Providence Health & Services
HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA *Remote*
Providence Health & Services, Washington, District of Columbia, us, 20022
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 an HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA who will:
Perform internal coding audits of hierarchical condition category (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
Providence Health Plan welcomes applicants to apply who reside in the following States:
Oregon
Washington
Please note the following important detail regarding this role:
This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon
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
Active Certification in one or more of the following: RHIT, RHIA, CCS, or CPC
Preferred qualifications for this position include:
Bachelor's Degree
-OR-
a combination of equivalent education and experience
Active Certification: CRC
Why Join Providence Health Plan?
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.
Requisition ID:
318654
Company:
Providence Jobs
Job Category:
Coding
Job Function:
Revenue Cycle
Job Schedule:
Full time
Job Shift:
Career Track:
Business Professional
Department:
5018 GA ASO OR REGION
Address:
OR Beaverton 3601 SW Murray Blvd
Work Location:
Murray Business Ctr Beaverton-Beaverton
Workplace Type:
Remote
Pay Range:
$34.96 - $55.34
#J-18808-Ljbffr
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 an HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA who will:
Perform internal coding audits of hierarchical condition category (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
Providence Health Plan welcomes applicants to apply who reside in the following States:
Oregon
Washington
Please note the following important detail regarding this role:
This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon
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
Active Certification in one or more of the following: RHIT, RHIA, CCS, or CPC
Preferred qualifications for this position include:
Bachelor's Degree
-OR-
a combination of equivalent education and experience
Active Certification: CRC
Why Join Providence Health Plan?
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.
Requisition ID:
318654
Company:
Providence Jobs
Job Category:
Coding
Job Function:
Revenue Cycle
Job Schedule:
Full time
Job Shift:
Career Track:
Business Professional
Department:
5018 GA ASO OR REGION
Address:
OR Beaverton 3601 SW Murray Blvd
Work Location:
Murray Business Ctr Beaverton-Beaverton
Workplace Type:
Remote
Pay Range:
$34.96 - $55.34
#J-18808-Ljbffr