Confluence Health
Salary Range: $24.86 - $39.66
Overview
Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members. Employees of Confluence Health receive a wide range of benefits in addition to compensation. Medical, Dental & Vision Insurance Flexible Spending Accounts & Health Saving Accounts CH Wellness Program Paid Time Off Generous Retirement Plans Life Insurance Long-Term Disability Gym Membership Discount Tuition Reimbursement Employee Assistance Program Adoption Assistance Shift Differential Summary
The Revenue Integrity Auditor I plays a critical role in ensuring accurate coding, documentation, and billing practices for Physicians and Advanced Practice Providers. This position supports compliance with national and payer-specific coding guidelines, enhances revenue capture, and promotes billing integrity. The Auditor collaborates closely with Provider Educators and other stakeholders to deliver audit findings and support continuous improvement. This position is responsible for following the internal auditing schedule to ensure compliance with organizational guidelines. The Auditor will apply standard quality scoring criteria to ensure fair and comprehensive evaluations and prepare findings in a single report. The Auditor is expected to clearly communicate audit results, cite sources, and be open to debate disputed findings. Success is measured by audit turnaround time and how many are completed monthly. Opportunities to grow within auditor tiers and also into other positions within Revenue Integrity. Will use tools such as Optum, Epic, ICD 10-CM, and CPT books. This position is remote and reports to the Revenue Integrity Supervisor. Position Reports To:
Revenue Integrity Manager Essential Functions
Conduct audits of patient records to validate coding, documentation, and billing accuracy in alignment with AMA, CMS, and payer-specific guidelines. Ensure coding specificity and proper sequencing, including Risk Adjustment and Hierarchical Condition Category (HCC) codes. Apply standardized quality scoring criteria and prepare comprehensive audit reports. Frequently review and maintain auditing spreadsheets to ensure completeness. Collaborate with Provider Educators to deliver findings and support educational initiatives. Engage in open dialogue regarding disputed findings and follow escalation protocols when necessary. Maintain current knowledge of federal, state, and local regulations, including ICD-10, CPT, HCPCS, and HIPAA. Participate in continuing education and departmental meetings. Manage assigned work queues (WQs) and provide timely feedback to providers. Demonstrate organizational Standards of Behavior and uphold the Code of Conduct. Must have attention to detail, excellent written and verbal communication skills, and critical thinking. Document, analyze, interpret, and cite source data to support audit findings. Assure audits are completed timely and accurately in accordance with internal policies. Complete ad hoc audits as assigned. Performs other duties as assigned. Qualifications
Required: High school diploma or GED. Minimum two years working as a certified professional coder. Proficiency in Word, Excel, Outlook, Teams, and use of AI. One or more of the following certifications: CPC, COC, CIC, CCA, CCS, CCS-P. Desired: Associate's Degree (AA) or above. Previous auditing experience. Experience using Epic EHR. Experience in inpatient coding. Physical/Sensory Demands
Walking – Occasional Sitting/Standing - Frequent Reaching: Shoulder Height - Frequent Reaching: Above shoulder height - Occasional Reaching: Below shoulder height - Frequent Climbing - Occasional Pulling/Pushing: 25 pounds or less - Occasional Pulling/Pushing: 25 pounds to 50 pounds - Occasional Pulling/Pushing: Over 50 pounds - Occasional Lifting: 25 pounds or less - Occasional Lifting: 25 pounds to 50 pounds - Occasional Lifting: Over 50 pounds - Occasional Carrying: 25 pounds or less - Occasional Carrying: 25 pounds to 50 pounds - Occasional Carrying: Over 50 pounds - Occasional Crawling/Kneeling - Occasional Bending/Stooping/Crouching - Occasional Twisting/Turning - Frequent Repetitive Movement - Frequent Working Conditions
Normal office conditions. Job Classification
FLSA: Non-Exempt Hourly/Salary: Hourly Physical Exposures
Unprotected Heights – No Heat – No Cold – No Mechanical Hazards – No Hazardous Substances – No Blood Borne Pathogens Exposure Potential – No Lighting – Yes Noise – Yes Ionizing/Non-Ionizing Radiation – No Infectious Diseases – No
