Revenue Cycle Quality Analyst (Coding Compliance)

At Proliance Surgeons, Bellingham Surgery Center and Surgery Center at Valley our patients come from all walks of life — and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered.
We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at www.proliancesurgeons.com/careers
Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity.
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Position Summary
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.

Essential Qualities
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

Key Duties and Responsibilities

The key duties and responsibilities of the Revenue Cycle Payment poster include, but are not limited to:

• 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

Education/Experience

• 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

Skills/Knowledge/Abilities

• 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

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by an teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• You will be required to provide your own internet
• You will be required to maintain your own quiet workspace
• The teammate is required to sit for long periods of time. Use of telephone and Computer is required.
• Manual dexterity required for use of computer keyboard.
• Requires working under stressful conditions or working irregular hours.

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.