Providence Health & Services Director of Coding and Compliance - PMI South Bay & Westside in Torrance, California


Providence is calling a Director of Coding and Compliance ( Full Time / Day Shift ) for Providence Medical Institute - Saint John's Medical Foundation

In this position you will:

  • Be responsible for the planning, development and implementation of coding/ compliance policies for the Providence Medical Institute and Saint John’s Medical Foundation.

  • This includes but is not limited to the, research of best practices, training of staff and physicians and auditing of practices as part of the quality assurance program for proper coding of medical charges billed by the Providence Physicians Business Office.

  • Act as the LA Market subject matter expert in guiding practices and outcomes in this specialty area.

  • Be responsible for researching CPT, ICD-10, Medicare and Medicaid billing rules, and providing appropriate training including presentations with written and verbal communication.

  • This includes obtaining, recording and reporting essential data, assisting in problem solving coding issues and ongoing education of physicians and staff.

  • Manage projects for updating and training all multi-specialty physician clinics.


Required qualifications for this position include:

  • Minimum 7 years experience in a physician outpatient clinic business office

  • Minimum 10 years experience in medical coding with thorough knowledge of CPT and ICD - 10 coding principles

  • Substancial previous experience in dealing with Medicare, Medicaid and other applicable rules and regulations

  • Minimum 5 years of leadership experience in providing physician education and coder education

  • Minimum 3 years auditing experience

  • Knowledge of medical terminology, disease processes and pharmacology

  • Knowledge of CMS, Medicaid and other regulatory guidelines including current Evaluation and Management documentation and coding rules

  • Working knowledge of the HIPPA Privacy Regulations

  • Proficient in Excel, MS Word and general PC applications

Preferred qualifications for this position include:

  • Certified Professoinal Coder ( CPC ) Certification.

  • Bachelor’s degree in management, health care, or related field.

About the hospital you will serve:

Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

We offer a full comprehensive range of benefits - see our website for details

Our Mission

As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.

About Us

Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Billing / Insurance

Location: California-Torrance

Req ID: 188216