Professional Coding Analyst

Salary : $109,994.56 - $133,760.64 Annually
Location : Throughout the County of Santa Clara, CA
Job Type: Full-Time/Part-Time
Job Number: 25-B9S-A
Department: County-Wide Recruitment
Opening Date: 03/07/2025
Closing Date: 3/21/2025 11:59 PM Pacific
Bargaining Unit: 92

Description
Under supervision, to support and review patient records and billing information to ensure that all services of Santa Clara Valley Medical Center are captured and billed appropriately and to perform analytic studies and projects related to coordination, implementation, and maintenance of Santa Clara Valley Medical Center's professional fee coding, education, and to support management in projects related to revenue generation, enhancement and control.

The list established from this recruitment will be used for all vacancies throughout the County of Santa Clara. This may include full time, part time, and extra help positions. If you are interested in these opportunities, please fill out the appropriate questions.
* * * * * * * * * * * * * * * * IMPORTANT * * * * * * * * * * * * * *
EXAMINATION: Candidates who meet the employment standards will be invited to take an in-person written examination tentatively scheduled for the following dates:

April 1, 2025
April 2, 2025

The exam will be conducted at 70 West Hedding, 8th floor, in San Jose.

The Power of WE: Together, we can make a greater impact. Bringing better care and expanding healthcare services across the community.
Santa Clara Valley Healthcare (SCVH) is the second largest public health care system in California and includes three acute care hospitals, 14 clinics and 60+ specialty and sub-specialty services. Our mission is to provide high-quality, accessible healthcare and excellent service to everyone in Santa Clara County.

Santa Clara Valley Medical Center - SCVMC is a full-service tertiary acute care teaching hospital with 699 licensed beds providing a wide range of specialized services, including Rehabilitation, Burn, Trauma, and NICU. SCVMC was ranked by U.S. News and World Report as #6 Rehabilitation Hospital in the nation and #1 in the West and designated as a 2024 High Performing hospital for Maternity Care, Heart Failure, Stroke, Hip Fracture, and Pneumonia.

O'Connor Hospital - O'Connor Hospital (OCH) is a 358 licensed bed acute care facility offering a full range of inpatient and outpatient medical, surgical and specialty programs to residents of Santa Clara County. It was founded in 1889 as one of the first hospitals in the county. OCH has grown significantly over the past five years in both its inpatient volume and its Emergency Department visits. Along with these volume increases other ancillary and clinical departments like imaging, lab, pharmacy, and respiratory have seen growth as well.

St. Louise Regional Hospital - Since 1989, St. Louise Regional Hospital (SLRH) has been caring for the residents in Santa Clara and San Benito Counties, offering a wide range of inpatient and outpatient medical specialties. SLRH has 93 beds, is a Designated Primary Stroke Center, and is the only acute care hospital in the area. Located in Gilroy, SLRH maintains a CALSTAR 2 emergency helicopter base on the premises.
Learn more about Santa Clara Valley Healthcare: https://www.scvh.org/home and follow us on:

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Typical Tasks

• Reviews services performed within the Santa Clara Valley Health & Hospital System to ensure appropriateness of charges, and the accuracy of service coding by utilizing Common Physician Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Relative Value Units (RVU) and International Classification of Diseases - Clinical Modifications (ICD-CM);
  
• Assists providers to accurately capture revenue and provide professional fee coding expertise to department managers, nurses and physicians through ongoing provider education;
• Conducts concurrent audits for professional services;
  
• Performs concurrent documentation reviews of patient records to clarify conditions/diagnoses and procedures;
  
• Queries physicians regarding missing, unclear, or conflicting documentation related to diagnosis and procedure codes as documented by provider Answers professional coding questions regarding specific documentation in compliance with governmental and third-party payer guidelines;
  
• Serves as an institutional subject matter expert and resource for interpretation and application of coding rules and regulations pertaining to professional services and third party guidelines;
  
• Assists in the development of provider education curriculum and training materials; including new governmental and third party payor requirements;
  
• Develops effective relationships with hospital departments, clinics and medical staff, as well as peers at other similar institutions and professional organizations;
• Participates in revenue cycle meetings, providing data and information on coding in regards to reimbursement concerns;
  
• Analyzes and interprets existing, new and proposed State and Federal legislation and the impact it will have on coding/billing/, financial reporting and programs.
  
• Meets with Information Services Department to assist in resolving computer system problems;
  
• Compiles information and prepares reports;
  
• May be assigned as a Disaster Service Worker, as required;
  
• Performs other related duties as required.

Employment Standards
Possession of one of the following certifications: Certified Professional Coder (CPC) or Certified Coding Specialist - Professional (CCS-P).

