Coder - Revenue Cycle Providence St. Joseph HealthCoder - Revenue CycleSeattle, WAFull timeOur strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services. Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties.
Senior Coder - Physicians Billing Providence St. Joseph HealthSenior Coder - Physicians BillingSeattle, WAFull timeTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Medical Coder The Progressive CorpMedical CoderFederal Way, WA$24.03–$26.68 / hourThe ideal candidate will have strong customer service and interpersonal skills - which you'll rely on while assisting medical representatives with coding questions and answering calls from customers, providers, billing offices and attorneys. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ .
HIM/MEDICAL RECORDS CODER University Health Services IncHIM/MEDICAL RECORDS CODERMONROE, WAOperating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)WA$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Coding Consultant I, II, or III DOE Cambia Health SolutionsCoding Consultant I, II, or III DOENewcastle, WAFull timeCoding Review Consultant: Certification in at least 1 of the following is required at the time of hire, and throughout tenure in job: Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), RHIT (Registered Health Information Technician), or RHIA (Registered Health Information Administrator). * Identify trends and patterns; collate audit results and analyze findings; identify root cause analysis; and identify system issues that may contribute to claims, coding, provider contracting and revenue cycle deficiencies.
Certified Coder-ProFee II Remote, Kirkland, Washington | Department: Revenue Integrity - Professional Coding | Job Type: Full-Time | Evergreen HealthcareCertified Coder-ProFee II Remote, Kirkland, Washington | Department: Revenue Integrity - Professional Coding | Job Type: Full-Time |Kirkland, WARemote$28.83–$46.14 / hourMust possess or achieve one of the following AAPC specialty surgical certification(s) within one year from hire or transfer into the position: (Certified Cardiology Coder [CCC], Certified Coding Associate [CCA, Certified Cardiovascular and Thoracic Surgery Coder [CCVTC], Certified Gastroenterology Coder [CGIC], Certified General Surgery Coder [CGSC], Certified Interventional Radiology Cardiovascular Coder [CIRCC], Certified Obstetrics Gynecology Coder [COBGC], Certified Ophthalmology Coder [COPC], Certified Orthopedic Surgery Coder [COSC], Certified Urology Coder [CUC]). Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]), Certified Coding Associate CCA.
Certified Coder-Profee II Evergreen HealthcareCertified Coder-Profee IIKirkland, WA$28.83–$46.14 / hourMust possess or achieve one of the following AAPC specialty surgical certification(s) within one year from hire or transfer into the position: (Certified Cardiology Coder [CCC], Certified Coding Associate [CCA, Certified Cardiovascular and Thoracic Surgery Coder [CCVTC], Certified Gastroenterology Coder [CGIC], Certified General Surgery Coder [CGSC], Certified Interventional Radiology Cardiovascular Coder [CIRCC], Certified Obstetrics Gynecology Coder [COBGC], Certified Ophthalmology Coder [COPC], Certified Orthopedic Surgery Coder [COSC], Certified Urology Coder [CUC]). Current professional coding credential: AAPC (Certified Professional Coder [CPC], Certified Outpatient Coder [COC]), PMI (Certified Medical Coder [CMC]), or AHIMA (Certified Coding Specialist-Physician [CCS-P], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]), Certified Coding Associate CCA.
PB Coding Supervisor MultiCare Health SystemPB Coding SupervisorTacoma, WAFull timeThe Supervisor works closely with the vendor coding team to ensure complete, accurate, and timely coding & billing, management or work queues to include denials, and claim edits; oversees coding staff/coding vendor to complete accurate and timely coding/billing of charges, management of denials, and claim edits; ensures maintenance and completion of compliance audits for the coding staff/coding vendor and provides coverage for the Directors of Coding, as needed. If your purpose and passions align with ours, you'll find a place to grow, do meaningful work and build a career you love in a community that feels like home.
HB Coding Supervisor MultiCare Health SystemHB Coding SupervisorTacoma, WAFull timeThe Supervisor works closely with the vendor coding team to ensure complete, accurate, and timely coding & billing, management or work queues to include denials, and claim edits; oversees coding staff/coding vendor to complete accurate and timely coding/billing of charges, management of denials, and claim edits; ensures maintenance and completion of compliance audits for the coding staff/coding vendor and provides coverage for the Directors of Coding, as needed. If your purpose and passions align with ours, you'll find a place to grow, do meaningful work and build a career you love in a community that feels like home.
