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Coding Analyst Specialist Job in San Jose, California

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Job Title: Coding Analyst Specialist

Employer:Verity Medical Foundation
Specialties:Clinic, Ambulatory, Medical Groups
Required Certifications:College Degree or License
Preferred Certifications:CPC,ICD-9 and HCPCS coding systems,CPT-4
Location: San Jose 95126, CA, US
Date Posted:6/14/2018

Verity Medical Foundation offers a dynamic environment for individuals dedicated to careers in health care -- whether you seek a clinical or administrative role. Created in 2015, as part of the new Verity Health System, the team is re-inventing healthcare for the patients we serve.  With more than 200 primary care and specialty physicians, we offer medical, surgical and related healthcare services for people of all ages at community-based, multi-specialty clinics conveniently located in areas served by Verity Health System hospitals. We are a values-driven organization with a deep-rooted commitment to serving diverse communities from the San Francisco Bay Area to the Greater Los Angeles region for generations to come. At Verity Medical Foundation, we pride ourselves in having a well-trained, highly skilled staff focused on patient-centered healthcare. We offer a supportive work environment and a competitive benefits package. Not only do we take care of patients, we also take good care of our employees.



The Coding Analyst Specialist is responsible for analyzing and researching coding activity to maximize reimbursement.  This includes analyzing accounting adjustments and charge rejections. A Coding Analyst Specialist must be knowledgeable about all charge input formats, functions, error codes, registration and the accounting process.



  • Analyze rejected charges and adjustments. Analyze the reason for the rejection.
  • Communicates with clinic/department representatives daily regarding corrections.
  • Analyze and define problem patterns and reports them.
  • Identify recurring problems resulting in data rejections. Bring these problems to the attention of the Manager and assist in corrective measures.
  • Analyze rejections in an online billing system. This process will require the Analyst to identify and analyze patients via keying into the online billing system, communicate with branches/departments or Hospital Data control regarding reversals and process them as needed.
  • Coordinate and retrieve document batch research request.
  • Serve as a clearing house for information on coding and charge abstraction.
  • Analyze coding patters to detect behavior that can result in changes in reimbursement.
  • Review and analyze behavior of third-party payers regarding coding.
  • Analyze up-coding and down coding of procedures by the payers. Make recommendations to clinic/departments regarding changes in behavior that will impact payments.
  • Review and analyze chart documentation, coding for services and payments for those services. Recommend changes to documentation that more appropriately reflect service level. Recommend changes to coding that reflects a better description of services actually delivered to the patient.
  • Gathers, audits, corrects Clinic fee tickets with respect to proper linkage of CPT4 and ICD-10 codes, correct level of service performed, presence of accurate demographic information, total charges and monitoring or patient's chart to verify ticket information.
  • Responsible for being up-to-date and knowledgeable of coding and diagnostic procedures, as well as remaining current about federal legislative changes that affect outcomes.
  • Performs other related department duties which may be inclusive but not listed in job description.
  • Maintains procedure code master file. Evaluates and develops new entries.
  • Maintains diagnosis code master files including identifying inappropriate codes and informing appropriate medical staff.
  • Maintains fee ticket system including creating, updating and printing tickets as necessary.
  • Works with Physicians to resolve coding issues in their department.
  • Maintains fee schedules for Medicare, fee for service, health maintenance organizations.
  • Monitors Medicare reimbursements and maintains files.
  • Assures information is available for peer review and Medicare review.


Laura Carton
Recruiter | Verity Health System
Email: LauraCarton@verity.org 

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