Training and Experience Note: The knowledge and abilities would be acquired by a minimum of three (3) years of experience as a Revenue Control Analyst, Health Services Representative, Patient Business Services Clerk, Medical Administrative Assistant, Health Information Clerk, or related class plus one (1) year of experience in revenue control or related work with the ability to perform complex tasks independently

-OR-

Possession of an Associate's Degree or equivalent training in accounting, medical terminology, computer science and other areas listed in the knowledge and abilities and three (3) years of increasingly responsible experience in a hospital accounting, billing, accounts receivable, or revenue control office.
Knowledge of:

• Principles and practices of professional fee coding compliance;
  
• Personal computers and software applications to produce revenue generations projects and objectives;
  
• Principles of organization and administration;
  
• Communication techniques for gathering, evaluating, and conveying information;
  
• Medical terminology, relating to diseases and related treatments;
  
• Current Procedural Terminology (CPT) coding, Healthcare Common Procedure Coding Systems (HCPCS), Relative Value Units (RVU), current International Classification of Diseases - Clinical Modification (ICD-CM) and other medical coding resources;
  
• Medical Services and patient treatment, interrelationship and sequences of a comprehensive teaching hospital;
  
• Components and format of a medical record, including but not limited to laboratory findings, special tests, medications, etc.;
  
• Policies, procedures, and regulations relating to services performed;
  
• Coding regulations, laws, and reporting requirements common to the operation of California hospitals;
  
• Medicare, Medi-Cal and third party payer procedures common to medical billing;
  
• Data collection techniques.

Ability to:

• Initiate, plan, and complete work assignments with limited direction;
  
• Develop and implement an effective work flow process to maximize coding/charging accuracy while maintaining optimal productivity standards;
  
• Develop education curriculum and training materials;
  
• Prepare reports supporting recommendations;
  
• Define problem areas;
  
• Plan, coordinate, and initiate action necessary to implement recommendations or changes required by third party payers and legislative action;
  
• Perform research regarding specific techniques of procedures performed as well as understanding the concept of the CPT codes being assigned;
  
• Collect, assemble, analyze, and present technical data;
  
• Speak effectively and participate in group meetings;
  
• Follow oral and written directions;
  
• Interact with hospital and other personnel with issues related to hospital rates, reimbursement requirements, professional fee coding compliance, and other issues with third party payer representative, monitors, and the public;
  
• Maintain effective working relationships with hospital staff, including department managers, physicians, and hospital administration;
  
• Learn new information and more complex tasks involved in hospital revenue;
  
• Function under stress of strict deadlines or confrontational situation;
  
• Deal cooperatively, tactfully, and effectively with those contacted in the course of work.

The County offers comprehensive first-class medical, dental, and vision benefits plans for County employees and their dependents, including plans with no deductibles, no co-pays, no co-insurance, and no prescription drug co-pays. Learn more

The County also offers generous paid time off with significant vacation, sick time, and 13 paid County holidays annually! Details are included in the with the bargaining unit applicable to the job classification.

In addition to the amazing perks above, the County also offers the additional benefits below.

Retirement Benefits
The County offers robust retirement plans including a (similar to the private sector's 401(k) plan) and the In addition to lifetime retirement income available through the CalPERS pension plan, the 457(b) Deferred Compensation plan provides a great way to save for retirement and supplement the defined benefit pension available to employees. These plans help our employees build a plan for their future and contribute to their family's long-term financial well-being.

Health Flexible Spending Account
The empowers employees to manage healthcare expenses efficiently with tax-free contributions (up to $3,200 for the 2024 calendar year). Secure tax-free solutions for your healthcare expenses and enjoy the flexibility to manage your healthcare finances effectively with the HFSA.

Dependent Care Assistance Program (DCAP)
The enables employees to utilize tax-free funds for dependent care services, facilitating a convenient and cost-effective approach for managing your dependent care expenses. The County also offers the , an employer-funded DCAP, for employees with annual income under $120,000.

Life and AD&D
The County offers life and disability benefits including , Insurance, These benefits ensure financial security and income support when you and your family need it most.

Employee Assistance Program (EAP)
The County prioritizes employee mental health and well-being and offers a top-tier through Concern providing confidential counseling sessions covering stress, anxiety, relationships, grief, as well as financial/legal services, personal coaching, child and elder care referrals, and comprehensive crisis support.

Employee Wellness
The offers free wellness programing, fitness classes and resources; including Elevate My Wellness an all-in-one platform designed to elevate your well-being journey.

Education Reimbursement
A generous program is available, including Education Reimbursement for employees seeking additional training and professional development.

NOTE: Benefit and Retirement information may vary from bargaining unit to bargaining unit. Due to changes in State Law, current pension provisions described in the union contracts are not automatically applied. Specific pension benefits for new hires who start on or after January 1, 2013 may be different than indicated in the union contracts.

