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Title: Intake Specialist

Location: Remote – United States

JobDescription:

About Us

NOCD is the #1 telehealth provider for the treatment of obsessive-compulsive disorder (OCD). OCD is one of the most severe, prevalent, and misunderstood mental health conditions. NOCD creates access to online therapy for people with OCD through our telehealth platform. In the NOCD app, members can quickly access and schedule live, face-to-face video therapy sessions with our national network of licensed therapists that specialize in Exposure and Response Prevention Therapy (ERP) – considered the “gold standard” in OCD treatment.

At NOCD, we help people reclaim their lives with clinically proven OCD treatment, by removing barriers to OCD care, and reducing the stigma associated with OCD. Were changing the world and need other like-minded iniduals to accelerate and expand our efforts.

About the Role

• Member Advocates (Intake Specialists) represent the first impression of NOCD and your role would be to provide an extraordinary customer experience while communicating the services we have to offer.
• As a member of the Intake team, you will be responsible for inside sales, as well as patient advocacy.
• The Member Advocate is responsible for selling tele-therapy services to consumers who contact us via phone, text, and email, and completing the intake process to confidently and accurately get them started on the road to treatment.
• Job duties include inside sales of tele-therapy services, appointment coordination, registering and scheduling of therapy appointments as well as post-sales support.
• No cold calling.
• This is a goal-oriented team environment at a fast-growing company where we are all united in providing a top-notch patient experience.

Preferred Qualifications:

• Empathy-driven relationship building skills
• 1-3 years of inside sales or related experience
• Extremely detail-focused and technologically savvy, capable of using multiple software programs at once
• Ability to adapt in a fast-paced environment, common with start-ups and ever changing processes
• Ability to thrive under moderate pressure in a sales environment

Minimum Requirements:

• Must be perceived by the patient to be caring, courteous, professional, competent, and able to communicate effectively and with empathy
• Enhance the reputation of NOCD by creating a positive customer experience, including understanding and articulating the value of NOCD to the OCD community
• Demonstrate consistent, excellent customer service with both internal and external customers
• Demonstrate effective communication and interpersonal relation skills
• High School Diploma or GED required; Bachelor’s degree strongly preferred

What We Offer

• Casual, challenging, and engaging startup environment with an outstanding, mission-driven team atmosphere
• Competitive compensation and comprehensive benefits package including medical, dental, and vision coverage
• Hours: Thursday – Monday (off Tuesday/Wednesday); Weekday hours are 11:30 AM – 8 PM CST, Weekend hours are 9 AM – 5:30 PM CST

If you’re interested, we’d love to hear from you. Tell us why you’d be a good fit. A well written cover letter helps us understand who you are and what you want to be, and a resume tells the story of where you’ve been.

NOCD is proud to be an equal opportunity employer. We do not discriminate in hiring or any employment decision based on race, color, religion, national origin, age, sex (including pregnancy, childbirth, or related medical conditions), marital status, ancestry, physical or mental disability, genetic information, veteran status, gender identity or expression, sexual orientation, or other applicable legally protected characteristic. NOCD is also committed to providing reasonable accommodations for qualified iniduals with disabilities and disabled veterans in our job application procedures.

Applicants have rights under Federal Employment Laws. Family and Medical Leave Act (FMLA); Equal Employment Opportunity (EEO); Employee Polygraph Protection Act (EPPA).

https://www.treatmyocd.com/employee-privacy-notice

Title: Registered Nurse

Location: Remote – Work From Home

JobDescription:

**MUST HAVE EXPERIENCE WORKING WITH CLIENTS WITH EATING DISORDERS **

*MUST HAVE COMPACT LICENSE OR ELIGIBLE TO APPLY FOR ONE*

Job Summary:

The Registered Nurse (RN) will function as a member of a larger multidisciplinary treatment team. They will work closely with clients and monitor providers in order to provide the best care possible to our eating disorder clients. They will be responsible for assessing clients, contributing to the multidisciplinary treatment plan, and carrying out related nursing interventions. They will facilitate, and co-facilitate, groups throughout the week. They will also serve as a liaison with clients, families, providers, community organizations and other health related service agencies to provide quality care to our clients. The RN specializes in working with clients with eating disorders, is thoughtful, sensitive, respectful, flexible, and brings a loving, positive attitude to our expert Clinical Team. Shift times will vary and may include on-call hours at night and on weekends.

Major Area of Responsibility:

• Perform focused nursing assessments utilizing remote patient monitoring devices.
• Oversee a team of therapists, dietitians, and care partners providing recommended treatments for clients.
• Document all client interactions appropriately and within designated timeframes.
• Conduct weekly family coaching calls.
• Coordinate care and program services with patient, family, treatment team, and outpatient team.
• Educate clients, and family members when appropriate, regarding medical complications of eating disorders.
• Educate clients, and family members when appropriate, regarding psychiatric medications.
• Provide in-the-moment feedback by utilizing between-session messaging to motivate and support clients and families .
• Alert medical and clinical professionals to intervene during emergencies.
• Maintain strict client confidentiality.
• Participate in Staff meetings.
• Participate in scheduled Partnership Meetings.
• Participate in scheduled Family Partnership Meetings.
• Facilitate or co-facilitate groups as appropriate.
• Attend supervision and department meetings.
• Participate in initial and ongoing training.
• Provide case management for clients, ensuring effective communication with those involved in the recovery process, including school administrators, law enforcement, attorneys, etc.
• Communicate with clients, family members, team members, & outpatient teams in a timely and consistent manner.
• Give direction and direct feedback to different team members.
• Other related duties as assigned based on need.

Qualifications:

• Active, unrestricted, unsupervised RN license, with willingness to obtain additional RN licenses or Compact license in multiple states.
• 3+ years experience as an RN in an eating disorder or behavioral health setting.
• Minimum 1 year of supervisory experience.
• Strong communicator, both verbally and in writing.
• Ability to foster teamwork and create a cohesive work environment in a virtual setting.
• Experience treating clients with eating disorders and Disordered Eating preferred.
• Ability to demonstrate understanding of a variety of models and theories of eating disorders, trauma, mental illness, and related issues.
• Knowledge of philosophies, practices, policies and outcomes of models of treatment, recovery, relapse prevention, and continuing care for dually diagnosed populations.
• Understanding of diagnostic criteria for co-occurring conditions and ability to conceptualize modalities and placement criteria within the continuum of care.
• Understanding of erse cultures and gender specific issues and ability to incorporate needs of gender and culturally erse groups into practice settings.
• Excellent organizational and time management skills.
• Ability to prioritize workload and work independently.

Physical and Environmental Requirements:

• Employees are required to read, review, prepare and analyze written data and figures, using a computer or similar, and should possess visual acuity.
• This position answers and places telephone calls as well as video conferences and must be able to converse.
• Must be able to converse with colleagues via telephone and computer programs.
• Must be able to operate a computer and navigate applications within a smart-phone, iPhone, MacBook computer and/or tablet.
• Able to sit for the majority of shifts.
• Must have reliable internet connection.
• This is a work-from-home position. Work should be performed in a private, quiet space with minimal background noise.

Pay Range: $85-90k/Year

Title: REMOTE Full Time NY / Pennsylvania Licensed Nurse Practitioner (NP)

Location: Remote

JobDescription:

Nice to meet you, were 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 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. Its an insurance covered benefit, so its available to most adults with Caregivers free of charge to them.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing whats best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be able to:

• Conduct video visits for chronic care management and remote patient monitoring to create an appropriate care plan for the member
• Conduct care coordination and recommend/identify cost effective research based treatment and intervention
• Utilize strong clinical skills in physical assessment and chronic disease management for at risk adults and apply member specific Care Management and inidualized care planning
• Be comfortable with advanced care planning discussions with caregivers and members
• Serve as a consulting resource on care management practice as needed
• Attend meetings, training sessions and participates on committees as needed
• Possess a strong knowledge of clinical procedures, standards and quality control checks
• Possess a strong knowledge of medical conditions, interventions and treatment
• Provide members, caregivers and facility education
• Monitor the quality of members care and updates plan of care

Would you describe yourself as someone who has:

• Certified and licensed as a Nurse Practitioner in good standing in the state of New York and Pennsylvania (required)
• Masters or doctoral degree from an accredited institution for nurse practitioners (required)
• Medicare participation and ability to have the company bill for services on your behalf (required)
• Certification from ANCC (or equivalent) as an Adult, Family, Geriatric, and/or Acute Nurse practitioner (required)
• 1+ years of Nurse Practitioner Experience (required), qualified for independent practice in your licensed jurisdiction (preferred)
• 1+ years of telephonic triage or equivalent experience (required)
• 2+ years of clinical experience working with complex adult populations (required)
• Ability to practice independently with little clinical support (required)
• Comfort using technology like Google Suite, multiple EMRs, Slack (required)
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• Strong organizational skills, including the ability to prioritize
• Passionate about our mission to improve peoples lives
• Comfortable in a dynamic and always evolving startup environment

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 $125K – $130K annually. (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, we are constantly searching for the most dynamic and best talent to join our team with a mission of empowering caregivers in the home! You might see things from a similar domain address, but with a slight misspelling, for example.

CERTIFIED CODER – REMOTE

Molina Healthcare

Job ID 2024266

JOB DESCRIPTION

Job Summary

Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.

KNOWLEDGE/SKILLS/ABILITIES

• Performs on-going chart reviews and abstracts diagnosis codes
• Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
• Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
• Builds positive relationships between providers and Molina by providing coding assistance when necessary
• Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
• Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
• Contributes to team effort by accomplishing related results as needed
• Other duties as assigned
•   2 years previous coding experience
• Proficient in Microsoft Office Suite
• Ability to effectively interface with staff, clinicians, and management
• Excellent verbal and written communication skills
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
• Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance

JOB QUALIFICATIONS

Required Education

Associates degree or equivalent combination of education and experience

Required License, Certification, Association

• Certified  Professional Coder (CPC)
• Certified Coding Specialist (CCS)

Preferred Education

Bachelor’s Degree in related field

Preferred Experience

• Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
• Background in supporting risk adjustment management activities and clinical informatics
• Experience with Risk Adjustment Data Validation

Preferred License, Certification, Association

• Certified Risk Adjustment Coder – (CRC)
• Certified Professional Payer – Payer (CPC-P)
• Certified Coding Specialist – Physician based (CCS-P)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $17.85 – $38.69 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time

REMOTE Full Time NY Licensed Nurse Practitioner (NP)

at Vesta Healthcare

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 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.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be able to:

• Conduct video visits for chronic care management and remote patient monitoring to create an appropriate care plan for the member
• Conduct care coordination and recommend/identify cost effective research based treatment and intervention
• Utilize strong clinical skills in physical assessment and chronic disease management for at risk adults and apply member specific Care Management and inidualized care planning
• Be comfortable with advanced care planning discussions with caregivers and members
• Serve as a consulting resource on care management practice as needed
• Attend meetings, training sessions and participates on committees as needed
• Possess a strong knowledge of clinical procedures, standards and quality control checks
• Possess a strong knowledge of medical conditions, interventions and treatment
• Provide members, caregivers and facility education
• Monitor the quality of member’s care and updates plan of care

Would you describe yourself as someone who has:

• Certified and licensed as a Nurse Practitioner in good standing in the state of New York (required)
• Master’s or doctoral degree from an accredited institution for nurse practitioners (required)
• Medicare participation and ability to have the company bill for services on your behalf (required)
• Certification from ANCC (or equivalent) as an Adult, Family, Geriatric, and/or Acute Nurse practitioner (required)
• 1+ years of Nurse Practitioner Experience (required), qualified for independent practice in your licensed jurisdiction (preferred)
• 1+ years of telephonic triage or equivalent experience (required)
• 2+ years of clinical experience working with complex adult populations (required)
• Ability to practice independently with little clinical support (required)
• Comfort using technology like Google Suite, multiple EMRs, Slack (required)
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• Strong organizational skills, including the ability to prioritize
• Passionate about our mission to improve people’s lives
• Comfortable in a dynamic and always evolving startup environment

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 $125K – $130K annually. (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, 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 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 domain. If you have any concerns that outreach might not be legitimate, please reach out to [email protected] for confirmation.

Licensed Triage Nurse Practitioner

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 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.

We seek team members who are passionate about making home the best place it can be for people with home care needs and see the important role Caregivers play. Our team members are collaborative data-driven optimists who always focus on doing what’s best for patients and their caregivers. We see ourselves as being here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids).

The ideal teammate would be able to:

• Be a point of contact for weekend call escalations
• Chart reviews
• Review remote patient monitoring alerts
• Conduct video visits for chronic care management and remote patient monitoring to create an appropriate care plan for the member
• Conduct care coordination and recommend/identify cost effective research based treatment and intervention
• Utilize strong clinical skills in physical assessment and chronic disease management for at risk adults and apply member specific Care Management and inidualized care planning
• Be comfortable with advanced care planning discussions with caregivers and members
• Serve as a consulting resource on care management practice as needed
• Attend meetings, training sessions and participates on committees as needed
• Possess a strong knowledge of clinical procedures, standards and quality control checks
• Possess a strong knowledge of medical conditions, interventions and treatment
• Provide members, caregivers and facility education
• Monitor the quality of member’s care and updates plan of care

Would you describe yourself as someone who has:

• The ability to work every Saturday AND Sunday from either 8am-8pm OR 8pm-8am ET, every week and weekend (required)
• Certified and licensed as a Nurse Practitioner in good standing in the state of New York (required)
• Master’s or doctoral degree from an accredited institution for nurse practitioners (required)
• Medicare participation and ability to have the company bill for services on your behalf (required)
• Certification from ANCC (or equivalent) as an Adult, Family, Geriatric, and/or Acute Nurse practitioner (required)
• 1+ years of Nurse Practitioner Experience (required), qualified for independent practice in your licensed jurisdiction (preferred)
• 1+ years of telephonic triage or equivalent experience (required)
• 2+ years of clinical experience working with complex adult populations (required)
• Ability to practice independently with little clinical support (required)
• Comfort using technology like Google Suite, multiple EMRs, Slack (required)
• The ability to work remotely and has a private area with a computer in their home/workspace (required)
• Experience working in home care and/or family medicine, geriatrics (preferred)
• Experience working within a clinical team environment
• Strong organizational skills, including the ability to prioritize
• Passionate about our mission to improve people’s lives
• Comfortable in a dynamic and always evolving startup environment

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

Average compensation $70-$80 hourly based on visit completion.

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, 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 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 domain. If you have any concerns that outreach might not be legitimate, please reach out to [email protected] for confirmation.

Coding Specialist III

Remote – USA

Full time

R3122

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 Coding Specialist III can maintain up to two concurrent client assignments that are short-term in nature.

For each client, the Coding Specialist III reviews documentation to code diagnoses and procedures for inpatient hospital-based claims and data needs.  For both professional and technical claims and data needs, the Coding Specialist III reviews clinical documentation to code diagnoses, EM level, and surgical CPT codes. Additionally, this role also validates MS-DRG and APC calculations, abstracts clinical data, mitigates diagnosis, EM level, surgical CPT, and/or PCS coding-related claims scrubber edits, and may interact with client staff and providers.

Essential Duties & Responsibilities:

• Assigns either ICD-10-CM and PCS codes for inpatient visits or assigns ICD-10 CM codes, professional and technical EM levels, and surgical CPT codes for physician visits at commercially reasonable production rates and at a consistent 95% or greater quality level.
• Validates either MS-DRG or APC assignments, as applicable.
• Abstracts clinical data appropriately.
• Mitigates either hospital inpatient coding-related claims scrubber edits or professional and technical coding-related claims scrubber edits.
• Tolerates short-term assignments for up to two different clients.
• Participates in client and Savista meetings and training sessions as instructed by management.
• Maintains an ongoing current working knowledge of the coding convention in play at client assignments.
• Performs other related duties as required.

Minimum Qualifications:

• An active AHIMA (American Health Information Association) credential or an active AAPC (American Academy of Professional Coders) credential
• One year of relevant, productive coding experience for the specific patient type being hired and within the last six months
• Passing score of 80% on specific pre-employment tests assigned

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.

