Revenue Cycle Quality Analyst (Coding Compliance)

Proliance Surgeons•Seattle, WA

23h

About The Position

The Revenue Cycle Quality Analyst (Coding Compliance) supports accurate coding practices, reduces compliance risk, and strengthens overall coding quality across the organization. This role assists with coding audits, regulatory monitoring, coding education, policy development, and workflow improvements. The analyst helps ensure coding integrity by reviewing claims, identifying trends, validating audit findings, and supporting training efforts in alignment with payer rules, CMS guidelines, and internal standards. The essential qualities necessary include, but are not limited to: Strong attention to detail and accuracy Analytical mindset with solid critical-thinking skills High level of integrity and compliance awareness Clear and supportive communicator Comfortable educating and partnering with coding staff and providers Process-improvement oriented Able to work independently and within a collaborative team environment

Requirements

Bachelor’s degree or equivalent experience preferred
Certified Professional Coder (CPC, CCS, or equivalent) required
At least five years of medical coding experience (orthopedics preferred)
Solid understanding of CMS rules, payer policies, and regulatory standards
Working knowledge of ICD-10, CPT, HCPCS, and payer billing rules
Ability to interpret and apply Medicare and commercial payor guidance
Skilled in reviewing medical documentation and assessing coding accuracy.
Proficient in EMR systems and audit software
Strong analytical skills, problem-solving ability, and documentation skills
Ability to navigate complex coding scenarios and provide clear recommendations
Comfortable supporting education and explaining coding concepts simply
Excellent communication, organization, and time-management skills

Responsibilities

Assist in internal coding audits and quality checks for providers and coding staff
Validate and document audit findings and support data-driven reporting
Identify trends, patterns, and risk areas
Track audit results and follow-up remediation activities
Monitor federal, state, and payer-specific coding and billing updates
Help maintain compliance with CMS, payer rules, ICD-10, CPT, and HIPAA
Research coding and compliance questions and escalate when needed
Identify risk trends and provide recommendations to improve compliance
Assist in updating compliance monitors, workflows, and audit protocols
Support the development and maintenance of policies and SOPs
Participate in coding and provider training sessions
Support annual compliance training coordination
Assist in preparing reports for compliance initiatives and regulatory readiness