Coding Consultant I, II, or III DOE
Hybrid within Oregon, Washington, Idaho or Utah
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day, Cambia's dedicated team of Coding Consultants are living our mission to make health care easier and lives better. As a member of the Payment Integrity team, our Coding Consultant coordinates, monitors, and audits documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. Initiate and/or recommend corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. Support internal/external departments with coding research and insight - all in service of creating a person-focused health care experience.
What if your coding expertise didn't just process claims - it actually shaped the future of person-focused health care? What if your coding knowledge was the bridge between clinical teams, internal departments, and the health care experience members deserve? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
* Bachelor's degree in business administration or related health care field
* 3 years coding experience
* 2 years of experience participating in coding audits and quality performance measures, preparing audit reports with recommendations, and providing education and feedback to facilitate improvement in documentation and coding or equivalent combination of education and experience.
* Coding Review Consultant: Certification in at least 1 of the following is required at the time of hire, and throughout tenure in job: Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), RHIT (Registered Health Information Technician), or RHIA (Registered Health Information Administrator)
Skills and Attributes:
* Understanding of medical terminology, pharmacology, body systems/anatomy, physiology and concepts of disease processes.
* Basic knowledge of CDT and revenue codes.
* Knowledge of ICD-10, CPT, HCPCS.
* Demonstrated ability to provide effective statistical analysis and analytical problem solving.
* Strong working knowledge of the critical elements of the coding process.
* Demonstrated ability to communicate, verbally and in writing, clearly and effectively with a wide variety of individuals at all levels of the organization.
* Knowledge of adult learning principles.
* Basic computer experience and ability to learn new computer applications quickly and independently, including: Microsoft Office Suite and other software products.
* Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision.
* Understanding of government rules and regulations and areas of scrutiny for potential areas of risk for fraud and abuse regarding coding and documentation.
* Basic knowledge of insurance reimbursement methodology
* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
What You Will Do at Cambia:
* Identify trends and patterns; collate audit results and analyze findings; identify root cause analysis; and identify system issues that may contribute to claims, coding, provider contracting and revenue cycle deficiencies. Prepare written audit report for noted deficiencies and make recommendations to internal/external departments and others as appropriate/requested (i.e. training
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