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Title: SSM – Hospital Outpatient Coder – National Remote

Location: Dallas TX US

Job Category: Clinical

Job Type: Full-time

$3,000 Sign On Bonus For External Candidates

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

We’re focused on improving the health of our members, enhancing our operational effectiveness, and reinforcing our reputation for high-quality health services. As a Medical Coder, you will provide coding and coding auditing services directly to providers. You’ll play a key part in healing the health system by making sure our high standards for documentation processes are being met.

What makes your clinical career greater with UnitedHealth Group? You’ll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you’ll open doors for yourself that simply do not exist in any other organization, anywhere.

As a part of our continued growth, we are searching for a new Medical Coder to join our team.

This position is full-time, Monday – Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for inpatient and/or outpatient hospital accounts.
• Reviews HCPCS charges and codes for appropriateness of modifiers in relation to NCCI/CCI edits, when appropriate
• Enters accurate charge information, when appropriate
• Monitors assigned work queues to ensure all records are charged/coded in a timely matter.
• Generates coding queries for clarification regarding physician documentation as needed
• Stays abreast of all changes in coding conventions and coding updates

Required Qualifications:

• High School Diploma / GED (or higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (RHIT, RHIA, CCA, CPC, COC, CPC-P, CCS) to be maintained annually
• 1+ years of coding experience within a hospital and/or a medical facility
• 1+ years of experience coding Observation and/or Same-day surgery charts
• Experience with EMR systems

Preferred Qualifications:

• Experience coding clinics and ancillary charts
• Ability to use a PC in a Windows environment

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 – $32.26. The salary range for Connecticut / Nevada residents is $20.00 – $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a sign on bonus.

Title: Remote Medical Scribe

Location: United States

Oak Street Health is a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves outcomes, manages medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated care right in our patients’ communities, we can help keep them healthy and reinvest cost savings in further care for those same communities and others. Since 2013, Oak Street Health has brought its singular approach to tens of thousands of people across the nation. With an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oak Street values and are passionate about our mission to rebuild healthcare as it should be.

Role Description:

The goal of the Clinical Informatics Specialist (CIS) is to be the personal data assistant to the provider. The role is responsible for handling informatics responsibilities for providers during patient visits in our centers. CISs are trained to be experts in structured clinical assessments, accurate and specific documentation, population health workflows, and team-based care. Another major goal will be to facilitate efficient and effective medical care for our patients.

Core Responsibilities:

• Observing and recording patient encounters/examinations
• Documenting patient information, history, and diagnoses
• Assisting in medical management
• Documenting medical decision making
• Consulting with the care team and other providers on patient needs
• Other duties as assigned

What are we looking for?

• Applicants committed to ongoing learning that are interested in a full-time short-term (1 year) or longer term opportunity looking to gain practical, paid experience in a patient care setting.
• Advanced communication skills.
• Ability to type 70+ words per minute.
• Basic level of medical knowledge and/or a willingness to learn quickly.
• Ability and willingness to take direction and be a member of a team providing patient care.
• Excellent reliability.
• Compliance with hospital and Oak Street Health policies, including HIPAA.
• Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve, where necessary.
• US work authorization.
• Someone who embodies being Oaky.

What does being Oaky look like?

• Radiating positive energy
• Assuming good intentions
• Creating an unmatched patient experience
• Driving clinical excellence
• Taking ownership and delivering results
• Being scrappy

Why Oak Street?

Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as:

• Collaborative and energetic culture
• Fast-paced and innovative environment
• Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits

Multi-Specialty Coder

Remote

Full Time

Audit Services

Mid Level

We are seeking a highly motivated and dedicated coding professional to join our team as a multi-specialty coder preferably with strong revenue cycle management experience. This position is remote. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties as well as E/M. The position requires one to be resourceful, organized, and extremely driven.

The ideal candidate will possess the following:

• Minimum 5 years of coding experience
• Extensive coding in multiple specialties including: all primary care specialties, anesthesia, general surgery, dermatology, and orthopedics.
• Excellent written and verbal communication skills
• Detail oriented and deadline driven attitude
• Sound knowledge of medical terminology
• Strong computer skills (Excel, Word, and internet)
• Ability to multitask and keep a sense of urgency
• Excellent customer service skills
• Strong time management, organization skills, and work ethic

Job Duties:

• Accurately code medical records for evaluation and management services, ancillary services, surgical procedures, and diagnoses
• Ability to work independently and meet project deadlines
• Stay updated about new coding rules as codes routinely change
• Responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information. Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach
• Prepare coding reports for customers and AAPC Services manager
• Requires long periods of time sitting and using keyboard and mouse
• Meet and maintain department production and quality standards

Certification Requirements:

• CPC
• CPMA, CEMC preferred
• COSC, CPCD, CEDC, CGIC, CGSG, CANPC, CAHONC, CIRCC, COBGC, COPC preferred

What We Offer:

AAPC offers a competitive compensation commensurate with experience, along with a comprehensive benefits package including medical, dental and vision insurance, 401(k) retirement plan, Health Savings Account (HSA), and generous PTO and holiday pay.

Medical Coder

Requisition ID

2022-27959

# of Openings

1

Category (Portal Searching)

HIM / Coding

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Medical Coding Group is comprised of some of the brightest and most talented iniduals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

Details:

• Full time, Flexible Schedule
• Location: Remote/Work from home, NO VACCINATION REQUIREMENT
• Required: A minimum of 3 years of IP coding or auditing experience.
• Preferred: CCS, RHIT, or RHIA credentials.

We Offer:

• Full Benefits: 401k Savings Plan
• 20-24 free CEUs per year, provided by Ciox
• AAPC/AHIMA dues compensation
• Company equipment will be provided to you (including computer, monitor, etc.)
• Comprehensive training led by a credentialed profesional coding manager

What we need

A Coding Consultant, (Inpatient/Outpatient/Profee) codes complex cases for all lengths of stays and as needed and assigns diagnostic and procedural codes to patient records using ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes.

Responsibilities

What You Will Do…

• Reviews medical records and assigns accurate codes for diagnoses and procedures.
• Assigns and sequences codes accurately based on medical record documentation.
• Assigns the appropriate discharge disposition to medical records.
• Abstracts and enters the coded data for hospital statistical and reporting requirements.
• Audits the work of Level 1 & 2 Coders, if applicable.
• Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution.
• Maintains 95% coding accuracy rate and 95% accuracy rate for MS-DRG assignment and maintains site designated productivity standards.
• Maintains minimum production of 1 charts per hour or site specific productivity standards.
• Demonstrates excellent written and verbal communications skills.
• Communicates professionally with co-workers, management, and hospital staff regarding clinical and reimbursement issues.

ADDITIONAL JOB COMPONENTS:

• Typically works remotely, accessing work related tasks via VPN access.
• Reports to work as scheduled.
• Willing and able to travel when necessary, if applicable.
• Complies with all Company and HIM Division policies and procedures.
• Responsible for tracking continuing education credits to maintain professional credentials.
• Attends mandatory sponsored in-service and/or education meetings as required.
• Adheres to the American Health Information Management Association’s code of ethics.
• Performs other duties as assigned.

Qualifications

What Helps You Stand Out…

• Associate or Bachelor’ degree from AHIMA certified HIM Program or Nursing Program or completion of certificate program with CCS preferred.
• Ability to communicate effectively in the English language.
• A minimum of 2-5 years of coding experience in a hospital and/or coding consulting role.
• Experience in computerized encoding and abstracting software.
• Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

There is no COVID vaccine requirement for this role

Digital Registered Nurse

ABOUT US

Traditional health care is broken. Galileo is here to fix it. We’re a rapidly growing health startup that combines intuitive design and clinical expertise to deliver affordable, quality care for all.

Founded by Thomas Lee, MD, the physician entrepreneur behind One Medical and Epocrates, Galileo’s innovative, value-based digital and delivery systems revolve around peoplebringing better doctors and treatment to them, whoever they are and wherever they live.

At Galileo, we’re dedicated to flipping the traditional health care model and implementing a modern solution. Our empathetic, mission-driven vision celebrates creative problem-solving, and moves quickly to build great products. Our teamwork hinges on seamless collaboration. We believe in a hybrid, flexible working environment and have team members across the U.S. and Europe.

ABOUT THE ROLE

Galileo is looking for culturally sensitive Registered Nurses to join our digital-first, primary care medical group. In this role, you will provide support to digital clinicians. Our digital clinicians use asynchronous text-based chat and synchronous video to provide high-quality, comprehensive and evidence-based primary care. As a part of our collaborative clinical care team, you will leverage data, technology, and operational rigor to optimize great patient outcomes while offering highly personalized care and shared decision making with patients.

Here’s what you’ll do:

• Provide best-in-class care for Galileo patients by completing an initial intake and obtaining the following: vitals, medication doses and frequency, social history and preventative care history
• Provide compassionate and empathetic care to patients from age 0-100 across all needs assisting with the following: medication refills, facilitating referrals to specialty care when needed, ongoing chronic illness coaching, population management by condition, preventative care, reviewing imaging, labs and faxes
• Work with a erse patient population. We pride ourselves on fostering a culture that is inclusive of all backgrounds
• Solve patient problems in an efficient, nimble manner by drawing on resourcefulness, collaborating with team members to leverage their expertise, and a can-do approach

HOW WE WORK

Galileo is a 24/7 medical group utilizing asynchronous text-based chat and synchronous video to provide high-quality, comprehensive primary care. The Digital Registered Nurse is a new role to the platform and will be part – time at 20 hours per week.

ABOUT YOU

We look for passionate Registered Nurses who are invested in solving complex problems that impact millions of lives and are excited about fixing what’s broken to improve care quality and health outcomes for everyone.

We believe in a culture that fosters teamwork, excellence, and sound decision-makingone that is based on mutual respect and trust. We appreciate iniduals who are open and honest about what they’re looking for so we can ensure it’s a fit on both sides.

We would love to hear from you if you have the following or equivalent experience:

• Have 3+ years of clinical experience in a primary care setting
• Are experienced in or have an appetite for learning digital-first healthcare (e.g. virtual medicine)
• Are interested in new, innovative models of care that balance evidence-based approaches with creative ideas
• Are highly comfortable with using technology and various applications to deliver care to patients virtually. Our current tech stack is:
  • Proprietary built clinician-patient platform
  • Google Suite (gmail, sheets, docs, etc)
  • Slack
• Have a license in one of the following states: Texas, Florida, New York, California or Virginia
• It’s a bonus if you are professionally fluent in English/Spanish including reading, writing, speaking, and understanding the cultural nuances for native Spanish speakers in a medical setting

HOW WE CARE FOR YOU

• Flexible scheduling – design the schedule that works best for YOU
• 401(k) with company match

Title: Medical Bill Review Nurse I

Location: Virtual, AZ, US +12 more

With moderate direction, reviews complex medical billing to ensure relatedness and compliance with regional, country and/or local regulations and applicable coding guidelines, and contractual agreements. Determines the medical charges according to fairness and reasonableness for a compensational injury, to maximize the benefits to the claimant while ensuring appropriate costs to the carrier.

• Apply medical knowledge by validating the appropriateness of medical treatment and medical bill charges against compensable injury.
• Follow Best Practices and exercise judgment by accurately reviewing medical bills within appropriate time frame for regional, country and/or local jurisdiction.
• Assist in the identification of fraudulent billings by reporting suspicious activity to Special Investigations Unit.
• Escalate questions by engaging senior Medical Bill Review Specialty Nurse for assistance.
• Ensure customer satisfaction by responding to customer inquiries quickly, accurately and in a professional manner.
• Meet quality standards by adhering to Best Practices.
• Ensure legal compliance by following state and federal laws and regulations and internal control requirements.
• Protect Zurichs reputation by keeping claims information confidential.
• Maintain professional certifications and technical knowledge by participating in educational opportunities, staying current with industry trends, and establishing personal networks.
• Contribute to the team effort by accomplishing related results and participating on projects as needed.

Qualifications:

• Bachelors Degree and 2 or more years of experience in the Critical Care Unit or Emergency Room or Medical Billing or Medical Surgical Facility or Operating Room area
  OR
• Associate Degree and 4 or more years of experience in the Critical Care Unit or Emergency Room or Medical Billing or Medical Surgical Facility or Operating Room area
  Current Registered Professional Nurse license
  AND

• Microsoft Office experience

Preferred Skills:

• 1 or more years’ experience in utilization review, nurse case management, workers compensation, medical bill review, coding Certification(s) in any of the above
• Strong communication skills

Applicable Only to Jobs to be Performed in Remotely in any US State

The salary range for this role is $64,600.00 to $84,700.00. This is the range Zurich NA in good faith believes is the range of possible compensation for this role at the time of the posting. Zurich NA may ultimately pay more or less than the posted range and this range is only applicable for jobs to be performed remotely in any US state. This range may be modified in the future. This job is also bonus eligible. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable.

As a condition of employment at Zurich, employees must adhere to our COVID-related health and safety protocols (https://www.zurichna.com/careers/faq), including, without limitation, a requirement that employees attest as to their vaccination status with a YES/NO, and upload proof of vaccination status, or a negative COVID test result when applicable, to a third-party vendor. These protocols are continuously re-evaluated and the requirements may change at any time.

A future with Zurich. What can go right when you apply at Zurich?

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and iniduals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are erse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here to learn more.

As a global company, Zurich recognizes the ersity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, ersity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

Location(s): AM – Arizona Virtual Office, AM – Atlanta, AM – California Virtual Office, AM – Chicago, AM – Dallas, AM – Georgia Virtual Office, AM – Overland Park, AM – Owings Mills, AM – Parsippany, AM – Philadelphia, AM – Rancho Cordova, AM – Remote Work (US), AM – Schaumburg

Remote Working: Yes Schedule: Full Time

Linkedin Recruiter Tag: #LI-LC1

RN Case Manager – Remote

Remote

The Role:

We are looking for passionate and experienced RNs to provide clinical oversight and direction to our Field Providers and Case Management Teams to ensure quality care for our longitudinal populations.

The Company:

At MedArrive our mission is to improve lives by bringing more humanity to healthcare.

MedArrive enables healthcare providers to seamlessly extend care services into the home, unlocking access to high-quality healthcare for more people at a fraction of the cost. MedArrive’s care management platform allows providers and payers to bridge the virtual care gap, integrating physician-led telemedicine with in-person care from EMS professionals. Patients can access trusted medical expertise from their homes’ comfort and safety without interruption to the continuity of care, ultimately resulting in better patient outcomes, a better-utilized healthcare workforce, and significant cost savings for patients and providers alike. MedArrive has more than 50k highly-skilled EMS providers in its national network, and services span dozens of clinical use cases, including urgent care, complex condition monitoring, and medication administration.

This is a 100% remote role that can be based anywhere in the United States or its territories. Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.