Inpatient Coder, Level 1 Trauma University of WashingtonInpatient Coder, Level 1 TraumaSeattle, WARemotePRIMARY JOB RESPONSIBILITIES** + Performs chart analysis and assigns ICD-CM and ICD-PCS codes using 3M computer assisted coding (CAC) to compute the final DRG assignment to diagnoses and procedures in an integrated system to ensure the appropriate coding for the facility inpatient billing and reimbursement + Reviews patient records upon admission and at discharge to the inpatient Rehabilitation Unit; assigns codes to each record to assure proper Case Mix Group (CMG) assignment and appropriate reimbursement to the facility for Medicare Rehab patients + Abstracts and/or reviews necessary patient data within EPIC and 3M 360 CAC to ensure data integrity, accurate reimbursement, proper case mix and hospital decision support. + Performs daily activities related to of abstract Diagnosis Related Group (DRG) coding and billing + Analyzes the medical record to assign International Classification of Diseases (ICD), Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines **DEPARTMENT DESCRIPTION** Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding, billing, release, and tracking to management of access, retention, and destruction.
Coder - Physicians Billing Providence Health & ServicesCoder - Physicians BillingSeattle, WA$29.62–$45.31 / hourIt is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Requsition ID: 427824 Company: Swedish Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Admin Support Department: 3908 PHYSICIANS BILLING WA Address: WA Seattle 1730 Minor Ave Work Location: Swedish Metropolitan Park East-Seattle Workplace Type: On-site Pay Range: $29.62 - $45.31
Coder - Physicians Billing Providence St. Joseph HealthCoder - Physicians BillingSeattle, WARequired Qualifications: National Certified Inpatient Coder upon hire or, National Certified Professional Coder upon hire or, National Certified Coding Specialist - American Health Information Management Association upon hire or, National Certified Coding Specialist - Physician - American Health Information Management Association upon hire or, National Registered Health Information Technician - American Health Information Management Association upon hire or, National Registered Health Information Administrator - American Health Information Management Association upon hire. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)WA$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Sr Outpatient Coder Houston Methodist HospitalSr Outpatient CoderWAMust have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CCA - Certified Coding Associate (AHIMA) • CCS-P - Certified Coding Specialist Physician-Based (AHIMA) • CPC - Certified Professional Coder (AAPC). Must have one of the following: •RHIT - Certified Health Information Technician (AHIMA) •RHIA - Registered Health Information Administrator (AHIMA) •CCS - Certified Coding Specialist (AHIMA) •CCA - Certified Coding Associate (AHIMA) •CCS-P - Certified Coding Specialist Physician-Based (AHIMA) •CPC - Certified Professional Coder (AAPC).
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.
Senior Coder - Physicians Billing Providence Health & ServicesSenior Coder - Physicians BillingSeattle, WARequsition ID: 431336 Company: Swedish Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Admin Support Department: 3908 PHYSICIANS BILLING WA Address: WA Seattle 1730 Minor Ave Work Location: Swedish Metropolitan Park East-Seattle Workplace Type: Remote Pay Range: $35.06 - $54.43 Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Vice President Payment Integrity Cambia Health SolutionsVice President Payment IntegrityNewcastle, WAFull timeMinimum of 8-10 years of experience in business process design, improvement, and transformation within healthcare payment environments and a minimum of 12-15 years of progressive leadership experience in Healthcare Payment Integrity, Health Plan Claims, Health Plan Operations or related Healthcare management or an equivalent combination of education and experience. This position drives enterprise-wide strategic vision and execution across post-pay and pre-pay audit functions, provider-facing operations and advance analytics capabilities - all in service of creating an economically sustainable health care system.
