Title: Centralized Order Entry Pharmacist

Location: US

Job Description:

Do you have the career opportunities as a(an) Centralized Order Entry Pharmacist you want with your current employer? We have an exciting opportunity for you to join Work from Home which is part of the nation’s leading provider of healthcare services, HCA Healthcare.

SCHEDULE: NIGHT SHIFT

MUST BE LICENSED IN TEXAS

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Note: Eligibility for benefits may vary by location.

Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Centralized Order Entry Pharmacist where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!

Job Summary and Qualifications

As the Centralized Order Entry (COE) Pharmacist, you will monitor, evaluate and make recommendations to assure the appropriate and effective use of pharmaceuticals for patient care. You will use the medication process to assess, plan, intervene, when necessary, implement and evaluate patient care in compliance with client hospital policies, protocols and procedures.

What you will do in this role:

• Provide patient care activities to ensure safe and effective drug therapy.
• Accurately enter orders in the computer in a timely manner.
• Follow facility procedures when non-formulary drugs, target drugs, restricted drugs and investigational drugs are ordered.
• Screen for drug interactions, allergies, order duplications, appropriate diagnosis, renal and liver function prior to order entry.
• Address facility queues in a timely manner.
• Investigate and report adverse drug events and medication incidents.
• Review and interpret all physician orders received, using the patient profile.
• Monitor for incompatibilities, concentration and rate on intravenous drugs.
• Document clinical interventions and follow-up when indicated.
• Assess orders for age-specific appropriateness from neonatal through geriatric.

What qualifications you will need:

• Bachelor’s degree from an accredited college of pharmacy is required.
• Pharm D is preferred.
• One (1) year of hospital experience is preferred
• Meditech experience is preferred.
• License – State Board of Pharmacy Required
• MUST BE LICENSED IN TEXAS

HealthTrust Supply Chain is a critical part of HCA Healthcare’s strategy. Our focus is to improve performance and reduce costs. We do this by joining non-clinical and administrative functions. HealthTrust Supply Chain best practice methodologies. We develop, apply and monitor cost-efficient initiatives and programs for HCA Healthcare. By improving facility efficiency, medical professionals can focus on our mission – patient care.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

“Bricks and mortar do not make a hospital. People do.”- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Centralized Order Entry Pharmacist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer and value ersity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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Details

United States

Pharmacy and Pharmacy Technician

Work from Home

schedule Full-time • Work From Home

About HCA Healthcare

What matters most to our erse and talented colleagues is giving people the absolute best healthcare in the most compassionate way possible.

Manager of Client Coding Integration

Remote – Nationwide

Full time

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

The Manager of Client Coding Integration is responsible for assisting in the development and evolution of the overall strategy for Ensemble Coding Operations. The Manager is responsible for assisting with all client coding customer service operational processes and workflow, including but not limited to, new client onboarding, provider clinical documentation improvement, support of operational coding processes, and customer coding relationship management. The Manager interprets client policies and procedures, recommends changes as appropriate, and provides relevant feedback. The Manager assists the Director of Coding Integration with the oversight and implementation of Coding Operations operational planning, service commitment, workflow processes and internal controls. As the Manager, this person serves as a key promoter of Ensemble PRC Coding Operations and is responsible for setting the tone of Coding Operations as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs.

Job Responsibilities:

• Sets clear goals and objectives for team members to drive operational excellence and problem-solving initiatives
• Ensures understanding and adherence to policies, practices, and procedures by direct reports, customers, and stakeholders
• Collaborates with practice Leadership teams to provide coding direction and guidance, fostering transparency and efficiency in coding processes
• Works closely with PRC Coding Operations to identify and resolve client issues promptly, maintaining alignment with organizational objectives
• Facilitates active engagement of client leadership in coding reporting with physicians, promoting transparency and collaboration.
• Collaborates with client leadership and physicians to ensure customer satisfaction and address coding accuracy concerns effectively
• Maintains effective working relationships with client leadership and providers, serving as a liaison between Ensemble PRC Coding Operations and practice management
• Supports strategic initiatives to enhance working relationships with clients, participating in committee meetings and strategic updates
• Proactively manages operational challenges within practice operations and coding teams, ensuring timely resolution and effective communication
• Contributes to innovation and knowledge sharing efforts within Coding Operations, identifying and implementing process improvements
• Participates in delivering coding training and education programs for physicians and client leadership, promoting continuous improvement
• Supports the performance review process for direct and indirect reports, fostering professional development and organizational success

Experience We Love:

• 5-7 years relevant experience
• 3-5 years of supervisory/management experience in Coding
• Experience working in large organizations, preferred.
• Consulting or proven work experience in areas of process reengineering and project management strongly preferred.
• Travel to client sites (estimate 20-40% travel)
• PC skills demonstrates proficiency in Excel, Power Point, and ability to work in multiple EMR systems (Meditech, AllScripts, Cerner, Power Chart, Epic)
• Tactical execution oversees the development, deployment and direction of complex programs and processes.
• Customer relationship establishes and maintains longterm customer relationships, building trust and respect by consistently meeting and exceeding expectations. Cultivating strategic customer relationships and ensuring that the customer perspective is the driving force behind all valueadded business activities.

Minimum Education:

• Bachelors Degree or Equivalent experience

Licensure/Certification Required:

Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred):

• CPC (Certified Professional Coder)
• CCS-P (Certified Coding Specialist-Phys Based)
• CCS (Certified Coding Specialist)
• RHIA (Registered Health Information Administrator)
• RHIT (Registered Health Information Technician)

Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Title: Centralized Coding Specialist – Remote PRN

Location: Denver, CO United States

Job Description:

The Physician Services Revenue Integrity team at Lifepoint Health is a nationwide revenue cycle management services provider that has been offering high quality medical billing services since 2004. We offer a rewarding work environment with career advancement opportunities while maintaining a small company, employee-focused atmosphere.

This is a fully remote position! You must live in the United States.

We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

We are always looking for people inspired to help us in our mission. If you are someone who wants to change the lives of patients, drive success for our partners and be part of a team driven to improve care, we may have your next opportunity.

We are currently seeking a Centralized Coding Specialist. This remote-based position will spend the bulk of their time making sure that their clients are fully supported from a charge entry, coding, and billing perspective.

The Centralized Coding Specialist will spend the bulk of their time making sure that their clients are fully supported from a charge entry, coding, and billing perspective. You will be responsible for reviewing a patient’s medical record after a visit and translating the information into codes that insurers use to process claims. You will make sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations, complying with medical coding guidelines and policies. Following up and clarifying any information that is not clear. Clearinghouse knowledge and working experience is also a plus You would be working in a team environment with guidance from the Manager – Coding and Integrity. This position also works closely with the AR department for coding related issues.

Perform Evaluation and Management coding, procedure, ICD-10 and HCPC quality reviews as well as other projects related to physician coding compliance. Demonstrates a thorough understanding of complex coding, and reimbursement, as they relate to physician practices and clinic settings. Keeps informed regarding current coding regulations, professional standards and company/department policies and procedures and effectively applies this knowledge.

This Position is 100% Remote; can work from anywhere within the US.

ESSENTIAL FUNCTIONS

• Seeking Certified Pro-Fee with a minimum of 3-5 years’ coding experience.
• Experience with Provider Based and Rural Health preferred.
• Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding.
• Resolve medical record documentation deficiencies through healthcare provider query and provide routine feedback to correct deficiencies.
• Perform quality assessment of records, including verification of medical record documentation (both electronic and handwritten).
• Responsible for researching errors or missing documentation from medical record in order to provide accurate coding processes.
• Abstract and assign the appropriate ICD-10, HCPCS/CPT codes; including Level I & Level II modifiers as appropriate for all diagnosis and procedures performed in outpatient and inpatient settings.
• Assist in the development and ongoing maintenance of processes and procedures for each assigned client revolving around system use, billing/coding rules, and client specific guidelines.
• Manage time effectively to meet all required deadlines and timeframes for client and department needs.
• Collaborate in a team environment with the Department Manager and other staff on a regular basis.
• Ensure compliance with all relevant regulations, standards, and laws.

Other Functions

1. Maintains regular and predictable attendance.

2. Performs other essential duties as assigned.

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: High school diploma or equivalent required. Bachelor’s Degree preferred or equivalent experience

Experience: 3-5 years of medical coding experience

License or Certification:

This position requires credentialing through AHIMA, and/or AAPC

The following certifications are accepted:

• CPC
• CEMC
• CPMA
• CRC
• CPB
• Specialty certification
• CCS-P
• RHIT

Skills and Abilities:

• Ability to create and follow written procedure.
• Ability to provide professional written communication and excellent customer service.
• Technical proficiency with computers, basic Microsoft software, and medical software systems (PM/EHR)
• Strong organizational skills
• Excellent communication skills and ability to work in a team environment.
• Strong technical and computer skills (PM/EHR Software, Excel, Outlook, MS Office, Web)
• Ability to learn new systems, software, and client specialties quickly.
• Self-starter with little to no supervision

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 20 pounds. Repetitive motion of upper body required for extended use of computer. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:

Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential job responsibilities.

Benefits

At Lifepoint, our Mission of Making Communities Healthier extends to our employees. We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.

Pay range: $25-31/hour DOE The final agreed upon compensation is based on inidual education, qualifications, experience, and work location. This position is bonus eligible.

Lifepoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.

Nurse Practitioner (Telehealth) – Colorado

locations

Remote USA

Full time

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, erse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology – to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we’ve grown fast and now serve members across the United States. And we’ve just started. So join us on this mission!

Job Description

This role is a fully remote position to care for our current members in Colorado.

A bit about this role:

This position represents an amazing opportunity for a caring nurse practitioner (APRN). Your primary focus will be delivering world class comprehensive care to our members. One of Devoted Medical’s missions is to bring care to where our members live – meaning your visits will be predominantly virtual telehealth.

Required skills and experience:

• APRN with 3 or more years working in outpatient clinical practice.
• An active and clear RN and APRN license in one of the following states: Colorado
• Active BLS is required at time of hire and must be maintained while employed at Devoted Medical.

Desired skills and experience:

• Experience in primary care, family medicine, geriatrics and/or palliative care.
• Experience performing Medicare annual wellness visits or in-home comprehensive visits with elderly patients or Medicare patients.
• Experience performing visits over telehealth video platforms.
• An understanding of managed care is a plus, including how to appropriately assess STARS/HEDIS measures, code clinical comorbidities, and identify clinical care gaps.

Your Responsibilities will include:

• Conduct primarily telehealth video visits to members with the opportunity for a small volume of home based visits (drive to member’s home). In some instances when appropriate and compliant with licensure, you may also provide telehealth visits to members located in other geographies.
• Primarily perform comprehensive assessment visits (CAVs) including comprehensive diagnosis/disease review, medication review, and assessment for quality of care (STARS/HEDIS) interventions as well as social and home health/DME needs.
• Work closely with other members of the member’s care team including their PCP, specialists, and other Devoted team members including pharmacy, clinical nursing, and social work as well as interfacing with family members and caregivers in order to coordinate care for the member and deliver a collaborative care plan.

Salary Range: $115,000 – $122,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the inidual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more….

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Title: Nurse/APC Fellow- Medical Standards Implementation

Location: Telecommuter

Type: Fellow

Workplace: remote

Category: Medical Services

Job Description:

Planned Parenthood is the nation’s leading provider and advocate of high-quality, affordable sexual and reproductive health care for all people, as well as the nation’s largest provider of sex education. With more than 600 health centers across the country, Planned Parenthood organizations serve all patients with care and compassion, with respect, and without judgment, striving to create equitable access to health care. Through health centers, programs in schools and communities, and online resources, Planned Parenthood is a trusted source of reliable education and information that allows people to make informed health decisions. We do all this because we care passionately about helping people lead healthier lives.

Planned Parenthood Federation of America (PPFA) is a 501(c)(3) charitable organization that supports the independently incorporated Planned Parenthood affiliates operating health centers across the U.S. Planned Parenthood Action Fund is an independent, nonpartisan, not-for-profit membership organization formed as the advocacy and political arm of Planned Parenthood Federation of America. The Action Fund engages in educational, advocacy, and electoral activity, including grassroots organizing, legislative advocacy, and voter education.

Planned Parenthood Federation of America (PPFA) and Planned Parenthood Action Fund (PPAF) seek a Nurse Fellow – Medical Standards Implementation for January 2025 through December 2025. This job reports to the Director of Medical Standards Implementation in the Medical Services Team in the Care and Access Division of PPFA. The Medical Services Team is dedicated to supporting Planned Parenthood affiliates in the delivery of high-quality health care.

We invite you to explore the PPFA Medical Services Student Nurse/APC Fellowship, an employment and learning experience for students in an undergraduate nursing program or graduate nursing/APC students. During this telecommuter opportunity, you’ll be a member of an interdisciplinary healthcare team and work alongside clinicians, RNs, and administrative professionals at PPFA. You will also have access to clinical resources, and to PPFA-sponsored continuing education activities, professional development activities, and networking opportunities.

The PPFA Medical Services Student Nurse/APC Fellowship is a paid 12-month part-time program from January through December 2025, providing opportunities to gain valuable clinical support skills and experience. The fellow will typically work 15 hours per week, with scheduling flexibility based on student needs, including the ability to work evening and weekend hours. Weekday daytime hours will occasionally be required, which will be discussed and arranged with the supervisor. We understand that you are a student first and that your schedule will change throughout the program.

Purpose:

• Provide support to the Medical Services Team to increase quality, safety, equity and consistency of affiliate clinical care by enhancing implementation and training programs related to PPFA Medical Standards & Guidelines (MS&Gs).
• Learn about and contribute to clinical support and administrative activities necessary to help support frontline Planned Parenthood affiliate staff in their delivery of patient care.

Delivery:

Under the direction of the Director of Medical Standards Implementation:

• Participates in the planning, designing, delivery, and evaluation of trainings to enhance implementation of the PPFA MS&Gs, which may include federation-wide virtual and live activities.
• Participates in continuing education (CME/CE) application processes.
• Reviews, edits, and creates implementation and training resources to enhance affiliate implementation of the PPFA MS&Gs.
• Reviews, edits, and creates patient education resources.
• Assists in supporting the PPFA Clinical Advisory Committee (CAC), including planning for and participating in the quarterly CAC meetings and supporting the CAC membership process.
• Reviews, uploads, removes and edits Medical Services intranet resources.
• Participates in the planning and evaluation of the annual meeting of the National Medical Committee.
• Completes other duties as assigned.

Engagement:

• Regularly collaborates with all staff within the Medical Services Team at PPFA.
• May interact with staff of all levels in other departments and isions, as well as at affiliates and a wide variety of professionals and professional organizations external to Planned Parenthood.

Knowledge, Skills and Abilities (KSAs):

• Education/Credentials: Currently enrolled in an accredited undergraduate nursing program through at least November or December 2025 or currently enrolled in an accredited graduate clinician program through at least November or December 2025. Preferred: enrollment in a nursing education program.
• Experience: at least two years of employment experience.
• Comfort with technology and with learning new technologies.
• Excellent computer skills, as this position will require the use of Google Suite, Microsoft Office Suite, Adobe Pro, Asana, Smartsheet, and webinar platforms, among others.
• Knowledge of communicating with erse groups, working with a multicultural workforce, and exhibiting sensitivity and appreciation of cultural differences is required.
• Must be a self-starter with the ability to work with remote supervision.
• Must have good oral and written communication skills.
• Must be able to perform literature searches.
• Must be detail-oriented.
• Must be flexible.
• Must have excellent interpersonal and customer service skills.
• Must be comfortable working with telecommuters.
• Must recognize the value of ersity and maintain relationships with staff and external audiences that respect inidual dignity.

Travel: None required, though optional travel to 1 meeting may be possible

• Total offer package to include generous vacation + sick leave + paid holidays, inidual/family provided medical, dental and vision benefits effective day 1, life insurance, short/long term disability, paid family leave and 401k. We also offer voluntary opt-in for Flexible Spending Account (FSA) and Transportation/Commuter accounts.

We value a truly erse workforce and a culture of inclusivity and belonging. Our goal is to attract qualified candidates and encourage applications from all iniduals without regard to race, color, religion, sex, national origin, age, disability, veteran status, marital status, sexual orientation, gender identity, or any other characteristic protected by applicable law. We’re committed to creating a dynamic work environment that values ersity and inclusion, respect and integrity, customer focus, and innovation.

PPFA participates in the E-Verify program and is an Equal Opportunity Employer.

#LI-SY1

*PDN-HR

Roles that are denoted as NYC, DC, or both will work a hybrid schedule, requiring 2-3 days per week in the office unless the role is denoted as onsite, which requires working onsite full time or 5 days per week.

Billing Specialist

Job LocationsUS-WA-VANCOUVER

ID

2024-151418

Line of Business

PharMerica

Position Type

Full-Time

Pay Min

USD $21.00/Hr.

Pay Max

USD $21.00/Hr.

