Payment 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.
Charge Master Analyst Sutter HealthCharge Master AnalystOlympia, WA$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWA$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)Auburn, 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.
NewRN Nurse Care Manager - Nisqually Generations Healing Center Nisqually Indian TribeRN Nurse Care Manager - Nisqually Generations Healing CenterOlympia, WAFull timeWhile performing the duties of this position, the employee is frequently required to stand; walk; use hands; handle; feel; or grip objects, stretch and/or reach with hands and arms; stoop; crouch or work in cramped or awkward positions; repetitive motions. Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and This includes symptoms, treatment alternatives, drug properties and Interactions, and preventive health-care measures.
Billing and Patient Services Representative Downtown TacomaBilling and Patient Services RepresentativeTacoma, WashingtonThis position is responsible for addressing and resolving complex patient inquiries, concerns, and billing-related issues across various areas including eligibility, claims, denials, appeals, patient balances, collections and financial assistance. We are led by a progressive group of approximately 100 sub-specialized radiologists who take pride in delivering high-quality, patient-centered care while fostering a practice culture intended to feel more like a family than a corporation.
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.
Care Coordinator, Onsite - Centralia, WA - (Hybrid - RN/PT/OT/ST) UnitedHealth Group IncCare Coordinator, Onsite - Centralia, WA - (Hybrid - RN/PT/OT/ST)Centralia, 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. The Care Coordinator completes weekly functional assessments and engages the post-acute care PAC inter-disciplinary care team to coordinate discharge planning to support the members PAC journey.
Billing and Patient Services Representative TRA Medical ImagingBilling and Patient Services RepresentativeTacoma, WA$19.54–$23.77 / hourJob Summary: This position is responsible for addressing and resolving complex patient inquiries, concerns, and billing-related issues across various areas including eligibility, claims, denials, appeals, patient balances, collections and financial assistance. Essential Job Functions: Address complex patient inquiries, questions and concerns in all areas including eligibility, claims, denials, appeals, refunds, authorizations, collections, price quotes, financial assistance and grant matching.
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.
Associate Program Director - Resident Affairs (39754) Community Health CareAssociate Program Director - Resident Affairs (39754)Tacoma, WAAttains and maintains current knowledge of the ACGME Special Requirements for Residency in Family Medicine found at: https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/120_FamilyMedicine_2020.pdf . Supervises, teaches, mentors, evaluates and advises residents and rotating medical students in full-spectrum ambulatory and inpatient settings in accordance with ACGME Special Requirements for Residency in Family Medicine.
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.
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.
Senior Product Manager (PM/RCM) - Full Time - Remote Experity IncSenior Product Manager (PM/RCM) - Full Time - RemoteWARemote$107,750–$151,400 / yearResponsibilities: Own day-to-day execution of the Revenue Cycle Management product roadmap, ensuring on-time delivery of capabilities across charge capture, coding, claim creation and submission, payer processing, payment posting, denial management, accounts receivable, patient balances, reporting, and related billing workflows. Deep knowledge of healthcare revenue cycle management, including charge capture, coding, claim submission, clearinghouses, payer adjudication, remittance processing, denial management, accounts receivable, and payment posting.
L&I Workers' Compensation Adjudicator 2-Apprentice State of WashingtonL&I Workers' Compensation Adjudicator 2-ApprenticeTumwater, WA$55,596–$74,748 / yearRequired: One year of experience working with insurance claims within Labor and Industries or in claims/insurance adjusting, claims investigations, paramedical occupations, disability management, claims risk management/loss control, medical billing or paralegal services with experience in personal injury or medical insurance, or related fields. Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Epic Application Analyst Valley Medical CenterEpic Application AnalystRenton, WAMinimum of 2 years of relevant experience required in one or more of the following areas: Information Services with entry-level or early IT analyst experience; clinical experience in acute or ambulatory settings (clinical education or licensure is a plus); or healthcare operations experience involving billing, scheduling, access services, or HIM, with familiarity in appointment scheduling, billing procedures, coding, and patient flow. The role partners closely with business, clinical, IT, and vendor stakeholders to ensure system reliability, data integrity, workflow effectiveness, and compliance with organizational and regulatory requirements, while working within a more defined scope and escalating higher-risk or more complex issues appropriately.
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.
NewRN Nurse Care Manager - Nisqually Generations Healing Center NISQUALLY INDIAN TRIBERN Nurse Care Manager - Nisqually Generations Healing CenterOlympia, WAWhile performing the duties of this position, the employee is frequently required to stand; walk; use hands; handle; feel; or grip objects, stretch and/or reach with hands and arms; stoop; crouch or work in cramped or awkward positions; repetitive motions. In compliance with Federal Law, this position will not be filled by an applicant with any felonious offense or any of two or more misdemeanor offenses under Federal, State, or Tribal Law involving crimes of violence; sexual assault, molestation, exploitation, contact, or prostitution; crimes against persons; or offenses committed against children.
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.