Medical Coding Auditor II
2 days ago
Healthcare Management Administrators (HMA) is a leading third-party health plan administrator in the Pacific Northwest and beyond. We pride ourselves on delivering customized health plans to medium to large-size employers, offering high-quality, affordable healthcare options with best-in-class customer service.
We've been recognized as one of Washington's Best Workplaces for three consecutive years, and our vision, 'Proving What's Possible in Healthcare,' and values, People First, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture and drive our results.
What We're Looking ForWe're seeking a unique individual to join our team, someone who cares deeply about others, thrives in evolving environments, and is motivated by tackling complex challenges. You should be a motivated self-starter with strong problem-solving and critical thinking skills, able to work independently and prioritize tasks effectively.
What You Can ExpectAs a Certified Professional Coder with HMA, you'll enjoy an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. You'll have the chance to contribute to something meaningful and make a difference in the healthcare industry.
Job ResponsibilitiesAs a Medical Coding Auditor II, you'll apply coding expertise, medical claims knowledge, and critical thinking skills to perform timely and accurate audits of medical claims invoices according to appropriate guidelines, including current Regence policies and provider contracts, industry standards, and company practices.
You'll consistently complete your allocation of the total medical bill audits closed each month, with a high percentage of your reviews completed within the current turn-around time (TAT). Our present TAT is three business days for 80% of reviews.
You'll become a subject matter expert on coding guidelines and collaborate effectively with internal teams, including Appeals, Claims, Stop Loss, and Care Management, and external stakeholders, such as Regence and providers, to deliver a high-quality, coordinated claim experience for groups and members.
You'll provide accurate and timely support for HMA responses to provider disputes of CPR determinations by analyzing provider concerns and delivering verbal and written explanations suitable for external parties.
You'll contribute to efficient and effective medical claims review processes, practices, and formal documentation, maintain CPC certification, and regularly complete educational and training sessions to expand coding knowledge and understanding.
RequirementsWe're looking for a candidate with a Current Certified Professional Coder certificate, 3-5 years of health plan experience, 3+ years of medical code auditing experience, and 3+ years of experience with Microsoft Office applications (Outlook and Word) and Adobe. You should have strong problem-solving and critical thinking skills, strong client-facing verbal and written communication skills, and be a motivated self-starter with the ability to work independently.
You should enjoy the pace and rhythm of a deadline-oriented environment requiring strong prioritization skills and be able to work effectively in a remote setting with a reliable internet connection.
CompensationThe base salary range for this position in the greater Seattle area is $25/hr - $29/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. We offer a comprehensive total rewards package, including competitive pay, annual incentive, wellness programs, medical, dental, and vision insurance, 401K retirement plan with match, generous PTO and holidays, an onsite gym, life, AD&D, short and long-term disability insurances, an Employee Assistance Plan with additional mental health support, free parking and easy freeway access to I-405 and I-520, a stocked kitchen on-site with subsidized snacks and refreshments, year-round wellness activities, monthly events, paid volunteer hours, and more.
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