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Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members. Employees of Confluence Health receive a wide range of benefits in addition to compensation. Medical, Dental & Vision Insurance Flexible Spending Accounts & Health Saving Accounts CH Wellness Program Paid Time Off Generous Retirement Plans Life Insurance Long-Term Disability Gym Membership Discount Tuition Reimbursement Employee Assistance Program Adoption Assistance Shift Differential Summary
The Revenue Integrity Auditor I plays a critical role in ensuring accurate coding, documentation, and billing practices for Physicians and Advanced Practice Providers. This position supports compliance with national and payer-specific coding guidelines, enhances revenue capture, and promotes billing integrity. The Auditor collaborates closely with Provider Educators and other stakeholders to deliver audit findings and support continuous improvement. This position is responsible for following the internal auditing schedule to ensure compliance with organizational guidelines. The Auditor will apply standard quality scoring criteria to ensure fair and comprehensive evaluations and prepare findings in a single report. The Auditor is expected to clearly communicate audit results, cite sources, and be open to debate disputed findings. Success is measured by audit turnaround time and how many are completed monthly. Opportunities to grow within auditor tiers and also into other positions within Revenue Integrity. Will use tools such as Optum, Epic, ICD 10-CM, and CPT books. This position is remote and reports to the Revenue Integrity Supervisor. Position Reports To:
Revenue Integrity Manager Essential Functions
Conduct audits of patient records to validate coding, documentation, and billing accuracy in alignment with AMA, CMS, and payer-specific guidelines. Ensure coding specificity and proper sequencing, including Risk Adjustment and Hierarchical Condition Category (HCC) codes. Apply standardized quality scoring criteria and prepare comprehensive audit reports. Frequently review and maintain auditing spreadsheets to ensure completeness. Collaborate with Provider Educators to deliver findings and support educational initiatives. Engage in open dialogue regarding disputed findings and follow escalation protocols when necessary. Maintain current knowledge of federal, state, and local regulations, including ICD-10, CPT, HCPCS, and HIPAA. Participate in continuing education and departmental meetings. Manage assigned work queues (WQs) and provide timely feedback to providers. Demonstrate organizational Standards of Behavior and uphold the Code of Conduct. Must have attention to detail, excellent written and verbal communication skills, and critical thinking. Document, analyze, interpret, and cite source data to support audit findings. Assure audits are completed timely and accurately in accordance with internal policies. Complete ad hoc audits as assigned. Performs other duties as assigned. Qualifications
Required: High school diploma or GED. Minimum two years working as a certified professional coder. Proficiency in Word, Excel, Outlook, Teams, and use of AI. One or more of the following certifications: CPC, COC, CIC, CCA, CCS, CCS-P. Desired: Associate's Degree (AA) or above. Previous auditing experience. Experience using Epic EHR. Experience in inpatient coding. Physical/Sensory Demands
Walking – Occasional Sitting/Standing - Frequent Reaching: Shoulder Height - Frequent Reaching: Above shoulder height - Occasional Reaching: Below shoulder height - Frequent Climbing - Occasional Pulling/Pushing: 25 pounds or less - Occasional Pulling/Pushing: 25 pounds to 50 pounds - Occasional Pulling/Pushing: Over 50 pounds - Occasional Lifting: 25 pounds or less - Occasional Lifting: 25 pounds to 50 pounds - Occasional Lifting: Over 50 pounds - Occasional Carrying: 25 pounds or less - Occasional Carrying: 25 pounds to 50 pounds - Occasional Carrying: Over 50 pounds - Occasional Crawling/Kneeling - Occasional Bending/Stooping/Crouching - Occasional Twisting/Turning - Frequent Repetitive Movement - Frequent Working Conditions
Normal office conditions. Job Classification
FLSA: Non-Exempt Hourly/Salary: Hourly Physical Exposures
Unprotected Heights – No Heat – No Cold – No Mechanical Hazards – No Hazardous Substances – No Blood Borne Pathogens Exposure Potential – No Lighting – Yes Noise – Yes Ionizing/Non-Ionizing Radiation – No Infectious Diseases – No
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