Providence Health Plan Group

Providence Medical Foundation seeks a qualified coder to perform audits of patient care documentation, ensuring CPT/ICD alignment with payor policies and regulations. The role requires extensive AHIMA/AAPC credentials and 3+ years of coding and billing experience in diverse medical services. Candidates should possess strong MS Office skills and a Bachelor’s or related certificate. This is an on-site opportunity with Providence facilities and potential for growth within a mission-driven health #J-18808-Ljbffr

Under direction of the Coding Supervisor and Coding Manager, performs coding audits of patient care billing documentation to ensure adherence with CPT and ICD coding guidelines and federal, state, and commercial payor billing and payment policy for all services provided by Providence Medical Foundation. Required qualifications Upon hire: National Certification from American Academy of Professional Coders Upon hire: National Certified Coding Associate - American Health Information Management Association Upon hire: National Certified Coding Specialist - American Health Information Management Association Upon hire: National Certified Coding Specialist - Physician - American Health Information Management Association Upon hire: National Certified Documentation Improvement Practitioner - American Health Information Management Association Upon hire: National Certified Health Data Analyst - American Health Information Management Association Upon hire: National Registered Health...

Providence Health Plan Group is looking for a Compliance Auditor for a remote position to evaluate compliance with various regulations regarding revenue cycle operations. The auditor will work closely with multiple teams, conduct audits, analyze data, and ensure adherence to federal and state laws. Qualifications include a Bachelor's degree and substantial experience in hospital billing auditing. The position also includes competitive salary and benefits, making it an attractive opportunity. #J-18808-Ljbffr

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...