Professional Coding Education Specialist Evergreen HealthcareProfessional Coding Education SpecialistKirkland, WA$32.92–$52.68 / hourAAPC specialty surgical certification(s): Certified Professional Medical Auditor [CPMA], Certified Evaluation & Management Coder [CEMC], Certified Cardiology Coder [CCC], 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 Associate [CCA], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]).
Professional Coding Education Specialist Kirkland, Washington | Department: Revenue Integrity - Professional Coding | Job Type: Full-Time | Evergreen HealthcareProfessional Coding Education Specialist Kirkland, Washington | Department: Revenue Integrity - Professional Coding | Job Type: Full-Time |Kirkland, WA$32.92–$52.68 / hourAAPC specialty surgical certification(s): Certified Professional Medical Auditor [CPMA], Certified Evaluation & Management Coder [CEMC], Certified Cardiology Coder [CCC], 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 Associate [CCA], Certified Coding Specialist [CCS], Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT]).
NewPayment Integrity Analyst CareOregon IncPayment Integrity AnalystWA$32.06–$39.19 / hourCareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). Research and audit simple to complex claims payments including researching tools provided by the Oregon Health Authority (OHA), Medicare billing guidelines, CareOregon's claims processing policies and procedures and other resources to identify claims overpayments.
Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield AssociationClinical Coding Analyst RN, ConsultantSeattle, WAIn this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.
Coding Auditor and Educator (Remote - WA Residents Only) Valley Medical CenterCoding Auditor and Educator (Remote - WA Residents Only)Renton, WARemoteJOB OVERVIEW: The Coding Auditor and Educator plays a key role in the orientation, auditing, and education of all healthcare providers involved in professional fee coding and documentation at Valley Medical Center. Must be able to interact professionally and effectively with a wide variety of people, including operations staff, providers, the general public, and departments in UW Medicine/Valley Medical Center (VMC).
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.
NewCoding Analyst HealthPoint CareersCoding AnalystRenton, WashingtonThe Coding Analyst educates and collaborates with providers and coding staff to improve documentation accuracy, coding quality, and adherence to guidelines, ultimately reducing audit exposure and supporting overall revenue cycle performance. Demonstrate a commitment to the mission, core values and goals of HealthPoint and its healthcare delivery including the ability to integrate values of integrity, wisdom, creativity, cooperation, responsibility and respect into appropriate programs and 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, WashingtonRemoteCertified 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.
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.
NewSIU 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.
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.
Referral Coordinator COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTYReferral CoordinatorLynnwood, WAIn addition, the Coordinator initiates referrals with hospitals, specialists, and other organizations when services are authorized and educates patients and providers about insurance plans and their benefits. Clerical, reception, medical or dental assisting, administrative or secretarial experience in a medical/dental setting or healthcare insurance organization (1 year); or a combination of equivalent education and work experience.
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.
Investigator III Blue Cross and Blue Shield AssociationInvestigator IIIMountlake Terrace, WA$80,200–$118,300 / yearDevelop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement and regulatory agencies. May attend webinars and conferences like BCBSA, National Health Care Anti-Fraud Association (NHCAA), and Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud.
Investigator III Premera Blue CrossInvestigator IIIMountlake Terrace, WashingtonDevelop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement and regulatory agencies. May attend webinars and conferences like BCBSA, National Health Care Anti-Fraud Association (NHCAA), and Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud.
Special 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.
Payment Integrity Subject Matter Expert (SME) BerryDunnPayment Integrity Subject Matter Expert (SME)Seattle, Washington$95,000–$120,000 / yearFull timeThis position will provide subject matter expertise in Medicaid program integrity, claims audits, risk assessment, external audit coordination, interpretation and application of Medicaid policy and applicable federal and state requirements, and development of data-driven methodologies to identify improper payments, billing anomalies, fraud risks, compliance issues, cost avoidance opportunities, and recovery opportunities across Medicaid medical, dental, behavioral health, pharmacy, provider, member, financial, and operational data. You Will: Develop, refine, and apply analytics approaches to identify improper payments, billing anomalies, outliers, fraud risk indicators, cost avoidance opportunities, recovery opportunities, and program integrity risks across Medicaid medical, dental, behavioral health, pharmacy, provider, member, financial, audit, TPL, and operational data.
Special Investigations Unit Investigator CareOregon IncSpecial Investigations Unit InvestigatorWA$74,250–$90,750 / 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.