Our Company

PharMerica

Overview

Remote

Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for iniduals who are looking for career progression!

This is a remote position. Applicants can live anywhere within the continental USA.

Must be able to effectivley work in the Pacific Time Zone

40 hours per week: 9:30am-6:00pm, Days will vary. Pacific Time Zone

This is an excellent opportunity for a Pharmacy Technician to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.

Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.

We offer:

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

*Position will be posted for a minimum of 7 business days

Responsibilities

The Client Billing Associate will:

• Interpret contract documents to ensure billing is performed in compliance with all contract terms
• Processes changes in information systems to support accurate and efficient billing process and financial close
• Facilitates and ensures accurately and timely billing of services and fees to facility clients
• Completes interim statement review to ensure charges are accurate
• Participate in month-end closing and audits as necessary
• Provides customer support via phone or electronic communications
• Supports other departments, such as Census, when volumes or needs dictate
• Works under general supervision
• Performs other tasks as assigned
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
• To perform this job successfully, an inidual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

Qualifications

• High School graduate, GED or equivalent experience is required; 2 year degree is preferred
• Customer Service, Financial Service, Accounting, Technical, or other experience in which the ability to problem solve, work under strict deadlines, and produce quality outputs are displayed is required
• Third Party Billing or collections/billing experience in the healthcare industry; AS400 computer experience is preferred
• Flexibility, decisiveness, tenacity, problem solving, practical learning, detail conscious, communicates effectively, dependability, responsible, builds trust, resolves conflicts constructively is required
• Ability to be inventive and analytical are preferred competencies

About our Line of Business

PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation’s largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

Salary Range

USD $21.00 / Hour

ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information.

We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at [email protected].

Click here for additional FAQ information.

Title: Family Nurse Practitioner (EST)

Location: Remote – USA

Type: Full-Time

Workplace: remote

Category: Medical

About Equip

Equip is the leading virtual, evidence-based eating disorder treatment program on a mission to ensure that everyone with an eating disorder can access treatment that works. Created by clinical experts in the field and people with lived experience, Equip builds upon evidence-based treatments to empower iniduals to reach lasting recovery. All Equip patients receive a dedicated care team, including a therapist, dietitian, physician, and peer and family mentor. The company operates in all 50 states and is partnered with most major health insurance plans. Learn more about our strong outcomes and treatment approach at www.equip.health

Founded in 2019, Equip has been a fully virtual company since its inception and is proud of the highly-engaged, passionate, and erse Equisters that have created Equip’s culture. Recognized by Time as one of the most influential companies of 2023, along with awards from Linkedin and Lattice, we are grateful to Equipsters for building a sustainable treatment program that has served thousands of patients and families.

About the role:

The Family Nurse Practitioner or Physician Assistant will be responsible for caring for children and adults with eating disorders via Equip’s 100% virtual Telehealth platform. Family Nurse Practitioners and Physician Assistants are essential members of Equip’s 5-person virtual treatment team, working alongside a therapist, dietitian, peer mentor, and family mentor to help people recover from eating disorders.

Responsibilities:

• Provide comprehensive assessments and diagnoses of eating disorders and co-occurring psychiatric conditions (psychiatric consultation available).
• Implement medication treatment plans for eating disorders and co-occurring conditions in a virtual clinic (i.e. telehealth) setting.
• Collaborate with a multidisciplinary treatment team of physicians, dietitians, therapists, patient mentors, and family mentors, along with outside providers.
• Utilize between-session messaging to support patients and communicate with the treatment team through Equip EMR in accordance with Equip’s policies and procedures.
• Engage in treatment team meetings, supervision, and department meetings.
• Perform other duties as assigned.

Qualifications:

• Board Certification as a Family Practice Nurse Practitioner or Physician Assistant.
• Ability to maintain active NP or PA licenses and pursue cross licensing as applicable (cost of licenses to be covered by Equip).
• 3+ years of experience treating pediatric, adolescent, and adult patients in an outpatient setting.
• Demonstrate a commitment to providing excellent evidence-based care, advancing clinical skills, and a passion for professional development.
• Communicate effectively with patients and patient’s carers, and respond to messages within a timely manner.
• Be curious, enjoy learning, and participate enthusiastically and collaboratively in a multidisciplinary team.

Schedule

• Monday – Friday. 40 Hours.

The pay range for this position in the US is $110,000 – $130,000/yr.

Equip offers a comprehensive benefit package, including medical, dental and vision insurance, 401k, paid time off, family and short-term disability leave.

Physical Demands

Work is performed 100% from home with no requirement to travel. This is a stationary position that requires the ability to operate standard office equipment and keyboards as well as to talk or hear by telephone. Sit or stand as needed.

At Equip, ersity, equity, inclusion and belonging are woven into everything we do. At the heart of Equip’s mission is a relentless dedication to making sure that everyone with an eating disorder has access to care that works regardless of race, gender, sexuality, ability, weight, socio-economic status, and any marginalized identity.

As an equal opportunity employer, we provide equal opportunity in all aspects of employment, including recruiting, hiring, compensation, training and promotion, termination, and any other terms and conditions of employment without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, gender expression, familial status, age, disability, and/or any other legally protected classification protected by federal, state, or local law.

Auditor Clinical Validation OPSP Coding

Job Locations US-Remote

ID 2024-13397

Category

Audit – Healthcare

Position Type

Full-Time

Overview

This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.

Responsibilities

Audits Outpatient and Specialty Claims:

• Utilizes medical chart coding principles and client specific guidelines in performance of medical audit activities with Outpatient (APC, PNPP), Pharmacy and/or Inpatient DRG claims.
• Draws on advanced coding expertise and industry knowledge to substantiate conclusions.
• Performs work independently, reviews and interprets medical records and applies in-depth knowledge of coding principles to determine potential billing/coding issues.
• Effectively Utilizes Audit Tools
• Utilizes advanced proficiency, Cotiviti encoder and audit tools required to perform duties.
• Enters claim into Cotiviti system accurately and in accordance with standard procedures.
• Meets or Exceeds Standards/Guidelines for Productivity Maintains production goals, accuracy and quality standards set by the audit for the auditing concept.
• Meets or Exceeds Standards/Guidelines for Quality
• Achieves the expected level of quality set by the audit for the auditing concept, for valid claim identification and documentation.
• Identifies New Claim Types
• Identifies potential claims outside of the concept where additional recoveries may be available.
• Suggests and develops high quality, high value concepts and/or processes improvement, tools, etc.
• Recommends New Concepts and Processes
• Has broad in-depth knowledge of client, contract terms and complex claim types gained from extensive healthcare auditing experience.
• Suggests, develops and implements new ideas, approaches and/or technological improvements that will support and enhance audit production, communication and client satisfaction.
• Evaluates information and draws logical conclusions.
• Complete all responsibilities as outlined on annual Performance Plan.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

Qualifications

Education (required)

• Associate or bachelor’s degree Health Information Management (RHIA or RHIT)
• Or equivalent combination of relative work experience.

Certifications/Licenses (required)

• Coding Certification required and maintained i.e. CPC, CIC, CCS, CCS-P, RHIA or RHIT

Experience

• 5 to 7 years of experience with clinical medical record coding or auditing and a working knowledge of HIPAA Privacy and Security Rules and CMS security requirements.
• Working knowledge of HIPAA Privacy and Security Rules, CMS security requirements and clinical medical record coding or auditing.
• A broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology.
• Ability and desire to utilize base coding and clinical auditing knowledge to learn and become proficient in a variety of outpatient and specialty review types.
• Adherence to official coding guidelines, coding clinic determinations and CMS and other regulatory compliance guidelines and mandates. Requires expert coding knowledge – DRG, ICD-10, CPT, HCPCS codes.
• Excellent verbal and written communication skills.
• Ability to work well in an inidual and team environment

Working Conditions and Physical Requirements:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Communicating with others to exchange information.
• Repeating motions that may include the wrists, hands and/or fingers.
• Assessing the accuracy, neatness and thoroughness of the work assigned.
• No adverse environmental conditions expected.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access / connectivity and office setup and maintenance.

Cotiviti is an equal employment opportunity employer. Cotiviti recruits, hires and promotes iniduals based on their qualifications for a specific job. Cotiviti values its erse workforce and its selection of employees is made without regard to race, color, creed, sex, age, religion, pregnancy, childbirth or pregnancy-related conditions, national origin, sexual orientation, marital status, genetic carrier status, military service, veteran status, disability, or any other category of class protected by federal, state or local laws. All employment decisions and personnel actions, such as hiring, promotion, compensation, benefits, and termination, are and will continue to be administered in accordance with, and to further the principle of, equal employment opportunity.

Pay Transparency Nondiscrimination Provision

Cotiviti will not discharge or in any manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as part of their essential job functions cannot disclose the pay of other employees or applicants to iniduals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)

Title: UM Nurse

time type

Full time

job requisition id

R-5281

Utilization Management Nurse

Work from home within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia’s dedicated team of Nurses are living our mission to make health care easier and lives better. As a member of the Clinical Services team, our Utilization Management Nurses provide utilization management (such as prospective concurrent and retrospective review) to best meet the member’s specific healthcare needs and to promote quality and cost-effective outcomes and appropriate payment for services – all in service of making our members’ health journeys easier.

Are you a Nurse who has a passion for healthcare? Are you a Nurse who is ready to take your career to the next level and make a real difference in the lives of our members? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• Associate or Bachelor’s Degree in Nursing or related field
• 3 years of case management, utilization management, disease management, auditing or retrospective review experience
• Equivalent combination of education and experience
• Must have licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g. medical vs. behavioral health) and at least 3 years (or full time equivalent) of direct clinical care.
• May need to have licensure in all four states served by Cambia: Idaho, Oregon, Utah, Washington.
• Must have at least one of the following: Bachelor’s degree (or higher) in a health or human services-related field (psychiatric RN or Masters’ degree in Behavioral Health preferred for behavioral health); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management)

Skills and Attributes:

• Knowledge of health insurance industry trends, technology and contractual arrangements.
• General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems.
• Strong verbal, written and interpersonal communication and customer service skills.
• Ability to interpret policies and procedures and communicate complex topics effectively.
• Strong organizational and time management skills with the ability to manage workload independently.
• Ability to think critically and make decisions within inidual role and responsibility.

What You Will Do at Cambia:

• Conducts utilization management reviews (prospective, concurrent, and retrospective) to ensure medical necessity and compliance with policy and standards of care.
• Applies clinical expertise and evidence-based criteria to make determinations and consults with physician advisors as needed.
• Collaborates with interdisciplinary teams, case management, and other departments to facilitate transitions of care and resolve issues.
• Serves as a resource to internal and external customers, providing accurate and timely responses to inquiries.
• Identifies opportunities for improvement and participates in quality improvement efforts.
• Maintains accurate and consistent documentation and prioritizes assignments to meet performance standards and corporate goals.
• Protects confidentiality of sensitive documents and issues while communicating professionally with members, providers, and regulatory organizations.

#LI-Remote

The expected hiring range for a Utilization Management Nurse is $38.00 – $41.50 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 10%. The current full salary range for this role is $33.80 – $55.00 an hour.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we’re helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:

• Work alongside erse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce ersity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

Senior Coder

Remote – Nationwide

Full time

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

* We are seeking candidates with experience in General Surgery, ED and Vascular *

The Senior Coder is a certified coder with expert knowledge in front and back end coding. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership.

Job Responsibilities:

• Complete root cause analysis of identified front and/or back end coding opportunities as assigned.
• Support/lead opportunity improvement projects as assigned.
• Research and provide coding guidance for new client service lines/services.
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations.
• Maintain workflow/process knowledge of each functional area of coding.
• Provide and/or assist with provider education, as well as the development educational tools. Communicates professionally with physicians, management, and peers.
• Participates in all educational activities including coding meetings/calls necessary to provide information relating to coding and compliance. Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy. Assists with training of other coders.
• Takes initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities as deemed appropriate. Demonstrates personal responsibility for job performance.
• Other duties as assigned by Manager/Supervisor.
• Possible travel for education sessions, CME events, etc. as defined by Physician Revenue Cycle Leadership.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.
• Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient’s status and interprets the appropriate information needed to identify each patient’s requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.

Experience We Love:

• AAPC or AHIMA Coding Certification (i.e. CPC, CCS-P) required
• Minimum of 4 years coding experience required, 5 years preferred
• Extensive knowledge/experience in physician front end and back end coding with expert knowledge in a multiple coding specialties and the ability to provide education/support to coding team and providers as well as strong analytic skills.
• Knowledge of Medical Terminology, IDC-10, CPT, and HCPCS.
• PC and Computer application knowledge and experience. Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).
• Excellent skills of organization, communication, time management, financial analysis, written policy, trouble shooting and problem solving.
• Ability to multi-task and prioritize needs to meet short and long term timelines. Mobile phone access with adequate data to handle business needs is required.
• Experience with EPIC and previous use of coding software tools. Dual Certification.

Join an award-winning company

Three-time winner of Best in KLAS 2020-2022

2022Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners provides reasonable accommodations to qualified iniduals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [email protected].

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the roles range.

Title: Clinical Operations Coordinator

Location: United States

Job Description:

At Morgan & Morgan, the work we do matters. For millions of Americans, we’re their last line of defense against insurance companies, large corporations or defective goods. From attorneys to client support staff, creative marketing to operations teams, every member of our firm has a key role to play in the winning fight for consumer rights. Our over 3,000 employees are all united by one mission: For the People.

Summary

Our Medical Operations team is looking to add a Clinical Operations Coordinator to help support our medical team! Successful candidates will have a clinical background and be able to work with and assist in reviewing medical records and capturing all medical and treatment aspects of a client’s treatment plan. As an essential part of our growing team, you will track metrics for all cases that come through and have an opportunity to grow as business needs change.

This is a full-time remote position that requires RN clinical experience with Emergency Medicine, Neurology, or Orthopedic patients.

Responsibilities

• Working with several teams and initiatives.

• Reviewing and auditing legal files.

• Responsible for quality clinical evaluations and team performance.

• Interacting with both internal and external stakeholders.

• KPI driven and process improvement heavy.

Qualifications

• Required: Registered Nurse, Active License.

• Required Clinical Experience: Emergency Medicine, Neurology, Neurosurgery, Utilization Review, or Stroke experience.

• Ability to interact with people at all levels of the corporate structure, prioritize and handle numerous competing demands in a high-volume, fast paced working environment.

• Highly organized, details oriented with exceptional interpersonal skills.

• Excellent written and verbal communication skills with spoken and written fluency in English.

• Strong analytical and problem-solving skills required.

• Must be able to multitask and handle high-stress, sensitive situations with a high degree of confidentiality.

• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint, and Outlook, plus a variety of other word-processing, spreadsheet, database, email, and case management software.

The anticipated salary range of $60,000.00-$75,000.00 will be contingent upon various factors, including but not limited to, relevant experience, internal equity, market data, job location, and other job-related factors permitted by law.

#LI-CB1

Benefits

Morgan & Morgan is a leading personal injury law firm dedicated to protecting the people, not the powerful. This success starts with our staff. For full-time employees, we offer an excellent benefits package including medical and dental insurance, 401(k) plan, paid time off and paid holidays.

Equal Opportunity Statement

Morgan & Morgan provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

E-Verify

This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the I-9 Form.

Privacy Policy

Here is a link to Morgan & Morgan’s privacy policy.

Credentialing Coordinator – Remote

ID

2024-54858

Job Family

Billing

NOW HIRING: FULLY REMOTE CREDENTIALING COORDINATOR

Our Passion:

We exist to Lead Care With Light. We need passionate, talented people working together who share our desire to provide the best quality care to our patients and lead the fight against the opioid epidemic. We are prepared to treat the entire disease, not just a piece of it.

Our Team:

Acadia Healthcare’s Comprehensive Treatment Centers (CTC) ision operates 160+ outpatient addiction recovery centers nationwide, serving patients undergoing treatment for opioid use disorder. As the leading provider of medication-assisted treatment in the nation, we care for more than 70,000 patients daily. Our mission is to deliver comprehensive care, combining therapies with safe and effective medications. Our team stands at the forefront of the battle against the opioid epidemic.

Our Benefits:

• Medical, dental, and vision insurance
• Acadia Healthcare 401(k) plan
• Paid vacation and sick time
• Flexible start time
• Opportunityfor growth that is second to none in the industry

Your Job as a Credentialing Coordinator:

The Credentialing Coordinator manages the credentialing portion of the contract process. You will partner with facilities to prepare the proper documentation for initial and re-credentialing application submissions to meet required deadlines, assist in the completion of Medicaid enrollments, and be responsible for completing POAs. The Credentialing Coordinator maintains the department work flow to ensure accuracy and completion of tasks in a timely manner.