Coder/Abstractor III (Remote, WA residents only) Valley Medical CenterCoder/Abstractor III (Remote, WA residents only)Renton, WARemoteEssential Responsibilities and Competencies: Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG). Reviews coding-based payment denials, identifies patterns, corrects errors, and educates clinic and revenue cycle staff on appropriate coding procedures when services are denied due to inappropriate diagnosis or procedure coding.
Inpatient Coder Houston Methodist HospitalInpatient CoderWAHouston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.
Creative Coder MetaCreative CoderSeattle, WAIdentity potential large scale opportunities within Meta and partner with design and engineering teams to deliver state of the art audio functionality, tooling and pipeline solutions 2. Provide audio engineering leadership to cross-functional partners, improving audio quality and automating workflows across Meta products and platforms through agentic pipelines 3. Use creativity and product thinking to develop audio-focused prototypes and experiences that drive team and company success 4. Support AI Audio teams throughout every stage of the model lifecycle, from training through implementation 5. Experience building AI audio pipelines using tools such as TensorFlow, PyTorch, Langchain and audio processing libraries (e.g., Librosa, torchaudio), integrating models, data preprocessing, feature extraction and building RAG pipelines 23.
Coding Compliance Auditor, Revenue Cycle Management, Amazon One Medical AmazonCoding Compliance Auditor, Revenue Cycle Management, Amazon One MedicalSeattle, WADescription As a key member of the Amazon One Medical Revenue Cycle team the Coding Compliance Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. Basic Qualifications - Associate's degree in related field - 3+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required.
Entry-Level Medical Billing & Coding Assistant Revel HealthcareEntry-Level Medical Billing & Coding AssistantSeattle, WashingtonWe are seeking an Entry-Level Medical Billing & Coding Assistant to support important administrative functions related to patient care, insurance claims, and healthcare reimbursement. You will help ensure medical services are documented accurately, claims are prepared correctly, and billing records are maintained in accordance with privacy and HIPAA requirements.
Medical Billing & Coding Specialist CrewBloomMedical Billing & Coding SpecialistSeattle, WARemoteYou will work closely with healthcare practitioners in private practices and medical clinics to accurately review, assign, and manage medical codes, ensuring compliant billing, timely reimbursements, and efficient revenue cycle operations. While industry certifications are a plus, what matters most is hands-on experience with medical billing and coding, particularly a strong understanding of Eye Care Practice (ECP) coding guidelines and regulations.
Coding Specialist 4 University of WashingtonCoding Specialist 4Seattle, WACertified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC) **Compensation, Benefits and Position Details** **Pay Range Minimum:** $34.16 hourly **Pay Range Maximum:** $48.89 hourly **Other Compensation:** - **Benefits:** For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/ **Shift:** First Shift (United States of America) **Temporary or Regular?** Analyzing the medical record to assign International Classification of Diseases (ICD), CPT and/or Healthcare Common Procedure Coding System (HCPCS) codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines **DEPARTMENT DESCRIPTION** Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding, billing, release, and tracking to management of access, retention, and destruction.
Coding Specialist 2 - GIM-Hospitalist University of WashingtonCoding Specialist 2 - GIM-HospitalistSeattle, WARemoteCertified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC). Identify all billable services (regardless of location rendered) requiring professional fee billing, as determined jointly by UWP and the Clinical Department: Review all applicable data sources (EPIC, ORCA, Mindscape,) or other, as applicable, for new admissions, transfers, discharges, expirations, ambulatory procedures, ambulatory visits or other possible sources of billable services.
Coding Specialist 1 University of WashingtonCoding Specialist 1Seattle, WARemoteThe Edits Coder is responsible for performing daily activities related to analyzing medical records to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal reimbursement for facility and/or professional fee coding and billing for Clinic, Outpatient and related charges needing coding review in compliance with State and Federal guidelines. Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC).
Documentation & Coding Consultant CommonSpirit HealthDocumentation & Coding ConsultantSeattle, WAOur comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care. Five (5) years of Current Procedural Terminology (CPT) and diagnosis coding experience in a healthcare provider or a third party payer and three (3) years of experience as an instructor/trainer.
