What are the responsibilities and job description for the Coding Policy Analyst *Remote position at Providence Health?
Description
Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team 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 Health Plan is calling a Coding Policy Analyst who will:
- Be responsible for the coordination of technically detailed work that has a significant impact on all operations and information systems within Providence Health Plan (PHP)
- Update and create Coding Policies and associated edit configurations within the PHP claims editing system
- Be responsible for replying to provider and member appeals and providing appropriate CPT, CMS, specialty society, Coding Policy, and/or other official documented rationale for Coding Policy edits
- Be responsible for monitoring changes to codes, coding guidelines and regulations, and coding edits from external agencies such as AMA, CMS, Medicaid, and specialty societies, and assists with implementation of such changes to the claims adjudication and editing software
- Have extensive knowledge of AMA and CMS coding guidelines, policies, and regulations
- Serve as a coding subject matter expert to other departments within PHP for questions about CPT, HCPCS, and ICD-10 codes, as well as coding guidelines and regulations
- Work closely with the Benefits Management Team and Regulatory Department to ensure coding edits are applied in a manner consistent with member benefits and all state and federal insurance regulations
We welcome 100% remote work for residents who reside in one of the following States / Regions:
- Oregon
- Washington: Clark County
Required qualifications for this position include:
- 5 years of experience directly related to CPT Coding from chart extraction with a healthcare provider, health insurance company or a capitated managed care company
- 5 years of excellent writing and grammar skills
- 5 years' experience in detailed coding applications and MS Office
- Coding certification through AAPC (CPC) or AHIMA (CCS) required upon hire
Preferred qualifications for this position include:
- 2 years' experience with facets claims adjudication system and / or Optum CES editing software
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.
About Providence
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.
The amounts listed 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.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 255656
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 HCS MEDICAL MANAGEMENT OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $31.08 - $49.21
The amounts listed 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.
Check out our benefits page for more information about our Benefits and Rewards.
Salary : $31 - $49