Responsibilities:

• Provide oversight through chart review to ensure quality, holistic care
• Collaborate with Clinical Team and provide triage to prioritize interventions
• Daily Monitoring of patient panel to provide feedback to team to make certain performance meets competency metrics while delivering compassionate care
• Identify gaps in resources and solutions to address these gaps
• Present the data obtained for discussion with cross functional teams
• Strategize to improve care delivery model and streamline workflows
• Identify opportunities for expansion of our Care Programs to present to our Demand Partners
• Work as a collaborative partner to our Demand Partners
• Synthesize reporting to our Sr. Director of Population Health to inform on both clinical and SDoH dirven needs of patient panel
• Assist with the Development of our Care Delivery Policies and Procedures

Minimum Requirements

• Registered Nurse
• 3 – 5 years’ Clinical Experience
• Must have an Current Unrestricted License to Practice as a Registered Nurse
• Ability to communicate and interact with Senior Leadership and external executive audiences.
• Excellent written, oral, and interpersonal skills.
• In-depth knowledge of current standard of medical practice

Preferred Requirements

• Texas licensure
• Certified Case Manager (CCM)
• BSN
• Discharge Planning Experience
• Home Health Care Coordination Experience

Skills & Abilities

• Energy and enthusiasm consistent with working for a startup; ability to self-teach in order to problem solve, takes initiative.
• Strong critical thinking, creative problem solving, judgment, and client management skills.
• Ability to maintain confidentiality, tact, and diplomacy.
• Ability to incorporate feedback from daily operations to improve the care program model.
• Ability to critically analyze and synthesize the data received from patient panel to improve the care we deliver and present to cross functional teams
• Ability to work strategically while implementing our care programs in real time

This is a 100% remote role that can be based anywhere in the United States or its territories. Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.

*At MedArrive we believe in the value of erse experiences. If you think you meet some of the qualifications, but don’t necessarily check every box in the job description, we encourage you to still apply. Your experience matters.

**At MedArrive we take multiple data points into consideration when calculating our opening base salary offers. While every effort is made to extend an equitable offer the first time, every time, we know that as humans we have the potential to fall short. Studies show that women and underrepresented people are less likely to negotiate their compensation. We encourage all applicants to feel comfortable articulating their unique value during salary negotiating conversations, every time.

Remote, United States | Medical Coding

Description

Position at GoHealth Urgent Care

JOB SUMMARY

Under limited supervision, the Coding Leads work with the Manager in the daily operations of the Coding Department. Works with Coders in answering questions and follow up emails to providers. Maintains department spreadsheets. Review, analyze and assign final EM levels, any office procedures and all diagnoses reflected in the provider chart notes according to CMS guidelines and GoHealth UC protocols. Works with our partners and markets to resolve problems, research new programs, updates protocols. Helps train new coders.

JOB REQUIREMENTS

Education

• High School Diploma or GED required
• Associates Degree preferred

Work Experience Required

• Minimum of 5 years outpatient EM/office procedure coding
• Minimum 1 year working with coders in auditing/education
• Knowledge of revenue cycle

Required Licenses/Certifications

• Medical Coding Certificate – RHIT or CPC certification
• ICD10 Proficiency

Additional Knowledge, Skills and Abilities Required

• Federal laws and regulations affecting coding requirements
• Working knowledge of payor guidelines, ie-modifier usage, timely filing
• Strong Knowledge of Excel
• Knowledge of billing practices
• Denial Management
• Knowledge of Epic and eCW EMR required
• Excellent Communication Skills

Additional Knowledge, Skills, and Abilities Preferred

• Experience working with computer assisted coding

ESSENTIAL FUNCTIONS

Duties May Include:

• Point person for the Market Specialists, outsourced coding and CAC emails and questions
• Review and analyze CAC and Market processes for continued department improvement.
• Point person for research in new market programs and processes that include coding changes.
• Review’s pending WQ’s for timely follow up by coders.
• Review Code Correct Errors for trends. Report patterns and potential coding changes.
• Trains new coders in each Market and CAC system.
• Works with off shore team to ensure GH processes and protocols are followed.
• Maintains Market Specific Guide’s and ensure contact list is up to date in the assigned Market.
• Works to ensure a smooth process in each Market
• Meets weekly with the Market Specialist, keeps ticket spreadsheet current w/in 2 weeks.
• Accurately follows CMS coding guidelines and GoHealth Protocols to ensure compliance with federal and state regulatory bodies
• Alerts Coding Manager to any market trends for additional coder/provider training
• Provide feedback to Coding Manager on any Market issues
• Reviews Coder Time/Productivity Quarterly as sent by Manager
• Is the Coder point person for coding/GH Process Questions.
• Approves all Time Off and ensures the coders add their time off to the Coders Time Off Calendar.
• Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct. Reports compliance problems appropriately.
• Meets with Manger/Coders to review yearly goals.
• Maintains Coder productivity spreadsheets.
• Codes weekly in each of the assigned Markets
• Attends seminars and in-services as required to remain current on coding issues
• Maintain current coding certificate
• Performs other related duties as assigned

Clinical Documentation Coder- Remote position

Full time

job requisition id R040576

Building Location: Business Service Center

Department: 46290 Clinical Documentation

Job Description:

Responsible for auditing diagnosis codes within the medical record documentation for completeness, to capture the accurate level of patient acuity and to cross reference with information on Problem Lists and Claim Forms to ensure appropriate and proactive care management and to ensure severity level is reflected in the reimbursement level. This position will also be responsible for identifying coding trends and behaviors and educating providers on better documentation and diagnosis code selection. Responsibilities include cross referencing assigned enrollees under applicable contracts and ensuring that all enrollment information is accurately entered into the EPIC registry. Responsible for initiating enrollee communication, including heath information and ensuring regular provider visits.

Experience:

• Minimum of 4 years experience with review and interpretation of provider medical record documentation.

Education Qualifications:

• Associate degree required with a preference in business, medical coding, nursing or related field.

Licensure/Certification Qualifications:

For Department 46290 – Clinical Documentation only

RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician), CCS (Certified Coding Specialist), CPC-H (Certified Professional Coder – Hospital) or CPC (Certified Professional Coder) required upon hire.

Senior Clinical Data Manager – REMOTE

Location: Remote

Why consider joining us? As a member of our thriving team, you have the opportunity to work alongside clinical research colleagues who understand the patients’ mindset and their disease experiences. We help translate science into success for trials with a strategic and targeted, patient-centric approach. We are specialists who find solutions for novel trial challenges in our detailed approach throughout every study phase. From the beginning, we have nurtured an employee-centric company culture that focuses on patients’ needs. Precision’s team-focused culture ensures that team members will thrive and learn. These important key elements result in high quality work output while still having fun and giving back to the patient community.

We invite you to explore joining our team who are dedicated to helping our clients, so that ultimately patients can receive much-needed treatments whether it is oncology, rare disease or COVID-19.

About You:

• Want to do a good job, help others and have a passion for making a difference.
• Care about patients and understand the importance of quality data leading to successful outcomes.
• Are highly experienced in clinical data management and have keen attention to detail, clear communication abilities and organizational skills.
• Foster and value client and internal team collaboration.
• Have a strong belief that all team members are valuable and appreciated.
• Enjoy working alongside teammates and having project-specific data management and managerial support.
• Excited about exercising your data management knowledge and expertise.
• Look forward to opportunities to be involved in innovative data management technology initiatives and training.

A glimpse into the day to day:

• Lead all aspects of the clinical trial data management process from pre-study start up to post database lock for assigned projects.
• Collaborate with clients and team members to develop Case Report Forms (CRFs) and methodical data cleaning strategies to support protocol endpoints.
• Be involved in the Electronic Data Capture (EDC) clinical database development and user acceptance testing (UAT).
• Actively cleaning data, managing CRF and query trends and data reporting to ensure a clean database lock ready for analysis.
• Work alongside key functional areas (such as Project Management, Biostatistics, Medical, Clinical, Safety, Quality Assurance, etc.).
• Standard Operating Procedures / Work Flow Tools (SOPs/WFTs); regulatory directives; study specific plans and guidelines will be followed.

Qualifications:

Minimum Required: Bachelor’s degree or in country local equivalent or equivalent related experience

Other Required:

• Minimum 5 years of Clinical Data Management experience utilizing various clinical database management systems
• Broad knowledge of drug, device and/or biologic development and effective data management practices
• Proficiency in Microsoft Office: Word, Excel, PowerPoint, Outlook
• Excellent organizational, interpersonal & leadership skills
• Professional use of the English language; both written and oral

Preferred:

• Experience in a clinical, scientific or healthcare discipline. Understanding of CDISC standards (CDASH, SDTM, etc.).
• Academic concentration in one or more of the following, or related discipline; life sciences, computer science, or engineering.
• Advanced degree in clinical data management, health informatics, biometrics or similar.

Precision medicine is revolutionizing the attack on cancer and rare diseases and we are passionate about helping you harness its power. We strike tumors on a molecular level using biomarkers to link specific mutations to specific treatments. We combine deep science with deep data from advanced technological platforms, then layer on specialized expertise in the design and execution of targeted, adaptive clinical trials. Ultimately, we deliver robust insights that inform real-time decisions and optimize the oncology development pathway.

Any data provided as a part of this application will be stored in accordance with our Privacy Policy.

Precision Medicine Group is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or other characteristics protected by law. 2020 Precision Medicine Group, LLC

If you are an inidual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact Precision Medicine Group at [email protected].

Coding Consultant Outpatient

Job Locations: US-Remote

Requisition ID: 2022-27687

# of Openings: 2

Category: HIM / Coding

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Medical Coding Group is comprised of some of the brightest and most talented iniduals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

Details:

• Full time, Flexible Schedule
• Location: Remote/Work from home, NO VACCINATION REQUIREMENT
• Required: A minimum of 3 years of IP coding or auditing experience.
• Preferred: CCS, RHIT, or RHIA credentials.

We Offer:

• Full Benefits: 401k Savings Plan
• 20-24 free CEUs per year, provided by Ciox
• AAPC/AHIMA dues compensation
• Company equipment will be provided to you (including computer, monitor, etc.)
• Comprehensive training led by a credentialed profesional coding manager

What we need

Our business is growing and we are looking for experienced, credentialed Outpatient Coders to join the team. Assigns diagnostic and procedural codes to patient records using ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes.

Responsibilities

What You Will Do…

• Reviews medical records and assigns accurate codes for diagnoses and procedures
• Assigns and sequences codes accurately based on medical record documentation
• Assigns the appropriate discharge disposition
• Abstracts and enters the coded data for hospital statistical and reporting requirements
• Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution
• Maintains 95% coding accuracy rate and 95% accuracy rate for APC assignment and maintains site designated productivity standards
• Responsible for tracking continuing education credits to maintain professional credentials
• Attend CIOX Health sponsored education meetings/in-services
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association’s code of ethics.
• Must be customer-service focused and exhibit professionalism, flexibility, dependability and desire to learn
• High complexity of work function and decision making
• Strong organizational and teamwork skills
• Willing and able to travel when necessary if applicable
• Must have excellent communications skills- email and verbal
• Reports to work as scheduled
• Complies with all HIM Division Policies
• Expected to frequently use the following equipment: Desktop PC or thin client, phone (with voice mail), fax machine, and other general office equipment.

Qualifications

What Helps You Stand Out…

• Associate or Bachelor’ degree from AHIMA certified HIM Program or Nursing Program or completion of certificate program with CCS, CPC or CCSP.
• Must be able to communicate effectively in the English language.
• One to five years of coding experience in a hospital and/or coding consulting role.
• Experience in computerized encoding and abstracting software
• Passing annual Introductory HIPAA examination and other assigned testing to be given annually in accordance with employee review

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

Coding Audit Specialist, Radiology and MIPS

Location: United States –Remote – Full-Time

At Zotec Partners, our People make it happen.

Transforming the healthcare industry isn’t easy. But when you build a team like the one we have, that goal can become a reality. Our accomplishments can’t happen without our extraordinary people – those across the country who make up our erse Zotec family and help make this company a best place to work.

Over 20 years ago, we started Zotec with a clear vision, to partner with physicians to simplify the business of healthcare. Today we are more than 1,000 employees strong and we continue to use our incredible talent and energy to bring that vision to life. We are a team of Innovators, Collaborators and Doers.

We’re seeking a Coding Audit Specialist to join us.

As a Radiology and MIPS Coding Audit Specialist, you will be responsible for performing coding audits, responding to coding queries, contributing to the development and implementation of Zotec Partners’ coding standards, and focus on client service delivery to include documentation education. This position will focus on all categories of diagnostic radiology and MIPS coding.

What you’ll do:

• Assure coding quality standards to include auditing of charges/claims for coding accuracy, creation of audit reports and summaries, and in-depth training of coding personnel
• Respond to coding and documentation questions from staff
• Assist in developing and implementing coding compliance guidelines including creation of education material and performance of training sessions
• Create clinical documentation improvement education to include review of dictated reports, creation and distribution of documentation material for client education
• Maintain professional development and perform interdepartmental duties to include participating in professional development activities to maintain coding certification and continuing education requirements
• Work closely with other team members and departments, establish and maintain audit workflow for assigned audit duties, and communicate with Director regarding projects and assignments

What you’ll bring to Zotec:

• High School Degree, plus 5 or more years of radiology coding experience, with 1 year in a senior/lead capacity preferred
• Basic knowledge of CMS MIPS program
• Auditing experience required
• Coding certification required
• Excel experience required
• Exceptional oral and written communication skills
• Strong organizational and problem-solving skills
• Flexible mentality: willing and capable of performing varied tasks
• Self-directing, self-starting, requiring little supervisory direction
• Ability to work in a team driven environment

Reproductive Nurse (Contract)

All US – Remote

Maven is the largest virtual clinic for women’s and family health, offering continuous, holistic care for fertility, pregnancy and parenting. Maven’s award-winning digital programs are trusted by leading employers and health plans to reduce costs and drive better health outcomes for both parents and children. Founded in 2014 by CEO Kate Ryder, Maven has supported more than 10 million women and families to date. Maven has raised more than $200 million in funding from leading investors including Sequoia, Oak HC/FT, Dragoneer Investment Group and Lux Capital.

An award-winning culture working towards an important mission Maven Clinic is a recipient of over 20 workplace and innovation awards, including:

• Fast Company #2 Best Workplaces for Innovators (2022)
• Fortune Best Workplaces NY (2020, 2021, 2022)
• Great Place to Work certified (2020, 2021, 2022)
• Inc. Best Workplaces (2022)
• CNBC Disruptor 50 List (2022)
• Fast Company #1 Most Innovative Company in Health (2020)
• Built In NYC Best Paying Companies (2022)
• Built In LGBTQIA+ Advocacy Award (2022)

Maven is looking for mission-driven, empathetic practitioners to support our members through virtual care services. As a Maven provider, you will have the opportunity to meet with members across the United States, scaling impact and healthcare access nationally. You will also have the opportunity to collaborate with a curated provider network spanning 30+ specialties and 350+ subspecialties to deliver holistic, high value care.