Medical Billing Associate

Location: Remote United States

Hazel partners with schools and families to provide physical and mental virtual health care that helps students feel better and get back to learning. As telehealth becomes more and more relevant in the lives of children, Hazel is experiencing tremendous company growth. Our innovative response to our nation’s call for equitable, affordable, and safe virtual access to healthcare has been recognized by Fast Company as “one of the world’s most innovative places to work” in 2023.

Helping students and their families feel better takes a team of smart, dedicated people. As an integral member of the Hazel team, you will…

• Make an Impact: Work with a team that is increasing equitable access to quality healthcare experiences for students and their families
• Enable Scale: Work with a team that is building and professionalizing a high-growth high impact social enterprise
• Feel Valued: Work with a team that is being compensated competitively, developed professionally, and celebrated frequently for making a meaningful difference

At Hazel Health, we believe talent is everywhere, and so is opportunity. While we have physical offices in San Francisco and Dallas, we have embraced working remotely throughout the United States.

While some roles may require proximity to our San Francisco or Dallas offices, remote roles can sit in any of the following states: AZ, CA, CO, DC, DE, FL, GA, HI, IL, ME, MD, MA, MI, MO, NE, NV, NJ, NM, NY, NC, OR, PA, SC, TN, TX, VT, VA, WA and WI. Please only

apply if you live and work full-time in one of the states listed above or plan to relocate to one of these states before starting your employment with Hazel. State locations and specifics are subject to change as our hiring requirements shift.

The Role: The Medical Billing Associate will support various functions of the Hazel Revenue Operations team, including securing real-time insurance benefits eligibility and coverage information for patients, following up on rejected/outstanding claims, and collaborating with third-party partners on data and clarification requests.

Role title: Medical Billing Associate

Location: Remote

What You’ll Bring:

Insurance Verification:

• Verifies detailed insurance benefits, medical necessity, and authorization/referral guidelines, consistently prioritizing and following the established verification process
• Read and interpret insurance Explanations of Benefits (EOB)/Remittance Advice (RA) with understanding and take appropriate steps to resolve issues.
• Verify all information obtained is correctly documented in the patient’s account, in the correct format.
• Communicate with insurance providers via phone and electronically via web portals to validate patient benefits, check authorization requirements, and review authorization status.

Billing/General

• Review regular data feeds from third party billing partner and research patient insurance coverage and billing status using internal and external tools.
• Create and utilize spreadsheets and other tools to track visit statuses and contracting/credentialing data.
• Ensures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs other duties as required or assigned within the scope of responsibility, including supporting other functions and teams within Revenue Operations.

What excites us:

• Passionate for our mission to transform healthcare for all children
• 2+ years experience in insurance verification with experience in Medicaid, Managed Medicaid and commercial payers across multiple states. Experience with California and Florida Medicaid strongly preferred.
• 1+ years or more experience with Google Suites (google sheets, google docs)
• 1+ years experience with Change Healthcare or other online eligibility healthcare tools
• 1+ years experience with claims adjudication/follow-up
• Experience navigating state Medicaid, Managed Medicaid, and commercial insurance portals
• Highly detail-oriented and comfortable with insurance, claims, and other data sources
• Ability to understand how job performance affects the outcomes of key performance indicators such as billing rates, denials, and write-offs.
• Self-motivated with excellent decision making and time management skills
• Ability to meet remote work expectations, including but not limited to active participation in virtual meetings and real-time communication via Slack
• Exceptional communication and collaboration skills, especially in a virtual work environment.
• 2+ years / Associate Degree, preferred

The compensation range for this role is $22.00-$26.00/hour with a 401k match, healthcare coverage, paid time off, and a broad range of other benefits.

Remote IP Coding 

Location: EMERYVILLE California

JobDescription: Job Description & Requirements 

Remote IP Coding  StartDate: ASAP Pay Rate: $30.00 – $40.00  Position Description 

JOB SUMMARY:

Under indirect supervision, is responsible for accurate coding of all inpatient services at a University Acute Care Facility with Trauma, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. All work is carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-10-CM/PCS, Centers for Medicare and Medicaid Services (CMS).

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Must have Inpatient Coding Experience in a Teaching Trauma Acute Care Facility.

Must possess a thorough knowledge of ICD-10-CM/PCS coding principles and applications as they relate to acute care hospital coding and grouping Thorough knowledge of Official Coding Guidelines and payer specific requirements When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. Maintain 95% DRG and overall accuracy rate Maintain average productivity standards. Works the review queue on a daily basis to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary. The coder is responsible for coding or pending every chart placed in their queue.

OTHER REQUIREMENTS

Smart Phone Workstation – Dual Monitors Standard Windows PC Internet Access with DSL or Cable VPN compatibility Printer/Fax

EDUCATION AND SKILLS

High school diploma or equivalent required. Requires one of the following coding credentials: AHIMA (CCS, CCS-P, or RHIT); AAPC (CPC, CPC, CPC-H). Must be proficient with Facilities Coding Standards. Minimum of five (5) years’ experience in medical coding. Working knowledge of ICD-10-CM/PCS.

SALARY AND BENEFITS

Paid Time Off and Sick Time 401K Medical, Dental, Life and Long/Short term disability Insurance Paid Association Dues Paid Educational Benefits AMN Healthcare is an EEO/AA/Disability/Protected Veteran Employer.

We encourage minority and female applicants to apply.

AMN Healthcare is committed to fostering and maintaining a erse team that reflects the communities we serve. Our commitment to the inclusion of many different backgrounds, experiences and perspectives enables our innovation and leadership in the healthcare services industry. Apply today and one of our team members will be in touch to help you find the role that best fits your skills and goals.

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

FULL AND PART TIME OPPORTUNITIES

About This Role

Are you ready to make a difference? Come work with Parallel!

We are looking for remote school psychologists with experience providing direct and indirect psychological services in schools and conducting comprehensive psycho-educational evaluations to join our talented team of clinicians. Our ideal candidate has a passion for supporting families and children with learning differences by ensuring they receive the best care and tools for success!

Why Join Us?

Parallel makes it easy to administer quality care! By taking care of the daily hassles of running a business, we empower you to focus on providing services. We provide:

• Easy Scheduling through our in-house scheduling system
• Templates & Databases so you can spend less time on administrative tasks
• Smart Matching to pair you with school districts/schools
• Student History & Eligibility information so you have the information you need
• Testing Materials so you have the tools to succeed!

We also offer:

• Flexibility: Ability to set your own schedule and work on your own time
• Testing & Licensure Programs: Cross-licensing programs & necessary test materials are covered by Parallel
• Innovation: Your feedback will help shape the program for providers and clients in the future!
• Community Events: Collaborate with top clinicians and educators to solve acute problems
• Growth: Access leadership and growth opportunities as we rapidly scale
• A Great Mission: Directly contribute to bettering the lives of students across the country

What You’ll Do

• Provide direct and indirect psychological services to support students with IEPs
• Conduct  comprehensive psycho-educational evaluations of students’ academic, cognitive, social\emotional, and/or behavioral functioning
• Write social\emotional\behavioral IEP goals and monitor students’ goal progress
• Serve as a critical member of students’ multi-disciplinary teams

What You’ll Need 

To succeed in this role, you’ll need:

• An EdS degree (or equivalent) in school psychology from a NASP-approved program
• A valid state license or certificate as a school psychologist
• NCSP preferred but not required
• At least 1 year of experience practicing full time as an on-site school psychologist (excluding practicum and internship years)
• Experience practicing as a remote school psychologist is preferred but not required
• Expertise across all NASP domains of practice
• Experience providing direct psychological services (e.g., intervention, counseling) within an MTSS framework of service delivery
• Experience consulting with educators and families
• Experience completing comprehensive psycho-educational evaluations of students’ academic, cognitive, social, emotional, and behavioral functioning
• Excellent communication skills, specifically the ability to communicate with children of different ages and from different cultural and socioeconomic backgrounds
• Tech-savvy and experience with conducting tele-health services on virtual meeting platforms
• A private workspace with a reliable computer, webcam, and secure internet connection
• Availability during traditional school hours (8:00am-3:00pm) and days (Monday-Friday).  Minimum availability of 15 hours per week 

Parallel is an equal opportunity employer that does not discriminate against applicants or employees and ensures equal employment opportunity for all persons regardless of their race, creed, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, marital status, disability, citizenship, military or veterans’ status, or any other classifications protected by applicable federal, state or local laws. Parallel’s equal opportunity policy applies to all terms and conditions of employment, including but not limited to recruiting, hiring, training, promotion, job benefits and pay.

About Us

Parallel is the first tech-forward provider of care for learning and thinking differences across the United States. We believe learning differences are parallel ways of thinking that should be celebrated! Our mission is to provide students with the resources and encouragement to succeed in the classroom and beyond. To us, this means helping them build confidence in their unique strengths and create strategies to work around their challenges.

Parallel simplifies the process of getting support for learning differences by consolidating providers and resources on a single platform. We connect students with qualified professionals while significantly reducing waiting times, costs, and confusion. We provide a variety of services, including:

• Psychological Assessment & Therapy
• Counseling
• Speech-Language Therapy
• Special Education
• And more!

Want to know what it’s like working here? Check out our Glassdoor reviews!

Our commitment to ersity, equity, and inclusion

At Parallel, we believe in celebrating differences. This belief extends from schools into our workplace and through the ways we work together toward our mission. We are committed to fostering a erse, accessible environment that represents many different cultures, backgrounds, viewpoints, and abilities by championing ersity, equity and inclusion.

This is why we are committed to having and fostering a erse workforce, including those from historically marginalized groups, and are committed to a work environment where employees’ strengths are championed, differences are celebrated, and no one is discriminated against based on age, race, ancestry, religion, sex, gender identity and expression, sexual orientation, pregnancy, marital status, physical or mental disability, military or veteran status, national origin, or any other characteristic.

We are a proud equal opportunity employer, and we are committed to building a erse, equitable, and inclusive organization in order to build the foundation for different learners and thinkers to thrive.

Remote Same Day Surgery Coder 

Location: EMERYVILLE California; United States

Job Description & Requirements

Pay Rate: $25.00 – $38.00 

TYPE OF JOB ORDER: Remote Facility OP Same Day Surgery Coder

REQUIRED SKILLS: Under indirect supervision, is responsible for accurate coding of outpatient surgery services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-10, CPT, Procedures (PCS), Healthcare Common Procedure Coding System (HCPCS) as well as other specialty systems as required by diagnostic category. All work is carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-10, Centers for Medicare and Medicaid Services (CMS), Office of Statewide Health Planning and Development (OSHPD), and organizational/institutional coding guidelines.

Other responsibilities include:

*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.

• Ability to maintain average productivity standards.

• Works the review queue on a daily basis to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.

• The coder is responsible for coding or pending every chart placed in their queue.

• Coders must maintain their current professional credentials.

# OF WEEKS: 52 weeks

SHIFT/HOURS: 1st shift 7a – 6p Pacific Time Zone

EXPECTED HOURS: FT M-F business hours Pacific Time Zone – some flexibility.

LICENSE/CREDENTIALS REQ: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H, CDIP, CCDS one or more is permitted.

SYSTEMS: 3M & EPIC.

NOTES: Will be a long-term project for the right fit.

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

Manager, Central Billing Office Coding (National, Remote) in Grand Rapids, Michigan

The Opportunity

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Position Summary

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Munson Healthcare revenue cycle operations are jointly operated by Huron and Munson Healthcare. Huron provides strategic revenue cycle operations leaders (managers and above are employed by Huron), while revenue cycle associates and supervisors are badged and employed by Munson Healthcare. Munson Healthcare, like all other providers in the market, is under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Munson, in collaboration with Huron, must empower leaders, clinicians, employees, affiliates, and communities to build a culture that fosters innovation to achieve the best outcomes for patients and succeed long-term.

Learn more about Munson Healthcare here: https://www.munsonhealthcare.org/.

Joining the Huron Managed Services team means you’ll help Munson Healthcare evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Manages and oversees the system-wide compliance program in areas that relate to the revenue cycle. Works with Adventist Health compliance leadership in maintaining oversight of system-wide revenue cycle functions including health information management, coding, billing and registration. Manages projects related to the design, implementation, revision and maintenance of system-wide processes and systems that promote compliance related to the revenue cycle. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment. Manages large program(s) with substantial budget/impact. Manages and coordinates the diagnostic and procedural coding processes with Federal/State regulations and payer requirements for legal compliance. Ensures compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment.

Supports Huron’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Huron’s business practices. This includes: becoming familiar with Huron’s Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

DUTIES & RESPONSIBILITIES:

• Develop, recommend and oversee the implementation and administration of policies and procedures of respective areas.
• CPC (Certified Professional Coder) Certification Required
• Evaluate processes and procedures coordinating with the management team to ensure efficient areas of focus and adhere to federal and local laws and regulations.
• Demonstrate, through plans and actions, a consistent standard of excellence to which all department work is expected to conform.
• Focus on continuous improvement working with the Senior Manager and respective teams Managers across the Health System with a goal of delivering the highest degree of quality service possible.
• Provide support for Human Resource guidance.
• Complete, review, manage and monitor department budget.
• Directs and leads the patient access team in the daily operations.
• Performs other duties as assigned.

REQUIRED SKILLS:

• Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members.
• Proven analytical and critical thinking skills required to synthesize complex data sets and interpret qualitative and quantitative data and and trends to implement recommendations resulting in measurable performance improvement and successful organizational change.
• Impactful and professional written and verbal communication setting clear project team direction.
• Develop key deliverables, escalate risks and influence key stakeholders inclusive of client and internal senior leadership.
• Ability to collaborate with team members and client counterparts to understand business challenges, adapt implementation methodologies and approaches to ensure results align with client’s business objectives.
• Team leadership experience including building talent, training, supervising, coaching/mentoring and performance management.

Qualifications

• Living location can be anywhere within the contiguous 48 states and near a major airport

The estimated salary range for this job is $100,000 – $120,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an inidual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron’s annual incentive compensation program, which reflects Huron’s pay for performance philosophy and Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

Posting Category

Healthcare

Opportunity Type

Regular

Country

United States of America

At Huron, we’re redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client’s challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together.

Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.

Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, ersity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Manager, Central Billing Office Coding (National, Remote) in Chicago, Illinois

The Opportunity

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Position Summary

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Munson Healthcare revenue cycle operations are jointly operated by Huron and Munson Healthcare. Huron provides strategic revenue cycle operations leaders (managers and above are employed by Huron), while revenue cycle associates and supervisors are badged and employed by Munson Healthcare. Munson Healthcare, like all other providers in the market, is under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Munson, in collaboration with Huron, must empower leaders, clinicians, employees, affiliates, and communities to build a culture that fosters innovation to achieve the best outcomes for patients and succeed long-term.

Learn more about Munson Healthcare here: https://www.munsonhealthcare.org/.

Joining the Huron Managed Services team means you’ll help Munson Healthcare evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Manages and oversees the system-wide compliance program in areas that relate to the revenue cycle. Works with Adventist Health compliance leadership in maintaining oversight of system-wide revenue cycle functions including health information management, coding, billing and registration. Manages projects related to the design, implementation, revision and maintenance of system-wide processes and systems that promote compliance related to the revenue cycle. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment. Manages large program(s) with substantial budget/impact. Manages and coordinates the diagnostic and procedural coding processes with Federal/State regulations and payer requirements for legal compliance. Ensures compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment.

Supports Huron’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to Huron’s business practices. This includes: becoming familiar with Huron’s Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

DUTIES & RESPONSIBILITIES:

Develop, recommend and oversee the implementation and administration of policies and procedures of respective areas.

CPC (Certified Professional Coder) Certification Required

Evaluate processes and procedures coordinating with the management team to ensure efficient areas of focus and adhere to federal and local laws and regulations.

Demonstrate, through plans and actions, a consistent standard of excellence to which all department work is expected to conform.

Focus on continuous improvement working with the Senior Manager and respective teams Managers across the Health System with a goal of delivering the highest degree of quality service possible.

Provide support for Human Resource guidance.

Complete, review, manage and monitor department budget.

Directs and leads the patient access team in the daily operations.

Performs other duties as assigned.

REQUIRED SKILLS:

Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members.

