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Medical Coding and Compliance Analyst

Company: Concentra
Location: Santa Clarita
Posted on: May 3, 2021

Job Description:


From our Dallas corporate headquarters to our clinics and worksite locations, Concentra colleagues remain focused on our driving purpose: to provide superb patient and employer experience by delivering the highest quality healthcare in an efficient, affordable, caring manner. We do this by putting all customers (internal and external) first and by displaying:

  • A healing focus
  • A selfless heart
  • A tireless resolve

Position Summary

Primarily responsible for analyzing provider coding, compliance activities and outcomes within Concentra Health Services, including but not limited to revenue optimization, coding analytics, coding research, documentation improvement training and level of service coding and diagnosis coding.


The Details

  • Coding analysis through data exported from internal and external systems to identify payment trends for management and coding auditors.
  • Coding analysis that will identify denial trends and provide possible solutions.
  • Sorting and formatting coding data for coding auditors and management.
  • Tracking of unpaid specialty services such as procedures, visits and surgeries through data exports.
  • Upon request, clinician payment research which includes documentation review and payment documents from carriers.
  • Completing analysis in presentation format for leadership meetings.
  • Clinician/Coder support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
  • Productivity and project tracking.
  • Upon request, create training materials.
  • Upon request, training as indicated from audit results, denial and down coding trends, level of service reports, etc. and/or as requested by medical leadership or CBO management.
  • Monitor Coding and State Workers' Compensation changes to ensure that most current information is available.
  • Provide coding support to CBO as requested.
  • Other duties as may be assigned.

Scope measures

  • Direct reports: No


Education/credentials/Additional Requirements

  • High School Diploma or GED equivalent.
  • Associate degree from an accredited college preferred
  • CPC or CCS-P codding certification required

Job-related experience

  • Five years progressive healthcare billing, coding and auditing experience including provider training and presentation.

Job-related skills/competencies

  • Auditing
  • Advanced computer skills - PowerPoint, Excel, Word
  • Create training materials and be able to convert and combine files to provide a finished presentation.
  • Strong process management skills
  • Familiarity with state specific workers' compensation regulations
  • Training and presentation skills
  • Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
  • Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
  • The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
  • Ability to work to and adhere to deadlines
  • High functioning and priority driven
  • Professional in appearance and demeanor

Physical/Mental Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently standing, sitting or walking. The employee is frequently to continuously required to use hands and fingers to feel, handle, or operate PC, type, flex or extend wrist in the performance office work and to use office equipment and/or other equipment. Due to the nature of this position, an employee can expect heavy computer usage requiring wrist flexion/extension for at least 8 hours per day. The ability to hear and understand with clarity and detect sound, and have conversations with staff, customers, management, etc. Hearing within the acceptable range for telephone and in-person contacts. Normal or corrected vision requiring color perception to acceptable levels for office work. The ability to lift/carry up to 20 pounds.

The mental demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. In this position, the employee may have imposed pressure on a routine and frequent basis to meet various deadlines, contact with people in demanding and unpredictable situations and to handle confidential and sensitive information and situations with care

Additional Data

  • 401(k) with Employer Match Medical/Vision/Prescription/Dental Plans Life Insurance/Disability Paid Time Off/Holidays Colleague Referral Bonus Program This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.Concentra is an Equal Opportunity Employer, M/F/Disability/Veteran.

Keywords: Concentra, Santa Clarita , Medical Coding and Compliance Analyst, Other , Santa Clarita, California

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