Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)WA$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Physical Therapist, PT - Olympia area - Bonus Available UnitedHealth Group IncPhysical Therapist, PT - Olympia area - Bonus AvailableOlympia, WAClinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support› U.S. › Ireland & UK › India › Philippines › Culture of Belonging› Employee Benefits› Blog Job seeker resources Login Bookmarked jobs 0. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Billing Specialist I, II or III Sea Mar Community Health CentersBilling Specialist I, II or IIIFederal Way, WA$20–$21.75 / hourSea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services.
L&I Health Services Analysis Program Manager State of WashingtonL&I Health Services Analysis Program ManagerTumwater, WA$104,772–$146,784 / yearThis includes credentialing providers, monitoring health care provider quality and performance, managing medical and spending through fee schedules and payment policies, paying medical bills, supporting providers through a call center and through outreach activities, managing language access services to ensure workers can effectively communicate with health care and vocational providers, and increasing providers' use of occupational health best practices. The program establishes and maintains medical fee schedules that are fair and competitive to ensure providers are willing to treat injured workers and workers have timely and equitable access to necessary medical services.
340B Program Operations Analyst Valley Medical Center340B Program Operations AnalystRenton, WAApplied Job Experience: 340 Program Services Background: Industry experience preferred as a 340B program analyst with 340B program audit experience or Clinical Background: Clinical experience in health care, hospital/health system pharmacy. PREREQUISITES: 340B Program Operations Analyst: Bachelor''s degree plus one to three (1-3) years industry related experience, OR Associate''s degree and four (4) years related experience, OR five (5) years related experience.
SIU Investigator Centene Corporation GroupSIU InvestigatorWA$56,200–$101,000 / yearLicenses/Certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or other related investigative, auditing, or compliance certification preferred. Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts.
Sr. Mgr., Patient Services & Advocacy Omeros CorpSr. Mgr., Patient Services & AdvocacySeattle, WA$190,000–$220,000 / yearOmeros' lead complement inhibitor YARTEMLEA (narsoplimab-wuug), which targets the lectin pathway's effector enzyme MASP-2, is FDA-approved and commercially available in the U.S. for the treatment of hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA) in adult and pediatric patients aged two years and older. Omeros' pipeline also includes OMS527, a phosphodiesterase 7 inhibitor in clinical development for cocaine use disorder, which is fully funded by the National Institute on Drug Abuse, and a growing portfolio of novel recombinant antibodies targeting multidrug-resistant organisms and novel molecular and cellular therapeutic programs for oncology.
Compliance & Privacy Specialist Overlake Hospital Medical CenterCompliance & Privacy SpecialistBellevue, WA$79,165–$118,747 / yearUnder the guidance of the Overlake Medical Center & Clinics Compliance & Risk Management Program, the Compliance Specialist provides compliance and privacy program support across Overlake to assist with the implementation of an effective Compliance and Risk Management Program. Facilitates the Conflict of Interest monitoring program, including policy management, process development, review of disclosures, audits of disclosures to Open Payment Data, and development of Conflict Management Plans.
Professional Fee Coder Seattle Children's Hospital Research and FoundationProfessional Fee CoderWashington, WARemote$29.16–$43.73 / hourTogether, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho - the largest region of any children's hospital in the country. Seattle Children's welcomes people of all experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families.
Manager, Payment Integrity Auditing Blue Cross and Blue Shield AssociationManager, Payment Integrity AuditingWA$118,900–$202,100 / yearYou will monitor audit performance, oversee internal and vendor audit activities, identify payment and billing trends, and leverage data-driven insights to improve payment accuracy, reduce inappropriate healthcare expenditures, and strengthen the organization's overall payment integrity strategy. This role is responsible for developing and executing audit strategies across multiple audit types, including DRG validation, itemized bill reviews, level of care reviews, hospital readmission audits, and other post-payment and pre-payment audit initiatives.
Clinical Quality Coder II Sutter HealthClinical Quality Coder IIOlympia, WA$35.04–$52.56 / hourSKILLS AND KNOWLEDGE: Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC, as well as medical terminology and abbreviations of disease, illness and injury process. Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines.