Job Responsibilities:

• Request and review key credentialing file documentation for each provider/clinician.
• Review and complete Primary Source Verification for all vital credentialing file documentation.
• Prepare and submit initial and re-credentialing documentation for each payor as needed.
• Track and monitor incoming and outgoing credentialing requests, including maintenance of credentialing files.
• Maintain various database systems.
• Prepare and submit state Medicaid and other payor enrollments and re-validations.
• Work directly with payers, the CBOs, and Contracting Departments to resolve disputes.
• Prepare and administer routine correspondence, memoranda, and notifications.
• Work closely with the CBOs and Contracting Departments to ensure efficiency of processes and create new workflow tools as needed.
• Update and maintain in-house documents.

Qualifications

Your Education and Qualifications:

• BA/BS degree preferred.
• Minimum of 2 years experience in credentialing in a healthcare setting required
• Must have experience with multi-state payor enrollment and require minimal assistance/training for the position
• Experience with state Medicaid and MCO payor enrollment for initial and recredentialing applications required
• Communicates effectively with healthcare provider and payors for any needed information to complete enrollment
• Experience with behavioral health credentialing a plus, but not necessary.
• Knowledge of CredentialingStream/Verity a plus, but not necessary.

Your Skills:

• Strong organizational and analytical skills, with attention to detail.
• Excellent verbal and written communication skills.
• Ability to prioritize task and to work independently.
• Also, the ability to work within a team environment.
• Should be able to multitask and work well under pressure.
• Ability to meet weekly goals.
• Comfortable working in a fast-paced healthcare environment.
• Willing to assist other team members and departments as needed to complete tasks
• Willing to assist and work on additional projects as needed.

We are committed toproviding equal employment opportunities to all applicants for employment regardless of an iniduals characteristics protected by applicable state, federal and local laws.

Title: Clinical Review Nurse

Location: United States United States

Job Description:

AmTrust Financial Services, a fast-growing commercial insurance company, has a need for Clinical Review Nurse remote or in an office location.

PRIMARY PURPOSE: The Clinical Review nurse has the responsibility of reviewing the medical necessity, appropriateness, quality and efficiency of services in the appropriate setting for Workers’ Compensation claimants. This position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the AmTrust Claims Adjuster team to expedite medically necessary treatment for each claim. They also review pharmacy authorizations to determine appropriateness of pharmaceutical treatment. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization.

Responsibilities

• Perform Utilization Review activities prospectively, concurrently, or retrospectively in accordance with the appropriate jurisdictional guidelines.
• Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered.
• Responsible for helping to ensure injured employees receive appropriate level and intensity of care directly related to the compensable injury using industry standard and/or state specific medical treatment guidelines and formularies.
• Objectively and critically assesses all information related to the current treatment request to make the appropriate medical necessity determination.
• Sends determination letters as needed to requesting physician(s) and refers to physician advisors for second level reviews as necessary.
• Responsible for accurate comprehensive documentation of Utilization Review activities in the case management and pharmacy benefit management systems.
• Responsible for completing timely reviews according to state’s requirements and communicating the UR determination to all parties.
• Uses clinical/nursing skills to help coordinate the inidual’s treatment program while maximizing quality and cost-effectiveness of care.
• Communicates effectively with providers, claims adjuster, client, and other parties as needed to expedite appropriate medical care
• Keeps current with market trends and demands.
• Performs other functionally related duties as assigned

Qualifications

Active unrestricted RN license in a state or territory of the United States with eligibility to get and/or renew a multistate license.

• 5+ years of related experience or equivalent combination of education and experience required to include 2+ years of direct clinical care OR2+ years of utilization management required.

Education & Licensing

• Bachelor’s degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred.
• Acquisition and maintenance of Insurance License(s) may be required to comply with state requirements. Preferred for license(s) to be obtained within three – six months of starting the job.

Skills & Knowledge

• Proficiency in all Microsoft Office products including Project, Word, Excel, PowerPoint, Visio, and SharePoint
• Knowledge of workers’ compensation laws and regulations, behavioral health, case management practice, URAC standards, ODG, Utilization review, pharmaceuticals to treat pain, pain management process, drug rehabilitation, state workers compensation guidelines, periods of disability, and treatment needed
• Excellent oral and written communication, including presentation skills

• Ability to interact collaboratively and work effectively with a multi-functional team and throughout the organization; fosters an environment of shared responsibility and accountability
• Strong organizational, communication and analytical skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding Auditory/Visual: Hearing, vision and talking

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a erse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the erse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see ersity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.

Bilingual Telehealth Nurse Practitioner

Remote USA

Full time

job requisition id

R2160

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, erse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology – to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we’ve grown fast and now serve members across the United States. And we’ve just started. So join us on this mission!

Job Description

This role is a fully remote position.

A bit about this role:

This position represents an amazing opportunity for a caring nurse practitioner (APRN). Your primary focus will be delivering world class comprehensive care to our members. One of Devoted Medical’s missions is to bring care to where our members live – meaning your visits will be predominantly virtual telehealth.

Required skills and experience:

• APRN with 3 or more years working in outpatient clinical practice.
• An active and clear RN and APRN license.
• Active BLS is required at time of hire and must be maintained while employed at Devoted Medical.

Desired skills and experience:

• Experience in primary care, family medicine, geriatrics and/or palliative care.
• Experience performing Medicare annual wellness visits or in-home comprehensive visits with elderly patients or Medicare patients.
• Experience performing visits over telehealth video platforms.
• An understanding of managed care is a plus, including how to appropriately assess STARS/HEDIS measures, code clinical comorbidities, and identify clinical care gaps.

Your Responsibilities will include:

• Conduct primarily telehealth video visits to members with the opportunity for a small volume of home based visits (drive to member’s home). In some instances when appropriate and compliant with licensure, you may also provide telehealth visits to members located in other geographies.
• Primarily perform comprehensive assessment visits (CAVs) including comprehensive diagnosis/disease review, medication review, and assessment for quality of care (STARS/HEDIS) interventions as well as social and home health/DME needs.
• Work closely with other members of the member’s care team including their PCP, specialists, and other Devoted team members including pharmacy, clinical nursing, and social work as well as interfacing with family members and caregivers in order to coordinate care for the member and deliver a collaborative care plan.

Salary Range: $115,000 – $125,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the inidual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more….

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a erse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value ersity and collaboration. Iniduals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Title: RN Case Manager

Location: Remote

Job Description:

Vytalize Health is a leading value-based care platform. It helps independent physicians and practices stay ahead in a rapidly changing healthcare system by strengthening relationships with their patients through data-driven, holistic, and personalized care. Vytalize provides an all-in-one solution, including value-based incentives, smart technology, and a virtual clinic that enables independent practices to succeed in value-based care arrangements. Vytalize’s care delivery model transforms the healthcare experience for more than 250,000+ Medicare beneficiaries across 36 states by helping them manage their chronic conditions in collaboration with their doctors.

About our Growth

Vytalize Health has grown its patient base over 100% year-over-year and is now partnered with over 1,000 providers across 36-states. Our all-in-one, vertically integrated solution for value-based care delivery is responsible for $2 billion in medical spending. We are expanding into new markets while increasing the concentration of practices in existing ones.

Visit www.vytalizehealth.com for more information.

Why you will love working here

We are an employee first, mission driven company that cares deeply about solving challenges in the healthcare space. We are open, collaborative and want to enhance how physicians interact with, and treat their patients. Our rapid growth means that we value working together as a team. You will be recognized and appreciated for your curiosity, tenacity and ability to challenge the status quo; approaching problems with an optimistic attitude. We are a erse team of physicians, technologists, MBAs, nurses, and operators. You will be making a massive impact on people’s lives and ultimately feel like you are doing your best work here at Vytalize.

Your opportunity

The RN Case Manager (Remote) works with the clinical department and acts as a liaison between our physician practices and their patients. The RN Case Manager advocates for personalized treatment options that address a patient’s unique care needs. The RN Care Manager uses a patient-centric approach that supports the value-based care model, offers education and guidance for navigating complex medical decisions, and coordinates care for patients when they need support the most, including post discharge and when social needs are not met. This RN Case Manager will support special clinical programs and initiatives to support VBC and shared savings goals.

What You Will Do

• You will be responsible for using your assessment and communication skills to engage with patients in need of clinical support to determine and prioritize their needs. You will deliver patient-centered care, provide exceptional customer service, and work within your scope of practice to provide evidence-based education, assessment, and care navigation
• Identify patient/caregiver education needs through telephonic assessment/engagement and ensure that patient/caregiver have adequate information to participate in the successful transition back to their home setting from an inpatient or post-acute facility stay
• Conduct timely telephonic clinical outreach to identified patients
• Collaborate with PCP, NP, and other members of the healthcare team to coordinate care for patientsand actively help keep them stable at home
• Serve as the point of contact and informational resource for patients, care team, family/caregiver(s), payers, and community resources.
• Implement interventions that improve health outcomes, lower costs, and improve the experience for the patient.
• Work collaboratively with provider offices, SNFs, hospitals, and other teams in Clinical Services to support each patient’s needs most efficiently and effectively.
• Assist in the coordination across the continuum of care while maintaining confidentiality.
• Guide patients through the health care system and help them overcome barriers.
• Coordinate treatment and services for patients
• Schedule medical appointments as needed
• Communicate about a patient’s health condition with the patient and their family
• Provides community resources to patientsas needed and to support resolution of SDoH
• Maintain a comprehensive working knowledge of community resources.
• Assume accountability for the quality of care.
• Continually seek new knowledge and learning that supports clinical care coordination.
• Support non-RN team members in their contributions to care coordination by educating and providing clinical guidance as needed
• May be asked to support the Director in day-to-day supervision of team members as needed.

What will make you successful here

• Bachelor’s Degree in Nursing
• 5 years experience as an RN or RN Care Manager
• Post Acute Care experience strongly preferred
• Transitions of Care experience strongly preferred
• Startup experience preferred
• Unencumbered RN license, compact nursing license preferred
• Accredited Case Manager (ACM) preferred
• Comfortable and able to adapt to rapid changes
• Excellent verbal and written communication skills
• Excellent organizational skills and attention to detail
• Entrepreneurial spirit, a sense of ownership and comfortable operating in ambiguity
• Solution oriented with the ability to think strategically and creatively in decision-making
• Able to work independently
• Coachable and able to take direction and feedback well, yet being forward-thinking to challenge the status quo
• Proficient with Microsoft Office Suite or related software.
• Demonstrate a positive attitude and respectful, professional customer service
• Acknowledge patient’s rights on confidentiality issues and follow HIPAA guidelines and regulations
• Passionate about patient experience
• Confident managing change, goal-oriented and has a growth mindset
• Comfortable with digital technology (including tools like MS Office, Google, various EMRs, etc.) and able to troubleshoot technology issues
• Compassionate and good at listening to patient or staff concerns
• Organized, efficient, and adaptable: able to carry out a variety of administrative and clinical duties
• Ability to critically think, solve problems, and bring professionalism to all situations
• Able to contribute to quality improvement and process improvement initiatives
• Maintain a professional and HIPAA compliant workspace
• Excellent written and verbal communication skills
• Strong clinical and problem-solving skills
• Strong attention to detail
• Proficiency in Microsoft Office Suite

Perks/Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for iniduals and families
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• Unlimited (or generous) paid “Vytal Time”, and 5 paid sick days after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization

Title: Inpatient Coder

Location: Savannah United States

Job Description:

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as an Inpatient Coder today with Work from Home.

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues

Note: Eligibility for benefits may vary by location.

Come join our team as an Inpatient Coder. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!

Job Summary and Qualifications

As an Inpatient Coding Specialist, you will be responsible for working inpatient coding related alerts/edits, predominately post initial/final coding. You will also perform the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked according to the established procedures and thresholds and communicated as appropriate.

What you will do in this role:

• Compiles daily work list from eRequest, CRT and/or other alert/edit systems
• Takes action and resolves alerts/edits daily following established procedures and thresholds
• Enters detailed notes to update eRequest to provide details if the alert/edit cannot be resolved or must be rerouted to another responsible party for research/resolution
• Escalates alert/edit resolution issues as appropriate to minimize final billing delays
• Monitors the aging of accounts held by an alert/edit, prioritizes aged accounts first, and reports to leadership
• Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits
• Assigns interim DRGs for in-house patients at month end
• Completes MOCK abstracts as necessary (e.g., combining the codes for outpatient and inpatient claims subject to the payment window)
• Assists the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons
• Communicates coding revisions to the applicable party (e.g., CIS, lead, manager, international log) 2 Job Description
• Periodically works with their manager to review inidual work accomplishments, discuss work problems/barriers, discuss progress in mastering tasks and work processes, and discusses inidual training needs and career progression

What qualifications you will need:

• Undergraduate (associate or bachelors) degree in HIM/HIT preferred.
• RHIA, RHIT, and or CCS preferred
• 1-year acute care inpatient coding experience required with 3 years’ experience preferred.
• RHIA, RHIT and/or CCS preferred

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Coder opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer and value ersity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Title: Medical Coder Auditor- Physician Rev Cycle Coding

Location: NC-Chapel Hill

Job Description:

Become part of an inclusive organization with over 40,000 erse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

Serves as a lead employee who audits coded records for multiple specialties. Analyzes coded records for compliance with federal, state and third party insurer rules and regulations. Establishes a collaborative relationship with stakeholders to ensure quality standards are met.

Responsibilities:

1. Accurately assigns International Classification of Diseases 10-CM (ICD-10) diagnostic and Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes. Analyzes information for optimal and proper reimbursement, including coding denial resolution. Ensures compliance with all appropriate coding, billing and data collection regulations and procedures. Uses appropriate software to validate information. 2. Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines. 3. Reviews, analyzes and abstracts provider documentation for diagnoses, procedures, ancillary testing, medications, laboratory and other services provided. Obtains missing information and/or clarifies existing documentation. 4. Performs pre-bill and/or post-bill audits for assigned coding teams. 5. Adheres to departmental quality and production standards. 6. Reviews work of staff, researches and resolves problems referred by coders or departmental leadership. Provides information on performance of coders to supervisor regarding performance. 7. Provides training and serves as a general resource to assist other coders and members of department staff. 8. Collaborates with team leadership to address coding trends. 9. Acquires continuing education via UNC Physicians approved programs and vendors. 10. Maintains required professional certification.

Other Information

Other information:

Education Requirements: High School diploma or GED Successful completion of the UNC HCS SS Rev Cycle Physician Coder Auditor Proficiency Test. Licensure/Certification Requirements: Must have one of the following: – AAPC (American Academy of Professional Coders) certification-AHIMA (American Health Information Management Association) CCSP Certification-Must obtain CPMA certification within 1 year of hire date. Professional Experience Requirements: If Associates Degree or Higher: Five (5) years of experience in physician medical coding. If High School Diploma: Seven (7) years of experience in physician medical coding. Knowledge/Skills/and Abilities Requirements:

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Physician Rev Cycle Coding

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $27.89 – $40.09 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Supervisor of Coding

Location: United States

Remote Worker

Salary: 36.12 – 50.56

Biweekly Hours: 80

Job Description:

This position is responsible for the organizational and functional integrity of the coding sections, ensuring staff compliance, development, and education. The incumbent is well-versed in Facility or Professional coding concepts, coordinates HIM initiatives to ensure accurate reimbursement in the Revenue Cycle, monitors productivity, and performs retrospective reviews for coding accuracy and educational opportunities. Focus is specific to hospital inpatient, outpatient, transitional care services or professional services.

temprop=”description”>Nature and Scope

temprop=”description”>Incumbent is responsible for the day-to-day operations of their coding team, ensuring adequate staffing, fair work distribution, and timely and accurate completion of coding tasks. They are responsible for coordinating work schedules, maintaining a calendar of scheduled time off for all employed coding staff and liaising with contract services when applicable to provide adequate coverage based on work volumes and required staffing plan adjustments.

temprop=”description”> The incumbent reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters, translating diagnostic and therapeutic phrases utilized by healthcare providers into coded form. The translation process may require interaction with the healthcare provider to ensure that the terms have been translated correctly. The coded information that is a product of the coding process is then utilized for reimbursement purposes, in the assessment of clinical care, to support medical research activity, and to support the identification of healthcare concerns critical to the public at large.

temprop=”description”>Incumbent must have a thorough understanding of the content of the medical record in order to be able to locate information to support or provide specificity for coding. Incumbent must be trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded and to provide direction and mentoring of staff to ensure their understanding of coding principles and correct coding initiatives.

temprop=”description”>This position is challenged to be aware of the continual changes in Federal and State regulations for prospective payment, respond appropriately to observed fraud or abuse and keep informed of changes in treatment modalities and new procedures, and to perform appropriate queries when physician documentation is vague or missing. The Supervisor is expected to share pertinent changes with staff and to assist subordinates in interpretation and application of these changes.

temprop=”description”>The incumbent will be familiar with computer operations, encoder software, and electronic health record (HER) software. They must be capable of training others in data entry and abstracting. Incumbent will audit/approve time and attendance bi-weekly and monitor staff compliance with Renown Health policies. Incumbent will also monitor staff productivity weekly. Completes employee evaluations and 90 and 180-day progress reports timely, offering developmental plans pertinent to the position and employee growth.

temprop=”description”>Supervisor of Coding (Professional Services Focus): The incumbent that oversees Professional Services coders should demonstrate experience with ICD-10-CM, CPT, HCPCS, E/M and HCC capture. This incumbent will be responsible for monitoring work queue volumes, productivity and quality of coding for Professional Services coders. They will provide reporting on provider education results for multiple audiences, and develop the Professional Coding staff. This person assesses and maintains impact of current compliance activities and evaluates risk factors of coding and documentation practices. In addition to supervising staff and provider/physician CPT coding, they are expected to have a close working relationship with the Medical Directors and Operations Mangers to support provider coding accuracy that is consistent with industry standards and in compliance coding guidelines.

temprop=”description”>This position does not provide patient care.

temprop=”description”>Disclaimer

temprop=”description”>The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

temprop=”description”>Minimum Qualifications

temprop=”description”>Requirements – Required and/or Preferred

temprop=”description”>Education:

temprop=”description”>Must have working-level knowledge of the English language, including reading, writing and speaking English. An Associate’s or Bachelor’s Degree is preferred.

temprop=”description”>Experience:

temprop=”description”>Experience in a managerial capacity in health information management for 3-5 years preferred. Two to four years of facility or professional coding experience required.

temprop=”description”>Certification(s):

temprop=”description”>Ability to obtain and maintain a credential recognized by AHIMA or AAPC is required, this excludes apprenticeship credentials (i.e. CCA or CPC-A)

temprop=”description”>Computer / Typing:

temprop=”description”>Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Actual salary offered may vary based on multiple factors, including but not limited to, an inidual’s location and their knowledge, skills, and experience as well as internal equity.

