Coding Quality Auditor

Under the supervision of the Coding Manager, Revenue Capture, the HCC Coding Quality Auditor is responsible for detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding.  The incumbent reviews and abstracts HCC codes to ensure they are coded accurately, to the highest specificity, queries providers to clinically validate or clarify diagnosis criteria, and reviews for compliant documentation resulting in compliant reporting/billing and RVU capture. Serves as a coding expert, working with the Quality Integrity Program manager and clinical documentation review team to ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions and regulatory oversight agencies. 

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Group Northwest Washington 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.

Required Qualifications: 

• 2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVU’s.
• Experienced in reviewing patient account information, insurance explanation of benefits, computer screens, and financial records.
• Within 1 year of hire: Certified Professional Coder (CPC) Or Certified Coding Specialist (CCS)

Preferred Qualifications:

• Bachelor's Degree. Or equivalent educ/experience 
• Within 1 year of hire: Certified Risk Adjustment Coder (CRC)
• Within 1 year of hire: Certified Professional Medical Auditor (CPMA) Or
• Within 1 year of hire: Certified Healthcare Compliance Auditor (CHCA)
• Experience in HCC coding.
   

Why Join Providence?

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.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

Providence Clinical Network (PCN)  is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers.

PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico.

Providence is proud to be an Equal Opportunity Employer. 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 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.