As a Maven provider, you will:

• • Provide virtual care and support to members via video consults and asynchronous messaging
  • Collaborate with Maven’s Care Advocate team to ensure member needs are met, including recommendations for in-person referrals, follow-ups, etc.
  • Serve as an ambassador of Maven’s unique care model, providing culturally humble care and championing our belief that better outcomes for women and families mean a better world for everyone.

We’re looking for you to bring:

• Coaching:
  • Active certification in your specialty area
• Clinical:
  • Independent, unrestricted license to practice in at least one state
  • Physicians: current board certification in good standing
• Ability to provide direct member care, ideally 5-10 hrs per week
• Experience providing empathetic, culturally humble care
• Strong organizational skills and an attention to detail
• Passion for women’s and family health

We offer our providers:

• Flexibility:
  • Ability to create your own schedule to accommodate professional and personal needs
  • Ability to work from anywhere with stable internet and a private space
• Exclusive network:
  • Community of exceptional health and wellness professionals across 30+ specialties
• Expand your practice:
  • Supplement your regular practice through Maven’s proprietary, secure telehealth platform:
  • Provide care via video and private messaging
  • Participate in unique opportunities, e.g. moderating community forums, leading virtual member classes–and more
• Training & events:
  • Complimentary opportunities for ongoing education

At Maven we believe that a erse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams.

Benefits & Perks:

We are reimagining what a supportive workplace looks like, from the inside out. On top of standards such as employer-covered health, dental, and insurance plan options, and generous PTO, we offer an all-of-you, inclusive approach to benefits:

• Maven for Mavens: access to the full platform and specialists, including care for everything from mental health, reproductive health, family planning, pediatrics.
• Whole-self care through wellness partnerships
• Weekly breakfast, lunch, and get-togethers
• 16 weeks 100% paid parental leave, flexible time upon return, and $1.5K/mo for 2 months, new parent stipend (for Mavens who’ve been with us at least six months)
• Udemy, annual professional development stipend, and access to a personal career coach through Maven
• 401K matching for US-based employees (immediately vesting)

These benefits are applicable to Maven Clinic Co., US-based, full-time employees only. 1099/Contract Providers are ineligible for these benefits.

Location:  US Locations Only; 100% Remote

Position Summary

Care Coordinators are responsible for all aspects of patient intake into UCM Digital Health’s “Digital Front Door” and managing patient flow through our digital healthcare continuum. Care Coordinators are responsible for call management, care coordination, and care follow-up for all UCM patients.

CC I – intake coordinator

CC II – referral coordinator (includes labs/imaging)

CC III – train and oversee intake coordinators – specialize in specific groups and insurers.

CC IV – shift leader trains and oversees referral coordinators + all other previously mentioned tasks

Position Objective

Care Coordinators ensure a smooth and efficient experience while connecting patients with a clinical provider. The primary goal of a Care Coordinator is to do the right things, at the right times, with clarity and purpose, always keeping the patient’s best interests in mind. The Care Coordinator achieves this goal by leveraging all of UCM Digital Health’s technology and expertise.

Shifts Available

1. 7:00am-3:00pm
2. 11:00am-7:00pm
3. 3:00pm-11:00pm

Functional Responsibilities and Duties:

Answer phones and guide the patient through UCM’s digital platform. Follows providers instructions regarding patient care. Work collaboratively to monitor and address clinical quality and gaps in care. Perform other special projects not related to a specific case such as process improvement, general research, or acting as a liaison for a specific project, when necessary. Adhere to all corporate Information Security policies and procedures. Identify any breaches or potential breaches of corporate Information Security standards and communicate those to appropriate iniduals. Maintain integrity, availability, and confidentiality of all PHI. Adhere to HIPAA standards for information security, privacy, and confidentiality.

Supervisory Responsibility

This position has no supervisory responsibilities.

Education

• High-school diploma or equivalency required; Associate’s degree a plus.

Competencies/Experience

• Two (2) years of call center customer service, or direct patient care required.
• Medical experience is a plus.
• One (1) year of working with blended technology platforms (i.e., software platforms, customer databases, dispatch CAD, call center, and telephony systems).
• Strong ability to organize effectively, delegate responsibility, solve problems quickly and communicate clearly
• Ability to manage time effectively and handle both internal and external conflicts
• Excellent interpersonal, communication and diplomacy skills; the ability to interact effectively in person (remote) and in writing with people of various professional and cultural backgrounds; prior exposure to a erse, multicultural work environment.
• The ability to communicate fluently in English; bi-lingual or multi-lingual is a plus.

Work Environment

This position operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.

Physical Demands

Occasional (0-40%)/ Frequent (41-71%)/Constant (72%-100%)

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.

• Constant computer work which may require repetitive motion, prolonged periods of sitting and sustained visual and mental applications and demands.
• Occasional lifting, bending, pulling, collating, and filing, some of which could be heavy (>10lbs)

This job description is intended to convey information essential to understand the scope of the position. It is not intended to be an exhaustive list of skills, efforts, duties, or responsibilities associated with the position. Duties, responsibilities, and activities may change at any time with or without notice.

Equal Employment Opportunity Statement

UCM Digital Health maintains a strong policy of equal opportunity in employment. It is out objective to recruit, hire, and retain the most qualified iniduals without regard to race, color, religion, sex, sexual orientation, or identity, national origin, age, disability, veteran status or any other characteristic or status protected by applicable federal, state or local law. Our equal employment philosophy applies to all aspects of employment, including recruitment, compensation, benefits, training, promotions, transfers, job benefits, and termination.

Location: US Locations Only

Professional Fee Women’s Health E/M Coder

Job ID 2022-2797

# of Openings 3

Job Locations US-Virtual/Remote

Category Medical Coding

Minimum Hours Varies

Overview

Professional Fee Women’s Health E/M Coding Specialist

GeBBS Healthcare Solutions, an industry leader in Health Information Management and Revenue Cycle Management solutions, is seeking highly motivated iniduals with a passion for excellence and collaboration, for careers in the healthcare industry. Here is your opportunity to be part of this exciting team! GeBBS is looking for a ProFee Women’s Health E/M Coding Specialist.

Responsibilities

Coding Information

This position will provide accurate coding services for E/M services and in office or bedside procedures. Coder will be responsible for coding ICD-10-CM, CPT and HCPCS Level II codes. Incoming coder will need to be proficient in the 2021 office visit changes demonstrated by passing an exam.

Position Requirements

The position requires the coder to achieve and maintain a 95% accuracy level and maintain production standards as outlined by service line.

EPIC experience is required.

Qualifications

• Current AAPC or AHIMA certification required
• 3+ years of experience professional fee OP coding diagnosis and charge review – OB/GYN, General Medicine, Internal Med, Family Practice
• Quality and production standards must be met (20 CPH, 95% accuracy)
• Flexible hours: Training will be scheduled during the week days.
• Immediate availability
• Ability to code accurately and maintain a quality score of 95% or greater
• Position will be required to pass ProFee coding test
• US-Based Candidates only

Aviacode provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identification, disability, or genetics. In addition to federal law requirements, Aviacode complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Aviacode expressly prohibits any form of workplace harassment based on protected classes. Improper interference with the ability of Aviacode’s employees to perform their job duties may result in discipline up to and including discharge.

Title: RN Case Manager: Special Needs Plan

Location: United States – Remote – Full-Time

Job Description

A bit more about this role:

We want to help members navigate the healthcare system in a better and safer way, and case management is critical to achieving this for our most vulnerable and complex members. You’ll be responsible for providing telephonic, ongoing case management support to our highest risk members, and you’ll be helping to build the program while doing so. You’ll focus initially on the members enrolled in our Dual Eligible Special Needs Plan (D-SNP). These members, eligible for both Medicaid and Medicare, represent some of the highest risk members who would most benefit from case management. You’ll serve as an advocate for these members, coordinating care and ensuring they have the necessary resources and support to achieve better health outcomes.

Our ideal case manager is caring, compassionate, solution-oriented, and enthusiastic about providing an outstanding experience for Devoted Health’s members. They are committed to integrity, excellence, and empowering our most complex members to confidently navigate the healthcare system and live healthier lives. They are ready to innovate, adaptable to a continuously evolving startup environment, and willing to start scrappy, working with the whole Devoted family to create a revolution in how care is delivered.

A day at Devoted could include:

Working with members

• Engaging with high-risk members (primarily telephonically) to understand their needs, supported by technology and data tools.
• Conducting holistic assessments to identify comorbid conditions, ED/hospitalization history, medications, psychosocial factors, and member values and preferences.
• Developing care plans in partnership with members and their caregivers – problems, goals, interventions – while continuously evaluating the member’s progress.
• Explaining complicated medical terms in plain language.
• Educating members on their chronic conditions including teaching “red flags,” developing plans during an exacerbation, and identifying barriers to important care elements such as medication adherence.
• Preparing members for their inpatient and outpatient treatments.

Working with other providers and resources

• Working closely with Devoted Community Guides (locally-based social workers) to identify community-based organizations to support our members in meeting their goals.
• Coordinating post-treatment care and DME needs.
• Collaborating closely with our PCP partners, as well as Devoted Medical Group, to coordinate care and deliver evidence-based, effective, and accessible health care.

Improving how we work

• Providing feedback and advice to help improve the operational processes, software tools, and data capabilities to improve how Devoted does transitions of care case management.

Attributes to success:

• A desire to make a change in the healthcare experience: you love to serve and make a difference.
• You enjoy being on the phone caring for patients.
• Strong clinical skills that will help you understand what a patient needs to help her avoid poor health outcomes.
• The ability to adjust your tone and approach to different people in order to build trust and achieve positive outcomes.
• The ability to articulate and break down complex information to ensure patients and caregivers are able to absorb and act on your guidance.
• Excellent organizational skills which you will use to prioritize and provide need-based levels of engagement with inidual patients, communicate and coordinate care needs across various organizations, and ensure none of our members fall through the cracks.
• Proven success and enjoyment in building relationships with a variety of stakeholders, such as care managers at hospitals and care coordinators at large PCP groups. The ability to learn quickly from past experiences and implement changes for improvement.
• You are comfortable working with technology and in a dynamic, startup environment.
• Comfort or interest in working remotely post COVID

Desired Skills and experience:

• An unrestricted, compact RN license and willingness to obtain non-compact state licenses if needed.
• Prior case management experience with DSNP population.
• The ability to comfortably multi-task: you’ll be listening, talking and typing all at the same time.
• Team player mentality with a can-do attitude.
• Bilingual in English and Spanish a plus
• Health insurance experience, particularly Medicare Advantage a plus.
• Experience working with dual eligibles in some capacity.

Title: Coder II Inpatient Coding – Remote Work From Home

Location: United States

Job Description

Overview

HonorHealth is a non-profit, local community healthcare system serving an area of 1.6 million people in the greater Phoenix area. The network encompasses six acute-care hospitals, an extensive medical group, outpatient surgery centers, a cancer care network, clinical research, medical education, a foundation and community services with approximately 12,300 employees, 3,700 affiliated physicians and 3,100 volunteers.

HonorHealth was formed by a merger between Scottsdale Healthcare and John C. Lincoln Health Network. HonorHealth’s mission is to improve the health and well-being of those we serve.

As a community healthcare system, we have a unique responsibility to keep our facilities as safe as possible to protect our patients and team members. With this in mind, we require all new hires to have received the first dose of a COVID-19 vaccine before their start date and be scheduled for their second dose. New hires who choose to receive the Johnson & Johnson vaccine only need one dose to fulfill this requirement. Reasonable accommodations will be considered.

Responsibilities

Job Summary

• Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT, and HCPCs codes through review of Inpatient or Outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. Codes complex accounts which requires advanced expertise in coding subject matters.
• Inpatient: Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. Reviews physician documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Codes complex accounts. Assigns DRGs as applicable.
• Outpatient: Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT, and HCPCs diagnostic and procedural codes for multiple outpatient accounts such as (same day surgery, endoscopy, ED/Trauma, breast health, or other more complex patient type) within HonorHealth. Reviews physician documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Codes complex accounts. Addresses NCCI, OCE, LCD, and other applicable coding edits.
• Inpatient/Outpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate code selection.
• Inpatient/Outpatient: Maintains query communication with providers to ensure timely notification of identified documentation issues that may impact revenue or compliance.
• Inpatient: Assists Patient Financial Services with interpretation of codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters
• Outpatient: Assists Patient Financial Services with interpretation of codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters. Performs outpatient charge validation/ reconciliation to ensure all submitted charges are posted timely and balance with total submitted charges. Assigns charges as applicable.
• Resolves routine coding issues/problems and appropriately seeks assistance from Coding Supervisor.
• Keeps supervisor informed of issues/problems and other such activities.
• Participates in continuing education activities to enhance knowledge, skills, and keep credentials current.
• Performs other duties as assigned.

Qualifications

Education

• High School Diploma or GED Required

Experience

2 years Inpatient:

• Two years experience in coding complex inpatient accounts including extended length of stay and extensive surgical and or medical accounts.

Outpatient:

• Two years experience in coding complex outpatient accounts which may include: Extensive emergency department trauma, newborn, obstetrics, day surgery, and observation.

Required

Licenses and Certifications

Inpatient:

• CCS (Certified Coding Specialist), or
• CIC (Certified Inpatient Coder), or
• RHIT (Registered Health Information Technician), or
• RHIA (Registered Health Information Administrator)

Outpatient:

• CPC-H (Certified Professional Coder – Hospital Outpatient), or
• CPC (Certified Professional Coder), or
• COC (Certified Outpatient Coder), or
• CCS-P (Certified Coding Specialist-Phys Based) or,
• CCS (Certified Coding Specialist), or
• RHIT (Registered Health Information Technician), or
• RHIA (Registered Health Information Administrator)

Hospital Inpatient Coder (SSM) – National Remote

Location: United States

Requisition Number: 2103388

Job Category: Medical & Clinical Operations

Compassion. It’s the starting point for health care providers like you and it’s what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you’re also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life’s best work.

$3000 Sign On Bonus For External Candidates

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Combine two of the fastest – growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making Healthcare data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

We’re focused on improving the health of our members, enhancing our operational effectiveness, and reinforcing our reputation for high-quality health services. As a Medical Coder, you will provide coding and coding auditing services directly to providers. You’ll play a key part in healing the health system by making sure our high standards for documentation processes are being met.

What makes your clinical career greater with UnitedHealth Group? You’ll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you’ll open doors for yourself that simply do not exist in any other organization, anywhere.