Coding Specialist 2 University of WashingtonCoding Specialist 2Seattle, WARemoteMINIMUM QUALIFICATIONS** - High school diploma or equivalent - Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC). **WORK SCHEDULE** - 40 hours per week - Day Shift - This position is Remote **PRIMARY JOB RESPONSIBILITIES** - Identify all billable services (regardless of location rendered) requiring professional fee billing, as determined jointly by UWP and the Clinical Department: - Review all applicable data sources (EPIC, ORCA, Mindscape,) or other, as applicable, for new admissions, transfers, discharges, expirations, ambulatory procedures, ambulatory visits or other possible sources of billable services.
Coding Quality Auditor Houston Methodist HospitalCoding Quality AuditorWAHouston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.
Ambulatory Payment Classification Coordinator Houston Methodist HospitalAmbulatory Payment Classification CoordinatorWAMust have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CCA - Certified Coding Associate (AHIMA) • CCS-P - Certified Coding Specialist Physician-Based (AHIMA) • CPC - Certified Professional Coder (AAPC) • CPC-H - Certified Professional Coder - Hospital (AAPC) • CPC-I - Certified Professional Coder Instructor (AAPC) • CPC-A - Certified Professional Coder Associate (AAPC) • CCC - Certified Cardiology Coder (AAPC) • COC - Certified Outpatient Coder (AAPC). Must have one of the following: •RHIT - Certified Health Information Technician (AHIMA) •RHIA - Registered Health Information Administrator (AHIMA) •CCS - Certified Coding Specialist (AHIMA) •CCA - Certified Coding Associate (AHIMA) •CCS-P - Certified Coding Specialist Physician-Based (AHIMA) •CPC - Certified Professional Coder (AAPC) •CPC-H - Certified Professional Coder - Hospital (AAPC) •CPC-I - Certified Professional Coder Instructor (AAPC) •CPC-A - Certified Professional Coder Associate (AAPC) •CCC - Certified Cardiology Coder (AAPC) •COC - Certified Outpatient Coder (AAPC).
Outpatient Analyst University of WashingtonOutpatient AnalystSeattle, WARemoteCertified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC); Extensive knowledge of DRG, ICD, CPT and/or HCPCS coding principles and. Respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)WA$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)Seattle, WA$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Payment Integrity Nurse I Cambia Health Solutions IncPayment Integrity Nurse IRenton, WARemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
Payment Integrity Nurse I Cambia HealthPayment Integrity Nurse ITacoma, WARemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
NewProgram Integrity Auditor NACBAProgram Integrity AuditorSeattle, WAEducationAssociate's degree or equivalent experience (2+ years of relevant experience + high school diploma or GED).Anticipated Weekly Hours40Time TypeFull timePay Range$46,988.00 - $122,400.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Primary ResponsibilitiesServe as an audit team member for a health plan(s) which currently administers benefits to Medicaid members across multiple lines of business including acute, behavioral health, individuals with developmental disabilities, and children in out-of-home care.
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadSeattle, WA$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Risk Adjustment Auditor and Physician Educator (4088) Valley Medical CenterRisk Adjustment Auditor and Physician Educator (4088)Renton, WAJOB OVERVIEW: The Risk Adjustment Auditor and Physician Educator is responsible for developing the process and reporting for performing annual, period, and other quality assurance reviews of medical record documentation and coding to ensure appropriate capture of Hierarchical Condition Categories (HCC) conditions. This position utilizes expertise and national coding guidelines as reference in performing medical record coding audits and in partnership with the Physician Champion, develops strategies for provider education and training.
NewDRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadSeattle, WA$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Coding Operations Coordinator Overlake Hospital Medical CenterCoding Operations CoordinatorBellevue, WA$35.25–$52.88 / hourThe Coding Operations Coordinator proactively identifies areas of opportunity to improve coding quality through ongoing coding audit results, coder questions, denials information and other feedback; demonstrates attention to detail to minimize coding errors. The Coding Operations Coordinator, as a key member of the Coding team, will support leadership in planning and implementing activities to optimize and/or support the furtherance of organizational performance goals as it relates to coding.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystSeattle, WARemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
NewProgram Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Seattle, WARemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
NewCompliance Auditor South East Alaska Regional Health ConsortiumCompliance AuditorRenton, WA$47.69–$67.19 / hourAbility toAudit health records for documentation, coding, and billing purposes; investigate compliance concerns; prepare written reports for audits; meet deadlines; understand compliance and regulatory issues; use effective training and communication skills; listen and understand; resolve conflict; analyze data; transform data into meaningful reports; work under pressure; multitask; and function independently. Develop Audit Plans: Create audits based on risk assessments, billing practices, new services, Medicare/Medicaid risk areas, Medicare/Medicaid audits, and RAC and PERM audits.