Remote Pro Fee Coder – Plastic Surgery

locations

US – Remote (Any location)

time type

Full time

job requisition id

21186

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

• Code Complex Plastic Surgery cases including facial trauma
• Works collaboratively with providers, other health care professionals and coding team to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to each patient, as well as ensuring compliant reimbursement of patient care services.

What You Will Need:

• High School Diploma/GED or 3 years of relevant equivalent experience in lieu of diploma/GED
• 5+ years of prior coding experience
• 3 years coding experience related directly to Plastic Surgery coding
• CPC

What Would Be Nice To Have:

• Multispecialty Surgical coding experience

#IndeedSponsored

The annual salary range for this position is $57,300.00-$85,900.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a erse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Director, Coding Outsource

locations

Remote – USA

time type

Full time

job requisition id

R3874

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).

The Director, Coding Outsource delivers operational performance outcomes as established in Savista’s annual financial packages and by contractual obligations to clients managed.

More specifically, this role requires talent that can:

• Institute and then continuously assess protocols for how client engagements are launched, managed, and monitored on an ongoing basis, including operationalizing contractual obligations, measuring performance, and sustaining expected levels of talent deployed.

• Oversee the staffing and performance management of the management team assigned to Coding Outsource.

• Analyze P&L outcomes and take action when necessary.

• Collaborate with Client Relationship Development team members to create pathways on how client satisfaction will be initially obtained and sustained thereafter.

• Support services growth.

• Seek ways and means to continuously improve service delivery.

• Maintain familiarity of pertinent and innovative healthcare related issues and regulations.

Minimum Qualifications:

• Bachelor’s in business or health information administration with an active RHIA

• 7 years of healthcare revenue cycle services management experience

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $135,000 to $150,000. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

Preferred Qualification:

• Post-implementation Epic systems experience that demonstrates the capability to refine Owning Area edits queuing to each coding team

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

Coding Supervisor

US – Remote (Any location)

Full time

22408

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Physician Coding Team Supervisor must be proficient in Surgical Coding and have experience overseeing physician coding teams. The Supervisor will perform training and initial QA review for coders who are direct reports. Supervisors must have the ability to review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the Coding Manager—Supervisors should be proficient in communicating with coding teams, Client contacts and Providers regarding the coding of conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The Supervisor scope may involve oversight of teams working coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines. Supervisors should be proficient in Excel and create reports as requested and must communicate professionally with all levels of personnel both internally and externally. Travel may be necessary to client sites at times. This position is full time and is 100% remote.

Duties and Responsibilities:

• Demonstrates the ability to perform oversight, training, and response to internal and external requests regarding quality and production.
• Respond to provider and client questions
• Host client-facing calls and create reports for leadership regarding assigned projects in a timely manner.
• Maintain team goals to promote coder accuracy and efficiency for assigned projects.
• Work with internal education resources to promote skillsets of assigned coding team both domestic and global as assigned.
• Maintain a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
• Ensure all services documented in the patient’s chart are properly coded with appropriate ICD-10 and CPT codes when reviewing coding work or responding to coder and client queries.
• Work with coders/client to attain proper documentation in a timely manner according to facility standards when services/diagnoses are not documented appropriately.
• Ensure assigned coding team maintains 95% accuracy in coding while maintaining a high level of productivity.
• Supervisors will work with coders one-on-one during monthly reviews to cover educational opportunities and accuracy.
• Ability to maintain average productivity standards as follows per internal and client coding contracts.
• Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process.
• Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.
• Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.
• Provides accurate coding and/or billing questions within eight hours of request.
• Responsible for coding or pending every chart placed in their queue within 24 hours.
• It is the responsibility of the Supervisor to coordinate with coding management in the event the 24 hour turn around standards cannot be met.
• Supervisors must maintain their current professional credentials while working for Guidehouse.
• Supervisors are responsible for becoming familiar with the Guidehouse coding website and using the information contained on the website as a daily tool to correctly code and abstract for each facility.
• Supervisors are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy).
• It is the responsibility of the supervisor to review and adhere to the coding ision policy and procedure manual content.
• Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.
• Communicates problems or coding discrepancies to Coding Leadership immediately.
• Communication in emails should always be professional (reference e-mail policy).

What You Will Need:

• Requires a University Degree and a minimum of 5 years of prior relevant experience (Relevant experience may be substituted for formal education)
• 3 years of pro fee ortho, trauma or surgical coding
• CPC certification from AAPC
• Must maintain credential throughout employment.
• Strong working knowledge & experience with Federal & State Coding Regulations and Guidelines.

What Would Be Nice to Have:

• Must be able to work independently, multi-task, and interface with all levels of personnel and clientele.
• Excellent verbal, written, and interpersonal communication skills.
• Experience in multiple EMR and/or practice management systems (EPIC, Cerner, Next Gen, Allscripts, IDX, etc.).
• Coding Supervisory experience preferred

#IndeedSponsored

The annual salary range for this position is $57,000.00-$85,400.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a erse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Multispecialty Medical Coding Specialist II

Remote, United States

Surgical Notes is hiring for a Multispecialty Medical Coding Specialist II to provide accurate and timely coding for our ambulatory surgical clients. The ideal candidate has excellent organizational skills, communication skills, with the desire and ability to learn quickly. Working as a part of the team to meet deadlines, but also being able to work independently is crucial to the success in this position. Our organization prides itself on being built upon a set of strong core values. We are looking for candidate who will actively exhibit these core values: Service Excellence, Transparency, Teamwork, Accountability, Hardwork, and Positive Attitude.

External Title: ASC Medical Coding Specialist II

Internal Title: US Coding Inidual Contributor II

Reports to: Manager, Coding

Responsibilities:

• Review operative reports to abstract information and apply CPT, HCPCS, and ICD-10-CM codes
• Provide coding for all Level 2 and some Level 3 procedures (ASC) as well as Level 1 as needed
• Perform coding for pro fee surgical encounters
• Verify LCD/NCD information as appropriate
• Utilize NCCI edits, AMA CPT Assistant, AHA Coding Clinic, and other resources as needed
• Initiate physician queries as needed
• Escalate coding/documentation problems when appropriate
• Participate in ongoing coding education
• Perform other related duties as required/assigned

Role Information:

• Full-Time or Part-Time
• Hourly
• Non-Exempt
• Eligible for Benefits if Full-Time
• Quarterly Bonus (based on quality and productivity)
• Remote: The minimum bandwidth requirements are 10 Mbps upload and 50 Mbps download speeds. The recommended bandwidth requirements are 20 Mbps upload and 100 Mbps download speeds.

Job Requirements:

Required Knowledge, Skills, Abilities & Education:

• High School Diploma or equivalent
• Coding certification through AAPC or AHIMA (CPC, COC, RHIT, CCS, etc., no apprentice designation)
• 2 years outpatient surgical coding
• 2 years of Ambulatory Surgical Center coding experience
• Extensive knowledge of medical terminology, anatomy and physiology
• Ability to work independently and as part of a team
• Flexibility to assume new tasks or assignments as needed
• Strong attention to detail and speed while working within tight deadlines
• Exceptional ability to follow oral and written instructions
• A high degree of flexibility and professionalism
• Excellent organizational skills
• Outstanding communications skills; both verbal and written

Preferred Knowledge, Skills, Abilities & Education:

• Associate Degree in healthcare related field
• Experience working in an /Ambulatory Surgery Center (ASC)
• Strong Microsoft Office skills in Excel, Outlook, and Teams

Physical Demands:

• Sitting and typing for an extended period of time
• Reading from a computer screen for an extended period of time
• Speaking and listening on a telephone
• Working independently
• Frequent use of a computer and other office equipment
• Work environment of a traditional fast-paced and deadline-oriented office

Key Competencies:

1. Job Knowledge/Technical Knowledge
2. Productivity
3. Initiative/Execution
4. Flexibility
5. Quality Control

US Pay Ranges

$21 – $28 USD

About Surgical Notes

Surgical Notes is the premier ASC revenue cycle management and billing services partner. Our expert teams with ASC-specific experience provide scalable billing, transcription, coding, and document management services and solutions that fully integrate with all leading ASC practice management systems. The largest management companies and hundreds of ASCs that partner with Surgical Notes experience and benefit from immediate operational and financial improvements that exceed industry performance levels.

Surgical Notes is an equal opportunity employer. We celebrate ersity and are committed to creating an inclusive environment for all employees.

Privacy Statement

We use the personal information collected for the purpose of processing job applications, evaluating candidates for employment, and/or carrying out and supporting HR functions and activities We may share your personal information in connection with, or during negotiations of, any merger, sales of Company assets, or acquisition of a portion or of all of our business to another company. If you have any questions regarding this California Job Applicant Privacy Notice or our privacy practices.

Coder

Job Ref:

10027156

Location:United States

Category:Billing & Coding

Job Type:Full-time

Shift: Days

Pay Rate:$29.78 – $46.16 per hour

Join the transformative team at City of Hope, where we’re changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

This role is responsible for following established procedures for the review, classification, and abstraction of clinical data from patients’ medical records regarding diseases, treatment given, and operative procedures for assignment of diagnostic and procedural codes and modifiers. This role abstracts and codes relevant data elements for a certain type of professional fee service area (i.e., Evaluation & Management, major and minor surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges) for multi-specialty physicians.

As a successful candidate, you will:

• Reads and interprets medical record documentation to identify all diagnosis, conditions, problems and procedures for Evaluation & Management, surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges.
• Clarifies conflicting, ambiguous, or non- specific information appearing in a medical record by consulting the appropriate physician.
• Applies Official ICD-10-CM Guidelines to select first-listed diagnosis, primary procedure, complications, co-morbid conditions, other diagnoses and significant procedures which require coding.
• Applies knowledge of ICD-10-CM and CPT-4 instructional notations and conventions to locate and assign the correct diagnostic and procedural codes and sequence them correctly.
• Applies knowledge of current approved ICD-10-CM and CPT-4 coding guidelines to assign and sequence the correct diagnoses and procedure codes.
• Applies knowledge of anatomy, clinical disease processes, and diagnostic and procedural terminology to assign accurate codes to diagnoses and procedures.
• Applies the Basic Coding Guidelines for professional fee physician coding to select and sequence diagnoses, conditions, problems, or other reasons which require coding for professional fee charges.
• Applies knowledge of CPT-4 coding guidelines and notes to locate the correct codes for all services and procedures performed during the encounter and sequence them correctly.
• Applies knowledge of government and commercial payer reimbursement guidelines to ensure optimal reimbursement.
• Ability to utilize computerized encoder/grouper as a reference tool for coding.
• Keeps current with ICD-10-CM and CPT-4 code changes, coding guidelines, and coding updates.
• Assist with charge corrections as identified when coding professional fee services.
• Reviews and completes required reporting documents as required by external and internal systems.
• Completes productivity reports and submits them to the manager, supervisor, or lead.
• Consistently meets coding quality standards and thresholds.
• Attends meetings as required.
• Successfully completes required education courses to maintain current coding certification.

Qualifications

Your qualifications should include:

• Post High School or equivalent.
• Two years of coding experience of professional fees (physician/medical office).
• Thorough knowledge of medical terminology/anatomy/ physiology.
• Comprehensive understanding of professional fee coding principles, including knowledge and proper application of assigning ICD and CPT codes, bundling, and modifiers based on regulatory guidelines.
• Current knowledge, training and experience in ICD-10.
• CPC, CCS-P, or CCS.

City of Hope is an equal opportunity employer. To learn more about our commitment to ersity, equity, and inclusion, please click here. To learn more about our Comprehensive Benefits, please CLICK HERE.

Additional Information:

• This position is represented by a collective bargaining agreement.

Title: Nurse Practitioner

Telemedicine (W2)

Location: Remote

Type: Full-Time

Workplace: remote

Category: Nurse Practioners

Job Description:

Curai Health is an AI-powered virtual clinic on a mission to improve access to care at scale. As the pioneer in deploying machine learning into clinical workflows, Curai Health enables its dedicated, specially trained clinicians to deliver primary care to more people at a fraction of the cost. Easy-to-use and convenient, Curai Health partners with insurers and health systems to keep patients engaged in their care over time, improving health outcomes and reducing costs.

Our company is remote-first, and we consider candidates across the United States. Our corporate office is located in San Francisco. We will consider any candidates that are fully licensed Nurse Practitioners to practice in the United States and carry the required state licenses.

Clinical Operations at Curai

The clinical team at Curai uses Artificial intelligence-empowered electronic records to deliver urgent care and primary care to our patients. Currently, we are searching for Family Practice Nurse Practitioners who can see both adult and pediatric patients. We operate 24/7 and seek flexible clinicians to meet our patients’ needs. Currently, we are seeking clinicians with at least 40 active state licenses which are available to work from 5am to 5pm Pacific time, 3 days a week plus 3 weekend days a month. Shifts can be 12 or 9-hour shifts for 36 clinic hours a week.

Who You Are

• Have worked remotely before, or have a strong feeling that you’d work well with a 100% remote team, spread across multiple time zones
• Value a team-based collaborative approach as it relates to providing healthcare
• Passionate about providing empathetic personalized patient care at the scale
• Have informed opinions that you hold lightly but are flexible to meet the needs of patients and the business
• Understand that flexibility and adaptability are key traits to being successful in a start-up environment and change is inevitable

What You’ll Do

A night in the life of a Curai Nurse Practitioner is spent doing things like:

• Seeing acute/urgent care patients in our live text-based chat clinic including straightforward chronic care cases requiring refills.
• 90% clinical and 10% administrative tasks. Administrative time is broken down between clinical meetings, EHR/automation product feedback projects, and clinical operations quality improvement projects.
• Being responsible for accurately diagnosing patients using detailed patient history-taking and providing evidence-based treatment recommendations.
• Writing efficient encounter visit notes in a clear fashion that demonstrates strong medical decision-making skills, differential diagnoses, and a well-written and relevant care plan. Closing all notes optimally by the end of the encounter, and the latest by the last shift of the day.
• Providing feedback to the AI/ML and product teams on features that improve provider efficiency and accuracy.
• Staying abreast of EHR feature updates by continuously training and remaining current on the platform.
• Working closely with physicians in collaborative agreements for states that require it.

What You’ll Need

• Board certified in Family Nurse Practitioner (FNP)
• Prior telemedicine experience
• Active NP License in 40 or more states (we will assist in licensing you up to all 50 states)
• You must also have a clear medical history (no nursing board actions or complaints).
• Completed an accredited Nurse Practitioner program in the United States.
• 5 years post NP training.
• Digital savviness, excellent typing skills, excellent grammatical construction, and excellent command of English.
• Proficiency in English. Spanish fluency is an added plus.
• Start-up experience in healthcare is a plus.

What We Offer

• Culture: Mission-driven talent with great colleagues committed to living our values, collaborating, and driving performance
• Pay: Competitive compensation
• Wellness: PTO and remote working
• Continued Education: 40 hours off and $5,000 a year to use toward CME
• Benefits: Excellent medical, dental, vision, flex spending plans, life/disability insurance and paid parental leave
• Financial: 401k plan with employer matching

Salary is dependent on a scale based on years of experience, license coverage, and work location. Thus, our annual base range is large, at $110,000 – $180,000 annually.