Click here to access all Memoranda of Understanding and most recent Summary of Changes.
01

Please answer the following questions. Completion of the following supplemental questions is REQUIRED and is an integral part of the evaluation process. Initially, it will be used to determine minimum qualifications. For those applicants meeting the employment standards, this information will be critical in the subsequent competitive assessment to identify those candidates to be invited to continue in the examination process. Your responses to the questions may also be reviewed and scored in a Competitive Rating evaluation process based on pre-determined rating criteria. Your answers should be as complete as possible, as no additional information will be accepted from applicants once the Competitive Rating evaluation has begun. A response of "see resume" or "see application" will deem your application incomplete. Include a detailed description of your work experience in the following format for EACH employer referenced, in each answer:
a) Employer name(s)
b) Job title(s)
c) Start/end dates of employment
d) Total hours worked per week
e) Description of task(s) performedDo you understand the requirement to provide complete answers in order to determine relevant experience for each area in question?

• Yes
• No

02

What is the highest level of education you have completed?

• None
• High School or GED equivalent
• College (1 to 29 semester units / 1 to 44 quarter units)
• College (30 to 59 semester units / 45 to 89 quarter units)
• College (60 to 89 semester units / 90 to 134 quarter units)
• College (90 to 119 semester units / 135 to 179 quarter units)
• College (120 or more semester units / 180 or more quarter units)
• Associate's Degree
• Bachelor's Degree
• Master's Degree
• Doctoral Degree

03

Do you have possession of an Associate's Degree or equivalent training in accounting, medical terminology, computer science or other areas listed in the knowledge and abilities?

• Yes
• No

04

Please enter your major area of study based on the previous question. If not applicable, enter N/A.
05

To qualify for this position, a candidate must possess one of the following certifications: Certified Professional Coder (CPC) or Certified Coding Specialist - Professional (CCS-P).
REQUIRED: Scan and attach your CURRENT certification(s) which include the certification number and expiration date. If not attached, your application will be rejected.

• Certified Professional Coder (CPC)
• Certified Coding Specialist - Professional (CCS-P)
• Do not possess either certification

06

Do you have three (3) years of increasingly responsible experience in a hospital accounting, billing, accounts receivable, or revenue control office?

• Yes
• No

07

Do you have a minimum of three (3) years of experience as a Revenue Control Analyst, Health Services Representative, Patient Business Services Clerk, Medical Administrative Assistant, Health Information Clerk, or related classification? If none, type N/A.

• Yes
• No

08

Describe, in detail, your work experience as a Revenue Control Analyst, Health Services Representative, Patient Business Services Clerk, Medical Administrative Assistant, Health Information Clerk, or related classification. Include increasingly responsible experience in a hospital accounting, billing, accounts receivable, or revenue control office.

Include a detailed description of your work experience in the following format:
a) Employer name(s)
b) Job title(s)
c) Start/end dates of employment
d) Total hours worked per week
e) Description of task(s) performed
09

Do you have one (1) year of required experience in revenue control or related work experience, with the ability to perform complex tasks independently? If none, type N/A.

• Yes
• No

10

Describe, in detail, your work experience in revenue control or related work, with the ability to perform complex tasks independently.
Include a detailed description of your work experience in the following format:
a) Employer name(s)
b) Job title(s)
c) Start/end dates of employment
d) Total hours worked per week
e) Description of task(s) performed
11

How many years of work experience do you possess interpreting rules and regulations related to claims, gathering data, and formulating recommendations, and writing reports?

• None
• Less than one year
• One to less than two years
• Two years to less than three years
• Three years or more years

12

Select which agencies you are interested in. Check all that apply.

• Valley Health Plan
• Valley Medical Center
• O'Connor Hospital
• St. Louise Regional Hospital
• Regional Medical Center

13

How did you find out about this job?

• Contacted by County Recruiter
• Contacted by a Recruitment Firm
• County Employee Referral
• County of Santa Clara Career Website
• County of Santa Clara Job Interests Email Notification
• Facebook
• Instagram
• LinkedIn
• Indeed
• Virtual Job Fair
• In Person Job Fair
• In-Person Networking Professional Event
• Virtual Networking Event
• Community Event
• Glassdoor
• Governmentjobs.com
• Professional Association
• Search Engine (Google, Bing, online search, etc.)
• Hospital Website: SCVMC, O'Connor Hospital, St. Louise Regional Hospital Website
• Handshake
• Student Career Center
• County Text Message
• Other (Specify in the next question)

14

If you selected an event/fair or other in the question above. Please specify. If not, type n/a.
Required Question