As a part of our continued growth, we are searching for a new Medical Coder to join our team…

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5:00 am – 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for inpatient and/or outpatient hospital accounts.
• Coordinates with the clinical documentation and quality teams to ensure validation of Medicare Severity Diagnosis Related Group (MSDRG), patient safety indicators, and hospital acquired conditions are supported by physician documentation to assign appropriate coding
• Monitors assigned work queues to ensure all records are charged/coded in a timely matter.
• Generates coding queries for clarification regarding physician documentation as needed
• Stays abreast of all changes in coding conventions and coding updates

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• Professional coder certification with credentialing from AHIMA and/or AAPC (RHIT, RHIA, CAC, CPC, COC, CPC-P, CCS) to be maintained annually
• Ability to pass all pre-employment requirements including, but not limited to: drug screening, background check, and coding
• 1+ year of hospital coding experience
• Ability to work any 8 hour shift between 5:00am – 5:00pm including the flexibility to work occasional overtime per business need

Preferred Qualifications:

• Ability to use a PC in a Windows environment, including EMR systems
• Inpatient Hospital Coding experience

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 – $32.26. The salary range for Connecticut / Nevada residents is $20.00 – $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a sign on bonus.

Nurse Practitioner/Physician Assistant – Connected Care Program

REMOTE 

CLINICAL STRATEGY AND SERVICES CLINICAL TEAM 

FULL-TIME

Included Health is looking for nurse practitioners/physician assistants who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading interventions, within our Connected Care Program (CCP).

Nurse practitioners/physician assistants will guide members through complex medical situations, partnering with a multidisciplinary clinical team that includes a nurse care manager, other healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in an innovative way. The nurse practitioner/physician assistant should enjoy a team-based collaborative approach to member care including spending time on the phone with members, listening to members’ needs, answering questions, and serving as an advocate. They should also excel in creation of cohesive care plans and in providing clinical depth for a member’s care.

The nurse practitioner/physician assistant should possess the clinical acumen to help guide care for members and navigate available benefits and resources. The nurse practitioner/physician assistant will support members through complex care management, disease management, and acute case management, ensuring they receive longitudinal care that results in excellent health outcomes.

Responsibilities

• • Deliver coordinated and compassionate virtual Care Management by telephone and/or video that improves members’ health outcomes.
  • Generate impactful care plans together with members, nurse care managers and our multidisciplinary care team, and help members achieve the desired goals, in both acute and longitudinal settings.
  • Partner with the members’ local providers to ensure coordinated care. Coordinate necessary resources that holistically address members’ problems, whether clinical or social.
  • Provide clinical depth to a member’s care and help to identify opportunities to improve a member’s healthPartner with our Credentialing Team to become licensed in additional states if needed.
  • Model our culture and values through humility and curiosity.

Requirements

• • Active medical license and Board Certification required.
  • Willingness to become licensed in multiple states
  • Be comfortable guiding care for a variety of medical conditions and disease states.
  • Be highly empathetic. We work with members and their families who are going through challenging times. Ideal candidates practice empathy and reassure members that we are available to help them.
  • Ability to understand cultural and socioeconomic issues affecting members and to coordinate all available resources to serve members.
  • Collaborate well across multidisciplinary teams with clinical and non-clinical members to deliver a seamless, top-quality care experience to members.
  • Strong verbal and written communication skills. You will spend time on the phone with members and families, as well as a lot of time communicating with colleagues. Therefore, the ability to gather a clinical history, answer questions at a member level, and succinctly summarize findings is critical.
  • Must be able to work efficiently. We are a fast growing company and we are busy. Our team is expected to meet volume goals without sacrificing quality. Good judgment for balancing priorities is a must.
  • Be flexible and comfortable with working in a rapidly-changing environment. Be able and willing to work until 6pm local time, with occasional weekend commitments as well.
  • Strictly follow security and HIPAA regulations to protect our members’ medical information.
  • Strong competence and ability to use multiple computer/medical record systems. Experience with telehealth preferred.

Schedule

• • 6am-3pm PT OR 7am – 4pm PT, Monday – Friday
  • Occasional evenings (until 6p) and weekends

Title: Medical Coder – Remote

Location: United States

Job Category: Clinical Job Type: Full-time Travel Percentage: -1 Job Description:

$3000 Sign On Bonus For External Candidates

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Combine two of the fastest – growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making Healthcare data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.

This position is full-time. Employees are required to work our normal business hours of 8:00 AM – 5:00 PM.

We offer 4 weeks of training. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Reviews and resolves all services in assigned charge review, claim edit, and denial / follow – up work queues to ensure timely and accurate charge capture or insurance follow – up
• Accurately deciphers charge error reasons and plan follow – up steps
• Conducts charge reconciliation by reviewing various reports detailing billable activity and following-up, as necessary to ensure charges are submitted and cleared from missing charge reports
• Reviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs (aka Op Logs), nursing home visit documentation, procedure reports generated from non – electronic health record systems, etc.
• Documents clear and concise notes within the electronic health record according to established standards to facilitate comprehensive and accurate claim history
• Reviews electronic health record, scanning database and other systems to obtain required information such as referral / authorization numbers, Advanced Beneficiary Notice (ABN) or financial responsibility form (FRF) capture, accident or work injury dates, etc.
• Follows all department policies and procedures, desk level procedures, guidance documents, or other work tools designed to ensure accuracy
• Performs other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• 1+ years of coding experience
• AHIMA OR AAPC certification
• Ability to work any 8-hour shift between the hours of 8:00 AM – 5:00 PM
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

• 1+ years of experience in a cardiology specific environment

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 – $32.26. The salary range for Connecticut / Nevada residents is $20.00 – $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a sign on bonus.

Title: Clinical Administrative Coordinator – National Remote

Location: United States

Job Category: Clinical Job Type: Full-time Travel Percentage: -1 Job Description:

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that can definitely come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Like you, UnitedHealth Group is strong on innovation. And like you, we’ll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive, and positive for our members and providers. You’ll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you’ll have a chance to make an impact.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am 5:00pm. It may be necessary, given the business need, to work occasional overtime.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Manage administrative intake of members
• Work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers
• Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
• Handle resolution/inquiries from members and/or providers

This is high volume, customer service environment. You’ll need to be efficient, productive, and thorough dealing with our members over the phone.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED or higher
• 2+ years of customer service experience
• Experience with MS Word, Excel, and Outlook
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am 5:00pm MST

Preferred Qualifications:

• Experience working within the health care industry and with healthcare insurance
• Experience working in a hospital, physician’s office or medical clinic setting
• A clerical or administrative support background
• Knowledge of ICD-9 and CPT codes
• Experience working in a call center

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $16.00 – $26.88. The salary range for Connecticut / Nevada residents is $16.83 – $29.66. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Title: Nursing Scientist

Location: United States – Remote

Full Time

Job Overview

Shriners Children’s is the premier pediatric burn, orthopaedic, spinal cord injury, cleft lip and palate, and pediatric subspecialties medical center. We have an opportunity for a remote Nursing Scientist reporting into our Headquarters location.

The Nurse Scientist provides leadership, assistance, and support in developing, implementing, evaluating, enhancing, and maintaining a comprehensive nursing research and evidence-based practice (EBP) program across Shriners Children’s. Nursing research will enhance the quality and outcomes of pediatric care. The program will assist Shriners Children’s in becoming the best at transforming children’s lives and providing the highest quality care to children with neuromusculoskeletal conditions, burn injuries, and other special healthcare needs.

The Nurse Scientist is responsible for developing and leading the Nursing Research Council. The Nurse Scientist will assist nurses and healthcare professionals in allied health services to find, evaluate, and apply evidence and build toward supporting practitioners to identify gaps in evidence and engage in nursing research.

The Nurse Scientist will act as a contact for nurses and healthcare professionals in allied health services seeking information to participate in research and EBP. The Nurse Scientist will identify and advocate for opportunities to build nursing expertise in knowledge exchange and research utilization across the system. The Nurse Scientist will support collaboration between the nursing community and other interprofessional researchers conducting and utilizing research.

This position will assist Shriners Children’s leadership in achieving its research mission and strategic initiatives, will provide leadership for the day-to-day operations of the nursing research program, and coordinate strategies to enhance interprofessional communication and collaboration. The Nurse Scientist will participate in the evaluation of the program.

Responsibilities

Position Responsibilities:

• Develop and lead the nursing research council.
• Provide research education and training to increase awareness of the importance of nursing and allied health services research and EBP for nurses and those in allied health services.
• Coach nurses and those in allied health services on EBP and how to conduct new research providing research resources and support leading to successful projects.
• Assist nurses and those in allied health services with research designs, methodologies, analysis, and writing research proposals, grants, presentations, and publications.
• Establish and maintain relationships with affiliate sites and academic institutions to support a pipeline of nurse scientists to meet the evolving needs of our healthcare system.
  Conduct independent research in areas of interest.

Qualifications

Experience Required/Preferred:

• 5 years of nursing education and / or research required
• 2 years of experience conducting research preferred

Education Required/Preferred:

• Doctorate (PhD, DNP, EdD, DNSc) required
• Nursing Specialty Certification preferred

Knowledge, Skills & Abilities:

• Analytical ability to collect information from erse sources, apply professional principles in performing various analyses and summarize the information and data in order to solve problems.
• Ability to utilize comprehensive computer and database skills to streamline work and communicate to other team members.
• Analytical ability to resolve complex problems requiring use of basic scientific, mathematical, or technical principles and in-depth, experience-based knowledge.
• Ability to be articulate in both oral and written communications.
• Ability to independently prioritize and respond to multiple simultaneous requests.
• Able to apply previous learnings to similar cases using critical thinking skills.
• Knowledge of statistics, data collection, analysis and data presentation.
• Strong communication, interpersonal and collaboration skills.
• Has the ability to organize and work within a team environment; unite resources from multiple disciplines.
• Keyboarding skills.
• Proficient skills in Microsoft programs.
• Prior electronic health/medical records (EHR/EMR) experience.
• Previous experience attending and hosting virtual meetings.

Patient Care Coordinator

Non-clinical

United States

Texas

At Talkiatry, we believe mental health is health. We’re a successful, high growth organization creating the gold standard in mental healthcare and helping people live their best lives. More specifically, we’re solving the behavioral health crisis in America by focusing on high-quality in-network care and proprietary technology that redefines how patients access and receive psychiatric care. The result? Through a personalized approach, we meet the needs of patients, physicians, and insurance partners while driving down costs and improving care.

The Patient Care Coordinator provides an excellent experience for patients and providers by fielding and responding to their requests. They help keep provider schedules full and optimized, and guide patients through the intake process. They also ensure all patients are matched appropriately to a provider, and take care of administrative tasks like faxes, emails, and authorizations.

Responsibilities:

What does a day in the life of a Talkiatry Patient Care Coordinator look like?

• Answer incoming phone calls to screen patients, answer questions, or schedule appointments
• Make outbound phone calls to patients, pharmacies, or insurance companies
• Register new patients in our EHR, e-Clinical Works
• Ensure that providers are scheduled for best use of time (Optimized)
• Support clinicians via Microsoft Teams Chat to:
• Schedule patient follow-up appointments
• Reach out to patients who are late to tele visits
• Send referral information to patients
• Send discharge letters
• Monitor and complete tickets in Zendesk to:
• Inform patients of insurance benefits
• Respond to patient inquiries
• Add copies of insurance cards/IDs to patient documents
• Troubleshoot minor technological issues or escalate them to our helpdesk

Desired Competencies:

• Medical Insurance benefits
• Electronic Health Record, prefer eClinicalWorks experience
• Microsoft Office (M365), plus if you have worked with Microsoft Teams

Qualifications:

Medical office reception experience, including:

• Use of a Electronic Health Record (EHR) in your daily work
• Answering phones and multitasking in a fast-paced clinical practice
• Scheduling patient appointments
• Insurance verification
• Understanding of patient privacy rules and experience in a HIPAA-compliant practice
• Strong written and verbal communication skills
• Excellent customer Service
• Understanding of general medical practice workflows
• Ability to multitask accurately
• Enjoy working in team based environment

We Offer:

• A collaborative, erse, fast-paced environment in a purpose-driven company; Join a team of 250+ team of difference-makers
• Flexible Location: Colleagues work virtually, in the office, or a combination of the two
• Opportunity to learn and grow as our organization grows thanks to a best-in-class Learning team
• Leadership committed to building a people-first, inclusive culture focused on your well-being and supporting your wellness ambitions
• Generous benefits including up to 100% of healthcare insurance costs paid from day 1, competitive 401K match with immediate vesting, generous PTO plus paid holidays, and more!

At Talkiatry, we are an equal opportunity employer committed to a erse, inclusive, and equitable workplace and candidate experience. We strive to create an environment where everyone has a sense of belonging and purpose, and where we learn from the unique experiences of those around us.

We encourage all qualified candidates to apply regardless of race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status.

Radiology Medical Coder

time type

Full time

job requisition id

R28665

Radiology Medical Coder

Overview of Position

The Medical Coder will abstract clinical information from a variety of radiology medical records and assigns appropriate ICD 10 CM and/or CPT codes to patient records according to established procedures. Analyzes, enters, and manipulates database. Knowledge in ICD-10 and CPT coding required.

What will be my duties and responsibilities in this job?

• ICD-10 and CPT coding into a hospital system for Radiology
• Assigns appropriate ICD-10 or CPT codes to patient records
• Meet productivity standards Identify any issues or trends and bring them to the attention of management

What are the requirements needed for this position?

• Highschool Diploma or Equivalent
• Professional Coding Certification (CPC, CCS or CCA)
• Minimum of 1 year of coding experience with ICD-10 and CPT-4
• 1 year Radiology Coding Experience
• Strong Knowledge of the Medical Coding Process

What other skills/experience would be helpful to have?

• Imagine Software experience highly preferred
• Ability to work independently in fast paced environment
• Organized and detail-oriented is critical
• Computer literate
• 10,000 alpha / numeric keying speed

What are the working conditions and physical requirements of this job?

• Physical requirements include general office demands
• Full time Remote, Monday- Friday business hours

How much should I expect to travel?

• Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.

#li-remote

#ChangeHealthcareCareers

#HiringNow

#RemoteWork

#WorkFromHome

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [email protected] with “Applicant requesting reasonable accommodation” as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Utilization Review Nurse – Night Shift (12AM to 8AM ET/Fully Remote USA)

Remote – Other

Full time

R010232

Are you an RN with a passion to help improve the quality of patient care without working bedside? Do you have acute care experience within an emergency room, critical care, or med/surg setting? Do you have experience doing concurrent review, case management, or utilization management? Are you seeking an opportunity to work in your home on a team with other dedicated clinicians in an organization focused on achieving the best outcomes?