Curai Health is a startup with a small but world-class team from high-tech companies, AI researchers, and practicing physicians to team members from non-traditional career paths and backgrounds. We also have research partnerships with leading universities across the country and access to medical data that facilitates research in this space. We are a highly collaborative, data-driven team focused on delivering our mission with funding from top-tier Silicon Valley investors, including Morningside, General Catalyst, and Khosla Ventures.

At Curai Health, we are highly committed to building a erse and inclusive environment. In keeping with our beliefs and values, no employee or applicant will face discrimination or harassment based on race, color, ancestry, national origin, religion, age, gender, marital domestic partner status, sexual orientation, gender identity, disability status, or veteran status. To promote an equitable and bias-free workplace, we set competitive compensation packages for each position and do not negotiate on our offers. We are looking for mission-driven teammates who embody our core values and appreciate our transparent approach.

Beware of job scam fraudsters! Our company uses @curai.com email addresses exclusively. We do not conduct interviews via text or instant message and we do not ask candidates to download software, to purchase equipment through us, or to provide sensitive personally identifiable information such as bank account or social security numbers. If you have been contacted by someone claiming to be from Curai from a different domain about a job offer, please report it as potential job fraud to law enforcement and contact us at [email protected].

Title: Remote – Licensed Practical Nurse – NLC – LPN – LVN

Location: Louisville KY US

Job Description:

Description

CareHarmony’s Care Coordinators (LPN) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients.

CareHarmony is seeking an experienced Licensed Practical Nurse to work 100% Remote – LPN Nurse (LPN) (LVN) with at least 3 years of direct patient-facing work experience; that thrives in a fast-paced environment, is self-motivated, has impeccable attention to detail, and values the impact they can have on a patient’s healthcare journey.

You will have experience identifying resources and coordinating needs for chronic care management patients.

What’s in it for you?

• Fully remote position – Work from the comfort of your own home in cozy clothes without a commute. Score!
• Consistent schedule – Full-Time Monday – Friday, no weekends, rotational on-call-once per year on average.
• Career growth – Many of our team members move up in the company at a faster-than-average rate. We love to see our people succeed!

Requirements

Responsibilities:

• Manage patient census with a resolution-driven approach to close gaps in clinical and non-clinical patient care.
• Identify and coordinate community resources with patients that would benefit their care.

• Provide patient education and health literacy on the management of chronic conditions.
• Perform medication management, including identifying potential medication concerns, reconciliation, adherence, and coordinating refills.
• Assist in ensuring timely delivery of services to your patients; Home Health, DME, Home Infusion, and other critical needs.
• Resolve patients’ questions and create an open dialogue to understand needs.
• Assist/Manage referrals and appointment scheduling.

Additional Requirements:

• Active Multi-State/Compact License (LPN) (NLC) (LVN)
• Technical aptitude – Microsoft Office Suite
• Excellent written and verbal communication skills

Plusses:

• Epic Experience
• Bilingual
• Additional single state licensures (LPN)

Remote Requirements:

• Must have active high-speed Wi-Fi
• Must have a home office or HIPAA-compliant workspace

Physical Requirements:

• This position is sedentary and will require sitting for long periods of time
• This position will require the ability to speak clearly and listen attentively, often by telephone, for an extended period of time
• The position will require the ability to understand, process, and take thorough notes in real-time on telephone conversations

Benefits:

• Health Benefits (core medical, dental, vision)
• Paid Holidays
• Paid Time Off (PTO)
• Sick Time Off (STO)

Pay:

• $21/hr-$28/hr
• Opportunities to pick up OT to increase earnings

Bilingual Cantonese Registered Nurse (Remote)

Remote

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a specialized medical group focused today on aging adults with long-term home care needs. We help these iniduals live happier, healthier lives by partnering with their aides and caregivers, as a key part of the care team. We use a combination of virtual care, home-based and mobile technologies, data integrations and partnerships with home care agencies to make the home an integrated setting of care with patients, and their Caregivers at the center.

Vesta is the Roman name for the goddess of home, hearth and family. She is the caregiver. Often unseen yet greatly revered, she puts others’ needs ahead of her own, keeping the hearth warm so the home and family can function.

We see Caregivers and recognize the power and potential they embody. More than just assistance, Caregivers are eyes, ears and hands in the home. Caregivers play the role of Doctor, Nurse, Pharmacist, EMT and more, but without support or guidance. That is where Vesta Healthcare comes in. Our program provides Caregivers with a personalized clinical team in their pocket. Our team links Caregivers to the people they care for and the other providers involved in their care. It’s an insurance covered benefit, so it’s available to most adults with Caregivers free of charge to them.

The ideal candidate would be able to:

• Plan and conduct intervention opportunity evaluations, respond to urgent alerts and remote patient monitoring alerts as needed to help drive high quality care at a lower cost
• Have the ability and skill to recognize clinical scenarios that require escalation to the internal team nurse practitioner
• Work directly with the member, via various forms of communication, texting, virtual visits, and telephone, to develop and achieve patient centered chronic care management goals
• Develop and update care plans for members while keeping a close eye on caregiver and/or family support
• Apply clinical experience and judgment to the utilization management/care management activities
• Be responsible for day to day work with patients related to interventions needed for quality outcomes to reduce avoidable admissions, readmissions and ED utilization.
• Collaborate with engagement and product teams to promote quality outcomes, optimize service experience, and promote effective use of resources for complex or elevated medical issues

Would you describe yourself as someone who has:

• Available to work full time Monday – Friday, 9:00 am – 6:00 pm EST (required)
• Current RN license in New York (required)
• Fluency in English and Cantonese in writing, reading, and speaking (required)
• Graduated from an accredited nursing program (required)
• At least 2 years of nursing experience providing care to adult and geriatric patient populations (required)
• Confidence with clinical skills and knowledge of chronic conditions (required)
• The ability to work remotely and has a private area in their home/workspace (required)
• A genuine, compassionate desire to serve others and help those in need
• High speed home WiFi/data connection to support company provided IT equipment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k plus match

Pay range is $85,000 – $101,000 per year based on experience and location. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level.)

If yes, then we look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a erse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

At Vesta Healthcare, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home! If you are ever contacted by e-mail from any domain other than https://vestahealthcare.com, please do not respond, as there is a likelihood it could be a scam as it is not a legitimate Vesta Healthcare email. You might see things from a similar domain address, but with a slight misspelling, for example. We have no responsibility for any communication that does not come from the https://vestahealthcare.com domain, and we strongly advise that you not provide information or respond if not from the legitimate Vesta Healthcare domain. If you have any concerns that outreach might not be legitimate, please reach out to [email protected] for confirmation.

Title: HIM Coder CCS RHIT or RHIA preferred – 1st Shift – (Full Time, Remote)

Location: USA – Remote

Job Description

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that’s wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community.

If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we’ve received multiple awards for quality, safety, and outstanding work environment.

In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we’re committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We’re also affiliated with Penn Medicine for cancer and neurosciences, and the Children’s Hospital of Philadelphia for pediatrics.

Location:

100% Remote

Currently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only.

Employment Type:

Employee

Employment Classification:

Regular

Time Type:

Full time

Work Shift:

1st Shift (United States of America)

Total Weekly Hours:

40

Additional Locations:

Job Information:

Summary:

Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding.

Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards.

Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation.

Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment.

Position Responsibilities:

Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and rules/conventions.

Records coded include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Sequences principal (or first-listed) diagnosis and principal procedures according to documentation found in the medical records and UHDDS definitions.

Utilizes ongoing knowledge and reference material regarding DRGs to validate DRG assignments.

Accurately utilizes written federal and state regulations and written guidelines regarding definitions and prioritizing of abstract data elements to assure uniformity of database.

Records abstracted include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Verifies and/or abstracts required data into computer system according to procedure. Utilizes equipment and processes appropriately, to ensure efficient coding and abstracting; utilizes the established downtime procedures as needed.

Participates in maintaining DNB and accounts receivable goal.

Maintains department level competencies. Participates in performance improvement activities.

Position Qualifications Required / Experience Required:

Minimum of two years inpatient records coding experience or equivalent.

Ability to perform functions in a Microsoft Windows environment.

Ability to be detailed oriented and perform tasks at a high level of accuracy.

Ability to make sound decisions.

Demonstrate good communication and team work skills.

Previous experience with an electronic legal health record system preferred.

Required Education:

High School Diploma or GED required.

Knowledge of Anatomy & Physiology/ Medical terminology required.

Coding education preferred or equivalent in years of experience.

Training/Certifications/Licensure:

AHIMA Certification: Certified Coding Specialist (CCS) Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT) preferred

Multispecialty Remote Pro Fee Coder – Wound Care

locations

Remote – USA

time type

Full time

job requisition id

R3773

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).

The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder may interact with client staff and providers.

DUTIES AND RESPONSIBILITIES:

• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee Hospitalist; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type.
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes 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 all HIPPA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS 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.

SKILLS AND QUALIFICATIONS:

• Candidates must successfully pass pre-employment skills assessment. Required:
• An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
• Two years of recent and relevant hands-on coding experience
• Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets
• Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards
• Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel)
• Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers

PREFFERED SKILLS:

• Recent and relevant experience in an active production coding environment strongly preferred
• Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
• Experience using EPIC(a plus)

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 – $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

California Job Candidate Notice

Title: PRN Corporate Coder (Remote based in US)

Location: Dallas United States

Job Description:

Tenet Healthcare has immediate needs for remote, home-based Corporate Coders to support the hospital business. Corporate Coders can be based anywhere in the country with home internet access.

The Corporate Coder (“CC”) functions under the direction of the Health Information Corporate Coding Manager. The CC is responsible for accurate coding and abstracting of clinical information from the medical record. The CC is responsible for maintaining standards for coding data quality and integrity, as well as productivity within established guidelines. The CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC’s and/or other projects where indicated.

• Accurately and productively code/abstract patient health documentation for Tenet facilities.
• Utilize coding abilities to review flagged cases, in CARDS and RevInt for coding accuracy.
• Assisting in coding quality reviews/audits and second level reviews as needed.
• Attends Tenet coding educations and maintains coding credentials.

Required:

• Associates or higher-level degree in a Health Information Management discipline.
• 1-3 years inpatient coding experience.
• Skilled and working knowledge of MS Office suite.
• Strong technical background and electronic medical record experience.
• Successful completion of at least one AHIMA (American Health Information Management Association) certified program with achievement of the correlating professional credential preferred (RHIA, RHIT, and / or CCS, etc.).

Preferred:

• Bachelor’s or higher-level degree in a Health Information Management discipline.
• 3+ years of inpatient coding experience.
• Coding experience in a large, complex health system.

A pre-employment coding proficiency assessment will be administered.

Compensation

• Pay: $26.40 to $39.00 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Observed holidays receive time and a half.

Benefits

The following benefits are available, subject to employment status:

• Medical, dental, vision, disability, life, AD&D and business travel insurance
• Paid time off (vacation & sick leave)
• Discretionary 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
• For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act is available.

Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

#LI-DM4

2403026910

Pay Range: $26.40 – $42.20 hourly **Inidual wages are determined based upon a number of factors including, but not limited to, an inidual’s qualifications and experience

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified iniduals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

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Remote Pro Fee Coder – Vascular Surgery

location

US – Remote (Any location)

Full time

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Vascular Surgery Pro Fee Coder must be proficient in surgical coding for Vascular surgery cases. E/M experience is also required. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager, the coder will accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

This position is full time and 100% remote.

Responsibilities:

• Demonstrates the ability to perform quality surgical coding on Vascular surgery and other cardiovascular chart types as assigned.

• Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. • Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. • Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. • Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary. • Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines. • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility. • Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. • Responsible for coding or pending every chart placed in their queue within 24 hours. • Coders are responsible for checking the Guidehouse email system at least every two hours during coding session. • Coders must maintain their current professional credentials while working for Guidehouse. • Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. • Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) • It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content. • Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services. • Communicates problems or coding principle discrepancies to their supervisor immediately. • Communication in emails should always be professional (reference e-mail policy).

What You Will Need:

• High School Diploma

• 3+ years of surgical coding with E/M experience

• 2-3 years coding Vascular procedures.

• CPC certification from AAPC • EMR experience • Must maintain credential throughout employment • Advanced knowledge of Excel, Word and PowerPoint •Knowledge & experience with Federal & State Coding regulations and Guidelines

What Would Be Nice To Have:

• Multi-specialty surgical coding experience

• Epic experience

#IndeedSponsored

The annual salary range for this position is $49,800.00-$74,700.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a erse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Title: Coder II

Location: United States

Job Description: Under the direct supervision of the Hospital Coding Supervisor, the Coder II will be responsible for abstracting and coding medical record documentation across various departments, including inpatient, outpatient, clinic, and emergency services. This role involves selecting and sequencing the appropriate ICD-10-CM/PCS, HCPCS, and CPT-4 codes to ensure accuracy and compliance with coding guidelines. The Coder II will contribute to coding compliance by ensuring timely and accurate assignment of codes for diagnoses and procedures, including the final DRG assignment.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC002307 SYS – Hospital Coding

Pay Rate Type

Hourly

Pay Grade

Health-25

Scheduled Weekly Hours

40

Work Shift

Job Description

Job Summary: Under the direct supervision of the Hospital Coding Supervisor, the Coder II will be responsible for abstracting and coding medical record documentation across various departments, including inpatient, outpatient, clinic, and emergency services. This role involves selecting and sequencing the appropriate ICD-10-CM/PCS, HCPCS, and CPT-4 codes to ensure accuracy and compliance with coding guidelines. The Coder II will contribute to coding compliance by ensuring timely and accurate assignment of codes for diagnoses and procedures, including the final DRG assignment.

Key Responsibilities:

· Abstract Medical Records: Review and abstract medical record documentation from inpatient, outpatient, clinic, and emergency department settings.

· Code Selection: Accurately select and sequence ICD-10-CM/PCS, HCPCS, and CPT-4 codes based on the medical record documentation.

· Compliance Adherence: Follow coding compliance guidelines to ensure the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedures.

· Final DRG Assignment: Assign the final Diagnosis Related Group (DRG) for inpatient cases, ensuring accurate grouping and coding.

· Documentation: Maintain detailed and accurate records of coding assignments and modifications, ensuring all coding decisions are well-supported by the documentation.

· Continuous Learning: Stay updated with current coding standards, regulations, and industry changes to ensure ongoing compliance and accuracy.

· Quality Assurance: Participate in quality assurance activities, including coding audits and reviews, to support continuous improvement in coding practices.

Qualifications:

· Must have one of the required credentials RHIA, RHIT, CCS or CPC.

· Minimum of 1 years of coding experience in a hospital setting.

· Proven experience in training or education, preferably in a healthcare environment.

· Expertise in ICD-10-CM/PCS, HCPCS, and CPT4 coding systems.

· Strong understanding of medical terminology, anatomy, physiology, and disease processes.

· Excellent communication and interpersonal skills with the ability to effectively convey complex information to erse audiences.

· Detail-oriented with strong analytical and problem-solving skills.

· Ability to work both independently and collaboratively within a team environment.

· Proficiency in using electronic health record (EHR) systems and coding software.

Preferred Qualifications:

· Experience in training and quality assurance of coded data.

· Experience in curriculum development or instructional design.

· Familiarity with DRG assignment and APC reimbursement methodologies.

Work Environment: This position operates primarily in a remote office environment. The Coder II may be required to sit for extended periods and use computer equipment and software extensively.

Additional Job Description

N/A

If you like working with energetic enthusiastic iniduals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program

Title: PB Medical Coder – Urology

Location: SC-Charleston

Job Description: Job Description

Job Description

Insight Global is searching for Experienced PB/Pro Fee Medical Coders to support one of our largest healthcare clients in the Southeast. These iniduals will sit remotely and work in EST, but will have flexibility of work schedule to start anytime between 6AM-9AM EST.

This position will be specifically dedicated to the Urology work queue. This person needs to be someone that has dealt with complex urology surgery cases, not just E/M and simple office visits. You will also be responsible for coding denials, assisting with coding audits and collaborating with teammates for complex cases.

To qualify for this role, you must hold an active CPC, CCS, RHIA or RHIT certification and must be certified through either HEMA or AAPC

Pay range for this role is $25-$35/hour.

We are a company committed to creating erse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process,

-5+ years of experience coding Urology surgery

-Active CPC, CCS, RHIA or RHIT Certification -Expert level pro-fee coder with complex Urology surgery medical coding

Nice to Have Skills & Experience

-Academic Healthcare Facility Coding Experience

-CUC Certification (Certified Urology Coder)

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.

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Medical Coding & Billing Specialist

United States

About us

Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct inidualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections and maternal mortality; we improve outcomes and reduce healthcare spend.

