Pacific Medical Centers Coding and Audit Program Manager - Uniformed Services Family Health Plan in Seattle, Washington
Find what you’re looking for in your career, at PacMed as a Coding and Audit Manager in Uniformed Services Family Health Plan at Seattle, WA.
The Coding and Audit Program Manager organizes and directs the daily activities of the Supervisor USFHP Claims under the supervision of the Director of USFHP Operations. Responsible for achieving and maintaining provider coding accuracy and completeness at the levels required by the yearly Corporate Compliance Work Plan. Responsible for the USFHP Records Management Program. Works directly with providers to educate and monitor their compliance to coding and reimbursement standards and to develop work plans for them to meet requirements. Conducts regular risk assessment audits.
In this position you will:
Sets policy for the Claims and Coding Departments in accordance with the Department of Defense, goals of the Departments and PacMed. Ensures policies and practices meet regulatory and health plan standards.
Supervises or directs the recruiting, hiring, training and performance evaluation of the Supervisor USFHP Claims and Claims Department staff.
Conducts ongoing training for staff, monitoring current coding guidelines and payment practices to ensure accuracy and completeness.
Works collaboratively with Coding Analysts. Shares knowledge and provides support for teams with regard to audits, coding, documentation, and contracted physician/facility requirements and feedback.
Develops and performs integrity risk assessments and audits based upon process and documentation standards.
Routinely completes coding and documentation audits based on compliance issues, Office of the Inspector General standards, and Defense Health Agency work plans and intuition. Audits medical chart documentation to ensure compliance with Federal guidelines regarding correct coding initiatives, fraud and abuse laws, and sanctions.
Required qualifications for this position include:
Hold and maintain CPC, CCS-P or CMC coding certification.
A minimum of 5 years health care experience in a physician group practice or other ambulatory care setting.
A minimum of 5 years of coding experience for a multi-specialty group.
A minimum of 2 years of experience conducting provider education and audits.
Hold or obtain and maintain ACS E/M or CEMA or CPMA CRC auditing certification within 6 (six) months of hire.
Bachelor's Degree or equivalent education/experience
Pacific Medical Center Beacon Hill Clinic:
The patient population we care for is culturally and clinically diverse, creating a stimulating and rewarding workplace. Our strong team environment and mission allow us to provide friendly services that focus on the highest quality patient care. PacMed’s compensation and competitive benefits package will support and enhance a lifelong career.
The Beacon Hill clinic is conveniently located near the intersection of I-5 and I-90 in central Seattle. Beacon Hill offers both primary care—including Family Medicine, Internal Medicine, Obstetrics and Geriatrics—and more than a dozen different areas of specialty care. Home to The Diagnostic and Wellness Center for Women, Beacon Hill offers digital mammography, breast ultrasound, MRI and biopsy as well as therapeutic massage. Other services offered at Beacon Hill include an anticoagulation clinic, infusion therapy, x-ray, onsite laboratory and pharmacy. Interpreter services are also available for our patients.
Seattle is the Pacific Northwest’s largest urban center (metro population 3.25 million), with world-class arts and entertainment, a robust economy and an outstanding school system. The city hugs magnificent Puget Sound and offers magnificent mountain views to the north, east and south. Seattleites are famously fond of the outdoors, fresh seafood and good coffee.
The Beacon Hill clinic is part of Pacific Medical Centers’ expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties. Pacific Medical Centers is affiliated with Providence Health & Services, which operates 28 exceptional not-for-profit hospitals and more than 350 clinics across the West. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models. Find what you are looking for in your next practice opportunity with Pacific Medical Centers! Learn more at www.pacmed.org/providerjobs.
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high-quality, patient-focused healthcare to each person and to the communities we serve.
Quality and respect. These are the words Pacific Medical Centers (PacMed) employees live and work by. PacMed is a private, not-for-profit, primary and integrated multispecialty health care network with 10 outpatient clinics across the Puget Sound region and more than 175 primary and specialty care providers. Affiliated with the Providence Health & Services system, PacMed provides patient-focused health care — and even same-day appointments — to patients in King, Snohomish and Pierce counties. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”
Pacific Medical Centers, PacMed, and their Affiliates' (collectively “PacMed”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. PacMed does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Job Category: Legal
Req ID: 240969