McBee Associates, a leader in clinical advisory services, is growing and adding to our remote team of Utilization Review Nurses focused on admissions and continued stay reviews. With the shift to value-based and patient-centered care, McBee has become the company health systems rely upon to ensure care management plans are effective and accurate. We take a partnership approach in care coordination with our clients that results in accurate patient status and reduced denials. Submit your application today and talk with us about the possibilities of working with McBee, a Netsmart company.

Responsibilities

As a remote associate working from home, it is important you have an office that provides the privacy needed for your critical work. Your reviews start at the point of admission, verifying that documentation meets medical necessity requirements utilizing hospitals’ approved evidence-based criteria, identifying missing and insufficient documentation. You will work with physicians on their plan of care and documentation to support the appropriateness of the level of care ordered. The work you do helps hospitals and health systems improve care efforts throughout their organization and increase their cash flow.

Qualifications

• Active RN licensure in your state of residency with at least 5 years’ clinical experience in an acute care setting in Emergency Department, Critical Care, or Medical/Surgical Care.
• At least 3 years’ experience in Case Management, Concurrent Review, or Utilization Management.
• Experience with InterQual and Milliman Clinical Guidelines (MCG).
• All shifts available. Associates are required to work two weekend shifts per month.

#LI-BF1

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all iniduals. We celebrate ersity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

Audit Specialist

Job LocationsUS-Remote

Requisition ID

2022-27110

# of Openings

10

Category (Portal Searching)

HIM / Coding

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer…

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Auditing/Coding Team is comprised of some of the brightest and most talented iniduals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need…

The Auditing Specialist will respond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews. Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues. Develop and maintain account relationships through responsiveness and calm, reflective work practices. Work cooperatively with the Data Quality & Coding Compliance leadership and scheduling for optimal services outcome.

Details:

• Full time and PRN positions available, flexible schedules,
• Location: Remote/Work from home, equipment provided.
• Required: A minimum of 3 years of auditing experience.
• Specific Experience with APRDRG andor EAPG required
• Preferred: CCS, RHIT, or RHIA credentials.
• Preferred: Recent academic medical center or level I trauma center auditing experience.

We Offer:

• Full Benefits: 401k Savings Plan
• 20-24 free CEUs per year, provided by Ciox
• AAPC/AHIMA dues compensation
• Company equipment will be provided to you (including computer, monitor, etc.)
• Comprehensive training lead by a hiring manager
• No Covid Vaccination requirement

Responsibilities

• Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
• Reviews non-CC/MCC records to determine if record was properly coded or if additional
• documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment
• Provides coder education via the auditing process
• Prepares preliminary results for review by the facility or CCS HIM director
• Reviews APC/DRG change disagreements with appropriate manager
• Prepares the final reports for the coding audit. Participates in settlement of audit findings.
• Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
• Attends coding workshops as necessary
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Shows versatility and exemplary work including a wide range of services coded
• Meets with client facility representatives to discuss issues and trends identified in audit
• Develops and implements education for physician, nursing, and other clinical staff to improve documentation
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association’s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Audits external coding staff as needed and provides reports to manager as directed
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

Qualifications

• Minimum of 3 years experience coding or auditing
• CCS and RHIA or RHIT credentials preferred
• Recent experience in academic/level 1 trauma centers
• Experience coding or auditing inpatient and outpatient records for various facilities
• APRDRG and/or EAPG experience required
• Track record of acceptable productivity standards
• Maintain 95% accuracy rate for APC assignment and 95% productivity rate
• Experience with various software including EMR, Encoder and Auditing software

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

ProFee Medical Coding Auditor – Part Time

• Job ID
• 2022-2787
• # of Openings
• 2
• Job Locations
• US-Virtual/Remote
• Category
• Medical Coding
• Minimum Hours
• 20

Overview

ProFee Medical Coding Auditor – Part Time

GeBBS Healthcare Solutions, an industry leader in Health Information Management and Revenue Cycle Management solutions, is seeking highly motivated iniduals with a passion for excellence & collaboration, for careers in the healthcare industry.

Here is your opportunity to be part of this exciting team! GeBBS is looking for remote Certified Medical Coding Auditors – ProFee.

Responsibilities

This position will be responsible for conducting professional coding audits for clients with the ability to provide EM educational feedback. The Professional Coding Auditor will support accurate coding audit reports and assist in preparation or execution of physician/coder education for GeBBS.

• Leverage extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding and billing to audit client charts and billing
• Analyze and identify opportunities for documentation improvement and prepare reports, presentations and recommendations based on the analysis
• Communicate with clients regarding findings and provide recommendations on actions to be taken for improvement

Qualifications

• CPMA required
• Minimum of 2-3 years’ preparing professional coding audits.
• Clear understanding of IP and OP ProFee EM Level Guidelines and able to provide concise educational feedback.
• Strong knowledge of coding disciplines; Professional Coding & Audit and Professional Provider Education
• Extensive knowledge of medical terminology, medical billing and payment methodologies, including coding guidelines for ICD-10, CPT, HCPC, E/M, etc.
• Comprehensive knowledge of procedure and diagnostic coding for professional services and Medicare, Medicaid and other 3rd party payer coding and billing regulations; knowledge of Medi-Cal a plus
• Demonstrated knowledge of 1995 and 1997 Evaluation and Management Documentation guidelines and other professional documentation requirements.
• Able to yield high quality coding audits via a manual coding audit process or technology enhanced audit tool
• Knowledge of quality metrics and commitment to enforcement of standards
• Cross functional expertise with the ability to work independently in a fast-paced environment
• Excellent verbal, written, and interpersonal communication skills
• Strong computer skills including MS Office (e.g., Excel and Word)
• Ability to multi-task and set/meet multiple deadlines under pressure with initiative, tact, and poise

Aviacode provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identification, disability, or genetics. In addition to federal law requirements, Aviacode complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Aviacode expressly prohibits any form of workplace harassment based on protected classes. Improper interference with the ability of Aviacode’s employees to perform their job duties may result in discipline up to and including discharge.

Title: Telemedicine Nurse Practitioner (Remote)

Location: United States

CONTRACTOR

Are you looking for an innovative primary care practice model that uses technology and healthcare data to empower patients to take greater ownership and accountability over their healthcare? At Forward, we believe that the future of medicine combines the best attributes of healthcare professionals with the efficiency and grace of innovative technology.

We are looking for a motivated Nurse Practitioner who thrives in delivering care in an innovative tech environment. You will support our members via telemedicine, working alongside highly acclaimed, board certified physicians. This is an ideal opportunity for those seeking a flexible opportunity to deliver primary care via telemedicine.

WHAT YOU’LL DO:

• Remotely triage, diagnose and treat patients via our online chat-based platform, including: proactively providing medical and wellness education (facilitated by Forward s technology), diagnosing and treating patients via our online chat-based telemedicine platform, recommending suitable treatment plans and considering cost-effective treatment modalities, and assisting in care coordination and onsite visit planning for both urgent and wellness member visits.
• Giving and receiving regular feedback on inidual member cases.
• Providing a positive member experience in telemedicine interactions, including quality of care recommended and tone / messaging with which care is delivered.

WHAT WE’RE LOOKING FOR:

• A Board Certified Nurse Practitioner with a minimum of 2 years of primary care experience
• Nurse Practitioners who are motivated by Forward s mission to make preventive care a bigger part of patient lives, and who enjoy practicing in telemedicine care environments.
• A hardworking, detail-oriented inidual with the ability to problem solve independently, reaching out for help / support on patient cases, as needed.
• A caring, compassionate inidual who enjoys helping others and providing a positive care experience in a telemedicine platform.
• Care providers who are flexible and interested in working in a telemedicine environment with frequent change / product improvements, and who are extremely comfortable using new technology and software.
• Nurse Practitioners who are used to balancing multiple, concurrent patient cases, and who are comfortable giving and receiving feedback to grow in their roles.
• Advanced computer skills including typing speed, email, internet research, downloading and uploading files, and working in multiple browser windows.

Additional Details

TECHNICAL REQUIREMENTS

Internet: You must have wired or wifi connectivity, with download speed minimum of 5.0 Mbps and upload speed minimum of 3.0 Mbps

Mobile device: You will need to install a few programs on a personal phone or tablet for authentication purposes. This device should be running Android iOS 8+ or iOS 12+

Computer: You need to provide your own laptop or desktop with a monitor capable of displaying 1920 x 1080 pixels, and a sound card installed for use with speakers or headphones. Your device should meet the following requirements:

Title: Ancillary – Medical Coder

Remote

Location: Dallas TX US

Job Category: Clinical

Job Type: Full-time

Travel Percentage: -1

Job Description:

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Combine two of the fastest – growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making Healthcare data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.SM

This position is full – time. Employees are required to work any shift (40 hours / week) between Tuesday – Saturday OR Sunday – Thursday (flexible hours) including the flexibility to work occasional overtime and 1 weekend based on business needs.

We offer 4 weeks of training. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Primary Responsibilities:

• Identify appropriate assignment of CPT and ICD-10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits
• Understand the Medicare Ambulatory Payment Classification (APC) codes
• Abstract additional data elements during the chart review process when coding, as needed
• Adhere to the ethical standards of coding as established by AAPC and/or AHIMA
• Adhere to and maintain required levels of performance in both coding quality and productivity as established by Optum360
• Provide documentation feedback to providers, as needed, and query physicians when appropriate
• Maintain up-to-date coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, among others
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and / or missing
• Additional responsibilities as identified by manager

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• 2+ years of Outpatient Facility coding experience
• Professional coder certification with credentialing from AHIMA and / OR AAPC (ROCC, CPC, COC, CPC – P, CCS) to be maintained annually
• ICD – 10 experience
• Ability to use a PC in a Windows environment, including MS Excel and EMR systems
• Ability to work any shift (40 hours / week) between Tuesday – Saturday OR Sunday – Thursday (flexible hours) including the flexibility to work occasional overtime and 1 weekend based on business need

Preferred Qualifications:

• Experience with various encoder systems (eCAC,3M, EPIC)
• Intermediate level of experience with Microsoft Excel (create, data entry, save)
• Experience with OSHPD reporting

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 – $32.26. The salary range for Connecticut / Nevada residents is $20.00 – $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Additional Job Detail Information

Requisition Number

2090927

Business Segment

OptumInsight

Employee Status

Regular

Job Level

Inidual Contributor

Travel

No

Additional Locations

• Phoenix, AZ, US
• Hartford, CT, US
• Tampa, FL, US
• Minneapolis, MN, US

Overtime Status

Non-exempt

Schedule

Full-time

Shift

Day Job

Telecommuter Position

Yes

Coder – Outpatient(REMOTE)

locations: Remote – US

time type: Full time

job requisition id: J198466

Company : Allegheny Health Network

GENERAL OVERVIEW:

This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days.

ESSENTIAL RESPONSIBILITIES

• Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%)
• Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%)
• Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%)
• Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. (5%)
• Performs other duties as assigned or required. (5%)

QUALIFICATIONS:

Minimum

• High School/GED
• Successful completion of coding courses in anatomy, physiology and medical terminology
• 1 year of Hospital and/or Physician Coding
• 1 year coding at mid-level facilities or clinics
• 1 year coding major surgeries, observations and/or E/Ms
• Medical Terminology
• Strong data entry skills
• An understanding of computer applications
• Ability to work with members of the health care team
• Any of the following:
  • Certified Coding Specialist (CCS)
  • Registered Health Information Technician (RHIT)
  • Registered Health Information Associate (RHIA)
  • Certified Coding Specialist Physician (CCS-P)
  • Certified Coding Associate (CCA)
  • Certified Professional Coder (CPC)
  • Certified Outpatient Coder (COC)

Preferred

• Associate’s Degree in Health Information Management or related field

Informatics Nurse Specialist

Remote

Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives apply to join our team.

SCOPE OF ROLE

Reporting directly to the Clinical Nurse Informatics Manager, the Informatic Nurse Specialist will support the development, maintenance, and quality assurance and ongoing improvements related to clinical protocols and virtual care clinical practice. This person will integrate nursing science, computer science, and information science to manage and communicate data, information, and knowledge with the team members and our clinical partners.

ROLE RESPONSIBILITIES

The Informatics Nurse Specialist job description is intended to point out major responsibilities within the role, but it is not limited to these items.

• Research and validate clinical content to assist with the creation and maintenance of new clinical protocols and clinical products
• Assist with building and maintenance of clinical content utilizing proprietary content development tools
• Assist with testing of clinical updates and bug fixes
• Assist with standardization of clinical documentation
• Run reports as needed based on defined quality metrics to maintain standards of are in the virtual care industry
• Clinical troubleshooting and review/respond to internal and external clinical feedback
• Other duties as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Must be baccalaureate prepared RN
• Minimum of 2-3 years of experience in healthcare, clinical, and/or nursing informatics, ideally in the field of telemedicine
• Minimum of 2 years of experience in a healthcare setting as a nurse

PROFESSIONAL COMPETENCIES

• Documented experience performing in-depth clinical research, complex analytics, and succinct reports
• Knowledge of current clinical practices, especially around telemedicine and telehealth
• Proficient in Microsoft Office Suite, especially Excel and PowerPoint
• General understanding of virtual care and telemedicine

LICENSURES AND CERTIFICATIONS

• Valid RN licensure in at least 1 state

Professional Cardiology E/M Coding Specialist

Job ID 2022-2761

# of Openings 1

Job Locations US-Virtual/Remote

Category Medical Coding

Minimum Hours 20

Overview

Professional Cardiology E/M Coding Specialist – Part Time

GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is seeking highly motivated iniduals with a passion for excellence & collaboration for careers in the healthcare industry.

Responsibilities

This position will provide high quality ICD-10 E/M and procedure coding for a large multi-specialty client. Coders will be responsible for reviewing the documentation and identifying and abstracting appropriate CPT and ICD-10 codes, for both Cardiology E/M, TEE, echoes, and EKGS, as well as interventional cardiology. Work must be of high quality, maintaining a 95% accuracy rate. Coder will access multiple EMR for various providers and enter coding into the clients coding portal. Coders are responsible for correcting their own denials and provider rebuttals. This position also provides education to providers related to coding and documentation.

Qualifications

• CPC or equivalent through the AAPC or AHIMA required
• CEMC preferred, but not required
• Must have at least 2 years of active Cardiology E/M experience
• Must reside in the US

Aviacode provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identification, disability, or genetics. In addition to federal law requirements, Aviacode complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Aviacode expressly prohibits any form of workplace harassment based on protected classes. Improper interference with the ability of Aviacode’s employees to perform their job duties may result in discipline up to and including discharge.

Coding Specialist – Outpatient Surgery, Remote, Health Information Management, FT, 08A-4:30P-126625

Baptist Health South Florida is once again one of the 2019 Fortune 100 Best Companies to Work For! This is the 19th time Baptist Health has been named to the prestigious list and is the only healthcare provider in the state to be ranked. We have also been recognized for being among the best healthcare providers in the nation by U.S. News & World Reports in its 2018-2019 Best Hospitals report.

Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with more than 19,000 employees working across ten hospital campuses and more than 50 outpatient facilities throughout Miami-Dade, Monroe, Broward, and Palm Beach counties. In 2016 we welcome the newest weapon in the fight against cancer, the world-class Miami Cancer Institute and proton therapy center. Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why this is the best place to be your best!

Description

Accurately codes Outpatient Surgery and Observation records for the classification of all diseases, injuries, procedures, and operations using the ICD10CM and CPT4 coding system for BHSF facilities. Ensures compliance of coding rules and regulations according to Regulatory Agencies (CMS, OIG). Works as a team to meet departmental goals and AR goals. Abstracts prescribed data elements from the medical records.

Qualifications

Degrees: High School,Cert,GED,Trn,Exper Licenses & Certifications: AHIMA Certified Coding Specialist Additional Qualifications: Required Coding Certificate, preferred Certified Coding Specialist, CCS. Knowledge of encoder system, outpatient prospective payment system (OPPS), APCs and Ambulatory Surgical Center payment system (ASC). Knowledge and thorough understanding of National and Local Coverage Determination, NCD and LCD, Policies. Competency in Word and Excel. Ability to communicate effectively with coworkers, management staff and physicians. Required CCS certification within 2 years of employment, if not CCS certified. Minimum Required Experience: 2

Join our Talent Community and stay up-to-date on our career opportunities. We’ll send you alerts of new jobs matching your interests as well as exciting news and events happening at Baptist Health South Florida.

Nurse Practitioner

Remote

UNITED STATES 

TELEMEDICINE – NURSE PRACTITIONERS

CONTRACTOR

Are you looking for an innovative primary care practice model that uses technology and healthcare data to empower patients to take greater ownership and accountability over their healthcare? At Forward, we believe that the future of medicine combines the best attributes of healthcare professionals with the efficiency and grace of innovative technology.

We are looking for a motivated Nurse Practitioner who thrives in delivering care in an innovative tech environment. You will support our members via telemedicine, working alongside highly acclaimed, board certified physicians. This is an ideal opportunity for those seeking a flexible opportunity to deliver primary care via telemedicine.

WHAT YOU’LL DO:

• Remotely triage, diagnose and treat patients via our online chat-based platform, including: proactively providing medical and wellness education (facilitated by Forward’s technology), diagnosing and treating patients via our online chat-based telemedicine platform, recommending suitable treatment plans and considering cost-effective treatment modalities, and assisting in care coordination and onsite visit planning for both urgent and wellness member visits.
• Giving and receiving regular feedback on inidual member cases.
• Providing a positive member experience in telemedicine interactions, including quality of care recommended and tone / messaging with which care is delivered.

WHAT WE’RE LOOKING FOR:

• A Board Certified Nurse Practitioner with a minimum of 2 years of primary care experience
• Nurse Practitioners who are motivated by Forward’s mission to make preventive care a bigger part of patient lives, and who enjoy practicing in telemedicine care environments.
• A hardworking, detail-oriented inidual with the ability to problem solve independently, reaching out for help / support on patient cases, as needed.
• A caring, compassionate inidual who enjoys helping others and providing a positive care experience in a telemedicine platform.
• Care providers who are flexible and interested in working in a telemedicine environment with frequent change / product improvements, and who are extremely comfortable using new technology and software.
• Nurse Practitioners who are used to balancing multiple, concurrent patient cases, and who are comfortable giving and receiving feedback to grow in their roles.
• Advanced computer skills including typing speed, email, internet research, downloading and uploading files, and working in multiple browser windows.

TECHNICAL REQUIREMENTS

Internet: You must have wired or wifi connectivity, with download speed minimum of 5.0 Mbps and upload speed minimum of 3.0 Mbps

Mobile device: You will need to install a few programs on a personal phone or tablet for authentication purposes. This device should be running Android iOS 8+ or iOS 12+

Computer: You need to provide your own laptop or desktop with a monitor capable of displaying 1920 x 1080 pixels, and a sound card installed for use with speakers or headphones. Your device should meet the following requirements:

Processor

ChromeOS: Intel Pentium

Non-ChromeOS: Apple M1, Intel i3, AMD Ryzen, or better

Memory

ChromeOS: 4GB of RAM or better

Non-ChromeOS: 6 GB of RAM or better

Operating System

ChromeOS: no minimum

MacOS

Windows 10 or better

Browser

Google Chrome (latest version), Safari (latest version), or Internet Explorer 11

Title: Medical Coding Auditor – Remote

Location: United States

Job Category: Customer Service and Claims Job Type: Full-time Travel Percentage: -1

Job Description:

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Combine two of the fastest – growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making Healthcare data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 6:00pm. It may be necessary, given the business need, to work occasional overtime.

Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Investigate, review, and provide clinical and / or coding expertise in the application of medical and reimbursement policies within the claim adjudication process through file review. This could include Medical Director / physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information
• Perform clinical coverage review of claims, which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns
• Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing
• Knowledge of and the ability to: identify the ICD-10-CM/PCS code assignment, code sequencing, and discharge disposition, in accordance with CMS requirements, Official Guidelines for Coding and Reporting, and Coding Clinic guidance
• Must be fluent in application of current Official Coding Guidelines and Coding Clinic citations, in addition to demonstrating working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments
• Solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment
• Writes clear, accurate and concise rationales in support of findings
• Identify aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommend providers to be flagged for review
• Maintain and manages daily case review assignments, with a high emphasis on quality
• Provide clinical support and expertise to the other investigative and analytical areas
• Will be working in a high-volume production environment that is matrix drive

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED (or higher)
• 3+ years of acute care coding experience
• CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) or Unrestricted RN (registered nurse) with CCS or CIC OR the ability to obtain certification within 6 months of hire
• Inpatient facility DRG experience (coding or auditing)
• Experience with ICD – 10 coding
• Experience with ICD – 10 – PCS
• Ability to use a Windows PC with the ability to utilize multiple applications at the same time

Preferred Qualifications:

• RHIT (registered health information technician), RHIA (registered health information administrator), CDIP (certified documentation improvement practitioner) OR current certified facility in – patient coder
• Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry
• Healthcare claims experience
• Managed care experience
• Investigation and / or auditing experience
• Knowledge of health insurance business, industry terminology, and regulatory guidelines

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $25.63 – $45.72. The salary range for Connecticut / Nevada residents is $28.27 – $50.29. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Title: Lab Services Executive

Work Location: REMOTE –The Chief Medical Officer can reside anywhere in the US – Preferred residence in US North East or Metro Chicago

**** As a condition of employment with American Red Cross, you are required to provide proof that you are fully vaccinated for COVID 19 or qualify for an exemption, except in states where it is prohibited by law. Accordingly, employment is conditioned on providing proof of vaccination or having an approved exemption prior to starting employment ****

Job Description:

The Lab Services Executive provides medical and technical consultation to Biomedical Headquarters and Blood Regions regarding blood banking operations and oversees the development and implementation of all medical policies and procedures related to Laboratory Services (LS) operations. Responsible for the long-range planning, strategy and management of the Laboratory Services operations from a medical standpoint. Represents LS from medical standpoint to senior management and the laboratory industry at the national level. Also serves as the executive physician over LS, which includes diagnostic laboratories such as Molecular Diagnostics, Immunohematology, and Histocompatibility and Immunogenetics. Functions as Clinical Laboratory Improvement Amendments (CLIA) Laboratory Director for regulated activities in assigned regions related to the collection and performance of immunohematology testing, stem cell collection and processing, and as a Clinical Medical Consultant to support histocompatibility and molecular diagnostic laboratories.

Responsibilities;

• Strategic Planning-Participates in planning and implementation processes, ensuring long-range goals are developed to be relevant and effective for program management and are aligned with national initiatives and medical best practices.
• Business Development -Actively involved in expanding LS test menu offerings through direct sales presentations and assisting PPM & LS Leadership with medical advice. Builds industry relationships with advocates, customers, healthcare providers, and other industry stakeholders to increase the use of LS test menu offerings.
• Branding-Enhances LS brand recognition through industry collaborations and thought leadership activities that seek to improve the Standard of Care within the relevant industry/sector/specialty. Represents LS medical interests to national senior management and when requested, will participate in contract negations and customer meetings.
• Litigation-Provides expert medical opinion and participates as needed in all medically related litigation involving LS as requested by CMO or the Office of General Counsel.
• Program Management– Oversees medical activities for hospital customers, providing medical consultations in direct patient care and all clinical laboratory diagnostic testing including transfusion medicine/blood banking, histocompatibility, and molecular diagnostics (as applicable to assigned area).
• Performs medical director and clinical duties to support regional, isional, or national activities. Will operate under general guidelines from national senior management. Will work directly with LS Sr. Management to set priorities and own work. Provides support, development and/or leadership guidance to all volunteers.

Qualifications.

Requires an MD or DO with specialty in hematology, pathology, or related discipline and 7-10 years of experience with 3-5 years of supervisory experience. Must be licensed in the state of the primary site of the assigned regions and other states served by the regions and/or ision, as needed. Must obtain and maintain professional credentials in medicine, including but not limited to state medical licensure, laboratory director certification and specialty boards. Credentialing in Transfusion Medicine is desired.

Medical directors must meet all of the requirements of the state where they are designated as laboratory directors or assistant directors. Laboratory directors or assistant directors for a clinical laboratory or blood bank holding a New York State clinical laboratory permit must hold a Certificate of Qualification in the required category(ies). DEA certification may be required.

For those candidates located in Colorado, the salary range for this position is: $209,000- $230,000 Note that the American Red Cross sets salary ranges aligned to a specific geographic location in which the job or employee resides. The stated salary range in this posting is an average and may not be reflective of your inidual circumstances. We will review specific salary information at the time of phone screening based upon your location.

Title: Nurse Talent Operations Specialist

Location: United States

Remote

Do you love customer service and the idea of helping healthcare workers find their dream job? Do you want to be in a working environment surrounded by amazing fellow nurses who are just as passionate and excited as you are? Do you want to make a difference in the careers of nurses across the country?

Well, this is your lucky day because Incredible Health is hiring Registered Nurses for three different roles on our Talent Operations team!

Responsibilities:

We are looking for talented RNs with a passion for customer service and helping nurses find their dream career opportunities. We have three possible RN roles: Nurse Screener, Nurse Scheduler, and Nurse Talent Advocate.

Screeners speak with nurses, onboard them to our platform, and educate and provide them with an overview of our platform to get them started on the best path possible!

Schedulers help our platform’s nurse talent respond to and schedule interviews with hospital employers. Schedulers also interact with hospital staff on our platform to ensure the process goes smoothly!

Talent Advocates speak with nurses, match them to potential hospital employers, and coach and support them through their interview process.

During your interview process, we will discuss each role and the differences with you to see where you may be the best fit! Come work in a super energetic and collaborative environment with a team of nurses dedicated to helping Incredible Health grow and expand. These roles are a great fit for someone who works at a fast pace, is tech savvy, is friendly, and has a go-getter attitude.

Requirements:

• Current licensed Registered Nurse (RN).
• Customer service experience.
• Empathy and energy when interacting with nurse candidates by phone, email, and text.
• Collaborative, team-oriented working style with the ability to work independently and make decisions when needed.
• Ability to prioritize and organize a dashboard of candidates.
• Willingness and desire to learn.
• Ability to teach candidates how to navigate and master the interviewing process.
• Ability to support candidates through their hiring process.
• 40 hours per week of availability. 9-5pm and night/weekend options available.

And now a little bit about us. Incredible Health is a fast-growing, venture-backed career marketplace for healthcare workers. Our software and service help healthcare workers like nurses find and do their best work. We’re using technology to give healthcare recruiting a much-needed speed and quality boost while solving the number one problem of our hospital partners – how to get the staff they need. Our vision is to help healthcare workers live better lives. We’re backed by top venture firms and we’re growing and moving fast.

Working here is awesome because:

• We’re moving quickly so things never get stale.
• We get to make a difference in the lives of healthcare workers who are truly amazing people.
• We are a very high caliber team of medical doctors, nurses, software engineers, designers, sales leaders, account managers, and more.
• We welcome candidates with backgrounds that are commonly underrepresented in our industries.
• We know there is more to life than just work, so we all take the time to hang out with our family and friends.
• We deeply value culture, community, and camaraderie amongst our team – we strive to create a work environment that lets you have fun and celebrate (team events and trivia galore!).

locations: Remote – USA

time type: Full time

job requisition id: R1439

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).

• Select and sequence ICD-10 CM and PCS codes for designated patient types which may include but is not limited to: Acute Facility Inpatient for Teaching Level facilities.
• Review and analyze clinical records to ensure that MS-DRG assignments accurately reflect the diagnoses/procedures documented in the clinical record.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
• Complete assigned work functions utilizing appropriate resources.
• May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain strict patient and provider confidentiality in compliance with HIPPA
• Participate in client and staff meetings, trainings, and conference calls as requested and/or required.
• Maintain current working knowledge of ICD-10 CM and PCS and coding guidelines, government regulations, protocols, and third-party requirements regarding coding and/or billing.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
• Support Savista’s Compliance Program by demonstrating adherence to all relevant compliance policies and procedures as evidenced by in-service attendance and daily practice; notifying management when there is a compliance concern or incident; demonstrating knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information; promoting confidentiality and using discretion when handling patient and/or client information.
• Performs other related duties as assigned or requested.

QUALIFICATIONS

Required:

• Candidates must successfully pass pre-employment skills assessment.
• An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
• Three (3) years of recent and relevant hands-on coding experience with all record types: Acute Inpatient
• Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 CM & PCS code sets.
• Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and/or Savista production and/or quality standards
• Proficient computer knowledge including basic MS Office knowledge. Basic MS Office knowledge includes data entry, sort, filter, copy, paste and password protect functions in Excel and/or Word programs. Basic MS Outlook knowledge is opening and responding to emails and accepting and scheduling meetings using the Outlook calendar.
• Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers

Preferred:

• Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
• Recent and relevant experience in an active production coding environment strongly preferred
• Experience with multiple Electronic Medical Record software applications including but not limited to EPIC, Cerner and Meditech.
• Experience with multiple Encoder software applications including but not limited to 3M, 3M360 and TruCode.

Title: Billing Quality Review Auditor

Location: United States – Remote Full-Time

Are you looking for an exciting opportunity?

We currently have a full-time opening for a REMOTE Billing Quality Review Auditor. This position is a work-from-home opportunity anywhere in the US. If you are looking for a fast paced environment where you can make a difference every day, then this is the opportunity for you!

