Coding Compliance Analyst at Legacy Health – Portland, Oregon

Coding Compliance Analyst
US-OR-

Job ID: 25-45887
Type: Regular Full-Time
Homebased EE Oregon

Overview

Remote Position (OR/WA Only)

This is a remote position – incumbents, who reside in Oregon or Washington only. There may be occasional situations that require work to be performed on-site at an assigned Legacy Health location. All new hires are required to come to a designated Legacy Health office location in Portland, Oregon prior to their start date for a new hire health assessment and to complete new hire paperwork. This position may require initial training and orientation to be site-based, before transitioning to the remote schedule.

Responsibilities

You recognize that your coding and compliance expertise serves a greater purpose within the Legacy community - improving the lives of others. By developing, implementing, and monitoring systems that ensure compliance with Medicare and other payor documentation guidelines, you uphold the standards of excellence that define Legacy.

Coding Compliance Analyst:

RHIT, RHIA, CCS, CCS-P or CPC certification required for this role.

Compliance

• Works closely with Regulatory department to support adherence to compliance policies relating to professional coding.
• Provides new physician orientation related to regulatory compliance, documentation and coding guidelines.

Charge Capture

• Analyzes physician practices to identify charge opportunities and ensure all billable services are captured.
• Provides in-services to providers and staff on proper coding and documentation.
• Oversees the set-up of new CPT Codes.
• Updates and reviews fee tickets annually and ensures system files are updated accordingly.
• Identifies need for and enlists consultant services as needed.

Participation in Reimbursement Analysis of Professional Services

• Participates in reimbursement analysis to determine if denials relate to CPT or diagnostic coding.
• Defines criteria for payor specific reimbursement for correct payment analysis.
• Investigates payor response to new CPT/HCPCS codes.
• Analyzes and documents the patient account cycle for each physician or physician line of business for timely and accurate processing.

Provider and Staff Training

• Provides onsite initial and ongoing CPT and ICD-9 training to providers and staff.
• Acts as a resource to physicians for CPT and diagnostic coding questions.
• Performs regular audits to ensure compliance with coding and documentation guidelines. Provides feedback to physicians, both written and verbally, regarding coding and documentation accuracy.

Qualifications

Education:

• Associate’s degree in business or healthcare, or equivalent experience, required.

Experience:

• Minimum of two years healthcare experience required.
• CPT/ICD9 experience in a multi-specialty setting preferred. Database experience preferred.

Skills:

• 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.