Infrastructure Engineer The Allen Institute for AIInfrastructure EngineerSeattle, WAThis employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact the Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. We have a beautiful new office right across from Lake Union in Seattle; catered lunches five times a week; great pay and benefits; smart, friendly, and helpful coworkers; and even a couple of kayaks and paddleboards you can take out on sunny days.
Clinical Documentation Improvement Specialist R1 RCM IncClinical Documentation Improvement SpecialistWA$48,131–$81,225.49 / yearHere's what you will experience working as a Clinical Documentation Improvement (CDI) Specialist: Initiates physician interaction when ambiguous, missing, or conflicting information is in the medical record, through the physician query process and/or participation in rounding with the physicians by requesting additional documentation for correct coding and compliance necessary for accurate reflection of CMI, LOS, and optimal resource utilization. Utilizes Hospital coding code set, policies and procedures, Federal and State coding reimbursement guidelines, and application of the Coding Clinic Guidelines to assign working DRG, reviewing patient records throughout hospitalization that have been identified as focus DRG by regulatory agencies or the facility to ensure the codes are reported at the highest specificity.
NewSpecial Investigations Unit (Siu) Investigator II Or III DOE Cambia HealthSpecial Investigations Unit (Siu) Investigator II Or III DOERenton, WAWhat You Will Do at Cambia: Receives, analyzes and coordinates fraud and abuse complaints from internal sources (customer services, claims processing, underwriting, professional affairs) and external sources (members, providers, state and federal regulatory agencies, law enforcement), then conducts and coordinates moderately complex investigations with expertise across various case types, participating in post-audit exit interviews where appropriate. Maintains continuing education through anti-fraud and legal issue seminars, holds at least one professional credential (CPC, CPC-H or CPC-P), reviews pertinent articles and regulatory requirements, and provides post-audit education to providers to correct discrepancies, and trains new Investigators and other Cambia employees in detection of abusive or fraudulent billing practices.
NewSpecial Investigations Unit (SIU) Investigator II or III DOE Cambia Health Solutions IncSpecial Investigations Unit (SIU) Investigator II or III DOERenton, WAWhat You Will Do at Cambia: Receives, analyzes and coordinates fraud and abuse complaints from internal sources (customer services, claims processing, underwriting, professional affairs) and external sources (members, providers, state and federal regulatory agencies, law enforcement), then conducts and coordinates moderately complex investigations with expertise across various case types, participating in post-audit exit interviews where appropriate. Maintains continuing education through anti-fraud and legal issue seminars, holds at least one professional credential (CPC, CPC-H or CPC-P), reviews pertinent articles and regulatory requirements, and provides post-audit education to providers to correct discrepancies, and trains new Investigators and other Cambia employees in detection of abusive or fraudulent billing practices.
Sr. Manager Field Reimbursement - West Integra LifeSciences Holdings CorpSr. 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.
Special Investigations Unit Investigator CareOregon IncSpecial Investigations Unit InvestigatorWA$72,765–$88,935 / yearStrong research, investigative and problem-solving skills Strong communication skills, including written, verbal and listening skills Effective computer skills, including MS Office Suite Strong interpersonal and motivational skills Ability to think logically and creatively without undue influence from personal biases Ability to operate with a high degree of professionalism and confidentially Ability to plan, organize, manage, and monitor work projects Ability to facilitate learning opportunities in a variety of informal and formal settings Ability to make presentations to small and large groups. Ability to bend and speak clearly for at least 3 hours/day Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read and hear and for at least 6 hours/day Ability to perform repetitive finger and wrist movement for at least 3-6 hours/day Ability to work effectively with diverse individuals and groups.