Proven analytical and critical thinking skills required to synthesize complex data sets and interpret qualitative and quantitative data and and trends to implement recommendations resulting in measurable performance improvement and successful organizational change.

Impactful and professional written and verbal communication setting clear project team direction.

Develop key deliverables, escalate risks and influence key stakeholders inclusive of client and internal senior leadership.

Ability to collaborate with team members and client counterparts to understand business challenges, adapt implementation methodologies and approaches to ensure results align with client’s business objectives.

Team leadership experience including building talent, training, supervising, coaching/mentoring and performance management.

Qualifications

• Living location can be anywhere within the contiguous 48 states and near a major airport

The estimated salary range for this job is $100,000 – $120,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an inidual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron’s annual incentive compensation program, which reflects Huron’s pay for performance philosophy and Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

Posting Category

Healthcare

Opportunity Type

Regular

Country

United States of America

At Huron, we’re redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client’s challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together.

Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.

Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, ersity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Location:  US Locations Only; 100% Remote

The Enrollment Specialist contacts patients to explain our Chronic Care Management Program and offer them the opportunity to enroll. In addition, the Enrollment Specialist gains consent to enroll and manages the enrollment process. Enrollment Specialists spend the majority of their time speaking with patients via telephone in a contact center environment.

Essential Duties:

• Educating potential program participants on the benefits of the Chronic Care Management program

• Retrieving patient information to determine suitability for the Chronic Care Management Program

• Interpreting and explaining information such as eligibility requirements, application details, program pricing, and what to expect after enrollment

• Protecting the security of patient information

• Complying with HIPAA and Medicare Fraud, Waste, and Abuse rules and regulations at all times

• Maintaining knowledge of Medicare Part A and Part B insurance

• Meeting Key Performance Indicators (KPIs) required for the role, including daily enrollment minimum, quality, and attendance

• Other duties as assigned

Skills and Abilities Required:

• High level of critical thinking

• Exceptional sales skills

• Computer proficiency with the ability to learn new applications

• Ability to accurately type 40 words per minute

• Ability to accurately document call content and chart transcription with strong attention to detail

• Ability to clearly articulate thoughts and ideas

• Active listening skills

• Meet productivity requirements established by the company

Physical Requirements:

This position requires the following physical activities with or without accommodation.

• Must be able to remain in a stationary position 50% – 85% of the time.

• Frequent communication with others requires the exchange of accurate information.

Work Environment

• This job operates in a fully remote professional office environment.

• This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.

Required Education:

High School Diploma or equivalent

Location: US Locations Only

Location:  US Locations Only; 100% Remote

ChartSpan is the largest chronic care management (CCM) managed service provider in the US. CCM programs focus on patients who have multiple (two or more) chronic conditions that are expected to last at least 12 months or more.

An LPN Patient Care Coordinator at ChartSpan plays a key role in caring for the patients in our program while working in conjunction with the patient care team to facilitate and address existing and new chronic health issues.  We provide an essential service that helps providers stay in touch with and meet their patients’ healthcare needs in between office visits.

Your role is to support and assist patients in obtaining the resources they need to improve their health, happiness, and longevity. LPN Patient Care Coordinators are patient advocates who form ongoing, collaborative relationships with patients to help improve their lifestyles for the better. This is a fully remote role.

Responsibilities

• Provides monthly care coordination through a collaborative process of planning, facilitation, and advocacy for options and services to meet patient’s health needs. Communicates resources and services available to patients through the continuum of care.
• Identifies patient-specific problems, goals, and interventions designed to meet the patient’s needs as identified by the clinical assessment/reassessment that are action-oriented and time-specific.
• Maintain patient chart compliance through proper documentation and updates of medical history, medication, immunizations, allergies, surgical history, and family history.
• Demonstrates awareness of circumstances necessitating revisions to the plan of care, such as changes in the client’s condition, lack of response to the care plan, preference changes, transitions across settings, and barriers to care and services.
• Documents relevant, comprehensive information and data using standard assessments and tools supporting the plan of care and organized care coordination systems aimed at improving the outcomes of patients.
• Provide appropriate health education.
• Escalate patient concerns to the triage nurse team.

Qualifications

• Licensure: License and current registration to practice as a Licensed Practical Nurse in a COMPACT state.
• Education: An LPN degree from an approved program is required.
• Pass background check

Job Type: Full-time (Remote)

Location: US Locations Only

UTILIZATION REVIEW NURSE

(REMOTE)

• Baltimore, MD
• SINAI HOSPITAL
• UTILIZATION REVIEW
• Full-time w/Weekend Commitment – Day shift – 8:00am-4:30pm
• RN Other
• 81138
• Posted: Today

Summary

UTILIZATION REVIEW NURSE (remote)

Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.

Essential Functions:

Chart Review: Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption.

Enters clinical reviews into the software program. Maintains close communication with external reviewers/internal financial counselors/patient access personnel and performs certification activities as required by payor.

Denial Management: Monitors and identifies patterns or trends in utilization management

Monitors potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary. Documents in software program the actions taken to coordinate care and avoid denials. Assists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disag

Qualifications/Requirements:

Education/Knowledge: Basic professional knowledge; equivalent to a Bachelor’s degree; working knowledge of theory and practice within a specialized field Education/Knowledge:

Education Discipline: Minimal degree requirement: Bachelor of Science in Nursing (BSN’s from A CCNE accredited school)

Certification or Licenses: Maryland Registered Nurse License REQUIRED

Experience:

• Medical terminology (Frequently)
• Nursing Process skills based on MD Nurse
• Practice Act (Frequently)
• Critical thinking skills (Frequently) Midas (Frequently)
• Healthstream (Occasionally)
• Utilization Review Criteria (Frequently)
• Microsoft Office Suite (Frequently)
• Basic computer skills (Frequently)
• Cerner (Frequently)
• Standard Office Equipment (Frequently)

Additional Comments Work from home will be 95% or greater. Training/remediation may be onsite with occasional onsite meetings.

Additional Information

As one of the largest health care providers in Maryland, with 13,000 team members, We strive to CARE BRAVELY for over 1 million patients annually. LifeBridge Health includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland.

Licensed Clinical Social Worker

Job description

We are looking for full-time Licensed Therapists to join our team and provide outpatient services through our telehealth program! Benefits: _ Our team works 100% remotely from their own homes! _ W2, Full-time Compensation package includes a base plus bonus! $66K-$100k earning potential. Monday – Friday schedule; No weekends! Liability insurance covered and annual stipend for growth & education opportunities We not only partner with commercial health plans, but are also a licensed Medicaid and Medicare provider and see patients across the lifespan Requirements: Brave licensed therapists may be based anywhere in the US, but must have an active FL license to get started. Don’t yet have one of these licenses but interested? Let’s talk! Brave will provide reimbursement for associated licensure fees for new hires. Master’s level degree (LCSW, LMHC, LCPC, LMFT, or equivalent credential) Eligibility to work in the United States Work from home space must have privacy for patient safety and HIPAA purposes Fluency in English, Spanish preferred; proficiency in other languages a plus Meets background/regulatory requirements Skills: Knowledge of mental health and/or substance abuse diagnosis Treatment planning Comfortable with utilizing technology at all points of the day, including telehealth software, video communication, and internal communication tools Experience working in partnership with clients to achieve goals Ability to utilize comprehensive assessments Why We’re Here: Brave Health is on a mission to expand access to high-quality, affordable care for behavioral health conditions. We utilize the power of technology to eliminate barriers and expand access to high quality mental health and substance use disorder treatment. Through telehealth services we are able to reach those in need, when and where they need it. As a community based start-up, our goal is to make quality mental health services accessible for all. Brave Health is very proud of the erse team we have that cares for our erse population of patients. We are an equal opportunity employer and encourage all applicants from every background and life experience without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status_ Job Type: Full-time Pay: $66,000.00 – $100,000.00 per year Benefits: Dental insurance Employee assistance program Health insurance Life insurance Paid time off Professional development assistance Vision insurance Schedule: Monday to Friday Work setting: Remote People with a criminal record are encouraged to apply Application Question(s): Are you currently licensed as a FL LCSW, FL LMHC, or FL LMFT? On average, how many clients are you seeing daily? Do you have experience using an Electronic Medical/Health Record (EMR or EHR)? What year did you obtain your license? I would like to receive updates from a Brave Health recruiter about my application via SMS. (Yes / No) Work Location: Remote C: 0.300

Nurse Case Manager

remote type

Hybrid

locations

United States – Remote

time type

Full time

job requisition id

R2415557

Medical Case Manager – CT08GE

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

As Nurse Case Manager, we seek to improve on our patients’ abilities! This position is part of a dynamic, fast-paced team of experienced Nurse Case Manager located remotely across the United States.

The ideal candidate for the Nurse Case Manager role will oversee Workers’ Compensation claims with complex medical conditions referred for medical assessment, clarification of limitations/restrictions or case management. On average, a Nurse Case Manager shall handle 50-60 cases with a moderate degree of complexity and acuity of medical condition. This inidual will have the opportunity to collaborate with claims staff, the injured worker, an employer, and other healthcare professionals to promote quality medical care with a focus on returning our patients back to work. Our goal is to achieve optimum, cost-effective medical and vocational outcomes.

RESPONSIBILITIES include but are not limited to:

•  Through the use of clinical tools, telephonic interviews, and clinical information/data, completes assessments that will take into account information from various sources to address all conditions including biopsychosocial, co-morbid and multiple diagnoses that impact recovery and return to work.
• Leverages critical thinking, extensive clinical knowledge, experience, and skills in a collaborative process to develop a comprehensive strategy for the injured worker to become medically stable and/or return to work.
• Independently identifies complex situations where communication with internal and/or external partners is needed to reach a full understanding of the factors involved with the assessment of the mechanism of injury, causality, and ability to return to work.
• Application, Interpretation and Compliance with clinical criteria and guidelines, applicable policies and procedures, regulatory standards, and jurisdictional guidelines to determine eligibility and integration with available internal/external resources and programs.
• Using holistic approach to focus on medical and ability management activities resulting in accurate and timely treatment and return to work.
• Consults with supervisor and others to address and problem solve barriers to meeting goals and objectives, participate in roundtables and claim meetings with claim partners to focus and benefit overall claim management.

QUALIFICATIONS:

•  RN with current unrestricted state licensure required.
• Associate degree in nursing required.
• 3 years clinical practice experience required.
• Bachelor’s degree in nursing preferred, but not required.
• Certification as a CCM (CDMS, CRC, CVE and/or current CRRN), or willingness to pursue.
• Workers Compensation case management experience preferred.

Key Competencies:

• Basic Computer proficiency (Microsoft Office Products including Word, Outlook, Excel, Power Point); which includes navigating multiple systems.
• Ability to effectively communicate telephonically and in written form.
• Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
• Work requires the ability to perform close inspection of handwritten and computer-generated documents as well as a PC monitor.
• Ability to synthesize large volumes of medical records & facilitate multi-point care coordination.
• Must meet productivity & quality expectations.
• Ability to organize and prioritize daily work independently and effectively.

Additional Competencies:

• Strategic thinking.
• Customer focus.
• Business knowledge.
• Problem solving.
• Collaboration – partnership.
• Decision making skills.
• Communication skills.

Additional Information:

Start date: 4/29/2024

• This role can have a Hybrid or Remote work arrangement.  Candidates who live near one of our offices and will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.

For full-time, occasional, part-time, or remote positions: (1) high speed broadband internet service is required, we do not recommend or support DSL, wireless, Mifi, Hotspots, Fiber without a modem and Satellite; (2) Internet provider supplied modem/router/gateway is hardwired to the Hartford issued computer with an ethernet cable; and (3) minimum upload/download speeds of 5Mbps/30Mbps will be required. To confirm whether your Internet system has sufficient speeds, please visit http://www.speedtest.net from your personal computer.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$67,680 – $101,520

Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

Title: Clinical Trial Nurse Navigator

Location: USA-

Why LLS

How many people can answer the question, “What do you do for a living?” with the answer, “I help find cures for cancer.” At LLS, employees take our mission seriously. Whether you work in one of our chapters, are an accountant at the national office or a specialist in our Information Resource Center, you work each day on making our mission a reality: Cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of life of patients and their families. Join us and give new meaning to the word, “job.”

Overview

Works with patients, family members and/or health-care providers to assist patients in their efforts to identify appropriate clinical trials and help overcome obstacles to enrollment. Utilizes nursing assessment skills, online databases, and information from clinical sites to determine qualification for clinical trials. Educates patients and family members about the patient’s blood cancer diagnosis, helps them to understand both standard of care and clinical trial treatment options, and provides support around decisions to end treatment. Collaborates with The LLS’ Information Resource Center (IRC) staff to provide education, services and support to patients and family members.

As a valued member of LLS, you are eligible for a comprehensive benefits package. Our offerings include medical, dental, and vision insurance; life insurance; flexible spending accounts; a 403b retirement plan along with generous paid time off. In addition, we observe federal paid holidays throughout the year, and offer a wellness program and an employee assistance program.

While employees may be permitted to work remotely, travel to the assigned office, HUB or Satellite Offices may be required as determined by the employee’s manager and the employee’s Strategic Talent Partner.

Additional Position Information

Reports to: Director of Clinical Trial Support Center

Responsibilities

Duties and Responsibilities:

+ Independently maintain own caseload of patients seeking enrollment into clinical trials; this includes assessing, educating, and objectively presenting information to patients about available treatment options, including clinical trials

+ Use problem solving skills to help patients overcome obstacles to enrollment

+ Collaborates with LLS’s Information Resource Center (IRC) staff to educate and support patients and family members in their efforts to understand their diagnosis, treatment options and available services

+ Serve in consulting role to the Information Resource Center about clinical trials

+ Serves as a resource to The LLS Patient and Professional Education staff as they develop clinical trial related materials and programs.

+ Maintain/increase knowledge and understanding of hematologic cancers, blood and bone marrow transplant and psychosocial aspects of living with cancer

+ Contribute to continual process improvement of Clinical Trial Support Center procedures

+ Develop effective working relationships within The Leukemia & Lymphoma Society and with trial site staff, investigators, sponsors, patient and professional organization

+ Exhibit comprehensive understanding of ethical standards and federal regulations in human subjects research

#LI-Remote

Qualifications

Education, Experience, and Qualifications:

+ Bachelor’s degree in Nursing required; Masters preferred. Master’s degree in non-nursing area considered.

+ Current RN licensure required

+ Oncology experience preferred; specialty training in Oncology/Hematology preferred; OCN certification preferred; clinical research experience preferred

+ Ability and desire to excel in independent work and in a team environment

+ Spanish speaking preferred

Position Requirements:

+ Outstanding critical thinking, problem-solving, and collaboration skills

+ Excellent ability to communicate verbally and in writing

+ Ability and desire to excel in independent work and in a team environment

+ Demonstrated commitment to independent learning and skill enhancement

+ Expertise in Microsoft Office including Excel, Word, and OneNote

Physical Demands & Work Environment:

+ Physical demands are minimal and typical of similar jobs in comparable organizations

+ Work environment is representative and typical of similar jobs in comparable organizations

+ Occasional travel to national oncology/hematology meetings and meetings at the National Office of LLS

+ Must have reliable internet; minimum download speed 50mbps minimum upload speed 50mbps. Recommended download speed 100mbps recommended upload speed 100mbps.

+ Average salary range is $95K-$110K, open to further discussion based on geography.

Disclaimer

The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of employees. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the Company. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

Job LocationsUS-(REMOTE – Work from Home)

Job ID 2024-8009

# of Openings 1

Category Hidden (58428)

FLSA Status Exempt

Type Full Time Regular

Credentialing Coordinator Remote

Job Category: Managed Care

Requisition Number: CREDE020819

Full-Time

USA Remote

United States

Job Details

Description

The Credentialing Coordinator administers the provider credentialing process for Ambulatory Surgery Centers. This is a Full-Time remote position.

ESSENTIAL FUNCTIONS:

• Process initial and re-credentialing provider applications for Ambulatory Surgery Centers
• Conducts primary source verification via various state and national sources
• Maintains working knowledge of various provider credentialing policies and required procedures/forms
• Data entry of provider demographics information in the credentialing software

Other assigned duties as required

*2 Years Experience of provider level credentialing with a CVO, surgery centers or hospitals preferred.

