Coding Compliance Analyst

Legacy Health•, OR

9d•$31 - $45•Remote

About The Position

This is a remote position for individuals residing in Oregon or Washington. While the role is primarily remote, there may be occasional on-site work required at Legacy Health locations. New hires must visit a designated Legacy Health office in Portland, Oregon, before their start date for a health assessment and to complete paperwork. Initial training and orientation may be site-based before transitioning to a remote schedule.

Requirements

Associate’s degree in business or healthcare, or equivalent experience, required.
Minimum of two years healthcare experience required.
RHIT, RHIA, CCS, CCS-P or CPC certification required.
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.

Nice To Haves

CPT/ICD9 experience in a multi-specialty setting preferred.
Database experience preferred.

Responsibilities

Develop, implement, and monitor systems to ensure compliance with Medicare and other payor documentation guidelines.
Support adherence to compliance policies relating to professional coding in collaboration with the Regulatory department.
Provide new physician orientation on regulatory compliance, documentation, and coding guidelines.
Analyze physician practices to identify charge opportunities and ensure all billable services are captured.
Provide in-services to providers and staff on proper coding and documentation.
Oversee the setup of new CPT Codes.
Update and review fee tickets annually and ensure system files are updated accordingly.
Identify the need for and enlist consultant services as needed.
Participate in reimbursement analysis to determine if denials relate to CPT or diagnostic coding.
Define criteria for payor-specific reimbursement for correct payment analysis.
Investigate payor response to new CPT/HCPCS codes.
Analyze and document the patient account cycle for each physician or physician line of business for timely and accurate processing.
Provide onsite initial and ongoing CPT and ICD-9 training to providers and staff.
Act as a resource to physicians for CPT and diagnostic coding questions.
Perform regular audits to ensure compliance with coding and documentation guidelines.
Provide feedback to physicians, both written and verbally, regarding coding and documentation accuracy.