Coding Quality Auditor ? Medicare Advantage ACA *Remote in Beaverton, OR
Posted 2025-03-15Coding Quality Auditor - Medicare Advantage ACA *Remote - Providence Health & Services - Beaverton, OR - work from home job
Company: Providence Health & Services
Job description: Job 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 Quality Auditor: Medicare Advantage & ACA who will:
? Perform internal coding audits of HCC coding review for Risk Adjustment staff, contractors, and vendors
? Perform audits to ensure compliance with national coding guidelines and industry regulations, as well as adherence to Providence Health Plan's coding policies
? Review appropriate ICD-10-CM code assignments on risk adjustment retrospective and prospective projects
? Partner with the coding team, Supervisors, and Director to improve the accuracy, integrity, and quality of coding practices as well as to ensure minimal variation in coding practices
? Identify coding issues and report issues to Supervisor or Director
? Provide coder specific education based on audit findings and trends
? Perform HCC abstract reviews, chart reviews, and other reviews as assigned
We welcome 100% remote work for residents who live in the States of Oregon and Washington.
Required qualifications for this position include:
? 5+ years HCC specific coding experience
? 3+ years of recent auditing experience
? Proficiency in Microsoft Excel, Word, and various EMR systems
? RHIT, RHIA, CCS, or CPC Certifications
Preferred qualifications for this position include:
? Bachelor's Degree -OR- a combination of equivalent education and experience
? CRC
Why Join Providence?
Our 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 of caring for everyone, especially the most vulnerable in our communities.
About Us: 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 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.
Expected salary:
Location: Beaverton, OR
Job date: Thu, 14 Sep 2023 07:13:53 GMT
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