ABILITIES:

• Maintains strict confidentiality with demonstrated experience applying good judgment and discretion
• Strong detail oriented skills
• Effective verbal and written communication skills and work effectively with medical staff and external agencies
• Identify, analyze and solve provider enrollment and credentialing issues
• Handle multiple projects and reach multiple deadlines.
• Exercise sound judgment in decision-making
• Excellent time management skills
• Exceptional ability to plan, organize, and implement a plan to completion
• Work effectively within a team environment
• Deal courteously with internal and external customers
• Prioritize duties and be self-motivated
• Microsoft Office and other industry specific software
• Type 40-50 wpm.

Title: Assistant, Nurse

Location: USA-

Cardinal Health

Assistant, Nurse in United States What Inidualized Care contributes to Cardinal Health

Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.

Inidualized Care provides care that is planned to meet the particular needs of an inidual patient.

Job Summary

The Nurse, Inidualized Care promotes high-quality patient care and treatment through patient education. With a focus on the products and treatments of a small number of pharmaceutical clients, the Nurse receives inbound calls from patients and schedules outbound calls for patients who have begun treatment with one or more of the client’s products. The Nurse educates patients on their treatments and disease states, refers patients to a variety of additional services, and reports adverse events in accordance to FDA and client requirements.

Qualifications

• 0-2 years of experience preferred
• BA, BS or equivalent experience in related field preferred
• LVN is required
• 2-4 years of Case Management experience is preferred
• Demonstrate effective, empathetic and professional communication
• Clear knowledge of Medicare (A, B, C, D)
• 1-2 years of experience with Prior Authorization and Appeal submissions
• Must be able to manage multiple concurrent assignments
• Must communicate clearly and effectively in both a written and verbal format
• Ability to work with high volume production teams with an emphasis on quality
• Able to thrive in a competitive and dynamic environment
• Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and preferred Excel capabilities
• Previous medical experience is preferred

Responsibilities

• Deliver virtual or telephonic educational support to identified patients, caregivers, Healthcare Professionals (HCPs) and their staff to meet all relevant standards as set by the client company
• Be a champion for each patient and consented care partner(s)
• Answer inbound inquiries of patients, care partners and HCPs
• Act as primary point of contact for patients and HCPs
• Understand a patient’s support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their pathway to treatment as prescribed by their HCP
• Provide support and guidance to help ensure patients have access to the patient support program resources by compliantly navigating reimbursement, and mitigating any patient out-of-pocket barriers, as applicable
• Experience in supporting time sensitive requests and prioritization of assignments and working with a sense of urgency.
• Investigate and resolve patient/healthcare provider inquiries and concerns in a timely manner
• Work closely with patients, patient caregivers, healthcare providers. Sonexus Health reimbursement team, the manufacturer’s employees, third party vendors to clearly identify issues and provide resolution.
• Responsible for meeting the newly identified patient, patient caregivers, healthcare providers over the phone to provide education on the drug, disease process, diagnostic testing, support services provided by the manufacturer and review benefit information.
• Exhibit effective communication and tele-management skills.
• Proactive follow-up with various contacts to ensure patient access to therapy.
• Converse with callers in an empathetic manner and build rapport
• Act as patient and healthcare providers single point of contact for all inquiries
• Possess effective organizational skills, including working on multiple cases simultaneously.
• Responsible for the identification, intake, documentation, and submission of all Adverse Event Reports occurring in patients which are taking or have previously taken the manufacturer’s product.
• Submit all adverse event reports to manufacturer/third party vendor within stipulated timeframe; additionally follow up if requested to do so.
• Responsible for addressing Medical Information inquiries from consumers, healthcare providers and other entities, including but not limited to, requests for product information, inquiries about side effects, guidelines for appropriate use of the product, etc.
• Provide identification, intake, documentation, and submission of all reported Product Complaints, per the manufacturer guidelines.
• Perform other activities related to the internal initiatives and/or the manufacturer’s programs as assigned.
• Responsible for maintaining HIPAA guidelines.
• Must adhere to strict guidelines regarding the protection of proprietary educational materials and product information that may be printed or available via email, websites, or other electronic means, provided by the manufacturer.
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties

What is expected of you and others at this level

• Applies basic concepts, principles and technical capabilities to perform routine tasks
• Works on projects of limited scope and complexity
• Follows established procedures to resolve readily identifiable technical problems
• Works under direct supervision and receives detailed instructions
• Develops competence by performing structured work assignments

Training and Work Schedules:

Your new hire training will take place 8:00am – 5:00pm CST, mandatory attendance is required.

This position is full-time (40 hours/week). Employees are required to work Monday – Friday, 8:00am – 5:00pm CST.

Remote Details:

You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location.Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.

• Download speed of 15Mbps (megabyte per second)
• Upload speed of 5Mbps (megabyte per second)
• Ping Rate Maximum of 30ms (milliseconds)
• Hardwired to the router
• Surge protector with Network Line Protection for CAH issued equipment

Anticipated hourly range: $25.80 per hour – $36.85 per hour

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close: 03/04/2024 *if interested in opportunity, please submit application as soon as possible.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values ersity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

We are a team of nearly 48,000 mission-driven partners striving each day to advance healthcare and improve lives. We are Essential to care.

Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for health care facilities

We are a crucial link between the clinical and operational sides of care, working with more than 4,500 sourcing and manufacturing partners to deliver end-to-end solutions and data-driven insights that advance healthcare and improve lives every day. With deep partnerships, erse perspectives and innovative digital solutions, we build connections across the continuum of care.

With 50 years of experience, approximately 44,000 employees and operations in more than 30 countries, Cardinal Health seizes the opportunity to address healthcare’s most complicated challenges — now, and in the future.

On Thursday, Jan. 7, 2021, we celebrated the day our founder, Bob Walter, had the vision to start a business that became known as Cardinal Health.

One of the most important ways we celebrated was by giving back to the communities where we live and work. 2021 was a “Year of Service” for all Cardinal Health employees around the world.

View Cardinal Health on YouTube

Cardinal Health is an Equal Opportunity/Affirmative Action 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.

Title: Coordinator Quality Coding, Inpatient

Location: CO-Denver

This is a full-time, remote/work from home, exempt/salary position on UCHealth’s Inpatient Coding team based in Denver, CO. Potential opportunity for eligible out-of-state applicants. Responsible for coding data integrity by reviewing diagnosis and procedure code assignments, and validating MS-DRG and APR-DRG designations. Works closely with Leadership, CDI, Physician Advisors and other internal quality departments, providing answers to coding questions and correctly applying Official Coding guidelines, Coding Clinics and other official guidance which support your recommendations.

Job Duties

+ Conducts internal quality reviews, in accordance with the Coding Compliance Plan. Reviews government, commercial and other external audits. Performs internal audits as requested by other departments. Monitors and reports issues/trends.

+ Presents coding education to staff, leadership and others throughout the Health System. Provides training as necessary. Assists with developing and guiding SMEs responsibilities.

+ Responds to coding questions submitted throughout the Health System. Reviews physician queries for appropriateness, and related correspondence.

+ Reviews coded claims data in response to denials and customer service requests. Provides thorough rationale and explanation for proper code assignments.

+ Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements

+ + High School Diploma or GED

+ Coding-related certification from AHIMA or AAPC

+ 3 years of relevant coding experience

Preferred

+ Associate’s Degree

+ CCS

+ The pay range for this position is: $29.54 – $44.31 / hour. Pay is dependent on applicant’s relevant experience.

UCHealth offers a Five Year Incentive Bonus to recognize employee’s contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years’ employment.

UCHealth offers their employees a competitive and comprehensive total rewards package:

+ Full medical, dental and vision coverage

+ Retirement plans to include 403(b) matching

+ Paid time off. Start your employment at UCHealth with PTO in your bank

+ Employer-paid life and disability insurance with additional buy-up coverage options

+ Tuition and continuing education reimbursement

+ Wellness benefits

+ 5 year incentive bonus

+ Full suite of voluntary benefits such as identity theft protection and pet insurance

+ Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may also qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year

Loan Repayment:

UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program!

UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.

At UCHealth, we do things differently

We believe in something different: a focus on the iniduality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado’s largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it’s a passion.

Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for iniduals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we’ll do everything in our power to make sure you grow and have a meaningful career. There’s no limits to your potential here.

Be Extraordinary. Join Us Today!

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and ersity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the inidual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

Remote Inpatient Coder

Location: FRANKLIN Tennessee; United States

Job Description & Requirements

Pay Rate: $30.00 – $40.00

TYPE OF JOB ORDER: Remote Inpatient Coder (Community Hospital Setting)

REQUIRED SKILLS: 3-4 Years Inpatient Coding in an Acute Care setting

#OF WEEKS: 26 Weeks

SHIFT/HOURS: Flexible M-F some Weekends

EXPECTED HOURS: 40

LICENSE/CREDENTIALS REQ: RHIT, CCS, RHIA, CPC-H

SYSTEMS: 3M 360 CAC & Encoder; Cerner, eCharms, Legacy, McKesson, MedHost

***Must Have Cerner****

NOTES: Under indirect supervision, is responsible for accurate coding of all inpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record at a community based Health System. All work is carried out in accordance with the rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-10-CM/PCS, Centers for Medicare and Medicaid Services (CMS).

Facility Location

Franklin, close neighbor to the much larger Nashville, is a livable city with a lovely historic downtown. The city’s Main Street bustles with thriving small businesses and eateries, offering visitors and residents no shortage of entertainment options. The Franklin Theatre, established in 1937, is a cultural icon, boasting an ever-impressive roster of regional and national touring musicians, and showing classic movies on a weekly basis. Two annual Main Street Festivals reinforce the vibrant identity of the city and Pumpkinfest is a resident favorite, welcoming in autumn in style.

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Clinical Data Coder/Specialist-Temp

Remote

Position Summary:

The Clinical Data Coder/Specialist – Pre Claims is responsible for the accurate and timely work to effect filing of Insurance claims. Qualified inidual will demonstrate clinical claims detailed knowledge, coding and delivering resolutions to missing/ incomplete order data. This person will identify invalid clinical values to help drive clean claims and revenue pull through on all products and services.

This position will support the Revenue Cycle function and report to the Front End Manager of Revenue Cycle.

Essential Duties and Responsibilities:

– Identify order and reimbursement deficiencies – both clinical and code related

– Investigate and correct, where appropriate, deficient clinical claim information

-Identify and escalate missing, and sometimes invalid, clinical order data for timely contact resolution with supporting cross functional teams

– Partner with multiple internal cross-functional teams and successfully manage multiple product projects simultaneously.

-Research claim and account information using various systems and portals internal and external

-Stay current with relevant medical billing regulations, rules and guidelines

-Complete position responsibilities within the appropriate time frame while adhering to quality standards

-Ability to interact with various insurances/ third party payors accurately and timely to ensure that authorizations are obtained and necessary documents are available for claim support based on internal and external policies and regulations

– Participate in clinical data management activities including leading clinical data initiatives, analysis and optimization of our clinical data capture workflows

– Translate data into meaningful information and knowledge that supports decision making or determining action that drives performance improvement and quality

– Identifies and uses internal and external sources of information for benchmarking and comparative performance, which includes networking with clinical communities, researching literature and agencies, and staying current on new indicators and other requirements

-Act as SME for multiple purposes where coding and clinical operations data is relevant

– Support and comply with the company’s policies and procedures.

-Maintains strictest confidentiality, and adheres to all HIPAA guidelines/regulations

– Regular and reliable attendance. – Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.

-Perform analytical and special projects, prepare ad hoc reports/data queries as may be assigned/requested, working with leadership

Qualifications:

Minimum Qualifications:

– Bachelor degree in relevant field is preferred

– 3+ years professional coding experience with current certification including International Classification of Diseases (ICD-10) and Coding Procedure Terminology (CPT) and HCPCS coding. – Authorization to work in the United States without sponsorship.

– Certified coder designation/ certification by AHIMA or AAPC required

– Superior organization skills, detail oriented, and ability to be persistent and follow through

– Problem-solving, ability to adapt, flexibility in approaches to accomplishing tasks, and ability to independently arrive at creative solutions to problems

– Excellent communication skills, both verbal and written, particularly the ability to convey technical information in an accessible and understandable manner

– Ability to work both independently and in collaboration with iniduals from various disciplines

Preferred Qualifications:

– 5+ years of experience coding in the medical/healthcare billing area- Lab a plus

– Any years of experience in the revenue cycle function to include third party payer experience. – Thorough understanding of professional coding, documentation, medical billing processes. – Deep familiarity with payer/insurance Medical policy, Prior Auth, claims, appeals and reimbursement processes. – Knowledge and familiarization with Medicare billing regulations and reimbursement methodologies for Laboratory

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.

Remote USA

$20$30 USD

OUR OPPORTUNITY

Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits – Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a erse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

Virtual Care Nurse Practitioner (California Licensed)

Los Angeles, California, United States

About Us:

Founded in 2017 by Carolyn Witte and Felicity Yost, Tia is the modern medical home for women. We are trailblazing a new paradigm for women’s healthcare that treats women as whole people vs. parts or life stages. Blending in-person and virtual care services, Tia’s Whole Woman, Whole Life care model fuses gynecology, primary care, mental health and evidence-based wellness services to treat women comprehensively. By making women’s health higher quality and lower cost, Tia makes women healthier, providers happier, and the business of care delivery stronger setting a new standard of care for women everywhere.

Tia has raised more than $132 Million in venture capital funding to date, including a recent $100 Million Series B investment, one of the largest early-stage rounds ever for a healthcare company focused on women. Tia has ambitious plans to scale its whole-woman, whole-life model to more than 100,000 women by 2023. We’ll do this by growing virtual and in-person operations in existing and new markets while expanding its service lines to care for women throughout their entire lives — from puberty to menopause. Since launching in 2017, Tia has grown to serve thousands of women aged 18-80 with blended in-person and virtual care in New York City, Los Angeles, Phoenix and soon San Francisco.

We’re building a world class team to reimagine women’s healthcare. We’re an interdisciplinary team of clinicians, researchers, designers, technologists and operators who have seen firsthand how broken the healthcare system is for women. We’re united by a powerful mission to enable every woman to achieve optimal health, as defined by herself, as well as a shared set of values and principles that define our business, products, and culture.

Tia is building a culture of excellence in people, process and product. This is our northstar value;

What is excellence, exactly?

Excellence about constantly elevating yourself, it is the process of constantly striving to perform to the best of your abilities, and identifying your top potential through constant learning, experimentation and evolution. Excellence is not about achieving perfection, as that insinuates a pinnacle. Instead, in our terms, excellence is about the pursuit of constant improvement. We’re looking for people who want to go on that hard journey of constantly setting new personal records, and organizational records.

We practice excellence at Tia by demonstrating the following types of behaviors: We chose (and actively choose) excellence as Tia’s highest order value because it crystalizes into one word several behaviors that we hold dear, specifically:

1. A drive to constantly improve through experimentation, reflection. and an insatiable growth mindset said another way, we’re energized by the possibility of invention, innovation, and iteration
2. Being present in and grateful for the journey not just the goal line. Perfection is static. Excellence is a process (more on this important distinction below)
3. Asking why, then why again because accepting this is just the way it is is not good enough
4. Grit & perseverance a maker mentality that involves rolling up your sleeves, but also deep care for oneself and for others
5. A commitment to uncovering talents to unlock rock star potential across every inidual

Furthermore, excellence reflects the bigness and the boldness of Tia’s mission and vision a world in which every woman can achieve optimal health, as defined by herself.

Said another way, Tia’s mission is NOT to make healthcare incrementally better for women. Instead, we’ve intentionally set out to create a fundamentally new paradigm for modern women’s healthcare that’s truly excellent. We believe that creating a company that operates in a culture of excellence will manifest in our product. Reaching this goal is not an overnight pursuit or a one and done. We have not and will not get it right with the first swing. Rather, this higher order goal is a moving target one we have not and will not ever fully achieve. By design, we will never be done with this work, but instead, we will be continuously in pursuit of our mission. It is this continuous pursuit the journey, not the finish line that truly embodies excellence.