Role Description

Your north star: In this role, you will be accountable for the accurate and timely submission and reconciliation of claims for the Pomelo medical practice including:

• Reviewing and submitting claims within payor guidelines to ensure timely and accurate filing
• Reporting on aging encounters, and partnering with clinicians to resolve them, ensuring compliance with internal best practices
• Querying the clinical team to obtain additional, clarifying documentation to improve the completeness of encounter data
• Resolving and appealing claims denials, and working with the Revenue Cycle Manager to improve workflows and optimize our claim submission process
• Reconciling ERAs by resolving holds, manually posting payments and adjudicating claims
• Collaborating with other teams to identify and update missing patient demographic and insurance data
• Accurately applying appropriate CPT and ICD-10 codes for each encounter, adhering to federal and state rules and agreed-upon coding guidelines with our partner MCOs

Who you are

• 3+ years experience in revenue cycle support role
• 2+ years outpatient medical coding experience preferably in primary or maternal care
• Coding certification not required but a plus
• Proficiency in using medical billing software and EHR systems
• Proficient in Microsoft Excel and/or Google Sheets
• Independent, critical thinker with meticulous attention to detail

Why you should join our team

By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you’ll learn, grow, be challenged, and have fun with your team while doing it.

We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first.

At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need erse perspectives to reflect the ersity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Inidual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current hourly range is $20-$25 per hour. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.

#LI-Remote

Title:Registered Nurse Coordinator – RN

Location: NJ-Livingston

Job Description:

The Transplant Procurement Coordinator is a registered nurse trained in the evaluation of deceased donor organs offers, waitlist review, patient selection, post-transplant patient management and donor-recipient matching. The ability to coordinate, plan, and follow-up organ offers, procurement schedules/organ perfusion/organ transport, and timely communication with patients, Transplant Nephrologists, Transplant Surgeons, Transplant APPs/other team members as well as hospital OR personnel and Logistics/Bed Management is required. Functions effectively to effectively review organ offers and maximize acceptance of organs for transplantation in compliance with local, regional, national policies, in a responsible and professional manner. This new unit is in operation for 24 hours, 7 days per week.

Qualifications:

Required:

• Registered Nurse in the state of New Jersey
• Clinical experience in Medical-Surgical Unit, Emergency Room, ICU, OPO and/or transplantation preferred
• The ability to apply knowledge of the Organ Procurement Transplant Network (OPTN), and Centers for Medicate/Medicaid Services (CMS) Conditions of Participation (CoP) for Transplant Programs, and CBMC Transplant Division Policy and Procedures is required to ensure hospital and transplant program adherence to all regulations.
• Receives all organ offers through the OPTN system, requiring disposition of organ offer to include an acceptance or turn down with refusal codes within 60 minutes of electronic offer.
• Review and interpret the organ match run to identify the appropriate Cooperman Barnabas Medical Center (CBMC) recipients, identify when offer must bypass CBMC or when CBMC has secured local backup.
• Understands and communicates effectively waiver information on each organ offer, understanding the type of waiver, and implications for payment of organ.
• Presents critical aspects of the organ offered to the Transplant Nephrologist and/or Transplant Surgeon, focusing on donor history, hospital course, medications, and major treatment intervention, laboratory reviewing including serology, and blood type.
• This position is 100% pre-transplant work.
• Required to seek and maintain in depth knowledge of transplant nursing.
• Excellent interpersonal and communication skills required
• Proficiency with computer
• Completion of all orientation programs

Preferred:

• Bachelor s degree preferred
• Certified Clinical Transplant Coordinator (CCTC) certification preferred

Certifications and Licenses Required:

• New Jersey Registered Nursing License
• Basic Life Support Certification is required and maintained (American Heart Association Only)

Scheduling Requirements:

• Day Shift, 12.5 hr. shift
• Full-Time, 37.5 Hours Per Week
• Rotation to work every other weekend required
• Holiday rotation required
• Coordinator can work partially or fully remotely, with required in-person attendance for training at CBMC, and quarterly in-person staff meetings at CBMC or more, as required to maintain quality performance.
• On-site training is provided during the 8-hour day shift (Monday-Friday).

Essential Functions:

Coordinates all aspects of the evaluation/listing process for deceased donor and living donor transplantation for Chronic Kidney Disease patients. Acts as liaison between Cooperman Barnabas and all referring dialysis centers and referring MDs. Ensures continuity of care through effective communication and collaboration with the multidisciplinary team in all areas of the transplant department. Use an understanding of the principles of growth and development to assess each patient s age-specific needs and provide age-specific treatment. 100% of job responsibilities are pre-transplant no time study is required.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time, with or without notice.

Benefits and Perks:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners, such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health. RWJBarnabas Health aims to truly make a unique impact on local communities.

Title: Nurse Supervisor (RN), Virtual Care Support

Location: Remote

Type: Full-time

Workplace: remote

Category: Virtual Care Support

Job Description:

The RN Supervisor, Virtual Care Support is a role that will assist the Service Line and Clinical Managers in overseeing and leading the day-to-day efforts of the Registered Nurses and Certified Medical Assistants working on our Virtual Care Support team. Central to this role will be ensuring clinical accuracy and quality, while maintaining key performance indicators. This role will typically be 100% administrative, but with the expectation of supporting the needs of the team during periods of surge or unexpected low headcount.

Position will have direct management responsibilities for ~ 15-20 RNs and CMAs

Schedule: Monday – Friday

Shift: 8:00AM – 5:00PM PST (Pacific Standard Timezone)

Supervisory Responsibilities:

• • Provide workflow management, guidance, coaching, and display subject matter expertise to provide thorough support for the team
  • Demonstrate thorough understanding of and monitor service levels and performance guarantees on an hourly/daily basis
  • Provide training, support, technical and clinical leadership to team members
  • Assist the VCS manager in workflow enhancement changes, pilot projects, quality reviews, inidual and team coaching, and tracking data/outcomes
  • In collaboration with clinical liaison, monitor attendance and schedule adherence and ensure staffing levels are met and maintained for daily coverage requirements
  • Meet 1:1 monthly with direct reports for ongoing review of productivity, quality review and professional development
  • Assist the training and quality team in onboarding and call/case reviews, as needed
  • Serve as an escalation point for workflow questions/clarifications and complex cases
  • Assist the clinical team with day-to-day work and direct patient care, when needed
  • Display focus towards continuous improvement, suggests alternative solutions, as well as new ideas that improve team productivity, workflows, member experience, and efficiency aligning directly with our company values and goals

Qualifications:

• • Bachelor’s Degree in Nursing
  • 2+ years experience in primary or ambulatory care setting
  • Minimum of 2 years Supervisor/Managerial experience required
  • Registered Nurse, in good standing with current state of licensure
  • Maintain a compact state license and be willing to get licensed in non compact states
  • California state licensure highly preferred
  • Excellent organizational skills and attention to detail required
  • Previous quality and workflow management experience preferred
  • Data-driven and proficiency/comfort in using Google Sheets, Text Expander, and other tools to evaluate and optimize the standardization of care across our growing team
  • Previous management experience preferred
  • Ability to be agile and balance multiple priorities while maintaining positive and professional attitude
  • Demonstrates professional, appropriate, effective, and tactful communication skills, including written, verbal and nonverbal
  • Strong ambition and internal drive is essential to this position

The United States base salary range for this full-time position is $81,260.00 – $113,760.00 + equity + benefits.

Starting base salary for the successful candidate will depend on several job-related factors, unique to each candidate, which may include, but not limited to, education; training; skill set; years and depth of experience; certifications and licensure; business needs; internal peer equity; organizational considerations; and alignment with geographic and market data. Included Health reserves the right to modify these ranges in the future. For further information, please ask your Recruiter.

In addition to receiving a competitive base salary, the compensation package may include, depending on the role, the following:

Remote-first culture

401(k) savings plan through Fidelity

Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)

Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents

Generous Paid Time Off (“PTO”) and Discretionary Time Off (“DTO”)

12 weeks of 100% Paid Parental leave

Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance

Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)

11 Holidays Paid with one Floating Paid Holiday

Work-From-Home reimbursement to support team collaboration and effective home office work

24 hours of Paid Volunteer Time Off (“VTO”) Per Year to Volunteer with Charitable Organizations

#LI-Remote

Title: Remote NAL Triage RN 1 weekday shift 4p-10p+ Sat & Sun rotation

Location: Remote Remote US

IntellaTriage continues to GROW!

IntellaTriage Nurses enjoy the benefits of working from home, providing care, without the stress and expense of commuting each day!

**MUST have or be willing to obtain a Compact RN license

**MUST live in/work from a Compact US state

**Minimum of 3 years as a Nurse

**Minimum of 1 year of experience in a fast-paced environment (i.e. ED, Critical Care, Surgical Services, Med/Surg, etc.)

**Must have high speed internet

**Must be tech savvy, enjoy a fast-paced environment, and have no concerns typing

**Must be available to work 2 out of every 3 weekends & 1 weekday per week.

> 1 weekday shift 4p-10p (shift times are set/weekday flexes)

> 2 of every 3 weekend rotation (Sat & Sun) alternating 7:30a-4p/ 3:30p-12a CST

Our Nurse Advice Line Nurses:

• Have proven experience in a fast-paced, critical-thinking environment; ED, Critical Care, Surgical Services, etc.
• Work a minimum of 1 shift per weekday (Mon-Fri).
• Preferred scheduling for their weekday requirements.
• Work 2 weekends or every 3 weeks, both Saturday and Sunday on those weekends with rotating times. (For example: weekend 1: work, weekend 2: work, weekend 3: off)
• Train for 3 weeks. (Week 1: Day shift on Monday & Tuesday, & Wednesday then train 8-10 shifts during Week 2 & Week 3 primarily during the shift you are hired for, based on our Trainers schedule and availability).
• Must have a compact license and live in that compact state. (no states with pending legislation or future implementation dates are considered current compacts)

What is important to know?

We are growing and excited to be able to support our clients nursing staffs in the field who need time to focus on work-life balance, as well, while being able to trust that we are there to support them and their patients during nights and weekends!

• Patient care is #1. We do not have call quotas. We employ the best nurses to provide the best care.
• When our patients or their families reach our triage line, they immediately speak directly with a nurse.
• We do not have PRN positions.
• We are super busy. If you like fast-paced roles, keep reading

• Any nurse may pick up additional shifts, if shifts are available for the clients they are trained to support.
• We will provide you with a laptop and headset.
• Nurses are required to provide their own high-speed internet (only fiberoptic or coaxial cable internet is compatible with our remote call center technology).
• Our laptop is required to be directly connected to your modem. Working through Wi-Fi is not compatible with our systems. The calls will drop.
• It is essential to have a home office or quiet space free from noise or distractions in your home (Privacy/HIPAA compliant space is required).
• Training is provided remotely and is paid; no travel is required in this role.
• MUST be able to follow instructions (verbal and written) and be comfortable with technology (tech savvy).
• Must remain in good standing and ensure their home state license remains active.
• IntellaTriage will cover the cost of non-compact state licensure based on the client(s) that are assigned for support.
• All nurses must have a compact license and reside/work in that state.
• Shift prep is a minimum clock-in of 30 minutes prior to taking calls; this is paid time to prepare.
• Once calls roll to the next team/shift, our nurses remain clocked in and complete any remaining charting before leaving for the day. This may take 30 minutes or this may take 2 hours. It depends on the pace of the calls received during that shift and the pace of your ability to quickly navigate technology and type.

Sound exciting to you?

Then put those days on the floor and that commute or hours on the road between patients homes behind you! Our nurses enjoy working from their own home office; no more purchasing scrubs, expensive takeout, and the large gas bill along with extra wear-and-tear on your vehicle.

Most importantly, working remotely enables you to spend more time with those you love!

Requirements

• MUST have or be willing to obtain a Compact Nursing License(States with pending legislation or future implementation dates are not considered current compacts until the implementation date.)
• 3+ years as a RN
• Experience in a fast-paced environment: i.e. ED, Surgical Services, or Critical Care.
• Must be comfortable with technology and accessing multiple applications remotely to perform documentation during calls.
• Ability and comfort typing.
• Fluency in English is required, additional languages are a bonus.
• Must physically reside in the U.S. and be legally eligible to work for any employer.
• Must be able to complete the 3-week orientation and training (Schedule listed in this posting).
• Must be available to work Saturday & Sunday on your team’s required weekends; 2 of every 3 weekends.
• Holidays as they are required (rotation).
• Able to handle stress and multitask when calls are coming in (minimum of 5+ calls per hour on weekdays, and much higher on weekends).
• Able to communicate with patients and families with empathy while also maintaining adherence to client protocols.
• Must maintain CEUs as designated by the states you are answering calls in.
• Must attend any in-services, additional training on an as needed basis.
• Able to pass background check and nurse licensing check.

Benefits

All Remote Nurse Advice Line RN’s, once trained to their originally assigned team are at $23/hourly. All part-time nurses accumulate PTO, based on the number of hours they work (per year). All part-time nurses receive an additional 3-paid-sick-days per year. All part-time nurses are eligible to participate in our 401(k) plan.

Customer Success Manager

Req #584

United States

Job Description

About FinThrive

FinThrive is advancing the healthcare economy.

For the most recent information on FinThrive’s vision for healthcare revenue management visit finthrive.com/why-finthrive.

Award-winning Culture of Customer-centricity and Reliability

At FinThrive we’re proud of our agile and committed culture, which makes FinThrive an exceptional place to work. Explore our latest workplace recognitions at https://finthrive.com/careers#culture.

Our Perks and Benefits

FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits. For the most up-to-date offerings visit finthrive.com/careers-benefits.

About the Role

Impact you will make

The Customer Success Manager (CSM) is responsible for managing assigned Customers and supporting all aspects of Customer management activities. This role is accountable for Customer satisfaction and value realization as measured by Gross and Net revenue targets, contract renewal and referrals for expansion opportunities. The CSM will collaborate with other colleagues from Customer Success, Sales, Support, Implementation, Product Management, Development and Marketing, as appropriate to serve the needs of their customers.

What you will do

• Adopt and utilize of resources provided to pro-actively monitor and manage Customer outcomes and success to include:
  • Gainsight
  • Salesforce
  • FinThrive Analytics
• Capture and track Customer value metrics and targets, to demonstrate achievement of said metrics/results and return on investment (ROI)
• Responsible for creating an account plan and Customer growth strategy in collaboration with Sales Executives
• Internally document at risk mitigation plans
• Provide leadership regular updates on assigned customers status leveraging internal tools to back up their (red, yellow, green) status
• Own that the CSM is a key role in Customer satisfaction and performance
• Accept responsibility/accountability for responding to all assigned Customer issues and tasks
• Take full responsibility for the account in Customer satisfaction, communication, and when needed, escalation
• Assure satisfaction among customer groups with the quality and amount of support provided by monitoring and responding appropriately to outcomes and feedback
• Identify opportunities for operational and process improvements related to the utilization and integration
• Manage all renewals and accurate listing of contract expiration dates and notification requirements
• Protect existing revenue and monthly analysis of revenue variances
• Serve as internal escalation point for issues regarding a customer’s contract or invoices
• Conduct annual reviews quarterly pulse checks with customers
• Possess a full and complete understanding of the internal control requirements within their area of ownership/responsibility. Responsible and accountable for internal control implementation and performance within their area of ownership/responsibility. Ensures proper internal control change management protocol is followed
• Meet and exceed quarterly and annual Customer revenue targets
• Comply with renewal process and meeting or exceeding annual renewal targets
• Identify growth opportunities within assigned Customer base
• Secure and increase references
• Foster high response rate and positive KLAS and Net Promoter survey scores
• Ensure Customer satisfaction, to include owning communication of value realization, as well as by managing and setting Customer expectations through remote Customer management and some though less frequent Customer travel
• Manage escalations from assigned customers

What you will bring

• Bachelor’s Degree
• 3+ years’ work experience in Customer Success Management or in RCM function of a hospital

• Executive presence and presentation skills

• Work autonomously, independently and as part of a team for collaboration
• Written and verbal communication skills, ability to synthesize complex issues and communicate into simple messages
• Experience interfacing with both internal team members and external Customers, as part of a solutions-based team
• Computer knowledge including MS Office (Outlook, Word, Excel, Power Point)
• Proactive self-starter. Autonomy and ownership of territory. Hustle
• Collaborative team player. Quick learner
• Travel: Up to 40-60%

What we would like to see

• Experience in healthcare RCM
• Knowledge of FinThrive products and services or competitors
• Knowledge of the healthcare industry, specifically revenue cycle management
• Experience using Gainsight
• Involvement with HFMA

FinThrive’s Core Values and Expectations

• Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive’s core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities
• Support FinThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, GLBA and other laws applicable to FinThrive’s business practices; this includes becoming familiar with FinThrive’s Code of Ethics, attending training as required, notifying management or FinThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

Physical Demands

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

Statement of EEO

FinThrive values ersity and belonging and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We’re committed to providing reasonable accommodation for qualified applicants with disabilities in our job application and recruitment process.

