement 401(k) Savings Plan with employer matching.

• Medical, dental, and vision health care benefits.

• Life insurance.

• Disability insurance.

• Paid parental leave.

• Vacation time.

• Paid holidays.

• Paid time off for health-related matters.

• Voluntary benefits.

• Well-being resources.

• An inclusive workplace that values diversity.

• Additional compensation may be available for shift differentials, standby/on-call duties, overtime, premiums, extra shift incentives, or bonus opportunities.