Location: This is a fully remote position. (Active NP license for the state of CA required for this role but you may live outside of CA with the active CA license)

About the role:

We’re looking for a Full-Time Nurse Practitioner (active NP license for the state of CA) passionate about women’s health for Tia’s Virtual Care Team. As a Virtual Nurse Practitioner, you will be an integral part of the care delivery system. You will see patients virtually and deliver comprehensive and integrative care spanning across gynecology and primary care services: from virtual annual visits to birth control consults to flu/cold consults and dermatology management. Further, you will remotely triage, diagnose, and treat patients via our proprietary chat software.

Nurse Practitioners are integral to the formation and iteration of our technology development and care model. In addition to your clinical role, you’ll have an opportunity to shape the Tia care model and improve our technology tools. You’ll collaborate with our product & engineering teams to share insights and feedback.

Schedule is set with some flexibility. Start times are 7a-9a for early shifts and or 10a-12p for later shifts. Expectation is that you take two evening shifts per week. However we do have some flexibility depending on availability.

A bit about you:

Values and abilities you’ll bring to Tia:

• You’re motivated to elevate women’s care by bringing a shared-decision making approach to women’s health.
• You believe that each woman knows her body best, though she may need help interpreting what the signs mean. Your mission as a woman’s healthcare provider is to help your patients understand those signs and develop robust, multi-faceted treatment plans to reach health goals. You practice this by being a true partner on a patient’s health journey, never dogmatic, rigid or glued to institutions.
• You are an incredibly good question-asker & prober, this allows you to identify nuances of a patient’s life that could be pertinent to their story. You’re like a detective — but you do this with an elegance that makes the patient feel at ease sharing deeply personal information.
• You’re facile with technology, comfortable and experienced providing high quality care digitally via telemedicine and interested in the process of developing new technology to support the highest quality clinical care..
• You’re data driven and consistently incorporate new and evolving research into your day-to-day practice
• You’re a high functioning multi-tasker who has an incredible ability to stay calm and focused under pressure – this is a given – you are a NP after all! .
• You are a tolerant and inclusive thinker. You believe in sex-positive, no judgement and radically inclusive healthcare for every person, and espouse these values in your everyday life.

Skills and assets you’ll bring to Tia:

• You’re a board certified Nurse Practitioner (family nurse practitioner or women’s health nurse practitioner), with active and unrestricted licenses in the state of California and able to provide primary care and support of all aspects of women’s health with compassion and empathy. You have experience and a passion for delivering high quality integrated care via telemedicine and are highly tech savvy. While experience as a direct digital care provider in the past is not a must – it is highly desired!
• Deep clinical expertise in providing primary care and women’s health experience (at least 2 years of post-graduate clinical experience) including: STD screens, UTI & Vaginal infections consults, Pelvic Pain, Vaginal Bleeding, Birth Control counseling, annual exams and urgent care concerns (coughs, sore throat, abdominal pain, basic dermatological conditions) with an ability to take this brick and mortar experience and translate it to virtual delivery.
• Exceptional written and verbal communication skills.
• Demonstrated excellence in Interpreting and act on clinical labs + ultrasound results
• Willingness to work evenings + weekends as needed by schedule
• Authorized to work in the US

Other nice to have skills:

• As an organization that seeks to create an environment for all women to feel safe, heard, recognized and avowed in their health, bodies and lives, we are consistently seeking providers with backgrounds that are meaningfully different from those already forming our team. You bring a erse background, a range of care experiences in different communities or various modalities.
• Formal professional training in the following areas is highly valued: care delivery for women who have experienced trauma including having a lived experience of abuse, decision making support for low-income women, care delivery for LGBTQ identified folks, care delivery for immigrant or migrant or english-as-a-second-language support populations.
• A strong understanding of & interest in chronic stress and trauma as it relates to immune system compromise and inflammatory response systems is a plus.
• Experience or formal training weaving integrative medicine practices into your care plan development.
• Contracted with major payers (BCBS / Anthem, Cigna, Aetna, United)

Benefits

• Remote role with flexibility to work from home
• Market competitive salary ( 120-140K depending on experience for 40 hour work week)
• Annual CME stipend
• Medical and dental benefits
• Paid holidays, vacation, and sick leave

Remote Corporate Outpatient Coder

Job Category: Billing,Coding/Collection

Requisition Number: REMOT020771

Full-Time

Tampa, FL 33603, USA

USA Remote

United States

Job Details

Description

JOB TITLE: Corporate Coder (Remote)

GENERAL SUMMARY OF DUTIES:

The Corporate Coder (Remote) supports and contributes to the service excellence mission of Surgery Partners.

ESSENTIAL FUNCTIONS:

• Assisting with ensuring timely, accurate and complete coding of ICD-10-CM, PCS, CPT and HCPCS for ALL patient types in various facilities/case mix.

EDUCATION/EXPERIENCE:

• Required 5 years of hospital coding experience
• Outpatient CPT and HCPCS coding experience required
• Demonstrated success in coding with consistent accuracy
• One or more of the following Credential(s): RHIA, RHIT, CCS, COC, CPC
• Prefer Bachelors or Associates degree in Health Information Technology with RHIA or RHIT and CCS, Desired

QUALIFICATIONS:

• Must have knowledge of multiple hospital information systems
• Must be able to work independently and handle multiple tasks in fast-paced environment
• Must possess excellent leadership, verbal and written communication and problem-solving skills
• Must be able to maintain strict confidentiality at all times
• Must be capable of fostering a team environment
• Must have experience with computers and coding software

Title: Supervisor Coding and Billing – Remote

Location: United States

Full-Time

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

Job Title

Supervisor Coding and Billing

Location

Cleveland

Facility

Remote Location

Department

HIM Coding-Finance

Shift

Days

Schedule

7:00am-3:30pm

Job Summary

Job Details

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

As the coding Supervisor, you will supervise employees within the Coding section. You will assist the Manager with personnel-related duties as well as organize, direct, coordinate, and control coding section activity. You will assess, develop, and implement efficient systems that meet CCHS, JCAHO, and other government regulations. You may serve as a liaison between the Coding section and other CCHS Departments and interact with Revenue Cycle Management regarding billing issues and claims denials.

At Cleveland Clinic, we know what matters most. That’s why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you’ll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you’ll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.

Responsibilities:

• Supervises coding section personnel in daily operational activities.
• Directs the performance of inpatient coding and outpatient coding for the purpose of accurate patient billing.
• Supports internal and external coding review and education.
• Maintains and monitors performance indicators for unbilled coding accounts receivable and formulates action plans to reduce the number of outstanding cases.
• Identifies all problem areas and areas of opportunity regarding unbilled accounts.
• Monitors and maintains data on employee compliance with productivity and quality standards and takes appropriate action.
• Interacts with downstream departments on Revenue Cycle Management, Liaison and ITD, regarding billing related questions and/or accounts receivable.
• Management-level responsibilities include: hiring, performance appraisals, disciplinary actions, training, work distribution and flow, and employee engagement.
• Administers corrective action for areas of responsibilities.
• Develops and implements efficient systems and work flow to meet both CCF and government regulations.
• Protects the confidentiality of patient information per HIPAA regulations.
• May develop, implement, process and maintain clinical data computer systems.
• May protect the interest of the Clinic with HIM vendors. Interacts with ITD in the support of systems and processes in the section.
• Facilitates/trains coding staff on daily activities. Monitors and ensures time and attendance policy for the section.
• Interacts with the Coding Quality and Education Supervisor to support Coding Quality and Education initiatives.
• Interacts with the Supervisor of CDI to support the program initiatives and strategic planning goals.
• Promotes good morale and cooperation: encourages others, values their input, shares information and seeks ways to add value both to the customer and to the team.
• Anticipates and responds to changing skills requirements.
• Seeks opportunities to learn new skills and actively coaches and encourages team members to do the same.
• Prepares and presents at meetings.
• Integrates team into the coding process to promote their development.
• Other duties as assigned.

Education:

• Bachelor‘s Degree in Health Information Management or related field.
• High School Diploma/GED and five years of coding experience, including three years in a lead role may substitute for degree requirements.
• Associate’s degree and three years of coding experience, including one year in a lead role may substitute for degree requirement.

Certifications:

• Depending on department needs the Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA) is required and must be maintained.

Complexity of Work:

• Coding assessment relevant to the work may be required.
• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.
• Knowledge of medical record technology, statistics, and organization sufficient to identify and interpret clinical data, integrity of the data.
• Knowledge of supervisory techniques and methods and ability to train others in abstracting techniques and methods.
• Advanced knowledge of supervision, training/development, public relations and project management practices preferred.
• Comfortable with public speaking.

Work Experience:

• One year of coding experience in a lead role in a Professional Fee Coding environment required.

Physical Requirements:

• Ability to perform work in a stationary position for extended periods.
• Ability to travel throughout the hospital system.
• Ability to work with physical records, such as retrieving and filing them.
• Ability to operate a computer and other office equipment.
• Ability to communicate and exchange accurate information.
• In some locations, ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System’s Smoking Policy will be permitted to reapply for open positions after one year.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Title: Senior Coder Complex Inpatient

Location: United States

Primary City/State:

Arizona, Arizona

Department Name:

Coding-Acute Care Hospital

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

$26.29 – $39.44 / hour, based on education & experience

In accordance with State Pay Transparency Rules.

A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote work options. If you’re looking to leverage your abilities you belong at Banner Health.

As part of the Banner Health Revenue Cycle Team, there are opportunities within that team. We specialize in Inpatient coding on the facility side. We do not do pro-fee coding. We are a team of 4 Inpatient Coding Managers who cover for each other and report to the Director of Acute Care Coding. Each Associate Director leads a team of no more than 19 coders so that there is ample opportunity for communication between staff and leaders. These positions offer opportunities for growth within the coding department, including roles such as Coding Educator, Coding Quality Analyst, and supervisory/management opportunities. Additionally, as part of the Revenue Cycle team, there are opportunities within that team as well. There are also paid education opportunities, internal education, and opportunities for growth in this exceptional team environment.

Looking for a motivated, experienced Senior Complex Inpatient Facility | Acute Care | HIMS Coder –Remote | Medical Coder to join our talented Acute Care HIMS Coding Team. Ideally a minimum 5 years of inpatient coding experience in Acute Care inpatient facility coding (physician or pro-fee coding for IP is not needed). This requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).

Candidate should have experience coding all service lines including, but not limited to; Trauma, ICU, Cardiac, Transplant, Orthopedics, High-Risk OB, NICU, and more. Must have ICD-10-PCS coding experience. Banner has facilities in major metro areas as well as rural communities. The opportunity to code encounters from newborn babies to hospice patients and all service types in between presents itself on a daily basis. Banner has internal Acute Care Coding Educators that work directly with the new employee until such time as they are deemed proficient in the role they are hired for. Our IP coding expectation is 1.2 charts an hour when coding the mid-range charts ( $100,000-249,000) and 1.9 charts per hour when coding both mid-range and low-dollar ( less than $100,000) charts while maintaining a DRG accuracy rate of 95% or higher. We use the number of accounts for specific patient types and specialties in combination with the Case Mix Index and case financial information to formulate performance to Banner standards, which are currently more stringent than most national standards identified. Banner uses Optum eCAC – Optum Enterprise CAC applies clinically intelligent Optum natural language processing (NLP) to review medical records and deliver comprehensive, accurate code suggestions.

Meeting Accounts Receivable goals supports Banner Financial goals. In most of our Coding roles, there is a Coding Assessment given after each successful interview. Banner Health provides your equipment when hired. You will be fully supported in training for anywhere from 1 month+ according to inidual need, with continued support throughout your career here!

This is a fully remote position and available if you live in the following states only: AK, AL, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY

The hours are flexible as we have remote Coders across the Nation. The hours are flexible with some minor parameters. Generally, any 8 hour period between 7am 7pm can work, with production being the greatest emphasis.

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

POSITION SUMMARY

This position provides coding and abstracting for high tiered complexity range of acute care services at all Banner hospitals. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or procedures on inpatient records using ICD CM and PCS coding classification systems. Completes MS-DRG and APR-DRG assignments on inpatient records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding. Acts as subject-matter expert regarding experimental and newly developed procedural and diagnostic inpatient coding. This includes highest level of complexity of accounts encountered in Banner’s Academic, Trauma and high acuity facilities. Will serve as a role model for less experienced acute care coding Inpatient team members.

CORE FUNCTIONS

1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides timely and accurate coding in accordance to department specific productivity and quality standards thorough assignment of ICD CM and PCS codes, MS-DRGs, APR-DRGs and POAs for highest level of complexity of Inpatient accounts encountered in Banner’s Academic, Trauma and high acuity facilities.

2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the patient encounter. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists. Refers inconsistent patient treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment.

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

4. Acts as a knowledge resource for internal and external customers. Acts as subject-matter expert regarding experimental and newly developed procedural and diagnostic inpatient coding. Will provide mentorship to less experienced or otherwise identified staff members. Will collaborate with Acute Care Coding Leaders and Education team in identifying need for new and/or ongoing training for ACC team.

5. Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address related and complex matters independently with regard to interpretation of coding guidelines prior to referral to senior manager, educator or Coding Quality Analyst.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge and specialized formal training in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a health care field.

Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).

Must demonstrate a level of knowledge and understanding of ICD CM and PCS coding principles as recommended by the American Health Information Management Association coding competencies.

Requires five or more years of inpatient coding experience in Acute Care inpatient facility or healthcare system.

Must be able to work effectively and efficiently in a remote setting, utilizing common office software and coding software and abstracting systems.

PREFERRED QUALIFICATIONS

Associates degree in a job-related field or experience equivalent to same.

Previous experience in large, multi-system healthcare organization.

Additional related education and/or experience preferred.

Registered Nurse (Remote)

Location

Remote – United States, California

Type

Full time

Department

Clinical

Our Mission

Path’s mission is to make mental healthcare work for everyone.

Who we are

Path is a healthcare company powered by technology, dedicated to making mental health care work for everyone. Path takes a patient-first approach, where treatment is more accessible, personalized, and effective. With Path, it’s easy to find a high-quality therapist or psychiatric clinician who accepts insurance and is actively accepting new patients.

We are deeply committed to providing high-quality care that improves the lives of patients, investing in the providers who deliver that care, and always operating in an ethical and compliant manner.

What we’re solving

Over 65 million Americans have a treatable mental health issue that’s 1 in 5 people. Today it’s difficult to find a provider, and for those with complicated conditions, it’s nearly impossible to find coordinated care. There’s a good chance someone close to you could have used the help, even if it wasn’t obvious to the people around them. We’re here to fix this.

About the Role

Join our dynamic and fully remote Psych Clinical team at Path, where you will play a pivotal role in providing accessible, comprehensive, and personalized mental health care for a erse range of patients. As a psychiatric remote RN, you will play a pivotal role in supporting our PMHNP’s by triaging and providing crucial clinical support to patients in between video appointments. By assessing medication concerns, addressing safety issues, managing refills, and processing standing orders, the psychiatric RN ensures a seamless patient experience while our Nurse Practitioners engage in direct patient care. Collaborating closely with our Virtual Assistants and Care Navigators, you will oversee prior authorizations and paperwork requests. What sets this role apart is the opportunity to work at the forefront of telehealth, leveraging your organizational and tech-savvy skills to ensure effective communication between all team members and patients while fostering a collaborative culture. Your impact will extend beyond direct patient care, as you contribute to creating evidence-based protocols, policies, and workflows that elevate the standard of care we provide. If you’re passionate about delivering safe, patient-centered psychiatric care in a fast-paced and innovative environment, join us on our mission to make quality psychiatric care accessible to all. Your journey at Path begins with transforming lives, one virtual connection at a time.

