The primary responsibility of this position is to serve as the agency’s expert in medical coding and Medicaid program integrity to identify fraud, waste, and abuse and recover improper payments. The Medical Program Specialist 3 (MPS3) leads in analyzing complex health data, policies, and guidelines to create actionable intelligence and serves as a subject matter expert in medical coding systems including ICD, CPT, and HCPCS.
This position involves providing consultation and expert guidance on coding practices, developing trainings and alerts for providers on coding errors, staying current on coding standards, designing and leading training programs to improve coding accuracy, developing audit guides and procedures, conducting quality control reviews of medical coding audits, and planning and leading complex coding audits.
The role reports to the Healthcare Analytics and Insight unit manager and is eligible for telework, with a default work location in Olympia, WA.
Candidates must meet one of the following certification criteria: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent; or active credential as a certified medical coder under AHIMA (RHIA, RHIT, CCS, or CCS-P); or AAPC Certified Professional Coder (CPC).
Additionally, candidates must meet one of the experience and education criteria: Master's degree with 3 years supervisory/consultative experience in health services; Bachelor's degree with 5 years supervisory/consultative experience; 9 years supervisory/consultative experience without degree; or 1-2 years of relevant Medical Program Specialist experience.
Preferred qualifications include experience providing medical coding training, conducting or supervising coding compliance audits, expert proficiency in ICD-10-CM/PCS, CPT, and HCPCS, understanding of CMS guidelines and coding edits, and strong communication, planning, and software skills.
Meaningful work with supportive coworkers focused on community impact Work/life balance with flexible schedules and mobile work options Comprehensive compensation and benefits package Safe, pleasant workplace with nearby amenities and free parking Opportunities for diversity and inclusion engagement within the agency
Location
Washington, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$75,108 - $100,980
Remote work allowed
Yes
Posted
1 month ago