The right person to join our team is…

This position requires confidence, independent action, initiative, a sense of urgency, and the ability to make decisions and take responsibility for them. A well-suited candidate can react and adjust quickly to changing conditions and come up with practical ideas for dealing with them. This is primarily a task-focused job, requiring a somewhat authoritative, directive leadership style that encourages results-driven, task-oriented collaboration.

This position is responsible for…

The Billing Quality Review Auditor is responsible for providing ongoing feedback, training and education to Breg Billing, Field and Sales teams regarding the accuracy and integrity of companies billing operations. S/he is responsible for the chart review for Medicare and other payers as required. S/he will also conduct clinical reviews of medical records or other program integrity initiatives such as requests for information or in support of proactive data analysis efforts. Medicare and applicable payer guidelines will be applied in making clinical determinations as to the appropriateness of coverage.

Your day will be very busy you will:

• Conducts pre and post billing reviews to ensure quality standards are met prior to billing.
• Recommends improvements to Breg’s quality systems to ensure Best in Class practices.
• Monitors the results of claims audit policies and procedures and reports findings to appropriate leadership.
• Completes assignments in a manner that meets the quality assurance goal of 100% accuracy.
• Maintains related files and records in accordance with company and regulatory requirements and practice.
• Interprets national and state coding and documentation guidelines to ensure consistent and accurate implementation and compliance with external regulations.
• Utilizes Medicare and Contractor guidelines for coverage determinations. Utilizes extensive knowledge of medical terminology, ICD-10-CM, HCPCS Level II to conduct audits.

What your background will be:

• Associates degree and 3+ years relevant experience to include minimum 2+ years billing and coding experience. Equivalent combination of education and experience will be considered.
• Knowledge of quality and audit systems.
• Proficiency in reimbursement principles, medical terminology, payer groups and networks including Medicare, worker’s compensation and private insurance is highly recommended.
• Detailed knowledge of anatomy, physiology, and medical terminology.
• Knowledge of national coding and documentation guidelines and regulations.
• Competence in assigning ICD10, CPT codes and modifiers.
• Computer proficiency to include web browser/internet search, MS Outlook, MS office to include Excel, Word and PowerPoint. Technical competence includes the ability to learn new software and systems.

Title: Director of Therapy

Location: Remote – U.S.

Headspace and Ginger have recently merged to become Headspace Health! While roles are still being recruited separately on our respective websites, new hires from this point forward will be joining Headspace Health. For more information, please speak with your recruiter!

About the Director of Therapy at Headspace Health:

We are seeking a dynamic leader to oversee our large and growing team of Therapists. This leader will ensure that care is high quality, effective, and culturally responsive, and will work to sustain deep partnerships across the team and the organization. The Director of Therapy will work with a variety of stakeholders to ensure the team is engaged and retained, and to help us create a sustainable and supportive environment for our team, consistent with our mission and values. Deep clinical expertise, growth-mindset, willingness to tackle challenges related to scaling a 50-state remote practice, ability to motivate and inspire others, experience with the business and operational side of clinical practice, and excellent interpersonal skills are key attributes for this role.

How your skills and passion will come to life at Headspace Health:

• Manage Senior Managers of Therapy and oversees staff of therapists
• Responsible for leading the Senior Managers and Therapy Managers in our retention and satisfaction goals
• Oversee care provided by W2 therapists to ensure it is high quality, effective, culturally-responsive, and delivered in accordance with best practice and evidence-based methods
• Hire and onboard staff to support growth and new offerings, as needed
• Partner with Chief Clinical Officer and Senior Director of Care Enablement in strategic thinking related to care innovation, therapeutic services, and team scaling
• Partner with Senior Director of Care Enablement as well as Care Operations team to ensure that therapists are able to meet care contribution targets
• Partner with a variety of stakeholders across the organization to ensure that we are creating a sustainable system for therapists that supports their growth and professional development
• Responsible for providing dynamic and visionary leadership to the Therapy team and across Care Services
• Provide high-quality, telehealth services as well as rotating after-hours coverage

What you’ve accomplished:

• Licensed as a Therapist (LCSW, LPC, LMHC, Psychologist), preferably as a Psychologist with training in statistics and measurement
• Minimum of 8 years of direct care experience
• At least 3 years of experience as a supervisor to other therapists, preferably on a remote platform
• At least 1 year of experience overseeing a large team of mental health providers
• Demonstrated commitment to building a erse, equitable, inclusive team and ensuring that care is culturally responsive
• Demonstrated ability to work collaboratively as part of a cross-functional team in a fast-paced, high-growth environment
• Demonstrated ability to manage cross-functional projects, align stakeholders, identify and drive initiatives to completion, in order to support team and company goals
• Excellent interpersonal skills and willingness to create deep partnerships across the team
• Deep experience with measurement-based care (e.g., PHQ9 and GAD7) and focus on outcomes

Inpatient Audit Specialist

Job Locations: US-Remote

Requisition ID-2022-24648

Category: HIM / Coding

Overview

The Auditing Specialist will respond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews. Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues. Develop and maintain account relationships through responsiveness and calm, reflective work practices. Work cooperatively with the Data Quality & Coding Compliance leadership and scheduling for optimal services outcome.

Details:

• Full time, flexible schedule
• Location: Remote/Work from home
• Required: A minimum of 3 years of IP coding or auditing experience.
• Preferred: CCS, RHIT, or RHIA coding credentials.
• Preferred: Recent academic medical center or level I trauma center auditing experience.

We Offer:

• Full Benefits: 401k Savings Plan
• 20-24 free CEUs per year, provided by Ciox
• AAPC/AHIMA dues compensation
• Company equipment will be provided to you (including computer, monitor, etc.)
• Comprehensive training lead by a hiring manager

Responsibilities

• Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
• Reviews non-CC/MCC records to determine if record was properly coded or if additional
• documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment
• Provides coder education via the auditing process
• Prepares preliminary results for review by the facility or CCS HIM director
• Reviews APC/DRG change disagreements with appropriate manager
• Prepares the final reports for the coding audit. Participates in settlement of audit findings.
• Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
• Attends coding workshops as necessary
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Shows versatility and exemplary work including a wide range of services coded
• Meets with client facility representatives to discuss issues and trends identified in audit
• Develops and implements education for physician, nursing, and other clinical staff to improve documentation
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association’s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Audits external coding staff as needed and provides reports to manager as directed
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

Qualifications

• Minimum of 3 years experience coding or auditing
• CCS and RHIA or RHIT credentials preferred
• Recent experience in academic/level 1 trauma centers
• Experience coding or auditing inpatient and outpatient records for various facilities
• Track record of acceptable productivity standards
• Maintain 95% accuracy rate for APC assignment and 95% productivity rate
• Experience with various software including EMR, Encoder and Auditing software

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

There is no COVID vaccine requirement for this role

Coding/Reimbursement Specialist

• Job ID: 333549306
• Status: Full-Time
• Regular/Temporary: Regular
• Hours:
• Shift: Day Job
• Facility: Corporate Revenue Cycle
• Department: Rev Cyc Coding
• Location: Work From Home
• Union Position: No
• Salary Range: $20 to $33.22 / hour

Description

UPMC Corporate Revenue Cycle is hiring a Coding Reimbursement Specialist to join our team! This role will work Monday through Friday during daylight business hours. The position will work fully remote!

The position ensures that accurate claim submission and reimbursement has been met for all account types by identifying ICD-9, CPT and modifier usage thorough review of the medical record, which includes understanding anatomy, physiology, medical terminology, and disease processes, as well as payer reimbursement guidelines.

Do you have prior experience in Emergency Department coding? If so, this could be the next step in your coding career.

Responsibilities:

• Monitor and resolve coding edits and denials in a timely manner to ensure optimal reimbursement while adhering to major payer regulations prohibiting unbundling, and resolve issues related to unlisted procedures or procedures with -22 modifier to ensure additional reimbursement.
• Partner with providers and coders to investigate payers’ coding and reimbursement policies for new and/or existing services.
• Adhere to internal and system-wide competencies/behaviors, policies and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements.
• Contact payer representatives to discuss policy exceptions and make appeals to optimize reimbursement. Incorporate any necessary charges into the department’s daily process flow.
• Demonstrate proficiency in utilizing computer to access various software applications and resources essential to completing coding, edit, and denial processes efficiently, such as Epic (Resolute), payer reimbursement websites, and electronic medical record repositories.
• Ensure adherence to all applicable SOX coding/reimbursement controls, including, but not limited to Decentral Edit/Denial Processes and Review of Controllable Losses.
• Review applicable payer coding policy, submit appeals according to guidelines and update bulletins and communicate changes to coding staff and providers. Incorporate any necessary changes into the department’s daily process flow.
• Engage management to escalate issues when needed to assist in issue resolution.
• Develop and maintain a thorough knowledge of the department’s overall workflow with a general understanding of all functions and the importance of completing each task in a timely manner.
• Make forward progress within the training period toward meeting coding accuracy standards of the departments within the first year of employment. Meet appropriate coding productivity standards within the time frame established by the management staff.
• Provide education to staff and physicians to prevent similar edits or conflicting or ambiguous documentation in the future.
• Perform reimbursement training for new coders.

Qualifications

• High school graduate or equivalent.
• Graduate of a CPC or a certified coding program preferred.
• A minimum of two years experience with E/M and surgical CPT/ICD9 coding and five years payer reimbursement experience related to E/M and surgical coding in a hospital or provider office base setting or combined seven years experience.
• Must have experience with modifiers and their effect on payer reimbursement.
• Must be able to problem solve effectively and be knowledgeable in medical terminology, human anatomy/physiology, pharmacology, pathology, principles of ICD-9-CM and CPT Classification Systems.
• Must have experience with researching payer regulations and policies related to reimbursement. Proficient computer skills required, including payer websites and excel.

Licensure, Certifications, and Clearances:

• CPC or eligible preferred. CCS acceptable.

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

Clinical Nurse Supervisor

locations: US-Remote

time type: Full time

job requisition id: JR4762

RESPONSIBILITIES

• The Clinical Nurse Supervisor will be responsible for directing, organizing and supervising the work of their assigned group of Patient Care Managers, including registered nurses (RNs), licensed practical nurses (LPNs).
• Will manage a smaller population of patients and also coordinate nursing efforts to ensure that effective patient care is being provided and that quality standards are met.
• Responsible for evaluating the performance of the Care Managers, providing feedback and mentoring, developing education programs, contributing to staff professional development, interviewing and hiring nurses.
• Responsible for orienting and training new employees.
• Will recognize trends and work with Management to create solutions.
• Are responsible for approving time and vacation as well as yearly reviews.
• The Nurse Supervisor will also support the mission of the Company and the Care Management department.

QUALIFICATIONS

• Education: Minimum of an Associate’s Degree in Nursing required
• Previous Experience: Eight (8) years of experience in the healthcare field or clinic setting with knowledge of oncology required.
• Management experience preferred.
• Office experience: procedure entry with experience in insurance and medical terminology preferred.
• Core Capabilities: Attention to detail,
• excellent math skills,
• excellent deduction skills,
• the ability to work independently,
• good communication skills,
• data entry,
• knowledge of Excel
• Certifications/Licenses: Active RN license in state of employment is required.
• An OCN certification is preferred
• A valid Florida Driver’s License is required

Inpatient Facility Coder (Full Time) K

Job ID: 2022-2733

# of Openings: 1

Job Locations: US-Virtual/Remote

Category: Medical Coding

Minimum Hours: 40

Overview

Inpatient Facility Coding Specialist – Full Time

GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is seeking highly motivated iniduals with a passion for excellence & collaboration, for careers in the healthcare industry.

We have an immediate need for a full-time Inpatient Facility Coder. This is a remote W-2 position with flexible work schedules.

Eligible for a $5000 sign on bonus!

Responsibilities

This position will be responsible for medical coding for one of facility clients. Coder will be responsible for reviewing charts, coding appropriate charges and ensuring high quality standards are achieved.

Qualifications

• RHIA, RHIT, CCS certification through AHIMA required
• Minimum 3 years inpatient coding experience in facility setting
• The Inpatient Coder is responsible for assigning diagnostic and procedural codes to patient charts using ICD-10-CM, ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. The coder will abstract required clinical information. This position requires a thorough knowledge of medical terminology, disease processes, pharmacology, Medicare’s Inpatient Prospective Payment System (IPPS), Official Coding Guidelines for ICD-10-CM and ICD-10-PCS codes, and documentation requirements for correct and accurate coding.
• Maintain standard industry productivity rates for Inpatient coding (3 charts/hour)
• Demonstrated ability to maintain high quality standards of 95% or greater
• Proficient in utilizing technology (computer, VPN, MS Office, coding software) to perform responsibilities
• Strong verbal and written communication skills
• Must have ICD-10 coding experience and have completed an ICD-10 course
• Experience with trauma and highly complex cases, orthopedic, and cardiology preferred
• Hours must to be worked between 6a-6:30p Pacific time Mon-Fri only. Hours can flex between those times daily to reach 40 hrs/week.

Aviacode provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identification, disability, or genetics. In addition to federal law requirements, Aviacode complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Aviacode expressly prohibits any form of workplace harassment based on protected classes. Improper interference with the ability of Aviacode’s employees to perform their job duties may result in discipline up to and including discharge.

Specialist I, Patient Educ Job

Location: Valencia, CA, US, 91355

Additional Location(s): US-CA-Valencia

Diversity – Innovation – Caring – Global Collaboration – Winning Spirit – High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of erse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing whatever your ambitions.

This position has the flexibility to sit remote in the U.S.

About the role:

Patient Education Specialist acts as a direct contact for Territory Manager (TM) and TM team, along with physician’s offices and hospitals to educate prospective patients. You will be responsible for maintaining pipeline of candidates, contacting, educating, and progressing patients along their journey to potentially receiving a trial with the local physician, TM and team. You will be accountable for complying with all Regulatory requirements with respect to complaint handling and maintaining the accuracy of the data within BSC business systems. This is a great opportunity to provide patient care in an office-based setting.

Your responsibilities will include:

• Enter in all candidate information received from web site, post cards, local events and physician offices/hospitals into CRM tracking system.
• Contact all patient candidates within acceptable timeframe as determined by management.
• Educate candidates on spinal cord stimulation, pain management, insurance, psychological evaluations, and other requirements needed to get to a trial.
• Responsible for knowing all potential objections to SCS-therapy and respond per training.
• Provide summary reports to TM and local offices on a weekly basis.
• Draft written communication for letters and e-mails to candidates, TM and physician offices as needed.
• Support local TM and physicians with any education events and candidate follow-up as needed.
• Position will require periodic travel to meet with local sales reps, physicians, and customer staff.
• Perform other related duties as assigned, including special projects.

What we’re looking for in you:

Basic Qualifications

• Bachelor’s Degree in Engineering, IT, Health Science, Business, Nursing, Computer Science, Communications, Psychology, History.
• Knowledge of computer skills Microsoft Office.
• Excellent written and oral communication skills and organizational skills.