Required Qualifications

• Experience:
  • Two (2) years of recent experience in an outpatient mental health setting.
  • Familiarity with psychiatric medications and DSM-5 diagnoses, demonstrating expertise in patient education.
• Education and Licensure:
  • Graduate of an accredited nursing school with a BSN.
  • Current RN licensure with an active CA license.
• Telehealth and Technology:
  • Experience in a telehealth environment or utilizing technology for mental health services.
  • Strong EHR and general tech literacy.
• Clinical Skills:
  • Exceptional prioritization skills for assessing, triaging, and addressing patient requests.
  • Clear and effective verbal and written communication, including concise clinical documentation.
• Operational Knowledge:
  • Strong operational knowledge with an interest in developing and implementing workflows, policies, and procedures in compliance with healthcare regulations.
• Availability:
  • Available to work 5 days a week for 8-hour shifts, with regular and reliable attendance.
  • Willingness to cover during 4th of July holiday week and last week of the year on a rotational basis

Preferred Qualifications

While having the preferred qualifications enhances your candidacy, having all of them is not mandatory. We encourage all interested applicants to apply, even those who may not meet every preferred requirement.

• Interdisciplinary Support:
  • Experience supporting a erse range of providers and their patients within an interdisciplinary team.
• Supervisory and Leadership Experience:
  • Two (2) years of staff supervisory experience.
  • Two (2) years of leadership/management experience with a healthcare team.
• Work Style:
  • Self-motivated and thrives in a fast-paced, innovative environment.

As Part Of Our Team, Full-Time Employees Receive

• 100% remote work environment from anywhere in the US
• Competitive pay and benefits that don’t change based on location
• Health benefits: medical, dental, vision, life, disability, and FSA/HSA
• Access to our 401(k) plan
• Generous time off policies, including 2 company-wide shutdown weeks each year (for most employees) to focus on self-care
• Paid parental leave
• Employee Assistance Program (EAP)
• Stipend to ensure your home office sets you up for success
• Quarterly department stipend for team building or in-person gatherings
• Wellness events and lunch & learns spanning many topics

Our Team

The people of Path are what truly define our mission and determine our impact on the communities we serve. We believe in building not only a team, but a erse community, inspiring each other by taking on big challenges, growing and succeeding together.

Title: Global Safety Senior Manager

US Remote

Location: DC-Washington

If you feel like you’re part of something bigger, it’s because you are. At Amgen, our shared mission—to serve patients—drives all that we do. It is key to our becoming one of the world’s leading biotechnology companies. We are global collaborators who achieve together—researching, manufacturing, and delivering ever-better products that reach over 10 million patients worldwide. It’s time for a career you can be proud of.

Global Safety Senior Manager

Live

What you will do

Let’s do this. Let’s change the world. In this vital role you will be part of the Combination Product Global Safety Team within the Combination Products Safety group ensuring the excellence of Amgen products for the portfolio.

Responsibilities

• Assessing potential impact of quality findings on patient user safety for all clinical and commercial products in conjunction with members of the Global Safety Team
• Providing consultation to Therapeutic Area Safety for the review of adverse event data to detect potential product quality issues for commercial products
• Providing consultation for device combination product diagnostic safety data collection, analysis, and reporting
• Provide expertise for device combination product risk management activities
• Contribute to assigned product Safety Advisory Team/ Global Safety Team pharmacovigilance activities when they pertain to device, companion diagnostic and digital health safety, including single case assessment, aggregate data analysis, and risk management activities.
• Provide combination product safety expertise to protocol, ICF, CSR review and preparation of filing documents.
• Support responses to regulatory queries for safety information as required.
• Conduct review of adverse event aggregate data to detect potential product/device quality issues.
• For assigned products, provide review of and input to device risk management documents, including hazard analysis, use risk assessments, human factors protocols and reports, etc.
• Perform authoring of device combination product system risk/benefit analyses
• Be representative and point of contact for Health Authority Inspection and Internal Process Audits within the remit of role and responsibility

Win

What we expect of you

We are all different, yet we all use our unique contributions to serve patients. The safety professional we seek is a collaborative partner with these qualifications.

Basic Qualifications:

Doctorate degree in Science and 2 years of safety experience

Or

Master’s degree in Science and 6 years of safety experience

Or

Bachelor’s degree in Science and 8 years of safety experience

Or

Associate’s degree in Science and 10 years of safety experience

Or

High school diploma / GED and 12 years of safety experience

Preferred Qualifications:

• Relevant scientific training OR clinical experience in activities relevant to utilization of medical devices and/or companion diagnostics.
• Previous experience creating Medical Opinion Memos, Health Hazard Assessments, or Medical Inputs for product complaints.
• Solid understanding of clinical trial device safety monitoring regulations and standards
• Strong knowledge of device development and commercialization principles
• Knowledge of post market safety reporting regulations/standard methodologies for devices/combination products globally.
• Basic understanding of signal detection principles for drugs/biologics.

Thrive

What you can expect of us

As we work to develop treatments that take care of others, we also work to care for our teammates’ professional and personal growth and well-being.

Amgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including:

• Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts.
• A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
• Stock-based long-term incentives
• Award-winning time-off plans and bi-annual company-wide shutdowns
• Flexible work models, including remote work arrangements, where possible

Apply now

for a career that defies imagination

Objects in your future are closer than they appear. Join us.

careers.amgen.com

Amgen is an Equal Opportunity employer and will consider you without regard to your race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

We will ensure that iniduals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Remote Pro Fee Coder (Denials Review)

Location: LOUISVILLE Kentucky; United States

Job Description & Requirements

Pay Rate: $26.00 – $34.00

TYPE OF JOB ORDER: Remote Pro Fee Coder (Denials Review)

REQUIRED SKILLS: 3- 5 Yrs.Pro Fee Experience. Denials exp a plus. Neurosurgical or General Surgical Coding experience required.

Academic Level -1 – IP and OP settings

#OF WEEKS: 18 + Weeks

SHIFT/HOURS: M-F Flexible hours

EXPECTED HOURS: 40

LICENSE/CRED. REQ: Prefer a CPC

SYSTEMS: 3M EPIC, Cerner

NOTES: Must be comfortable with Trauma 1 Academic Medical Centers, Remote Work Setting. Appeals and Denials Coding Specialist Profee (Physician-based). Within RCM Dept

Facility Location

Kentucky s largest city is identified by its plethora of parks and green space and its affinity for all things fun. Cheer for your favorite horse at the world famous Kentucky Derby or catch a live performance at the Actors Theatre of Louisville, one of the cultural staples of the city. Countless other museums, performing arts venues, distinguished eateries and exhilarating night-life venues make up this famous city.

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Title: Certified Professional Coder (Outpatient/Same Day Surgery)

Role: Certified Coder, Professional

Location: Remote. Must work in a location within the United States.

Travel: No travel required.

Classification: Hourly, Non-Exempt

Reports to: Coding Leadership

Salary Range: Commensurate with experience

About the role:

The Certified Coder (Professional) is responsible for reviewing and evaluating clinical information within medical records to ensure high quality and compliant coding. They re able to analyze information and make decisions independently. Our coders have an eye for detail and an aptitude for accuracy.

Responsibilities:

• Reviews and/or evaluates relevant clinical and demographic information from the medical record to identify accurate and appropriate code selection and claim information.
• Selects CPT/HCPCS codes (including modifiers) and ICD-10 codes to the highest specificity with correct sequencing to ensure accuracy and maximum reimbursement.
• Solicits additional information from providers regarding ambiguous or conflicting documentation in the medical record. Corrects coding discrepancies as needed.
• Investigates and resolves coding-related system edits, rejections from payers, and/or insurance denials when needed.
• Identifies and escalates system or process breakdowns to leadership; assists with resolution when requested.
• Serves as a resource for coding and revenue cycle leadership.
• Consistently achieves productivity and quality metrics.
• Complies with and holds with utmost regard all compliance requirements to protect patient privacy and confidentiality.
• Stays curious, kind and contributes positively to the revology culture. The health + harmony of the team is everybody s responsibility at revology.

The statements stated in this job description reflect the general duties as necessary to describe the basic function, essential job duties/responsibilities, job requirements, physical requirements and working conditions typically required, and should not be considered an all-inclusive listing of the job. Iniduals may perform other duties as assigned, including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise balance the workload.

Requirements:

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) license or similar from a nationally accredited medical coding organization required; Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) accepted.
• Must remain current on coding guidelines, rules and regulations, and new codes. Must complete mandatory continuing education.
• Must demonstrate effective written and verbal communication skills.
• Ability to work independently to accomplish goals in a dynamic environment.
• High school diploma or equivalent required; bachelor s degree or equivalent experience preferred.

Remote work requirements:

Internet capability must be a high-speed internet connection.

Physical requirements:

Must be able to perform physical activities, such as, but not limited to: moving or handling (lifting, pushing, pulling and reaching overhead) office equipment and supplies weighing 1 to 25 lbs. unassisted. Frequently required to sit for extended periods during the workday. Manual dexterity and visual acuity required. Must be able to communicate effectively on the telephone and in person.

Working conditions:

Work will generally be performed indoors in an office environment. Must maintain a professional appearance and manner.

Employment eligibility:

Candidates must be legally authorized to work in the United States without sponsorship.

About revology:

revology is a technology-enabled healthcare revenue cycle management (RCM) firm providing outsourced services to hospitals, health systems, and physician groups. Our tech smart-from-the-start strategy enables us to break through conventional barriers and empower each revologist to drive a higher standard of revenue cycle performance. This is possible because we spend our lives in the sweet spot where smart tech and good humans reach their highest potential and maximize outcomes.

At revology, we are committed to stewarding and empowering an inclusive environment within our company and our communities. While we believe in culture – we don t believe in culture fit . We encourage every single revologist to bring their unique perspective, lived experience and authentic selves to the table. revology is an equal opportunity employer and we encourage everyone to apply for our available positions – including women, people of color, iniduals with disabilities and those in the LGBTQIA+ community.

LPN Care Coach

Remote

Atlanta, Georgia, United States

Care Coach

Contract

Description

Our Mission:

CircleLink Health is a company of passionate clinicians, technologists and business people tackling the $600B problem of preventable chronic condition complications. Our mission is to accelerate the shift to preventative care (from status quo reactive care) through our world-class preventative care platform.

Your Impact On Our Mission:

As a Care Coach you will work remotely for 20-25 hours per week with a team of nurses to manage patients with chronic conditions enrolled in Medicare’s Chronic Care Management program.

Your day to day is

• Educating patients on self-management skills and goal setting. Chronic conditions include: Diabetes, CHF, COPD/Asthma, Hypertension, CAD, Ischemic Heart Disease, Anxiety, Depression.
• Implement and improve the Plan of Care by updating medications, appointments due, record biometrics, vital signs, and care coaching provided.
• Utilize Motivational Interviewing or other behavior change techniques to coach and assist the patient with self-management.
• Conduct Transitional Care Management activities to high risk patients discharged from the hospital and the ER to reduce unnecessary readmissions, including medication reconciliation, medication adherence, identify red flags, address barriers, encourage follow-up care, how and when to seek appropriate level of care.
• Reduce care gaps by encouraging or assisting with preventive care, and chronic care management, i.e. annual well visits, follow up visits, medication management, pre-visit labs, diagnostic tests due, preventive cancer screens.
• Connect the patient with community resources as needed, including transportation, personal care needs, homemaker or chore services, social services, etc.

Requirements

Required Skills and Abilities:

• Fluent in English.
• Meet communication skills, must be self-directed, able to work independently with little supervision while meeting performance metrics
• Passion for nursing.
• Detail-oriented.
• Excellent organizational and time management skills.
• Strong communication and telephonic skills.
• Strong critical thinking and problem solving skills.
• Commitment to certain number of hours per day and days of week
• Availability to make calls on weekdays between 9am-7pm.
• LPN needs a STRONG internet-connected computer.

Education and Experience:

• Current, unrestricted Compact LPN license
• Proficiency with electronic health records and web based applications
• 5+ years experience as a Licensed Practical Nurse

Preferred Education and Experience, but not required:

• Case Management or Chronic Disease Management experience
• Case Management Certification
• Certified Diabetes Educator
• Transitional Care Management experience
• Experience with Motivational Interviewing or other behavior change communication techniques

Benefits

Compensation:

This is a 1099 contract position with no end date. Care Coaches are responsible for their own taxes and insurance.

Compensation is paid at the rate of $10.00 per initial clinical encounter per patient per month. A clinical encounter occurs after two criteria are met: a patient has a successful clinical call, and the patient has 20 minutes or more of time in their chart timer. Ex: If in one hour you called and spoke with 2 patients and spent 20 minutes with each of them, your pay for that hour would be $20.00 ($10.00/pt. reached x 2).

• In addition to successful clinical encounters, Care Coaches shall be entitled to $3.00 in the event that a patient within their caseload withdraws from the Chronic Care Management Program.
• Additionally, a compensation of $4.00 will be paid out following five unsuccessful attempts to contact the patient without receiving a response.

About CircleLink Health:

CircleLink is a digital healthcare company that improves health for the chronically ill by engaging patients through personal phone calls and/or mobile technology, helping to solve the ~$600 billion problem of preventable chronic complications. Our patient engagement software and services enable physicians to monitor and manage their patients’ chronic conditions between office visits without investing in additional staff or technology.

Location: MN-Minneapolis

Position Description:

Sr. Regulatory Affairs Program Manager reporting to Minneapolis, MN. Focus on tactical, operational activities for a major program with broad or ongoing impact. Coordinate with business partners to develop regulatory strategies to support the business goals and translate the strategies into work plans for the RA teams to implement. Coordinate and prepare guidance for documentation packages for regulatory submissions and regulatory readiness for internal audits and inspections. Establish processes for submission material compilation, license renewal and registrations. Recommend changes for labeling, advertising and marketing literature for regulatory compliance. Establish procedures and processes for the update to EU and UK Technical Documentation and for the preparation of pre-market and post market submissions for the EU and UK whilst providing guidance on impact to US FDA and International submissions. Communicate with regulatory agencies for pre-submissions and submissions under review. Review and interpret the US FDA and international regulations to ensure compliance of the quality management system for medical devices. Understand and navigate industry regulations to include 21 CFR 820, ISO 13485 and ISO 14971, EU Medical Device Directive (EU MDD 93/42/EEC), EU Medical Device Regulation and Canadian Medical Device Regulation (CMDR). Provide guidance on regulatory strategies for medical devices in accordance with applicable FDA and international regulations leveraging knowledge of product development processes. *This position is open to telecommuting from anywhere in the United States.

Basic Qualifications:

Requires a Master’s degree in Regulatory Affairs, Biomedical Engineering, Medical Technology or related field and five (5) years of experience as a regulatory affairs specialist or related occupation in regulatory affairs. Requires a minimum of five (5) years of experience with each of the following: Regulatory Affairs for Class II and Class III medical devices; EU Technical Documentation in accordance with the EU Medical Device Directive or EU Medical Device Regulation; Pre-market and post-market medical device submissions to the EU and US FDA and International submissions; Communicating with regulatory agencies including EU Notified Bodies for the tracking of pre-submissions and submissions under review and key alignment decisions; Review and interpretation of the US FDA and international regulations for medical devices and compliance in the Quality Management System; and 21 CFR 820, ISO 13485, ISO 14971, and Canadian Medical Device Regulation (CMDR). *This position is open to telecommuting from anywhere in the United States.

#LI-DNI

Min Salary

171800

Max Salary

237000

It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified iniduals with disabilities.

Medicare Part C Medical Review Nurse

Job Location

Remote

Position Type

Full-Time/Regular

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving iniduals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

Our Investigations MEDIC (I-MEDIC) clinical team is seeking a Medical Review RN (Claims Analyst II) with superior analytical skills and a proven ability to evaluate medical claims data. If you love digging into the data, this is the perfect job for you! As a Claims Analyst II on the I-MEDIC, you will play a key role on a team that detects and prevents fraud, waste and abuse in the Medicare Part C program on a national level. This is a home-based, full-time position with excellent benefits.

Job Summary:

Mid-level professional performs medical record and claims review for Medicare Part C and/or other claims data in order to ensure that proper guidelines have been followed. As a member of an investigative team, may act as a facilitator as well as a case manager regarding assessment for potential overpayment, fraud, waste, and abuse with regards to Medicare, Medicaid, and/or other claims.

Essential Duties and Responsibilities include some or all of the following. Other duties may be assigned.

