Lead Medical Coder (MPS3/DAIO)

Salary : $75,108.00 - $100,980.00 Annually
Location : Thurston County - Olympia, WA
Job Type: Full Time - Permanent
Remote Employment: Remote Optional
Job Number: 2026-03409
Department: Health Care Authority
Division: DAIO
Opening Date: 04/22/2026
Closing Date: Continuous
Salary Information: The high end of the salary range, Step M is typically a longevity step

Description
Lead Medical Coder (MPS3/DAIO)
71029080
This recruitment is posted continuously. You are encouraged to submit your application materials as soon as possible. The hiring manager reserves the right to close the posting at any time once a selection has been made.
The primary responsibility of this position is to serve as the agency's expert in medical coding and Medicaid program integrity. This work helps ensure that fraud, waste, and abuse is identified and improper payments are recovered. The level of expertise required for this work means that DAIO staff often serve as subject matter experts for the agency and others in a variety of areas related to medical and other benefits claims and billing. If you have a keen eye for details, enjoy sharing your expertise with others, and want to do meaningful work for your community, this might be the right fit for you!
All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.
About the division:
The Division of Audit, Integrity, and Oversight (DAIO) is responsible for providing oversight and helping ensure the integrity of our healthcare purchasing and grant activities. This includes auditing medical and other benefit providers and beneficiaries; the identification, prevention, and investigation of fraud, waste, and abuse; grant subrecipient monitoring; managed care organization contract monitoring; PEBB/SEBB monitoring; and the oversight of behavioral health and recovery spending.
About the position:
This Medical Program Specialist 3 (MPS3) reports to the Healthcare Analytics and Insight (HAI) unit manager and is a lead. This position serves as an agency expert in medical coding, focusing on identifying risks, vulnerabilities, and potential fraud, waste, and abuse within agency programs. As a medical coding expert, this position will work with agency program managers, subject matter experts, other clinicians, auditors, and fraud investigators to analyze complex health data, policies, and guidelines, to create actionable intelligence.
This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions - both on-site and telework eligible positions - is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.

Duties
Some of what you will do:

• Serve as the subject matter expert in medical coding, utilizing expertise in ICD, CPT, and HCPCS coding systems to ensure compliance with federal and state regulations.
• Provide consultation and expert guidance to DAIO, CQCT, DBHR, and others on coding practices, risks, and standards.
• Develop training and alerts for providers on common coding errors and issues.
• Stay current on changes in coding standards, regulations, and laws. Ensure information is shared as appropriate.
• Design and lead training programs focused on improving coding accuracy (ICD, CPT, and HCPCS) and fostering an understanding of program integrity fundamentals to reduce fraud, waste, and abuse within the system.
• Facilitate training in classrooms, remote settings, or recorded environments to ensure appropriate delivery of content to meet target audience needs.
• Track and coordinate continuous education opportunities for staff with coding certifications.
• Develop audit guides and procedures to support auditors in their reviews, ensuring that they have clear and standard protocols for identifying improper payments and potential risks for fraud, waste, and abuse.
• Plan, design, and lead the most complex or sensitive coding audits as assigned by the HAI manager in consultation with the Deputy Director.
• Conduct internal quality control reviews of medical coding audits - review for accuracy and quality.

Qualifications
Required qualifications:
Qualifying candidates will meet one of the following criteria options:
Option 1:

• Professional certification such as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent.

Option 2:

• Active credential as a certified medical coder under the American Health Information Management Association (AHIMA)- Registered Health Information Administration (RHIA) - Registered Health Information Technology (RHIT) - Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician-based (CCS-P).

Option 3:

• American Academy of Professional Coders (AAPC) - Certified Profession Coder (CPC).

Qualifying candidates will also meet one of the following criteria options:
Option 1:

• Master's degree with major study in public health, public administration, nursing, health administration, economics, business administration, or a closely allied field.
• Three (3) years of supervisory or consultative experience in a health services program.

Option 2:

• Bachelor's degree with major study in public health, public administration, nursing, health administration, economics, business administration, or a closely allied field.
• Five (5) years of supervisory or consultative experience in a health services program.

Option 3:

• Nine (9) years of supervisory or consultative experience in a health services program.

Option 4:

• One (1) year of experience as a Medical Program Specialist 2.