Preferred Qualifications:

• At least 1-year experience in a fast-paced customer service environment.
• Experience in medical device industry
• Biology, medical terminology, medical products or manufacturing

Requisition ID: 532762

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a erse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. Boston Scientific is proud to be an equal opportunity and affirmative action employer.

Boston Scientific maintains a drug-free workplace. Pursuant to Va. Code 2.2-4312 (2000), Boston Scientific is providing notification that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the workplace and that violations will result in disciplinary action up to and including termination.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.

School Social Worker

Join our team of highly-qualified speech-language therapists, physical therapists, occupational therapists, school counselors, school social workers, and school psychologists. You’ll enrich kids’ lives every day while enhancing your own!

Positions available in over 30 states. Opportunities with assistance in pursuing additional licensure available.

Position Overview:

Therapists are responsible for providing IEP-based Mental Health services to K-12 students in a virtual manner.

Job responsibilities for School Social Workers:

• Provide direct mental health counseling services in accordance with the mandated IEP
• Conduct comprehensive evaluations for initial eligibility or re-evaluations
• Complete daily SOAP notes
• Complete monthly or quarterly progress reports
• Attend IEP meetings and submit IEP paperwork as needed

Required Qualifications:

• Professional Social Work License
• School Social Worker Certification
• Minimum of 10 hours daytime availability
• Minimum of 1 year IEP experience (post-master’s) working in a school-based setting Job

Benefits:

• Work from home – there is zero commute time!
• Be your own boss and manage your own caseload
• Therapist has the ability to choose the number of hours according to his/her preference
• Competitive pay
• Excellent training from highly qualified lead clinicians
• Outstanding ongoing technical and clinical support from GT Support Team
• Online assessments and evaluation resources are available in our library free of charge
• Gain access to a complete online resource library of fun and engaging activities for you and your students to enjoy
• An online team of like-minded friends, mentoring lead therapists, and dedicated school relationship managers help make your job easier

Required Skills:

• Self-motivated and eager to create a positive difference in the lives of students
• Strong communication skills and dedicated to working collaboratively with an interdisciplinary team and support staff
• Excellent organization, problem-solving, and time management skills
• Sufficient technological skills including the ability to learn new softwares and programs, complete digital paperwork requirements, communicate effectively via email, and has a willingness to learn new skills/complete basic troubleshooting

Supervisor Hospital Coding Outpatient

locations: Remote

time type: Full time

job requisition id: R21808

Department: 10460 WI Revenue Cycle – Hospital Coding Administration

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Oversees day to day operational workflow and processes for hospital and home health coding. This position oversees a team of coders including managing work queues, prioritizing accounts to be coded, implementing strategies and making real-time adjustments based on account acuity and volume. Handles human resources responsibilities for staff including coaching and evaluations. This positions also manages software applications and hardware requirements for the coding staff. Serves as an expert resource for hospital related health information outpatient coding and Ambulatory Patient Categories. Identifies opportunities to improve coding and data abstracting accuracy and practices. Establishes work assignments and training of coding staff. Acts as a liaison between coding and other entities of the organization such as the quality team, patient accounts and Information Services.

Major Responsibilities:

• Monitors daily work queues to ensure timely coding of outpatient accounts across multiple hospital sites. Plans and implement strategies to achieve or exceeds the expected target DNFC goals. Makes real time adjustments to work assignment based on account acuity and volume.
• Tracks and provides feedback to the coding team regarding coder productivity. Manages PTO requests, work schedules, performance evaluations, and timecards for the coding team. Recommends to Coding Manager when additional working hours are needed (cross state coverage, overtime, contracted coding etc).
• Serves as liaison between area of responsibility and other groups within Advocate Aurora Healthcare such as patient access, quality and denials management. Works with Health Information Technology to implement and test computer updates. Ensures timely, compliant and efficient processes exist to process records through the outpatient coding and abstracting function. Assists in ensuring coding compliance with federal, state and/or other regulatory agencies, research cases, government payers and other selected third party payers.
• Manages the software applications and hardware requirements. Provides first line assistance for system users and coordinates communications internally. Reports any software issues to appropriate IT personnel for resolution. Tracks issues to resolution, providing support for hardware and software problem resolution.
• Identifies any technology learning needs for the coding team which includes verification of coder competency for all software applications utilized including 3M360, Epic, Allegra, Cardone, Care Connection, and Advocate Works.
• Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale. Recommends hiring, compensation changes, promotions, corrective action decisions, and terminations.
• Responsible for understanding and adhering to the organization’s Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization’s business.

Licensure, Registration, and/or Certification Required:

• Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or
• Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
• Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or

Education Required:

• Associate’s Degree in Health Information Management or related field.

Experience Required:

• Typically requires 3 years of experience in integrated acute care hospital coding.

Knowledge, Skills & Abilities Required:

• Demonstrated leadership skills and abilities including organization, prioritization, project management, delegation, team building, customer service, and conflict resolution.
• Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions.
• Expert knowledge and experience in ICD-10-CM and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT) modifiers and Ambulatory Patient Categories (APC).
• Knowledge and understanding of anatomy and physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology.)
• Advanced knowledge of pharmacology indications for drug usage and related adverse reactions.
• Expert knowledge of coding work flow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems.
• Intermediate computer skills including experience with Microsoft Office or similar applications.
• Excellent communication and reading comprehension skills.
• Demonstrated analytical aptitude, with a high attention to detail and accuracy.
• Ability to take initiative and work collaboratively with others.
• Experience with remote work force operations required.
• Strong sense of ethics.

Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties.

Title: Inpatient Medical Coding Auditor

Location: United States – Remote

time type: Full time

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate inidual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans. Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign’s Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity; and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

The Inpatient Medical Coding Auditor is responsible for verifying the accuracy of DRG (inpatient) claims reimbursement, coding, and billing in accordance with the Plans’ provider agreements and the National Healthcare Billing Audit guidelines. The Auditor will collaborate with a variety of business units including Market Operations, Claims, Health and Medical Management (including Medical Directors), Network Management and our external Provider community. The successful candidate must be capable of building and maintaining strong working relationships with key internal and external constituents and working effectively in a matrixed environment.

Responsibilities

• Conduct Diagnosis Related Grouper Validation (DRG) audits to verify the accuracy of claims reimbursement by applying National Healthcare Billing Audit standards, ICD-10 -CM/PCS guidelines and related American Hospital Association Coding Clinic guidelines, and the Plans’ agreements including published policies.
• Select claims samples for medical record reviews in accordance with pre-selection criteria, billing trends, and supporting documentation.
• Monitor existing/emerging trends and keep relevant stakeholders informed of risk areas and concerns that may require additional attention or result in additional savings.
• Participates in and/or leads inter-departmental process improvement initiatives. Acting as a subject matter expert with internal and external stakeholders in reference to coding, billing practices, and accuracy of assigned ICD-10 codes and DRGs.
• Identifies compliance risks and financial opportunities based on chart reviews. Performs concurrent review of hospital bills to document unbilled, under billed, and overbilled items/services
• Educate stakeholders on post audit findings and close audits in timely manner using audit program databases that incorporate 3M software.
• Identify potential quality of care issues and service or treatment delays. Make referrals for follow-up as necessary.
• Identify possible fraud and abuse, document billing errors, and benefit cost management and savings opportunities.
• Actively participate in internal/external meetings, training activities and other cost and trend initiatives.
• Identify and pursue new opportunities for cost avoidance savings that contribute to the company’s annual financial and service targets.
• Meet deadlines and commitments by tightly managing deliverables, coordinating matrixed inputs, and ensuring all tasks are performed to bring projects to timely closure.
• Represent department on cross functional workgroups and projects as needed.
• Conduct audits remotely using the EVH Payment Integrity platform and electronic medical record documentation.

The Experience You’ll Need (Required):

• Active Certified coder (CIC or CCS) required. Candidate would need to maintain active certification.
• In-depth knowledge of and ability to interpret ICD-10-CM/PCS, HCPCS/CPT, APR-DRG, MS-DRG codes and DRG grouping systems and Plan benefit designs.
• Ability to travel for onsite audits as needed.
• 1-2 years’ experience reviewing and auditing medical records, working in a health plan or health insurance, or similar environment.
• Strong quantitative, analytical, interpersonal, organizational, project management, problem-solving and communication skills.
• Ability to navigate and manage through difficult, complex conversations with positive outcomes.
• Strong computer skills: – proficient in MS Word, Excel, PowerPoint and Outlook, familiarity with Electronic Medical Record systems.
• Ability to work as part of a team with a positive attitude while also able to work independently.

Finishing Touches (Preferred):

• Clinical Documentation Improvement (CDI/CDEO) certification
• Hands-on work with complex medical and billing information preferred

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Compliance Nursing Supervisor

locations

• Remote Florida
• Remote Oklahoma
• Remote Ohio
• Remote North Dakota
• Remote North Carolina
• Remote New York
• Remote New Mexico
• Remote New Jersey
• Remote New Hampshire
• Remote Nevada
• Remote Nebraska
• Remote Montana
• Remote Missouri
• Remote Mississippi
• Remote Minnesota
• Remote Michigan
• Remote Massachusetts
• Remote Maryland
• Remote Maine
• Remote Louisiana
• Remote Kentucky
• Remote Kansas
• Remote Iowa
• Remote Indiana
• Remote Illinois
• Remote Idaho
• Remote Hawaii
• Remote Georgia
• Remote District of Columbia
• Remote Delaware
• Remote Connecticut
• Remote Colorado
• Remote California
• Remote Arkansas
• Remote Arizona
• Remote Alaska
• Remote Alabama
• Remote Wyoming
• Remote Wisconsin
• Remote West Virginia
• Remote Washington
• Remote Virginia
• Remote Vermont
• Remote Utah
• Remote Texas
• Remote Tennessee
• Remote South Dakota
• Remote South Carolina
• Remote Rhode Island
• Remote Pennsylvania
• Remote Oregon

time type: Full time

job requisition id: R-278568

Description

The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, Compliance Nursing ensures mandatory reporting completed. Conducts and summarizes compliance audits. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and iniduals. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Required Qualifications

• Current Unrestricted RN licensed in the state in which you reside with no disciplinary action.
• Two or more years of prior experience in auditing, compliance oversight, and/or utilization management for an insurance health plan.
• Two or more years of direct leadership experience (as defined by having direct reports) to include hiring, training, coaching and up to termination.
• Knowledge of regulations governing the Medicare line of business.
• Proficient in Microsoft Office applications including Word, Excel, Outlook and PowerPoint.
• Strong problem solving, data-analysis, and critical-thinking skills with the ability to operate and drive progress with limited information and ambiguity.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Work hours for this position are 8AM- 5 PM Monday- Friday Eastern Time, with occasional overtime to support business needs.
• Training: Virtual training, approximately 3 months
• This is a Remote position; you will be expected to work in Eastern Time zone regardless of what time zone you reside in.
• You will be expected to report to the Market office with advanced notice for meetings and/or planned work functions.

Preferred Qualifications

• Bachelor’s Degree
• Certification(s) relevant to area of expertise, such as certification in healthcare compliance (CHC).
• Prior Medicare health plan experience.
• Experience with writing and/or auditing member denial letters.
• Experience working with and interpreting CMS regulations and criteria.

Additional Information

• Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

• 40

Hospitalist Coder Remote

• Banner Health Corp Mesa (525 W Brown Rd)
• Remote Anaheim CA
• Remote Ava MO
• Remote Flushing MI
• Remote Tampa Bay FL
• Remote Burns TN
• Remote Lincoln NE
• Remote Casper WY
• Remote Ocean Springs MS
• Remote Cannon Falls MN
• Remote Phoenix AZ
• Remote Denver CO
• Remote West Islip, NY
• Remote Seattle WA
• Remote Glen Allen VA
• Remote Dallas TX
• Remote San Francisco CA
• Remote Bellevue NE
• Remote Woodbridge VA
• Remote Jacksonville, AR
• Remote Sparks NV
• Remote Avon Lake OH
• Remote Boise ID
• Remote Bismarck ND
• Remote Blauvelt NY
• Remote Norfolk VA
• Remote Centerton AR
• Remote Marion KY
• Remote San Diego CA
• Remote Salt Lake City UT
• Remote Fort Collins CO
• Remote San Antonio TX
• Remote Portland OR
• Remote Cedar Springs MI
• Full time
• R73364

Primary City/State:

Mesa, Arizona

Department Name:

Coding Ambulatory

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

$18.32/hr – $27.48/hr, based on education & experience

In accordance with Colorado’s EPEWA Equal Pay Transparency Rules.

Health care is full of possibilities. Medical Coders play a pivotal role in ensuring patients receive the best at Banner Health. If you’re looking to leverage your abilities – you belong at Banner Health.

Are you a superstar Hospitalist Coder with the ability to support charge capture of Hospitalist and Intensivist service lines, consider joining our team! Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. We code for Hospitalists and Intensivists both in teaching settings and standard hospital settings. We have over 200 providers, which also includes split/shared visits. Currently we have a team of 7, with more than 20 years of coding experience. Hospitalist and Intensivist coding and charges are worked as a team with shared responsibility, productivity reviewed on a weekly basis.

As a Hospitalist Coder you will have the remarkable opportunity to work remotely and still be part of an engaged team who works hard every day to make healthcare easier, so life can be better. You will use your attention to detail, as well as your Coding Certification skills to accurately translate physician’s notes to ensure patients are billed correctly. Shift will start 8:00am-5:00pm then will be flexible following training.

Our remote coders are required to live in one of the following states: Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Kentucky, Michigan, Mississippi, Minnesota, Missouri, Nebraska, Nevada, New York, North Dakota, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and Wyoming!

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you’ll find many options for contributing to our award-winning patient care.

POSITION SUMMARY

This position evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes in accordance with nationally recognized coding guidelines.

CORE FUNCTIONS

1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate assignments of ICD and/or CPT4 codes, MS-DRGs, APCs, POAs and reconciliation of charges.

2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, point of origin code, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysis, supervisor or inidual department for clarification/additional information for accurate code assignment

3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.

4. As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.

5. Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT and MS-DRG codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations).

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

MINIMUM QUALIFICATIONS

• High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
• Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders. Six months providing coding services within a broad range of health care facilities. Must be able to achieve an acceptable accuracy rate on the coding test administered by the hiring facility according to pre-established company standards.
• Must be able to work effectively with common office software, coding software, and abstracting systems.

PREFERRED QUALIFICATIONS

Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) in an active status or or Certified Coding Specialist-Physician (CCS-P) with American Health Information Management Association or American Academy of Professional Coders is preferred. Will consider experience in lieu of certification/degree. Additional related education and/or experience preferred.

Additional related education and/or experience preferred.