• Review beneficiary, provider, and/or pharmacy cases for drug seeking, drug selling, beneficiary and other potential overpayment, fraud, waste, and abuse.
• Completes desk review to meet applicable contract requirements and to identify evidence of potential overpayment or fraud.
• Effectively identifies and resolves claims issues and determines root cause.
• Consults with Benefit Integrity investigation experts and pharmacists for advice and clarification.
• Completes inquiry letters, investigation finding letters, and case summaries.
• Investigates and refers all potential fraud leads to the Investigators/Auditors.
• Has basic understanding of the use of the computer for entry and research.
• Responsible for case specific or plan specific data entry and reporting.
• Participates in internal and external focus groups and other projects, as required.
• Identifies opportunities to improve processes and procedures.
• Has the responsibility and authority to perform their job and provide customer satisfaction.
• May participate as an audit/investigation team member for both desk and field audits/investigations
• Has developed expertise with standard concepts, practice and procedures in field. Relies on limited experience and judgment to plan and accomplish goals.
• Testifies at various legal proceedings as necessary.
• May mentor and provide guidance to other analysts.
• Performs a variety of tasks some requiring independent thought and research. A degree of creativity and latitude is required.

Required Skills

To perform the job successfully, an inidual should demonstrate the following competencies:

• Analytical – Synthesizes complex or erse information; Collects and researches data; Uses intuition and experience to complement data.
• Problem Solving Gathers and analyses information skillfully; Identifies and resolves problems.
• Judgment – Supports and explains reasoning for decisions.
• Written Communication – Writes clearly and informatively; Able to read and interpret written information.
• Quality Management – Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
• Interpersonal Skills – Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others’ ideas and tries new things.
• Teamwork – Balances team and inidual responsibilities; Exhibits objectivity and openness to others’ views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; able to build morale and group commitments to goals and objectives; Supports everyone’s efforts to succeed.
• Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Computer Applications – Must have intermediate level experience with Microsoft Office to include Excel.

Required Experience

Education and/or Experience

• BSN OR an RN with additional current and active degree/license/certification/s in a relevant healthcare discipline (i.e., CPC, CPHM, CFE, CCM, HCAFA).
• Must possess at least five years clinical experience.
• At least one year healthcare experience that demonstrates expertise in conducting utilization reviews.
• ICD-10 coding, CPT coding, and knowledge of Medicare regulations preferred.
• Prior successful experience with CMS, State Medicaid, and OIG/FBI or similar agencies preferred.
• Medicare Advantage experience preferred
• Experience writing case summaries. Writing sample will be required.
• Legal case experience preferred.

Certificates, Licenses, Registrations: Current, active and non-restricted RN licensure required. An LVN does not meet requirements.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Iniduals with Disabilities.

CODING SUPERVISOR – REMOTE

Molina Healthcare

Job ID 2023465

Job Description

Job Summary

The Supv, Coding is responsible for providing assistance to the department leadership by ensuring compliance with coding guidelines. Subject Matter Expert who researches coding, coding relating issues, and reporting findings to management, providers and staff while providing direction and leadership to the team.

Knowledge/Skills/Abilities

Assist department leadership with oversight of coders’ day to day work including supervision of the internal coding staff to include hiring, performance management, recognition and development.

Ensures quality, productivity standards, and adherence to state and federal guidelines are met. Monitors compliance with corporate policies and procedures.

Identifies, assists, develops, and maintains corporate documentation, policy and procedures for standardized operations.

Acts as a coach and positive role model for staff and colleagues establishing/maintaining a positive work environment.

Coordinates staff schedules to ensure staging levels meet business needs.

Develops processes to ensure complete and accurate coding of assigned product lines.

Tracks coding issues and reviews coding inaccuracies to highlight areas of improvement.

Collaborates with interdepartmental or cross-functional teams for any assigned projects and provides departments with coding issues and updates to be shared with providers

Maintains a library of coding material and relevant resources to be available to personnel, when necessary.

Maintains a positive relationship with all clients and serves as a resource for clients and co-workers in regards to coding inquiries.

Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies as necessary or required. Maintains current knowledge of health care billing laws, rules and regulations and developments.

• Healthcare insurance experience
• 4+ years of medical coding experience
• Proven ability to perform strategic planning and priority setting for a coding department.
• High attention to detail

Job QualificationsRequired Education

Bachelor’s Degree or equivalent experience

Preferred Education

Bachelor’s Degree in related field

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $49,430.25 – $107,098.87 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time

Coding Denial Specialist

US – Remote (Any location)

Full time

15602

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Coding Denial Specialist will review assigned coding denials across multiple specialties, determine root cause and following established client workflow resolve and/or appeal denials based on clinical documentation and diagnostic results in alignment with Federal & State Coding regulations; including the National Correct Coding Initiative, CPT, HCPC’s and ICD10 CM Guidelines This position is full time as and 100% remote. What You Will Need:

• High School diploma and 1-3 years of prior relevant experience
• Minimum 3 years physician Coding experience
• Minimum 1 year physician coding denial management experience
• CPC certification from AAPC
• Must maintain credential throughout employment
• Excellent verbal, written and interpersonal communication skills
• Basic knowledge of Excel, Word and PowerPoint
• High level of accuracy and attention to detail
• Strong Working Knowledge of Federal & State Coding regulations; including the National Correct Coding Initiative
• Strong working knowledge of CPT, HCPC’s and ICD10 CM Guidelines
• Good working knowledge of HIPAA regulations, hospital operations, and working with electronic health record (EHR) systems such as EPIC or Cerner

What Would Be Nice To Have:

• Epic experience
• AAPC specialty credential(s)
• Proficient in the interpretation of Claim Adjustment and Remittance Advice Reason Codes

The annual salary range for this position is $39,200.00-$58,700.00. 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

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.

Title: Strategic Account Manager – Remote – Medical Benefit Products and Processes

Location: Orlando, FL

The Account Manager cultivates and maintains AssistRx’s relationship with our Pharmaceutical manufacturing partners. In this role, you’ll be working with pharmaceutical executives (Associate Director and above) on a daily basis to ensure they are receiving maximum value from iAssist’s features and services. The Pharmaceutical Account Manager presents new ideas and innovations to clients, upselling and enhancing their product and is the liaison between the Pharmaceutical Brand Teams and all key AssistRx stakeholders.

Responsibilities:

• Forms strategic partnership with clients by developing a working knowledge of their business goals, technical challenges and infrastructure configurations to ensure an outstanding customer experience.
• Establish and maintain a role as advisor to clients and colleagues.
• Present new ideas and innovations to client to upsell and enhance their products and services.
• Research high-level solutions for the client.
• Develop the relationship with the client through regular meetings/conference calls to review service quality and ensure they are receiving maximum benefit from iAssist’s features and benefits
• Works with Client Services to solve complex support issues effectively.
• Manages the delivery of recommended/agreed-upon services to achieve high client satisfaction and trust.
• Determines most effective method of problem resolution by utilizing internal resources when necessary.
• Primary point of contact for sales and service.
• Determines most effective method of problem resolution by utilizing internal resources when necessary.
• Participates in client quarterly reviews, attends annual Plan Of Action meetings and other travel as needed.
• Plan milestones and track progress.
• Effectively keeps others adequately informed by presenting information to everyone involved.

Requirements:

• Ability to effectively express ideas and thoughts verbally and in written form.
• Exhibits good listening skills and comprehension.
• Effectively keeps others adequately informed by presenting information to everyone involved.
• Ability to define problems, collect data, establish facts and draw valid conclusions.
• Bachelor’s Degree (B.A.) from four-year college or university or equivalent experience.
• Minimum three years of experience working in a customer support and/or sales capacity role.
• Experience working for or in Pharma.
• Experience working with Pharmaceutical Brand Teams is essential.
• Project Management, HUB Operations or Specialty Pharmacy Operations/Account Management strongly desired.
• Technical skills a must

Benefits:

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.

All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.

AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire

PAC Nurse

Job Locations Remote

Job ID

2023-15347

Category

Clinical / Post Acute Care

Min

USD $28.85/Yr.

Max

USD $38.46/Yr.

Overview

The PAC Nurse is a telephonic position responsible for managing the length of stay (LOS) for Long Term Acute Hospital (LTACH), Skilled Nursing Facility (SNF), and Institutional Rehab Facility (IRF) for their assigned post-acute care facilities through collaboration PAC Nurse will also collaborate with key facility personnel as well as with CareCentrix internal Medical Directors, Market Engagement Directors and Nurse Managers to develop and maintain a timely discharge plan.

Responsibilities

In this role, you will:

• For assigned post-acute facilities:
  • Establish scheduled telephonic touch points with each facility point person to review each member within that facility and confirm appropriateness for continued stay.
  • Authorize continued stay at SNF, IRF, LTACH and Home Health care (if delegated) using approved medical care guidelines and collaboration with key facility personnel within the healthcare setting.
  • Use clinical expertise, review clinical information and clinical criteria to determine if the service/device meets medical necessity for the member.
  • Ensure case review and elevation to complete the determination is rendered within the contractual and regulatory turnaround time standards to meet both contractual and regulatory requirements.
• Interact with the PAC Medical Director as needed to ensure proper medical necessity decisions are being rendered. Partner closely with the PAC Medical Director in care planning and goal setting, reviewing discharge plans and length of stay status to ensure optimal outcomes.
• Act as a clinical resource for unlicensed Post-Acute Care Coordinators, providing clinical expertise and helping to clarify referral source directives. Receive/respond to requests from unlicensed staff regarding scripted clinical questions and issues.
• Act as the primary contact to the post-acute facility or facilities to which they are assigned to obtain all clinical information required and to proactively obtain patient status updates.
• Through the Supervisor, work closely with Market Engagement Directors to efficiently address potential facility concerns, pushback or gaps in process.
• Communicate customer service/provider issues to supervisor for logging and resolution.

Support the following additional duties as requested:

• Participate in performance and operational improvement activities.
• Participate in and contribute to ongoing quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested.
• Assist team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
• Participate in special projects and performs other duties as assigned.
• Participate in an annual Inter-rater reliability Testing Process.
• Schedule options vary with this role based on business needs, currently we need nurses willing to work weekend schedules.

Qualifications

You should reach out if:

• You hold a current and unrestricted license as a Licensed Practical Nurse or Registered Nurse
• You have Associate’s Degree or Diploma in Nursing/Practical Nursing or the equivalent
• You possess a minimum of 2 years clinical experience in a clinical setting
• You are an expert in Utilization Management and knowledge of URAC & NCQA standards
• You have a broad knowledge of health care delivery/managed care regulations and experience with evidence based care guidelines (i.e. MCG/Milliman, InterQual)
• You have excellent negotiation, influencing, problem solving and decision making skills required
• You possess organizational skills and are able to effectively manage and prioritize tasks
• You can work independently, utilizing sound clinical judgment and critical thinking skills under minimal supervision
• You must have a strong commitment to quality and standards

What we offer:

• Salary Range: $32.00 – $36.00 / hour plus Annual Corporate Bonus incentive
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
• Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
• Advancement Opportunities, professional skills training, and tuition /exam reimbursement
• PayActiv – access earned income in between pay checks
• Walgreens Discount – receive up to 25% off eligible items
• Great culture with a sense of community

CareCentrix maintains a drug-free workplace

#IDCC

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

Job Title: Certified Medical Billing and Coding Specialist

Location: Remote

$25 $30 Hourly

Job Type: Full-Time

Company Overview:

Flow Health is a rapidly growing clinical diagnostic laboratory services provider, leading the way in inidualized, data-driven diagnostics. Based in Los Angeles, we hold both CAP accreditation and CLIA certification, uniquely positioned to combine the power of artificial intelligence (AI) with an end-to-end full service laboratory diagnostics platform. Our mission is clear: to revolutionize how clinicians and patients order and access personalized diagnostic insights, ultimately improving clinical outcomes and patient care.

Job Description:

We are seeking a highly skilled and detail-oriented Certified Medical Billing and Coding Specialist to join our laboratory team. The successful candidate will play a crucial role in ensuring accurate coding processes, contributing to the financial health of our organization. The ideal candidate should possess strong analytical skills, knowledge of medical terminology, and a deep understanding of coding principles and regulations within the diagnostic laboratory setting. The role is 100% remote, offering the applicant outstanding work flexibility.

Key Responsibilities:

• Assign appropriate codes to diagnoses, procedures, and laboratory services based on documentation provided by healthcare providers and laboratory professionals.
• Ensure compliance with all relevant coding guidelines, specifically ICD-10.
• Stay up-to-date with changes in coding regulations, payer policies, and healthcare laws relevant to diagnostic laboratory coding.
• Conduct regular audits to ensure compliance with coding and billing standards specific to diagnostic laboratory services.
• Demonstrate sound knowledge of laboratory coding guidelines and regulations to assist providers with the impact of diagnosis coding on risk adjustment payment models.
• Requires solid oral and written communication skills, and strong attention to detail.

Qualifications:

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is required.
• Associate s degree in Medical Billing and Coding or related field is preferred.
• Minimum of 2 years experience in medical billing and coding, ideally within a clinical or laboratory setting.
• Familiarity with medical billing software and claims processing systems specific to laboratory services.
• Expertise in ICD-10, with emphasis on diagnostic codes.
• Must have excellent time management skills, be highly organized, and self-motivated.

Title: Remote Pro Fee Coder

Location: Helena, MT

Job Family: General Coding

Travel Required: None

Clearance Required: None

What You Will Do:

• The General Surgery Coder must be proficient in surgical coding for all Trauma Surgery type cases.
• E/M experience is also required for associated providers.
• 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 should 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.

• Demonstrates the ability to perform quality surgical coding on General and Trauma surgery 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. Accuracy will be monitored during monthly reviews either within the facility.
• 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.
• 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.

What You Will Need:

• Minimum 3-5 years General Surgery Coding experience, both IP and OP coding for physician claims.
• 2-3 years coding Trauma or other complex procedures.
• CPC certification from AAPC
• EMR experience
• Must maintain credential throughout employment
• Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
• Advanced knowledge of Excel, Word and PowerPoint
• Strong Working Knowledge & experience with Federal & State Coding regulations and Guidelines

What Would Be Nice To Have:

• Multiple EMR and/or practice management systems experience
• E/M experience along with surgical coding experience (Office, OP and OR procedures

\#Indeedsponsored

\#LI- Remote

The annual salary range for this position is $40,200.00-$72,300.00. 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.

Clinical Coder II – Surgery

JOB DESCRIPTION:

The Department of Surgery is seeking a full-time Clinical Coder II position to assure that all clinical evaluation and management procedure services are captured, coded, and billed accurately and timely. Primary area of responsibility will be Surgical Critical Care. Candidates are required to be certified by one of the following institutions: Certified Professional Coder (CPC)/ American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required. This position is remote, however, an on-site training period may be required based on experience and qualifications.

Duties include:

• Performing highly specialized diagnosis and procedure coding for all non-operative and operative procedures performed.
• Verify all patient data for accuracy and resolve discrepancies.
• Review reports to determine billable services and apply the appropriate codes in a timely manner.
• Accurate and timely processing of charges in EPIC.
• Contacting Physicians or other clinical staff when appropriate to discuss coding, documentation, and/or compliance problems.
• Discussing coding, documentation, and compliance issues with co-workers on coding, documentation, and/or compliance issues.
• Demonstrating proficiency in the preparation and communication of physician queries.
• Remain current on coding and compliance information/guidelines and to become an expert in this specialized area of coding.
• Performs independent research and generates reports as requested by the department chairman, ision chiefs, and faculty members via the Assistant Director regarding amounts billed versus amounts paid to determine the effectiveness of coding practices.
• Review reimbursement reports and track payments for coding issues.
• Review reports from University of Florida Physicians reflecting payments for charges and uses this information to determine if coding is appropriate.

EXPECTED SALARY:

$21.70-$23.75 per hour; commensurate with education and experience.

MINIMUM REQUIREMENTS:

High school diploma or equivalent and three years of professional medical coding experience.

Appropriate college coursework or vocational/technical training may be substituted at an equivalent rate for the required experience. Certified Professional Coder (CPC)/American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required.

PREFERRED QUALIFICATIONS:

• Ability to code for both diagnosis and procedure required.
• Epic system knowledge preferred.
• The incumbent must be comfortable speaking with physicians and payers regarding procedure and diagnosis relationships, billing rules, and payment variances.
• Incumbent should be proficient in Microsoft Excel and Microsoft Word

SPECIAL INSTRUCTIONS TO APPLICANTS:

For consideration, you must apply online. Please upload your cover letter of interest, resume, and three professional references.

