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 the identification and researching of provider diagnostic coding issues; medical record review, documentation standards and identifying and offering education in relation to provider coding errors. Coding analyst will be in an 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.

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

Required 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.

Preferred qualifications:

• Bachelor's Degree. Or equivalent educ/experience
• 1 year Experience in HCC Coding.

Why Join ?

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.

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