Welcome to a medical center where you're the center of attention.

Pay Range

Hourly

$47.95 - $71.93

Responsible for the coordination of all procedural and substantive elements relating to the Centers for Medicare & Medicaid (CMS) Recovery Audit Contractor (RAC) program, commercial payer audits and charge capture auditing.

Prepare any activities pertaining to audits performed by a RAC vendor or other payer i.e., prepayment reviews, post payment denials, etc.
Address clinical payment denials and intervene to maximize reimbursement for the services rendered by the hospital.
Serve as a clinical expert on medical necessity criteria, inpatient/observation criteria, and emergency services criteria.
Prepare defense audits for accounts where a payer has identified discrepancies; review charges originally billed against necessary clinical documentation to identify possible under/over charges; communicate any charge findings to compliance and/or the department manager for follow up; and maintain communication with external auditors.
Review and analyze audit reports/RAC findings, investigate trends, and assist facilities in development and completion of plans to influence improvement.

Full Time / Days

Qualifications

Associate’s degree in nursing required. Bachelor's degree in nursing preferred.
Current licensure as a Registered Nurse in the State of Washington is required.
Minimum five years acute care nursing experience required. Prior utilization management, case management, compliance, or payer experience preferred.

Why join Overlake?

We're proud to offer benefits that support you in every stage of your career and life. But it's our inspirational culture that has made us one of America's Top 150 places to work in healthcare for several years in a row.

Local, visible leaders who care about you.
A values-based work environment.
Medical insurance premiums as low as $0 per month.
Many Overlake services covered at 100%.
Tuition reimbursement up to Ten thousand dollars per year.
Generous retirement plan matching starting at 5% and increasing to 7% after five years with immediate vesting.
Pre-tax and Roth after tax retirement savings plans.
An expanded Employee Assistance Program.
A caregiver support program to help with everything from childcare to eldercare.
Free parking and Orca transit passes.

If this sounds like an environment where you'll thrive, we'd love to hear from you.

How much will this job pay?

Posted pay ranges represent the entire pay scale, from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional pay based on shift, certification or level of education. Job offers are determined based on a candidate's years of relevant experience and internal equity. If you have questions about Overlake's pay practices, employee benefits or the pay for a specific position, please contact HR@overlakehospital.org

Overlake Medical Center & Clinics

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