The University of Florida is committed to nondiscrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, gender identity and expression, marital status, national origin, political opinions or affiliations, genetic information, and veteran status in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

This position is eligible for veteran’s preference. If you are claiming veteran’s preference, please upload a copy of your DD 214 Member Copy 4 with your application for consideration.

Application must be submitted by 11:55 p.m. (ET) of the posting end date.

Location: USA-

Contract Specialist I – Remote

Job Title

Contract Specialist I – Remote

Duration

Open until Filled.

Work From Home

Yes

Work Remote

Yes

Description

Let’s do great things, together

Founded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

This position is a subject matter expert regarding health plan contracts; preparation of a high volume of medical and dental plan documents for standard and non-standard groups in compliance with company specifications, turnaround time requirements and all state and federal laws and regulations; production of Summary of Benefit and Coverage and Plan Change Form documents.

This is a Remote Role.

Follow the link below and complete an application for this position.

https://j.brt.mv/jb.do?reqGK=27719378&refresh=true

Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Requirements:

• Bachelor’s degree or combination of college level coursework and relevant experience.
• 1-2 years of insurance experience preferred in areas such as Claims and/or Customer Service.
• Demonstrated proficiency using Adobe and Microsoft Office applications, including Word and Excel.
• Proficiency in computer keyboard; minimum typing ability of 35 wpm.
• Effective verbal, written and interpersonal communications skills.
• Demonstrated ability to identify problems and initiate a solution.
• Ability to initiate and follow departmental policies and procedures.
• Ability to work under pressure and exhibit flexibility in changing priorities.
• Ability to learn new information and apply it to a variety of situations.
• Highly effective organizational skills with the ability to prioritize and meet deadlines.
• Maintain confidentiality and project a professional business image to internal and external customers.
• Ability to come to work on time and on a daily basis.

Contact with Others:

Internally with Sales and Account Services, Regulatory, Claims, Business Implementation Unit, Benefit Configuration, Membership Accounting, Pharmacy, Underwriting, and Contract Services

Duties & Responsibilities:

• Analyze and comprehend source documents such as Group Application identify potential errors, research as appropriate and correct any incorrect information.
• Accurately prepare plan documents for new and renewing standard and non-standard groups.
• Learn and understand company products, including annual changes and new products, and how they relate to plan documents.
• Learn and understand the difference in standard and non-standard language.
• Function as subject matter expert and respond to inquiries from internal departments regarding plan documents.
• Identify discrepancies between source documents and contract department records and articulate questions to relevant internal departments.
• Communicate with internal departments on requested changes to plan documents
• Develop a chronology of actions taken and maintain group files and work logs accordingly.
• Assist in development of policies and procedures.
• Produce Summary of Benefit and Coverage (SBC) and Plan Change Form documents.
• Perform peer-audits and self-audits of plan documents for accuracy.
• Produce a quality product under short turnaround time requirements, in accordance with department productivity and accuracy standards.
• Support peers in a team structure.
• Train lower level staff, such as temporary staff.
• Perform other duties as assigned.

Working Conditions:

Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week during peak business periods.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our [email protected] email.

Pay Range

$22.00 Hourly to $25.25 Hourly

Title: Remote Medical Coder- Hospital Inpatient

Job Family :

General Coding

Travel Required :

None

Clearance Required :

None

What You Will Do :

The Remote Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS 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 should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets.

• Maintains a working knowledge of ICD-9-10 PCS 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/PCS 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.Maintains average productivity standards as follows: 2 IP charts per hour (These productivity standards are Guidehouse general expectations and are subject to change based upon Guidehouse client agreements and/or other factors as determined by management. Notification of expected productivity will be conveyed by Management prior to assignment of a client project).

What You Will Need :

• Minimum 2 – 5 years+ previous work experience coding hospital acute care Inpatient records.
• Minimum 5+ years medical coding experience
• CCS, RHIT or RHIA Certification from AHIMA or CIC required.
• Must have experience working in systems such as EPIC, Cerner, Optum and/or 3M
• Must have good working knowledge of Anatomy and Physiology as well as Medical Terminology.
• Must have advanced knowledge of Coding clinics ICD-10-CM and PCS
• High School Diploma

What Would Be Nice To Have :

• Previous experience working with CDI and physician queries.
• Has ability to analyze Provider documentation and assign codes accurately.
• Strong knowledge and application of Government and other payer guidelines as they relate to compliant coding.

#Indeedsponsored

#LI- Remote

The annual salary range for this position is $50,600.00-$91,100.00. 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 or via email at. 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.

Title: Remote Medical Coder- Hospital Inpatient

Location: OH-Columbus

**Job Family** **:**

General Coding

**Travel Required** **:**

None

**Clearance Required** **:**

None

**What You Will Do** **:**

The Remote Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS 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 should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets.

• Maintains a working knowledge of ICD-9-10 PCS 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/PCS 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.Maintains average productivity standards as follows: 2 IP charts per hour (These productivity standards are Guidehouse general expectations and are subject to change based upon Guidehouse client agreements and/or other factors as determined by management. Notification of expected productivity will be conveyed by Management prior to assignment of a client project).

What You Will Need :

• Minimum 2 – 5 years+ previous work experience coding hospital acute care Inpatient records.
• Minimum 5+ years relevant experience
• CCS, RHIT or RHIA Certification from AHIMA or CIC required.
• High School Diploma
• Must have experience working in systems such as EPIC, Cerner, Optum and/or 3M
• Must have good working knowledge of Anatomy and Physiology as well as Medical Terminology.
• Must have advanced knowledge of Coding clinics ICD-10-CM and PCS

What Would Be Nice To Have :

• Previous experience working with CDI and physician queries.
• Has ability to analyze Provider documentation and assign codes accurately.
• Strong knowledge and application of Government and other payer guidelines as they relate to compliant coding.

\#Indeedsponsored

\#LI- Remote

The annual salary range for this position is $50,600.00-$91,100.00. 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._

Remote Pro Fee Neurosurgery Coder

Location: MILWAUKEE Wisconsin; United States

Job Description & Requirements

Pay Rate: $35.00 – $50.00

POSITION SUMMARY : Remote Pro Fee Neurosurgery Coding

POSITION DUTIES: Coding of Provider services for Pro Fee Neurosurgery Services

MINIMUM REQUIRED QUALIFICATIONS: CPC, CCS-P or RHIT; 3-5 Years Hospital Based Pro Fee Neurosurgery Coding

PREFERRED QUALIFICATIONS: CRC credential, Pediatric experience a plus within specialtiy

LENGTH OF ASSIGNMENT: Ongoing

SHIFT / HOURS PER WEEK: 20-24 per week

SYSTEMS: EPIC, Optum

Facility Location

Experience the entertainment, celebration and fun of the City of Festivals, where a thriving seaport combines with great neighborhoods and a small-town atmosphere. From the sparkling shoreline of Lake Michigan to an impressive array of museums, performing arts and shopping and dining options, the city is filled with endless unexpected surprises!

Job Benefits

Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary but the perks don’t stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Title: Remote Medical Coder- Hospital Inpatient

Location: CT-Hartford

**Job Family** **:**

General Coding

**Travel Required** **:**

None

**Clearance Required** **:**

None

**What You Will Do** **:**

The Remote Inpatient Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS 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 should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets.

+ Maintains a working knowledge of ICD-9-10 PCS 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/PCS 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.Maintains average productivity standards as follows: 2 IP charts per hour (These productivity standards are Guidehouse general expectations and are subject to change based upon Guidehouse client agreements and/or other factors as determined by management. Notification of expected productivity will be conveyed by Management prior to assignment of a client project).

**What You Will Need** **:**

+ Minimum 2 – 5 years+ previous work experience coding hospital acute care Inpatient records.

+ Minimum 5+ years relevant experience

+ CCS, RHIT or RHIA Certification from AHIMA or CIC required.

+ High School Diploma

+ Must have experience working in systems such as EPIC, Cerner, Optum and/or 3M

+ Must have good working knowledge of Anatomy and Physiology as well as Medical Terminology.

+ Must have advanced knowledge of Coding clinics ICD-10-CM and PCS

**What Would Be Nice To Have** **:**

+ Previous experience working with CDI and physician queries.

+ Has ability to analyze Provider documentation and assign codes accurately.

+ Strong knowledge and application of Government and other payer guidelines as they relate to compliant coding.

#Indeedsponsored

#LI- Remote

The annual salary range for this position is $50,600.00-$91,100.00. 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.

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.

Title: Triage Registered Nurse

(Part-Time Evening)

Location: Remote

Type: Part-time

Workplace: remote JobDescription:

Role Summary:

The Remote Triage Registered Nurse / RN supports patients and their families by providing clear, safe and effective telephone triage using evidence-based processes and tools. The Registered Nurse on this team will blend critical thinking skills with a decision support tool enabling safe, standardized care to our patient population.

2 Part-Time Evening positions available!

Shift/Schedule:

#1

Week 1: Tues-Fri 3p-7p PST

Week 2: Tues and Wed 3p-7p PST, Sat and Sun 10a-7p PST

#2

Week 1: Tues and Wed 3p-7p PST, Sat and Sun 10a-7p PST

Week 2: Tues-Fri 3p-7p PST

Essential Job Duties:

• Respond promptly to each incoming call and assist patients by providing standardized care and benefits navigation, while quickly developing a friendly, yet professional rapport over the phone
• Conduct a thorough clinical assessment of symptoms and confidently determine the appropriate level of care required to safely meet the patient’s medical need, and refer them using established guidelines
• Follow standard procedures and protocols related to the triage service
• Educate and communicate recommendations to patients thoroughly in patient-friendly language
• Successfully route members to additional internal/external benefits and community resources, when needed
• Provides care based upon the Included Health Core Values
• Provides triage and support for urgent member prescription needs
• Serves as a central point of contact for all Included Health member emergency escalations
• Participate in team meetings and continuous quality improvement

Requirements:

• Bachelor of Science in Nursing required
• Registered Nurse, currently residing and licensed in a compact state with eligibility to obtain RN licensure in all 50 states
• 2+ years experience in a triage setting, preferably some of that experience being focused on phone triage, or 2+ years experience in an emergency room, or 4+ years experience in an ambulatory primary care role that included triage
• Ability to work in PST Timezone
• Rotating holiday and weekend rotation (every 3rd weekend for Full Time and every other weekend for Part Time)
• Expertise in advanced clinical decision making
• Comfortable working with a wide variety of medical conditions for both pediatric and adult populations
• Experience in engagement in complex decision making, including situations of uncertainty
• Excellent written and verbal communication skills. The ability to gather a clinical history, answer questions at a patient level, and succinctly summarize findings is critical.
• Strong competence and ability to use multiple computer/medical record systems, as well as Google suite
• Must be able to work efficiently. We are a fast growing company and we are busy. Our team is expected to meet role specific metrics without sacrificing quality. Good judgment for balancing priorities is a must.
• Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.

Other Skills/Abilities:

• Self-disciplined, energetic, passionate, innovative and flexible
• Must be able to work independently remotely and work well under stress
• A team player that can follow a system and protocol to achieve a common goal
• Demonstrates sound judgment, independent decision-making and problem-solving skills
• Maintain current nursing licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education.
• Maintains professional demeanor and service-oriented patient focus to prioritize the patient experience
• Possess the ability to multitask, and using best judgement when to seek additional input from leadership

The United States base salary range for this full-time position is $30.52 AND $39.67 + 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 pay, the compensation package may include, depending on the role, the following:

• 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
• Up to $25,000 Fertility and Family Building Benefit
• 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
• Your recruiter will share more about the benefits for this role during the hiring process.

#LI-Remote

#LI-LC1

About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.

Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.

Spanish Speaking Registered Nurse

Remote

Watertown, Massachusetts, United States

Clinical

Full time

Description

Firefly Health is building a revolutionary new type of comprehensive health “care and coverage, powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform.

Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver half-priced health care that’s twice as good, clinically and emotionally. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members.

We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, then we would love to hear from you.

What you’ll do:

As a Registered Nurse on the Firefly team, you’ll be responsible for:

• Acute and chronic disease management
  • Triage all new patient concerns that arise from the Firefly mobile application or phone calls to determine the urgency and disposition based on the patient’s clinical need. Along with the NP or MD, the RN facilitates the transition to the correct level of care, whether with a Firefly clinician, urgent care, specialty care, or the emergency department (ED)
  • Provide patient-tailored education on the management of acute conditions
  • Conduct follow-up on patients with evolving or recovering illnesses.
• Prescription management
  • Evaluate all prescription refill requests and coordinate refills with the prescriber, patient, and pharmacy; complete prior authorizations, review of controlled substance portals
  • Conduct medication training for patients with complex regimens, medicine adherence challenges, and injection education
• Care coordination and case management
  • Coordinate the delivery of care within the practice setting and across health care settings, including post ED and discharge
  • Work on a multi-disciplinary team to care for patients with hypertension, diabetes, and patients who are in need of oral anticoagulation
• Provide culturally sensitive, patient-centered care in line with Firefly Health’s member-first principles

You’ll be a good fit if you:

• Are Bi-Lingual English/Spanish. Fluent in conversational Spanish with competency in medical Spanish (written and spoken required)
• Hold a current RN license in Massachusetts
• Have at least 2+ years of clinical practice experience, preferably in primary care or family medicine
• Fluency with EMR systems, including web-based applications
• Have the ability to summarize and communicate moderately complex information verbally and in varied written formats; collaborate with all members of the clinical and operations teams as well as other key stakeholders to ensure that patients receive optimal clinical care
• Can provide a high level of customer service to our patients; resolve service issues in a timely and respectful manner
• Can respond to patient electronic messages and phone calls received during hours on shift
• Have experience with tools related to process improvement and rapid-cycle change
• Are available to work 11am-7pm EST Monday-Friday

It’d be nice if:

• You have compact Licensure/multiple RN licenses
• You have previous telehealth experience

Note-This is a remote work from home position, however, occasional travel for work events/training may be required.

Our office is located in Watertown, Massachusetts but we’ve developed a robust remote working structure to give us more flexibility geographically while hiring for many positions.

This role can be done largely remotely, there are several times a year when staff come together onsite for planning and team building.

We are always looking for valuable talent to add to our growing team. Even if you’re not sure this role is the one for you, don’t let that stop you. We’d love to have a conversation to see where you could fit.

Firefly is an equal opportunity employer. We value erse backgrounds and perspectives. We’re committed to building and sustaining an inclusive workplace culture where iniduals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need.

Utilization Review Nurse- FT (4p-12a EST)

remote type

Fully Remote

locations

Remote – Other

time type

Full time

job requisition id

R012177

Responsible for utilization review work for emergency admissions and continued stay reviews.

Responsibilities

• Review electronic medical records of emergency department admissions and screen for medical necessity, using InterQual or MCG criteria.
• Participate in telephonic discussions with emergency department physicians relative to documentation and admission status.
• Enter clinical review information into system for transmission to insurance companies for authorization.

Qualifications

Required

• Current RN licensure
• At least 5 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
• At least 2 years utilization management experience in acute admission and concurrent reviews
• Intermediate level experience with InterQual and/or MCG criteria within the last two years
• Proficiency in medical record review in an electronic medical record (EMR)
• Experience in MS Office and basic Excel
• Ability to thrive in a fast-paced, dynamic environment and adapt to frequent changing business needs

Preferred

• 3+ years utilization management experience within the hospital setting
• Bachelors of Science in Nursing
• Proficient in InterQual/MCG criteria
• Case Management Certification (CCM, ACM, CMCN, or CMGT-BC

Expectations

• This job operates in a remote environment that must be private. This role routinely uses standard office equipment such as computers, phones, and printers.
• Hours will vary, including two weekends a month.
• Must be able to remain in a stationary position 50% of the time and constantly operate a computer.
• Frequently communicates with internal, external and executive personnel and must be able to listen and exchange accurate information.

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

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the inidual can provide proof of valid prescription to Netsmart’s third party screening provider.

If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please contact[email protected] to request the details to which you may be legally entitled.

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