Medical Coding Auditor I

For over 30 years, HMA has been the premier third-party health plan administrator in the PNW. We relentlessly deliver on our promise to provide employers with customized health insurance plans, for their Staff, that offer high-quality healthcare, at a reasonable cost, with first-rate customer service support.
In 2021 AND 2022, HMA was chosen as a Washington's Best Workplaces by our Staff and PSBJ™. Our vision, 'Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are looking to hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team and helping others succeed, are motivated by tackling complex challenges, are courageous enough to share ideas, are action-oriented, are resilient, and are results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, benefits, and time off packages with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
As a Medical Coding Auditor with HMA, you will have the opportunity to further advance in your career as an integral part of our payment integrity efforts for our self-insured clients. We are looking for an energetic, collaborative Certified Professional Coder who will enjoy capturing disallowances due to policies and guidelines and optimizing the processes and efforts of our Coding Policy Review program within our Payment Integrity portfolio. You also may enjoy a flexible schedule and options for your work place (100% remote, 100% in our Bellevue, WA headquarters, or a hybrid arrangement). You must reside within one of our approved states, and given the private nature of reviewing member claims, your workspace set-up must prevent viewing of private health information or confidential HMA information by other people.
What YOU will do:

• Apply your CPC expertise, medical claims knowledge, and critical thinking skills to perform timely, accurate audits of itemized facility bills according to appropriate guidelines, including current Regence policies and provider contracts, industry standards, and company practices
• Quickly learn our review process and practices through detailed documentation, 1:1 peer training and in-depth, self-guided study of Regence Facility guidelines and policies
• 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
• Provide accurate and timely support to CPR or internal teams for HMA responses to provider appeals of CPR audit determinations
• Maintain CPC certification and regularly complete educational and training sessions to expand coding knowledge and understanding

Knowledge, Experience, and Key Attributes needed for Success:

• High School Diploma required
• Current Certified Professional Coder certificate required
• 1-3 years of medical billing/coding experience. Inpatient hospital billing experience preferred.
• Experience in the application of common coding and billing standards including the American Medical Association CPT (Current Procedural Terminology), the Centers for Medicare and Medicaid Services National Correct Coding Initiative, Optum Coding resource manuals, the UB04 Billing Manual coding guidelines, and the National Uniform Billing Committee.
• Ability to grasp new ideas, concepts, and systems quickly.
• Effective verbal and written communication skills.
• Proficiency with Microsoft Office applications (Outlook and Word) and Adobe.
• Motivated self-starter with the ability to work independently.
• Enjoys the pace and rhythm of a deadline-oriented environment requiring strong prioritization skills.

Compensation:The base salary range for this position in the greater Seattle area is $53,000 ($25.48/hr) - $66,000 ($31.73/hr) and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. In addition, HMA provides a generous total rewards package for full-time employees that includes: seventeen (IC) days paid time off; eleven paid holidays, one paid personal and one paid volunteer day; company-subsidized medical, dental, vision, and prescription insurance; company-paid disability, life, and AD&D insurances; voluntary life insurances; HSA and FSA pre-tax programs; 401(k)-retirement plan with company match; wellness incentive and reimbursement; remote work and continuing education reimbursements; discount program; parental leave; and a charitable giving match. For more information about HMA, visit www.accesshma.com .
Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law.
How we Support your Work, Life, and Wellness Goals
We offer a comprehensive total rewards package including: competitive pay; annual incentive; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym facility; a gym subsidy; Life, AD&D, Short-Term and Long-Term Disability Insurances; an Employee Assistance Plan; free parking and easy freeway access to I-405 and I-520; a well-stocked kitchen on-site with subsidized snacks and refreshments; year-round wellness activities; the ability to earn a $500 wellness incentive; monthly events; paid volunteer hours and more!
HMA requires a background screen prior to employment.
Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures.
HMA is an Equal Opportunity Employer