L&I Medical Coding Specialist, ICD/OIICS/SOC Coder

Our Mission: Keep Washington Safe and Working!Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, ReliabilityJob HighlightsAn exciting opportunity awaits within Claims Administration, in the Insurance Services Division, as a Medical Coding Specialist. This Medical Coding Specialist uses independent judgement to review and analyze medical and occupational information in individual claims files to adjudicate the most accurate International Classification of Disease Volume 10 (ICD-10) codes, Occupational Injury and Illness Classification System (OIICS) codes, Standard Occupational Classification (SOC) codes, and document their decision making. This position, under the direction of a supervisor and lead, applies specific coding business rules on incoming reports of accidents and other coding milestones to ensure that some 4 million bills received each year for health care services receive appropriate payment.This Medical Coding Specialist contributes to the economic well-being of the state by improving the accuracy of diagnostic and occupational codes on claims in the workers’ compensation system. Accurate coding helps workers heal and return to work by improving the agency’s ability to implement healthcare policies and utilize evidence-based medicine. Additionally, this position also applies specific coding business rules on incoming claims to enhance accuracy and quality for federal labor statistics, impacting data collection and employer-based rate setting.Some of what you’ll do:• Review and manage a caseload of compensation claims that require coding adjudication in accordance with the Federal Occupational and Industrial Insurance laws, case law, and department rules and policies.• Research medical, occupational, or legal issues for coding actions.• Research and resolve conflicting eligibility information regarding diagnostic and occupational coding.• Investigate, analyze, and review medical records to assist in recouping and/or adjusting health care payments.• Analyze claim files for appropriate level of medical and occupational academic detailing.• Explain adjudicative coding decisions to internal and external customers.• Act as a technical resource and subject matter expert for all ICD, OIICS, and SOC coding questions.• Document all claim interactions and decisions.Required:• Associate’s degreeAnd• Two years of experience in medical coding, medical billing, medical policy making or fee schedule creation with an emphasis on diagnosis coding.And• Current certification as a Certified Professional Coder with the American Association of Professional Coders (or equivalent) or ability to obtain certification within two years of hire.Or• Experience with Insurance workers' compensation, provider billing or other medical administrative support may be substituted year for year of education. Additional medical related education may be substituted year for year for experience.Things You Need To KnowTo help you maintain a proper work-life balance, teleworking is one of the work schedule options for this position. L&I also offers flexible custom work schedules.State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career. Click on the “Benefits” tab to learn more.At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.3 million workers. Take a look at this brief video and learn more about why L&I is an employer of choice.For this position, full time telework is available, along with flex and hybrid all work schedules are dependent upon business needs and supervisor approval. The assigned duty station for this position is Tumwater, Washington.For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer.Application processWe will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement.Please include the following documents with your application:• A cover letter describing specific qualifications.• A current resume detailing applicable experience and education.• A list of at least three professional references with current telephone numbers.Please do not attach or place any medical information (vaccination status included) within the application, resume, or cover letter. If you do, we will have to reject your application to safeguard others from receiving your confidential information. You will have to remove the confidential information before you can apply again.Background Check Notice:Prior to a placement in this position, a background check, including criminal history record will be conducted. Information from your background check will not necessarily preclude employment but will be considered in determining your eligibility to perform the requirements of the position.To learn more about our hiring process timeline at L&I please visit our L&I recruiting page at Hiring Process at L&I. If you would like to read our website in a language other than English, scroll up to the top of the page to select your language of choice from the banner.Other information• For positions requiring travel, you must have a valid unrestricted driver's license and have insurance if driving a privately owned vehicle on state business.• This position is represented by the Washington Federation of State Employees (WFSE).• Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.• The Department of Labor & Industries complies with the employment eligibility verification requirements of the federal employment eligibility verification form, I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment.• Please note: L&I may use this announcement to fill multiple permanent and/or non-permanent positions.• (IF DOING ASSESSMENT): Applicants selected to move forward in the hiring process will be contacted by email to schedule a skills assessmentDid You Know?Washington is America's Top State to live, play, and work, according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers.Veterans PreferenceApplicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers. For further information, contact L&I’s Jobs@lni.wa.gov.Diversity, Equity, and Inclusion EmployerL&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency’s greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.The State of Washington is an equal opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360-902-5700. TTY users should first call 711 to access the Washington Relay Service.You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.For more InformationIf you have any questions regarding this job posting, program, the agency, or to request a copy of the Position Description Form (PDF) please contact Rachael Niles at Jobs@lni.wa.gov.