FinThrive Privacy Notice for California Resident Job Candidates

Know Your Rights

Pay Transparency Notice

FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.

© 2024 FinThrive. All rights reserved. The FinThrive name, products, associated trademarks and logos are owned by FinThrive or relat­ed entities. RV092724TJO

finthrive.com | FinThrive Careers | FinThrive Benefits & Perks | Physical Demands

Job Details

Pay Type

Salary

Travel Required

Yes

Telecommute Percentage

100

Credentialing Coordinator II

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Credentialing

Remote

•

ID: 2015384

•

Full-Time/Regular

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Supports all department activities related to the credentialing and recredentialing of Medical and Behavioral Practitioners and Organizational Providers (“Providers”), in accordance with the Plan’s policies and procedures.

Our Investment in You:

· Full-time remote work

· Competitive salaries

· Excellent benefits

Key Functions/Responsibilities:

• Independently reviews practitioner and facility credentialing files to ensure completion and accuracy of information, per Plan’s policies. Ensures all files are completed in a timely manner, and meets the appropriate turnaround times

• Initiates the collection of all pertinent information/documentation from the practitioner, facility administrator or appropriate office staff. Verifies credentials through the appropriate primary sources • Independently identifies substantive adverse issues and initiates further data collection from internal and external sources. Analyzes provider files to identify discrepancies with information. Creates thorough and complete summary profiles for Medical Director and Credentialing Committee review. • May assist with the department’s ongoing monitoring activities. Reviews appropriate reports and databases against the Plan’s provider networks and completes outreach to providers regarding licensure actions. • Reviews sanction and exclusion sources to ensure that providers going through initial credentialing or recredentialing are not currently debarred, suspended or otherwise excluded from participation in Medicare, Medicaid or any other federal or state health care programs. • May assist in managing internal provider data queues. • Organizes and maintains assigned electronic credentialing files. Responsible for updating credentialing information within Visual Cactus and the Onyx provider database. • Maintains detailed log of all pending work. • Supports special projects and completes other duties as assigned.

Supervision Exercised:

• None

Supervision Received:

• Close supervision is received weekly

Qualifications:

Education Required:

• Bachelor’s degree in healthcare administration, related field, or equivalent combination of education, training and experience is required

Education Preferred:

• Bachelor’s degree in healthcare administration, related field, or equivalent combination of education, training and experience

Experience Required:

• 3 or more years of credentialing experience in a health plan or a hospital medical staff services department

Experience Preferred/Desirable:

• 3 or more years of credentialing experience in a health plan or a hospital medical staff services department

Required Licensure, Certification or Conditions of Employment:

• Successful completion of pre-employment background check

Competencies, Skills, and Attributes:

• Strong oral and written communication skills

• Maintains an intermediate understanding of the National Committee for Quality Assurance (NCQA) accreditation standards, MassHealth, NH DHHS and other Federal/State credentialing requirements • Ability to interact with other departments within the organization, and with external audiences • Strong analytical skills • Ability to compose accurate and comprehensive file summaries • Accurate and detail oriented • Flexible and able to work with minimal supervision • Ability to manage multiple tasks and possess excellent organizational and time management skills • A strong working knowledge of Microsoft Office products

Working Conditions and Physical Effort:

• Regular and reliable attendance is an essential function of the position

• Ability to work overtime during peak periods • Work is normally performed in a typical interior/office work environment • Very limited or no physical effort required. Very limited or no exposure to physical risk

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Inidual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the ersity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Title: Coordinator II, DMC/EAC

Full-Time

Remote

Locations

Remote – U.S.A

United States of America, 000000, USA

Job Category: DMC/EAC

Job Description:

Company Information

At Advarra, we are passionate about making a difference in the world of clinical research and advancing human health. With a rich history rooted in ethical review services combined with innovative technology solutions and deep industry expertise, we are at the forefront of industry change. A market leader and pioneer, Advarra breaks the silos that impede clinical research, aligning patients, sites, sponsors, and CROs in a connected ecosystem to accelerate trials.

Company Culture

Our employees are the heart of Advarra. They are the key to our success and the driving force behind our mission and vision. Our values (Patient-Centric, Ethical, Quality Focused, Collaborative) guide our actions and decisions. Knowing the impact of our work on trial participants and patients, we act with urgency and purpose to advance clinical research so that people can live happier, healthier lives.

At Advarra, we seek to foster an inclusive and collaborative environment where everyone is treated with respect and erse perspectives are embraced. Treating one another, our clients, and clinical trial participants with empathy and care are key tenets of our culture at Advarra; we are committed to creating a workplace where each employee is not only valued but empowered to thrive and make a meaningful impact.

Job Overview Summary

Advarra is a clinical research compliance company. Biostatistical Services focuses on oversight of research through Data Monitoring Committees (DMC) and Endpoint Adjudication Committees (EAC). The DMC/EAC Coordinator II provides administrative, and operations support to the overall operations of DMC and EACs. Support is provided by administering DMC/EAC member engagement, onboarding, meeting management, minutes, preparation of materials, result letters, and all other aspects of administering the DMC / EAC committee process. This position will also offer general administrative support and back-up coverage for other operations staff.

Job Duties & Responsibilities

• Works directly with DMC/EAC Committee Members to organize meetings, collect and post data packets for Committee Members review meeting preparation.
• Communicates as directed with Sponsor Company project manager and safety teams to ensure all information is being provided to the DMC/EAC in a timely manner (i.e., SAEs, enrollment, etc.). Creates study update reports with information received and submits to Committee Members.
• Creates meeting reports for signature by Board Members via transcription.
• Creates notes to charter and memos as necessary to record action within the Committee and with the Sponsor.
• Maintains communication tracking sheets and flow sheets to aid in Committee management.
• Maintains secure extranet accounts.
• Meeting planning – web/teleconferences, in-person same day, in-person overnight.
• Data management – organize and post data packets to the Extranet and archive all data in computer files by study.
• Manages stipend and expense requests, creates payment reports and submits them for payment.
• Archives final documents for study close-out.
• Presents documents for signatures, collects signature pages and integrates into final reports.
• Fills any special requests of the DMC/EAC and Sponsor Project Manager within scope and alerts management when requests are outside of scope.
• Provide administrative support for DMC / EAC meetings.
• Facilitate written and oral communications with members and consultants for expert and consultation reviews.
• Plan, Schedule and manage video-conference meetings.
• Ensure meeting attendees are equipped with the information, tools, and documents necessary to effectively participate in assigned meetings.
• Record and transcribe meeting minutes, ensuring components as required by the appropriate regulatory body and Advarra operating procedures are accurately identified and documented.
• Assist in Department and Company projects as they relate to Biostatistical Services.
• Provide coverage within the team and other teams as needed
• Quality control of digital images received from Sponsor via Sponsors platform
• Work within the electronic adjudication systems to gather data and create documents
• Other duties as assigned

Location

This role is open to candidates working remotely in the United States

Basic Qualifications

• Bachelor’s degree or associate degree with 2+ years industry or office administration experience
• 1+ years specific experience in regulatory committee administration
• Extremely detail-oriented and possess problem solving skills
• Ability to communicate effectively verbally and in writing, in English with attention to detail
• Excellent interpersonal skills to work effectively with others and provide high levels of customer service
• Ability to follow instructions and work independently as required; plan, organize, schedule and complete work within competing deadlines and priorities
• Ability to adapt to changes in office technology, equipment, and/or processes
• Demonstrated consistency and dependability in attendance, quantity, and quality of work
• Must be able to multi-task and switch to-and-from projects easily and with attention to detail

Preferred Qualifications

• 2+ years of DMC, EAC or Clinical Research Industry experience
• Exhibit an advanced knowledge and understanding of regulatory requirements and applications

Physical and Mental Requirements

• Sit or stand for extended periods of time at stationary workstation
• Regularly carry, raise, and lower objects of up to 10 Lbs.
• Learn and comprehend basic instructions
• Focus and attention to tasks and responsibilities
• Verbal communication; listening and understanding, responding, and speaking in English
• Specific vision abilities required by the job include color vision, close vision, distance vision, depth perception, and the ability to adjust focus in order to process medical images and other DMC/EAC materials
• This position requires regular oral/written interaction with clients, team members and management in English

Advarra is an equal opportunity employer that is committed to ersity, equity and inclusion and providing a workplace that is free from discrimination and harassment of any kind based on race, color, religion, creed, sex (including pregnancy, childbirth, and related medical conditions, sexual orientation, and gender identity), national origin, age, disability or genetic information or any other status or characteristic protected by federal, state, or local law. Advarra provides equal employment opportunity to all iniduals regardless of these protected characteristics. Further, Advarra takes affirmative action to ensure that applicants and employees are treated without regard to any of these protected characteristics in all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and separation from employment.

Pay Transparency Statement

The base salary range for this role is $36,200 – $61,500. Note that salary may vary based on location, skills, and experience and may vary from the amounts listed above. This position may also be eligible for a variable bonus in addition to base salary as well as health coverage, paid holidays, and other benefits.

Title: Him coding IP Trainer/auditor-hrly, FCH – Him – coding

This job is REMOTE.

Shift: Flexible 1st shift 7am to 5 pm

Job Description:

The IP Trainer/Auditor will utilize educational and team-building strategies, and a thorough understanding of ICD-10 coding conventions and DRG assignment to effectively train, educate and audit staff with the goal of maintaining a full complement of expertly trained inpatient coders enterprise-wide. Additionally, other duties as assigned.

EXPERIENCE DESCRIPTION:

A minimum of 3-5 years of HIM experience in an acute care environment coding inpatient records with DRG assignment is required.

Experience at an academic facility is preferred.

CDI (Clinical Documentation Improvement) experience is preferred

EDUCATION DESCRIPTION:

Associate degree in HIM or equivalent is required. In lieu of degree education or experience may be substituted on equivalent basis of three years of progressively responsible inpatient coding experience.

Bachelor’s Degree in HIM or equivalent is preferred.

LICENSURE DESCRIPTION:

Certified RHIA or RHIT or CCS is required.

ICD-10 Trainer certification is preferred.

Perks & Benefits at Froedtert Health

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan – 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

Title: ASU Coder II- Coding

Location: United States

Full Time – Day Shift

Job Description:

• Position Summary
• 100% remote, 40 hours per week
• This is the second level of a 4-tier career path. Under the general direction of the Coding Director, this position is responsible for the accurate assignment of ICD-10-CM and CPT-4 coding of diagnoses and procedures for outpatient medical records in the Ambulatory Surgery setting of a Level 1 Trauma Facility and Teaching Hospital. This position performs complex surgical coding in support of specialty or multi-specialty physician practices and OPPS and CAH hospitals. The position includes performing abstracting to determine accuracy and completeness of the outpatient record, utilizing the 3M Coding Reimbursement, other external encoder tools and Epic EMR systems to compile data. The Surgical Coder evaluates medical necessity and National Correct Coding Initiative edits and resolves them accurately. Data reported is used to meet licensure requirements, statistical purposes and reimbursement purposes.
• Required Minimum Knowledge, Skills, and Abilities (KSAs)
  • Education: Associates degree in science field strongly preferred with completion of an accredited program through AHIMA or AAPC.
  • License/Certifications: RHIT, RHIA, CCS, CCA, CPC, CPC-H,CASCC or CIRCC credential required.
  • Experience: Minimum of two (2) years of multi-specialty, preferably surgical coding experience, with CPT/ICD-9-CM/HCPCS/modifier coding for physician professional charges and a minimum of two (2) years’ experience in an acute care facility as a Clinical Coder II or equivalent. Required experience coding Surgical Observations, ASU, Professional Surgical CPT’s or any combination of these areas. Level 1 Trauma Facility coding experience preferred. This position performs complex surgical coding in support of specialty or multi-specialty physician practices and OPPS and CAH hospitals. Single Path Coding experience preferred.
  • Proficiencies: Must demonstrate an elevated level of knowledge of ICD-10-CM, CPT-4 and HCPCS coding guidelines and principles required. Employee has the ability to demonstrate competence and knowledge-base through the utilization of a standardized test with a minimum of 95% accuracy while meeting productivity requirements. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding. Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.
  • Specialized Knowledge: Strong ability to apply broad guidelines to specific coding situations, independently, utilizing discretion and a significant level of analytical ability. Advanced knowledge base of anatomy and physiology. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail. Experience working in an integrated delivery system, multi-hospital system a plus. Epic Experience preferred.

Coding Education Specialist III – REMOTE

Job ID2024-14928

Function

Revenue Cycle Management

Location

US-Remote

Employment Status

Full Time

Overview

The inidual in this role will serve as the key point of contact for coding and documentation information in the hospital and ASC setting, providing feedback, and charge capture resolution. Acts as a liaison between our Providers [Physician and/or CRNA) and the Physician Coding RCM Department. Coordinates communication and process information between Coding, Physicians/Providers, Medical Group Operations Leadership, Provider Compensation, Clinical Informatics, Compliance, and other partners.

This is a remote position; travel will be required.

Job Highlights

ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):

• Review and QA of professional coding accuracy and quality and educational feedback to coders and providers.
• Provide Clinical Documentation review and provider education to support correct coding and regulatory compliance.
• Provides on-site and or remote coding and documentation education and feedback related to anesthesia coding, payer requirements, performs regular rounding at sites and departments to provide adequate on-site support.
• Queries Physicians/Providers prompted by Physician Coding Department Coders to assist in resolving coding and documentation questions. Relays any coding changes, feedback, and education to Physicians/Providers as appropriate.
• Attends and provides coding and documentation information, as requested, to Physician/Provider and/or Clinic/Site Department meetings.
• Conducts Physician/Provider education that include coding and/or documentation topics, such as Documentation Specialist Provider on-line review meetings, and RCM ision meetings.
• Reviews and provides coding and/or documentation guidance, diagnosis, and charge capture preference lists as well as EMR templates.
• Under the Direction of QA/Education -Develops Physician/Provider specialty monthly reports to continually educate and communicate updates.
• Communicates Physician/Provider new services to Physician Coding RCM Department Leadership.
• Identifies and/or prompts documentation improvement as well as charge capture opportunities.
• Maintains current knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.
• Identifies and/or prompts documentation improvement as well as charge capture opportunities.
• Maintains current knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.
• Other duties as assigned.

REPORTING TO THIS POSITION: No direct reports

Qualifications

JOB REQUIREMENTS (Knowledge, Skills and Abilities):

• Typically requires 5 years of experience in expert-level Anesthesia professional coding and billing experience and at least 3 years of experience in education/training of licensed providers.
• Experienced Client Services Professional a plus
• Experience with LMS content creation preferred.

Licenses & Certifications

(Required)

• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC) or,
• Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA)

(Optional)

• Coding Specialist – Physician (CCS-P) 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
• (CHC) through the Healthcare Compliance Association (HCA)

EDUCATION/TRAINING/EXPERIENCE:

• High School Diploma required; Bachelor’s preferred, will consider a combination of education and work experience equivalent.
• Advanced training that includes the completion of an accredited or approved program.
• Clinical Licensing and experience welcomed.

PHYSICAL REQUIREMENTS:

• Requires prolonged sitting, some bending, stooping and stretching
• Must possess enough eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment
• Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations.
• Requires lifting papers and boxes weighing up to 35 pounds occasionally
• Requires dexterity to type at least 35 wpm.

WORKING CONDITIONS (environment and safety):

• Work performed in office environment
• Involves frequent contact with professional staff and managed care organizations
• Work may be stressful at times
• Interaction with others is frequent and often disruptive

disclaimer: The above job description has been written to indicate the general nature and level of work performed by employees within this classification. It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job.

Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.

Sr Medical Coder

Location: United States

Status (FT/PT): Full-Time Shift: Day shift

Description

**Eligible for $5,000 Sign on Bonus!

Find more than your next job. Find your community.

We’re northern Michigan’s largest healthcare system and we are deeply rooted in the communities we serve. That means that our patients are often our family, friends and neighbors – and it’s special to be able to care for them. And as one of the top healthcare systems to work for in Michigan by Forbes (American’s Best Employers by State 2022), we’re committed to your ongoing growth and development.

Why work as a Sr Medical Coder at Munson Healthcare?

• Flexible remote work schedule
• 1 on 1 training provided
• Opportunities for growth and development
• CEU offered
• Positive, supportive, and compassionate environments built on our organizational values.

Summary:

The facility Senior Coder/Abstractor is a critical member of the Revenue Cycle Team and is responsible for coding and abstracting inpatient and complex outpatient medical records for performance improvement, statistical research, administrative, and facility reimbursement purposes.

Coding is performed using utilizing ICD10-CM, ICD10-PCS and CPT-4 classification systems and is subject to the Official Guidelines for Coding and Reporting, AHIMA Code of Ethics “Standards of Ethical Coding”, AHA Coding Clinic and technical rules outlined by hospital guidelines.

