Senior Coder: Reimbursement (Remote)

Description

Providence is calling a Senior Coder: Reimbursement 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
• Be responsible for review of all medical coding and billing as part of the Reimbursement Team of Utilization Management. This includes claim audits to ensure correct coding, edit configuration in the claims editing system, replying to provider/facility appeals and providing appropriate CPT, CMS, specialty society, and/or other documented rationale for denials
• Possess extensive knowledge and experience with inpatient coding, including AMA CPT coding guidelines and National Correct Coding Initiative policy guidelines and edits
• Have working knowledge of CMS billing and coding rules and regulations
• Have extensive knowledge of reimbursement methodologies such as RVU, DRG, OPPS and HCC
• Assist with updating the company's reimbursement policies, which support various claim edits
• Serve as a resource to other departments within Providence Health Plan for questions around reimbursement policies and coding rules

We welcome 100% remote work for residents who live in the States of AK, WA, OR, MT, CA and or TX.

Required qualifications for this position include:

• Bachelor's Degree in Healthcare, Health Policy, Public Health -OR- a combination of equivalent education and experience
• 5 years facility coding experience (ER, outpatient, inpatient)

Licenses & Certifications Required Upon Hire:

• National Certification from American Academy of Professional Coders -OR-
• National Certified Coding Associate - American Health Information Management Association -OR-
• National Certified Coding Specialist - American Health Information Management Association -OR-
• National Certified Coding Specialist - Physician - American Health Information Management Association -OR-
• National Certified Documentation Improvement Practitioner - American Health Information Management Association -OR-
• National Certified Health Data Analyst - American Health Information Management Association -OR-
• National Registered Health Information Administrator - American Health Information Management Association -OR-
• National Registered Health Information Technician - American Health Information Management Association

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.

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.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 176850

Company: Providence Jobs

Job Category: Coding

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Day

Career Track: Admin Support

Department: 5018 HCS MEDICAL MANAGEMENT OR REGION

Address: OR Beaverton 3601 SW Murray Blvd

Pay Range: $30.48 - $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.

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.

Salary : $30 - $49