Coding Analyst

About Our Client:

Providence Clinical Network (PCN) is a healthcare service line operating across seven states, comprising multiple medical groups and affiliate practices. It is one of the largest healthcare provider groups in the country, with over 11,000 providers, 900 clinics, and 30,000 caregivers. The organization focuses on delivering coordinated, compassionate care and serves a diverse patient population across several states including Alaska, Washington, Montana, Oregon, California, Texas, and New Mexico.

About the Opportunity:

The CODING ANALYST plays a critical role in ensuring accurate diagnostic coding related to Risk Adjustment and Hierarchical Condition Categories (HCC). This position directly impacts revenue integrity and compliance with CMS regulations by coordinating complex coding applications that affect operations, information systems, and provider contracts. The role involves advisory responsibilities in developing payment rules related to risk adjustment and requires maintaining effective communication with providers and internal departments to address coding issues.

Responsibilities:

• Perform detailed diagnostic coding using ICD-9, ICD-10, and related coding systems.
• Identify and research provider diagnostic coding issues.
• Review medical records to ensure documentation standards.
• Educate providers on coding errors and best practices.
• Advise on the development of health plan payment rules related to risk adjustment.
• Maintain credibility with providers regarding coding rules and applications.
• Integrate coding applications within dynamic health plan environments.
• Manage multiple priorities and workloads efficiently.
• Communicate effectively with plan departments, providers, and hospital staff.
• Stay current with coding rules, regulations, and accreditation requirements.

Requirements:

• Completion of an accredited medical coding program or relevant experience in healthcare coding.
• Minimum of 3 years experience as a certified coder within a healthcare provider organization or health insurance company.
• Bachelor's degree or equivalent education/experience preferred.
• At least 1 year of experience in HCC coding preferred.

Pay Range and Compensation Package:

• The pay range for this position will be determined based on relevant job experience and other applicable factors. Base pay may be supplemented by shift differentials, standby/on-call, overtime, premiums, incentives, or bonuses.

Benefits & Perks:

• Retirement 401(k) savings plan with employer matching.
• Health care benefits including medical, dental, and vision insurance.
• Life insurance and disability insurance.
• Paid parental leave, vacations, holidays, and health-related time off.
• Voluntary benefits and well-being resources.

Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.

Note:

RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.