Option 5:

• Two (2) years of experience as a Medical Program Specialist 1.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Preferred qualifications:

• Demonstrated experience providing medical coding training or education, including developing training materials, delivering instruction, or mentoring staff in correct application of CPT, HCPCS, and ICD coding standards.
• Experience conducting or supervising coding compliance audits, including interpreting medical policies and procedural coding guidelines.
• Experience designing or implementing provider education programs related to medical billing, documentation standards, or coding accuracy.
• Expert level proficiency in ICD-10-CM/PCS, CPT, and HCPCS coding sets.
• Understanding of CMS guidelines, National Correct Coding Initiative (NCCI) edits, and Medically Unlikely Edits (MUEs).
• Demonstrated ability to analyze claims and encounter data to identify trends, outliers, and patterns suggestive of fraud, waste, and abuse.
• Demonstrated ability to translate highly technical coding guidelines and state regulations into clear, easily understandable training materials and presentations for diverse audiences.
• Ability to serve as an internal consultant to non-clinical/non-coding staff, providing guidance on guidelines and claim reviews.
• Demonstrated initiative and ability to see a task through to the end.
• Demonstrated ability to communicate effectively across multiple levels of the organization and with program customers and stakeholders.
• Demonstrated planning and organizational skills.
• Demonstrated proficiency in common software applications such as Microsoft Office (Project, Word, Excel, PowerPoint, Outlook, and PowerBI).
• Strong written communication skills with the ability to create clear reports for non-technical audiences.
• Demonstrated time and project management skills with the ability to develop and advance assigned projects from inception to completion.
• Demonstrated ability to exercise professional independent judgment and reach sound decisions.
• Demonstrated ability to contribute effectively to a team and participate in making team decisions.
• The ability to take action to meet the needs of others.
• Demonstrated ability to identify current and developing trends in medical healthcare delivery systems and billing.
• Previous experience conducting peer reviews on the work of other auditors/coders, providing constructive feedback and targeted retraining to improve team accuracy.

How to apply:
Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume

To take advantage of veteran preference, please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.

Supplemental Information
About HCA:

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.
There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
• And free parking!

Notes:
Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.
HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA's mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at HCAjobs@hca.wa.gov. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Angelic Matthews at angelic.matthews@hca.wa.gov
The Washington State Health Care Authority (HCA) is an . All applicants with a in the United States are encouraged to apply.
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More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.

We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.

Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.

Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.

Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.

Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.

To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.

Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.

Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.

The Washington State Employee Assistance Program promotes the health and well-being of employees.

Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.

Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.

Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.

Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.

Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.

Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.

Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.

Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.

Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.

Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.

Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.

Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.

Pay status includes hours worked, time on paid leave and paid holiday.

As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.

Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.

Military Leave
Washington State supports members of the armed forces with 21 days paid military leave per year.

Bereavement Leave
Most employees whose family member or household member dies, or for loss of pregnancy, are entitled to five (5) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.

Additional Leave
Leave Sharing

Family and Medical Leave Act (FMLA)
Leave Without Pay

Please visit the State HR Website for more detailed information regarding benefits.

Updated 01-07-2026
01

Will you require sponsorship for an employment-related immigration benefit, either now or in the future?

• Yes
• No

02

If hired for this position, do you currently possess required documents to allow you to legally work within the United States? The attached link lists acceptable documents: https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents

• Yes
• No

03

Please select the certification you possess below:

• Professional certification such as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent.
• Active credential as a certified medical coder under the American Health Information Management Association (AHIMA)- Registered Health Information Administration (RHIA) - Registered Health Information Technology (RHIT) - Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician-based (CCS-P).
• American Academy of Professional Coders (AAPC) - Certified Profession Coder (CPC).

04

Please select the highest level of education that you have completed:

• High school graduation or equivalent
• Associate degree
• Bachelor's degree
• Master's degree or higher
• None of the above

05

Which of the following best describes your professional supervisory or consultative experience in a health services program?

• I do not have this experience
• Less than 1 year
• More than 1 year, but less than 3 years
• More than 3 years, but less than 5 years
• More than 5 years, but less than 7 years
• More than 7 years, but less than 9 years
• More than 9 years, but less than 11 years
• More than 11 years

06

Do you have the ability to take action to learn and grow?

• Yes
• No

07

Do you have the ability to take action to meet the needs of others?

• Yes
• No

Required Question