Coding Compliance Analyst
$65,270–$65,270 year
RemoteWashington, United States or Oregon, United States
Job Summary
Develop and monitor systems ensuring compliance with Medicare and payor documentation guidelines. Analyze physician practices to identify charge opportunities and ensure all billable services are captured. Provide new physician orientation and in-services on regulatory compliance, coding policies, and proper documentation. Oversee the setup of new CPT codes, update fee tickets annually, and investigate payor responses to new codes. Participate in reimbursement analysis to determine denial causes and define payor-specific criteria. Perform regular audits to ensure adherence to coding standards, providing feedback to physicians on accuracy. Act as a resource for physicians regarding CPT and diagnostic coding questions while developing and delivering training programs.
Required Qualifications
- Reside in Oregon or Washington
- Available for occasional on-site work at an assigned Legacy Health location
- Required to come to a designated Legacy Health office location in Portland, Oregon prior to start date for new hire health assessment and paperwork
- Initial training and orientation to be site-based
- RHIT, RHIA, CCS, CCS-P or CPC certification
- Associate's degree in business or healthcare
- Equivalent experience to Associate's degree
- Minimum of two years healthcare experience
- Strong communication skills, both verbal and written
- Ability to speak in front of large and small groups
- Proven ability to develop training programs, provide training and oversee work processes
- Excellent organizational skills and the ability to handle large volumes of work
- Demonstrated understanding of insurance reimbursement and payment methodology
- Competent in Microsoft Excel and Word software
Desired Qualifications
- CPT/ICD9 experience in a multi-specialty setting
- Database experience
Additional Requirements
- Must reside in Oregon or Washington
- New hires must complete initial health assessment and paperwork at Legacy Health office in Portland, Oregon
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