Fred Hutchinson Cancer Research Center & Seattle Cancer Care Alliance

Medical Coding Analyst

Medical Coding Analyst

Job ID 
10469
Type 
Regular Full-Time
Company 
Seattle Cancer Care Alliance
Location 
US-WA-Seattle

More information about this job

Overview

Seattle Cancer Care Alliance brings together the leading research teams and cancer specialists of Fred Hutch, Seattle Children's and UW Medicine. One extraordinary group whose sole mission is the pursuit of better, longer, richer lives for our patients.
Seattle Cancer Care Alliance is ranked among the top ten cancer hospitals in the nation by U.S. News & World Report. Our care combines powerful science with devoted collaboration.
Above all, we exist to move patients forward, past boundaries and toward hope.


This Revenue Cycle Department Role provides data analysis and interpretation to support the department’s denial prevention initiatives.   This role collaborates with Revenue Cycle and Clinical Leadership to develop, implement and maintain training curriculum.  Provides medical staff and others ongoing education and information regarding documentation guidelines supporting medical necessity.  Responsible for abstracting facility services to ensure appropriate code assignment of CPT and ICD10 codes while maintaining department coding productive standards. The position is 80% on-site and 20% remote.

Responsibilities

Denials Management:

  • Reviews patient charts to identify opportunities for improved clinical documentation and/or accuracy in provider driven coding
  • Investigate denial claims related to coding, LCD/NCD and medical necessity
  • Recommend or educate others on policies regarding the proper use of CPT Codes, modifiers and diagnosis codes in order to comply with regulations set forth by Medicare, Medicaid, ManagedCare, PPO Contracts, Indemnity Insurers, and all other healthcare payers. This may include distribution of guidelines to providers.
  • Collaborate with clinical departments, Compliance, Quality and Revenue Cycle to improve any process gaps identified in front end charge capture processes.
  • Monitors assigned work queues and reviews accounts for denials
  • Assists Revenue Cycle with collection of clinical/medical necessity documentation
  • Serve as a resource for authorization/referral process, as appropriate
  • Prepares and distributes denials prevention and recovery related reports
  • Other duties as assigned

Facility Coding:

 

  • Reviews documentation for appropriate diagnosis and procedure code assignment for facility visits using the ICD-10-CM, CPT, and HCPCS coding systems.
  • Meets or exceeds productivity and quality standards.
  • Works independently and takes initiative to identify opportunities to maximize efficiencies.
  • Ensure coding compliance by applying all coding principles and guidelines
  • Respond to billing and coding questions from providers, staff and administrators
  • Provider follow-up related to clinical documentation clarification to support medical necessity
  • Perform assigned coding audit projects

Qualifications

Required:

 

Associate degree in Healthcare discipline or an equivalent of coding experience may substitute for education.

Preferred

Bachelor degree in Heath Informatics or Heath Information

 

Experience:

 

Minimum of 2 years of certified coding and hospital and billing experience including appeals.denials and payor policies/guidelines. CDI, case management/utilization review experience strongly preferred. Minimum of 2 years in education and training of medical providers regarding coding and documentation guidelines preferred.  Experience may be substituted for a Bachelor's degree in a medical field of study along with required certification. Prior experience working with clinical professionals is preferred. Prior oncology or transplant coding, prior training experience, surgical and infusion coding, EPIC HB, 3M encoder, ORCA experience is preferred.

 

Licesnses/Certifications/Registrations

Required:

RHIA, RHIT, CCS, CCS-P, CPC, OR COC