Clinical Data AMS Sr. Consultant Deloitte Touche Tohmatsu LtdClinical Data AMS Sr. ConsultantBellevue, WA$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
Operations Business Analyst Bellatrix HRMOperations Business AnalystColumbia, WashingtonTo be successful as an operations analyst you should be able to analyze complex data sets, identify shortcomings or opportunities, and work with entry-level management and employees to implement changes. Provide the FRA with alternative grantee and stakeholder institutional structures, taking into account cross comparisons among various projects and organizations and then highlighting strengths for future best practices.
Program Manager Bellatrix HRMProgram ManagerColumbia, WashingtonRemoteEfforts may also include assisting in defining scope, developing plans, timelines, tracking action items and their resolution, and assessing workforce distribution requirements. Like the Bellatrix Star in the Orion Constellation, our Team Members are the Brilliance of the company, and are all shareholders, leading the company to success.
Outpatient Hospital Coder Seattle Children's Hospital Research and FoundationOutpatient Hospital CoderSeattle, WA$29.16–$43.73 / hourUnder general supervision, the Outpatient Hospital Coder is responsible for the collection of relevant, pertinent, accurate and timely ICD-10 diagnosis, HCPCS codes, and CPT procedural codes abstracted from hospital case types that most commonly include but are not limited to: hospital outpatient clinics, emergency department, surgical cases, observation, infusion, imaging, and professional billing to the extent of the department's responsibility. Together, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho - the largest region of any children's hospital in the country.
Clinical Data AMS Sr. Consultant DeloitteClinical Data AMS Sr. ConsultantBellevue, WA$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
Documentation Education Specialist IV - Remote must live in Washington or Idaho Kaiser PermanenteDocumentation Education Specialist IV - Remote must live in Washington or IdahoRenton, WARemoteContributes to coding quality audits by: conducting special projects, audits, reviews, and/or monitoring of assigned lines of business or scope independently to monitor the accuracy and quality of coding and documentation; using processes to assess accuracy and completeness of coded documentation integrity; and following guidelines and procedures to ensure special projects, audits, reviews, and/or monitoring align with state and federal regulatory and reimbursement requirements, current documentation, and coding guidelines, and guiding team members to do the same. Contributes to enhancing coding integrity by: assisting with the identification of coding/documentation trends and opportunities; leveraging expert knowledge to aid teams in their assigned lines of business or scope in developing, implementing, and monitoring new processes and workflows that support regulatory needs and requirements, organizational goals, and business objectives; and leading the process of communicating up-to-date and accurate regulation, policy, and guideline changes impacting coding and documentation to all impacted employees.
Sr. Manager Field Reimbursement - West Integra LifeSciences Holdings Corp.Sr. Manager Field Reimbursement - WestSeattle, WA$109,000–$150,000 / yearExperience and strong subject matter expertise in financial systems and management practices of healthcare providers (physicians, medical directors, HCPs) in a variety of settings (hospitals, hospital outpatient clinics, ASC's, ACO's, wound care clinics, and physician offices). Execute regional payer strategies, including expanding and optimizing commercial coverage for priority technologies, engaging payer decision-makers, and aligning access initiatives with enterprise market access objectives to accelerate adoption and revenue growth.
Director Clinical Operations and Medical Policy Cambia Health Solutions IncDirector Clinical Operations and Medical PolicyRenton, WADemonstrated knowledge of the following: Health Plan and benefit design structures and application; Medicare/CMS regulations and applicability in administering the Medicare Product; Pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; Knowledge of health care coding and payment systems (such as ICD-10, CPT, HCPCS, NDC); Compliance related activities, legislative and regulatory activities, health insurance operations, or legal research helpful; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA. These activities include services pertaining to: evidence reviews of medications, formulary development, Pharmacy and Therapeutics (P&T) Committee support, medication use policy development, the Medication Policy Group (MPG), clinical prior authorization, implementation of utilization management activities, guidance for clinical edit coding for prescription claims processor or medical claims system, medication pipeline monitoring, medication trend management, and consultation and guidance on medication-related issues.
Co-Founder & CEO - AI Clinical Documentation Compliance FutureSight VenturesCo-Founder & CEO - AI Clinical Documentation ComplianceSeattle, Washington$80–$85 / hourYou’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth. The market signal is incredibly strong: Unprompted Product Pull: Every single lead described the exact product we want to build: a pre-billing, real-time, EHR-integrated flagging layer that checks documentation against payer-specific rules before claims are submitted.