The Senior Coder/Abstractor works closely with the Coding Analyst, Clinical Documentation Integrity Specialists, and the Regional Coding Operations Coordinator. Required qualities include teamwork, ability to code various patient types for a variety of Munson facilities, and flexibility in handling work assignments while maintaining productivity and quality standards. This position supports the timely and accurate submission of facility claims and works to achieve or exceed the established Accounts Receivable goals for the department.

What’s Required:

• Associate or Bachelor Degree in Health Information. CCS certification with a minimum of 2 years coding experience will be considered.
• Certification as a Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required. New graduates must obtain certification as Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) within 12 months of hire date.
• One to three years’ previous experience using ICD10-CM, ICD10 PCS and CPT-4 coding systems is required.
• Demonstrated ability to meet productivity and quality standards is required.

The Benefits of Working at Munson:

• Eligible for a $5,000 Sign on Bonus
• Competitive salaries
• Full benefits, paid holidays, and paid time off (up to 19 days your first year)
• Tuition reimbursement and ongoing educational opportunities
• Retirement savings plan with employer match and personal consulting
• Wellness plans, an employee assistance program and employee discounts

Surgical Coding Auditor

Industry: Coder – OP Surgical, Coder – Phy – General Surgery – 3 – Adv

Job Number: 3009

Job Description

SURGICAL CODING AUDITOR

Full Time OR Part Time I Remote

Are you a gifted medical auditor? Do you love to audit? This role may be the opportunity you’ve been looking for! We’re actively seeking talented Surgery Auditors with 5+ years of experience and AAPC or AHIMA certification; CPC or CCS-P to join our dedicated team. Job Description: This position plays an important role at CodingAID. The Surgery Auditor is responsible for auditing all CPT, HCPCS, ICD-10-CM, modifiers, units from the medical record documentation. Seeking experience in the following specialties: Bariactrics, Cardiothoracic, gen surg, GYN, GYN oncology, neurosurgery/spine surgery, ophthalmology, orthopedics, otolarngology, plastics, urology, kidney transplant Other responsibilities include accurately entering data into client software and/or Excel reports. Performing accurate auditing using applicable guidelines and client protocols and communicating with clients and/or providers as needed. Provide written feedback of auditing results as needed in the form of comments, summary findings and recommendations. Ensure compliance with federal and state laws, regulations, and standards related to health information and coding principles. Communicate with Project Manager as needed (i.e. schedule changes, daily assignments/work volume, coding questions, etc.). The contributions of the Surgery Auditor are invaluable to our organization, and each team member is made to feel welcome and appreciated for their unique talents and efforts. Job Requirements:

• To meet the needs of this role, we request candidates with the following qualifications apply:
• Must be a certified coder through AAPC or AHIMA (CPC or CCS-P credentials).
• A minimum of 5+ years’ experience required auditing CPT, E&M, HCPCS and ICD-10-CM codes from medical records.
• Requires advanced technical knowledge in specific surgical and medical specialties as assigned.
• Extensive knowledge of medical terminology.
• Experience in researching and applying coding rules and regulations.
• Must have experience with data entry of codes into a database and/or software tool.
• Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems.
• Excellent oral and written communication skills.
• Have a positive, respectful attitude.

A Little About Us:

CodingAID, a ision of Managed Resources Inc. is a nationwide leading provider of medical coding support, coding and compliance reviews, educational programs, recruitment, revenue cycle management, and many other managed healthcare solutions. We’re proud to have served healthcare organizations and medical groups for over 25 years with proven success in meeting their operational challenges. Learn more about our mission and vision here. CodingAID, a ision of Managed Resources Inc., is an Equal Opportunity Employer (EOE) M/F/D/V/SO

Bilingual (Spanish) Acute Care/Emergency Medicine Nurse Practitioner – Care OnDemand

locations

Remote USA

time type

Full time

job requisition id

R2085

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, erse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology – to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we’ve grown fast and now serve members across the United States. And we’ve just started. So join us on this mission!

Job Description

A bit about this role:

• This position is an amazing opportunity for a caring Nurse Practitioner (APRN) to help build and staff our growing telehealth medical group called Devoted Medical.
• Your primary focus will be delivering world class acute care to our members with emergent/critical illness. The Care OnDemand Nurse Practitioner will diagnose complex medical conditions, order and interpret diagnostic tests, and work with patients, families, and Care OnDemand team to establish care plans.
• One of Devoted Medical’s missions is to bring care to where our members live meaning your visits will be virtual telehealth care. On a day-to-day basis you will work closely with co-clinicians at Devoted Medical including physicians and APRNs as well as medical assistants, documentation experts, practice administrators, and our close social work and clinical nurse partners at Devoted Health Plan.

Required skills and experience:

• Role licensure and certification in good standing is required and the ability to get licensed in requested states within 90 days of hire date. You will be required to get licensed in additional states as needed.
• RN and APRN licenses are active and in good standing.
• Active BLS certification.
• Must be bilingual in Spanish/English.

Desired skills and experience:

• Experience in primary care, internal medicine, urgent care, emergency room, and/or geriatrics.
• Experience performing visits over telehealth video platforms.
• Experience in managing acute/chronic disease exacerbations including CHF exacerbations, diabetic emergencies, COPD exacerbations and hypertensive emergencies.
• A strong desire to continue practicing acute care – you believe in the mission of bringing care to where the patient lives.

Your Responsibilities and Impact will include:

• Performing Care OnDemand (acute care) visits including evaluating and diagnosing acute illnesses, ordering/interpreting diagnostic testing, establishing care plans including prescribing appropriate medications, and assessment for quality of care (STARS/HEDIS) interventions as well as social and home health/DME needs.
• Work closely with the member’s care team including their PCP, specialists, and other Devoted team members including pharmacy, clinical nursing, and social work as well as interfacing with family members and caregivers in order to coordinate care for the member and deliver a collaborative care plan.
• Utilize our home grown electronic health information system for visits while also providing feedback on how to improve the interface.
• In certain geographies, there will be a weekend on-call component to support our clinical nurses who triage calls from our members during the weekend.

Salary range: $110,000 – $130,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the inidual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more….

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a erse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value ersity and collaboration. Iniduals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Title: Nurse Practitioner – Bilingual – $7,500 Sign On Bonus Offered

Location: United States

Job Description:

Nurse Practitioner – Bilingual – $7,500 Sign On Bonus Offered

Job Category: Clinical

Requisition Number: NURSE003356

Posting Details

• Posted: August 9, 2024
• Full-Time

• Locations

  Showing 1 location

  Yuma

  Yuma, AZ 85365 / 85350 / 85349 / 85364, USA

  +1 more locations

Job Details

Description

Job Description: Nurse Practitioner – Bilingual

*Must be bilingual (English/Spanish)*

*There is a $7,500 Sign On Bonus offered!*

*Paid Relocation Assistance Offered!*

Monogram Health is looking for skilled Nurse Practitioners and Physician Assistants eager for the opportunity to make a difference in patients’ lives. The Advanced Practitioner at Monogram Health is a key member of an integrated Care Team which includes a Registered Nurse and a Social Worker. The patients we serve often struggle with multiple serious diseases. Our Nurse Practitioners and Physician Assistants help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes.

Your Impact

Using your skills in this position will allow you to deliver personalized compassionate medical care to iniduals mainly with CKD and/or ESRD/ESKD. You will also be responsible for caring for patients, maintaining accurate and current patient records and scheduling, and administering follow-up appointments to patients as required. Your gifts as a healthcare professional are urgently needed. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do.

Highlights & Benefits

• Flexible scheduling with a hybrid and in-home model
• Value-based care, patient-focused and allows you to spend time with those in your care
• Competitive compensation consistent with MGMA guidelines
• Comprehensive medical, dental, vision and life insurance
• Paid vacation and holiday time
• 401(k) plan with matching contributions
• Paid relocation assistance- location and case dependent

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for iniduals with chronic kidney and end-stage renal disease.

Roles and Responsibilities

• Conducts assessments, which includes comprehensive annual wellness exams on patients both in the patients’ home and in the virtual environment
• Counsels and educates patients and families about benefits and programs available to help them live healthier lives
• Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan
• Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services
• Completes all documentation and paperwork in a timely manner
• Maintains quality of care standards as defined by the practice
• This position will not be office-based but will be remote in state in which employed and will need to attend periodic training/meetings outside of that state
• Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first
• Prescribe medications, order tests, and collaborate with patient’s Monogram physician
• Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily
• Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing
• Assists patients with enrolling to access educational videos
• Participates in the integrated care team meetings
• Knowledge of disease diagnosis and prevention
• Make assessment of patient’s health status
• Develop treatment plan
• Implement a plan consistent with appropriate plan of care
• Follow-up and evaluate patient’s status
• Other duties as assigned

Position Requirements

• Bilingual (English/Spanish) required
• Active and unrestricted Registered Nurse and Nurse Practitioner or Physician Assistant license
• Board certified for appropriate licensure (NP: ANCC/AANP; PA: NCCPA)
• Current and unrestricted DEA certificate
• Ability to work without direct supervision and practice autonomously
• Access to transportation, a valid driver’s license, and car insurance
• Must be proficient with medical instruments and equipment required by the work
• Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology
• Ability to communicate effectively in verbal and written form with retail and medical partners at various levels, patients, family members, physicians and representatives of the community
• Sound understanding of all federal and state regulations including HIPAA and OSHA
• 2 or more years of direct patient care required
• Managed Care/IPA/Health Plan experience
• Experience conducting annual wellness visits or similar comprehensive visits virtually or in the home

Qualifications

Licenses & Certifications

Preferred

Adv RN Practitioner

Adv Practice Nurse Pract

Remote Nurse Practitioner – (Bi-lingual, Spanish)

Remote

Job summary:

The Nurse Practitioner for CareBridge is a key member of the clinical team and is responsible for providing primary and urgent health care primarily via telehealth modalities to patients who receive Home and Community Based Services (HCBS) through state Medicaid programs. The Provider works closely with the family, natural supports, paid caregivers, specialty, and primary care physicians to provide virtual and occasional in-person care, aimed at ensuring patients receive the necessary care to keep them home.

Responsibilities:

• Provide compassionate care to erse patients and their families.
• Manage the care of iniduals with a multitude of health problems ranging from primary care to urgent care issues.
• Thrive as a member of the interdisciplinary team and facilitate the continuum of care.
• Deliver cost-effective, high-quality care to patients.
• Perform follow up and check in with patients to monitors chronic conditions to minimize exacerbations or treat in place.
• Completes unplanned, urgent, and/or emergent contacts as needed to meet patient needs.
• Adjusts visit frequency and schedule based upon patient needs.
• Addresses Advance Care Planning proactively; identifies surrogate decision maker (POA, Health Proxy, etc.).
• Manages patient’s medical care as appropriate including:
  • Orders and monitors of diagnostics including laboratory studies, radiological studies, etc.
  • Refers to appropriate specialists or community services, i.e. Therapy, DME
  • Addresses recommended preventive and quality measures; acts to close or facilitate potential care gaps
  • Identifies, assesses, diagnoses, treats acute changes of condition
• Manages medication therapy effectively:
  • Reviews and reconciles medications each visit
  • Avoids high-risk medications
  • Prescribes medication, adjusts dosages, discontinues medications as appropriate
  • Simplifies medication regimen for improved adherence and safety
• Communicates effectively with entire care team including the patient’s community primary care provider and health plan care/service coordinator.
• Provides effective patient education using the Teach Back technique.
• Documents all patient encounters (in-home and telephonic) per documentation standards.
• Participates in clinical case conferences.
• Participates in on-call coverage for patient care.
• Maintains excellent punctuality and attendance during work hours.
• Other duties as assigned.

Qualifications:

• Fluent in Spanish
• Holds active, unencumbered Advanced Practice license
• Credentialed in adult, family, or geriatric care Has active DEA license
• Preference for: Developmental Disabilities Nurse certification
• Experience in care of adult, chronically ill patients
• Two or more years of practice experience of adult and chronic conditions
• Working knowledge of computers and ability to document effectively and efficiently in an electronic system
• Preference given to NPs with active DEA, NPI and Medicaid #
• Candidates with experience working with patients with intellectual and developmental disabilities
• Must have an active compact RN license.

Those who thrive at CareBridge tend to possess these qualities:

• An entrepreneurial spirit. Must be a tenacious self-starter.
• Flexible and adaptable to a constantly changing workload.
• Must enjoy working in a fast-paced environment.
• A sense of humor and a down-to-earth nature.

Employment Type: Full-Time

Location: Remote

About

CareBridge is a provider of technology and services that assist payers and states in caring for patients with physical, intellectual, and developmental disabilities. CareBridge’s services include 24/7-member support, benefit management, electronic visit verification (EVV) and data aggregation. CareBridge is led by a team of healthcare service and technology veterans and is headquartered in Nashville, Tennessee.

Title: Remote Utilization Management Review RN-SNF experience

Location: United States

Job Description:

Become a part of our caring community and help us put health first

The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Utilization Management Registered Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

• Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action.
• MUST have Compact License
• 3+ years of Skilled Nursing Facility experience
• Previous experience in utilization management required
• Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
• Comprehensive knowledge of Microsoft Word, Outlook and Excel
• Ability to work independently under general instructions and with a team
• Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Education: BSN or Bachelor’s degree in a related field
• Health Plan experience
• Previous Medicare/Medicaid Experience a plus
• Call center or triage experience
• Bilingual is a plus

Additional Information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and inidual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$69,800 – $96,200 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or inidual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, iniduals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Title: Coding Specialist III, FCH – Him – coding

REMOTE US

Job Description:

This job is REMOTE.

FTE: 1.000000

Shift: Flexible 1st shift

Job Summary:

Perform coding and related duties using established billing office policies in an accurate and timely manner. Primary contact with physicians, department administrators, hospital and/or clinical department administrators and their support staff and billing staff. Coordinates professional service billings for selected clinical departments. Coordination of provider education and training off staff. Assist in the analysis, development and implementation of new professional service lines related to coding, billing and charge capture.

EXPERIENCE DESCRIPTION:

A minimum of 3 years of coding experience including minimum of 1 year performing CPT and ICD coding.

Reviewing potential drug ersion and understanding of controlled substance management preferred.

Understanding of medication and controlled substance laws at federal, state, and local level preferred.

Experience with trending and analyzing data preferred.

EDUCATION DESCRIPTION:

High School diploma or equivalent is required.

SPECIAL SKILLS DESCRIPTION:

Comprehensive knowledge of E&M (Evaluation and Management) CPT coding, ICD-10 CM coding, payer and governmental policies.

Familiarity with HMO, Medicare, Medicaid and commercial insurance guidelines and medical terminology.

Must possess good oral and written communication skills.

Must be capable of dealing effectively with physicians, department administrators and their support staff, hospital/clinic administrators and their support staff and other contacts.

Must have the ability to work independently.

Basic PC skills. Epic experience is preferred.

LICENSURE DESCRIPTION:

Coding certification (CPC, CPC-A, CCS-P, CCA) and/or health information management credential, RHIT, RHIA.

ICD-10 proficient.

CRC certification preferred

Comprehensive knowledge of CPT, ICD-10 CM coding, payer and governmental policies preferred.

Perks & Benefits at Froedtert Health

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan – 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin’s only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a erse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.

Title: Remote Inpatient Coder III

Location: Remote United States

Datavant protects, connects, and delivers the world’s health data to power better decisions and advance human health. We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners.

By joining Datavant today, you’re stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We hire for three traits: we want people who are smart, nice, and get things done. We invest in our people and believe in hiring for high-potential and humble iniduals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.

We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace!

Responsibilities

What you will do:

• Assign diagnostic and procedural codes using ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes
• Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation
• Oversee and audit the work of Level 1 & 2 Coders, where applicable
• Champion documentation improvement opportunities and coding issues, facilitating resolution with relevant stakeholders
• Uphold an overall 95% coding accuracy rate and a 95% accuracy rate for MS-DRG assignments
• Maintain a minimum production of 1 chart per hour or site-specific productivity benchmarks
• Foster professional communication with colleagues, management, and hospital staff, while addressing clinical and reimbursement issues
• Occasionally travel for professional development or meetings, if required

Qualifications

What you will bring to the table:

• A minimum of 3 years of inpatient facility coding experience required
• CCS, RHIT, or RHIA required
• Strong verbal and written communication skills
• Level 1 trauma facility experience required

Bonus points if:

• Associate or Bachelor’s degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS
• Experience in computerized encoding and abstracting software

Perks:

• Full Benefits including a 401k Savings Plan
• Access to 20-24 free CEUs per year, provided by Datavant, to support your continuous professional development
• Compensation for AAPC/AHIMA dues
• Company-provided equipment including computer, monitor, mouse, etc
• Comprehensive training led by a credentialed professional coding manager
• Exceptional service-style management and mentorship (we’re in this together!)

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 Datavant 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.

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. Please note that 1 or more assessments may be required as a condition to being hired for this role. There is no COVID vaccine requirement for this role.

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated pay range for this role is $32 – $42 per hour.