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Supervisor, Intake Nurse Navigation – REMOTE (FT)

locations

Remote

time type

Full time

job requisition id

JR-08873

Supervisor, Intake Nurse Navigation – REMOTE (FT)

Cancer care is all we do

Hope in healing

Cancer Treatment Centers of America (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each inidual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.

Job Description:

**This position is REMOTE, Mon-Fri, 8a-5p PST**

The Supervisor of Nurse Navigation assumes the responsibility and oversite of the Intake Nurse Navigation team. The role entails ensuring the nurses are following related nursing hospital policies and procedures, professional nursing practice, application of the Mother Standard of Care and relationship-based care across the organization within clinical and/or programmatic areas. The supervisor will have the responsibility and oversight of the Intake Nurse Navigation process for tracking patients through to treatment decision along with understanding and overcoming any barriers to care. The role includes reporting on metrics and tracking department Key Performance Indicators along with identifying areas of opportunity for process improvement. This includes reporting on metrics at a minimum of weekly/monthly along with tracking real-time to identify and address opportunities in real-time.

Minimum Qualifications

Education: Bachelor of Nursing required, Masters’ preferred

Licensure: Registered Nurse (RN) in the current state of employment

Certifications: Oncology Nurse Certified (OCN) preferred

Experience:

• Minimum of 3 years experience working in a medical/surgical or oncology setting, preferred
• Previous office experience desirable
• Proven competence in staff nursing roles and strong ability to coordinate interdepartmental operations and management relations

JOB RESPONSIBILITIES

• Management of day-to-day operations in the assigned area including staffing issues, patient complaints or requests, physician concerns, issues revolving supplies and equipment.
• Proactively works with staff and models patient service mentality.
• Demonstrates and insists on the Mother Standard of Care.Working with their direct reports they will oversee the development and oversight of quality measures, productivity and financial metrics and interdepartmental cooperation.
• Monitors the provision of patient care and insists on the adherence to Nursing Service policies and Evidence Based practice. Integrating industry best practices related to patient navigation into existing processes as appropriate.
• Responsible for ensuring staff maintains appropriate licensure, certifications, and core competencies.

#LI-REMOTE

We win together

Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us.

Visit: Jobs.cancercenter.com to begin your journey.

Medical Billing Specialist

EOE STATEMENTCPSI is a proud equal opportunity employer (EOE). However you identify and whatever background you bring, we welcome you to apply to any role that would make you excited to work in healthcare. All employment decisions are based on business needs, job requirements and inidual qualifications, regardless of race, color, ethnicity, religion, sex (including pregnancy, childbirth, lactation, or related medical conditions), national origin, ancestry, age, marital status, sexual orientation, gender identity and expression, disability, veteran status, military or uniformed service member status, genetic information, or any other status protected by applicable federal, state, local, or international law. We are committed to being a company where people thrive by being themselves and are inspired to do their best work every day.

DESCRIPTION

TruBridge, a Healthcare Services company based in Mobile, AL is seeking applicants for a remote medical billing specialist (work from home)in its Business Services ision.

TruBridge is a rapidly growing organization that has a need of hiring experienced medical billers all across the country. If you possess critical access or acute care billing experience and are interested in joining a growing team, please submit your resume to TruBridge.This position is responsible for acting as a liaison for hospitals and clinics using TruBridge Accounts Receivable Management Services. They work closely with TruBridge management and hospital employees to ensure timely and accurate submission of insurance claims as well as to facilitate effective follow-up and receipting of insurance claims. Candidates must be detail oriented with excellent verbal and written communication skills, organizational skills, and time management skills.

Job Description: Daily billing of insurance claims, follow up on unpaid claims, denial management and filing appeals when appropriate to obtain maximum reimbursement.

Job Duties:

• Ensure all claims are submitted daily with a goal of zero errors
• Timely follow up on insurance claim status
• Reading and interpreting an EOB (Explanation of Benefits)
• Respond to inquiries by insurance companies
• Denial Management
• Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles
• Any additional duties as requested by management

POSITION REQUIREMENTS

Required Skills:

• 5 years of recent Critical Access or Acute Care facility billing
• Medicare Billing Experience Required
• Computer skills
• Experience in CPT and ICD-10 coding
• Familiarity with medical terminology
• Ability to communicate with various insurance payers
• Experience in filing claim appeals with insurance companies to ensure maximum reimbursement
• Responsible use of confidential information
• Strong written and verbal skills
• Ability to multi-task

Technical Specifications:

• Base download/upload internet speed of at least 5Mbps SATELLITE/HOT SPOT INTERNET IS NOT ACCEPTABLE.
• Quiet, dedicated space to work
• All equipment will be provided by TruBridge

Title: Telemedicine Registered Nurse (Remote)

Location: United States

Please note: An NLC Compact License is required for this position.

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

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

WHAT YOU’LL DO:

• Remotely triage patients via our online chat-based platform
• Recommend suitable treatment plans and consider cost-effective treatment modalities, within your scope of practice
• Assist in care coordination to ensure our members are cared for in a timely manner
• Provide relevant medical and wellness education within your scope of practice
• Act as a resource for the broader care team within your scope of practice
• Create draft orders for NPs and doctors to review and approve as appropriate
• Foster loyalty among our members by contributing to the overall Forward experience

WHAT WE’RE LOOKING FOR:

• An RN (BSN required) with an NLC Compact License AND 2+ years of experience.
• Available and eligible for licensure in all 50 states. We will provide assistance to get you licensed in the states in which you will practice.
• Motivated by Forward’s mission to make preventive care a bigger part of patient lives, and you enjoy practicing in telemedicine care environments.
• Hardworking and detail-oriented, with the ability to problem solve, reaching out for help / support on patient cases, as needed.
• A caring, compassionate inidual who enjoys helping others and providing a positive care experience in a telemedicine platform.
• Looking to work 20+ hours per week.
• Flexible with your availability and interested in working in a telemedicine environment with frequent change / product improvements.
• Someone with advanced computer skills including typing speed, email, internet research, downloading and uploading files, and working in multiple browser windows. You should be extremely comfortable using new technology and software.

Additional Details

TECHNICAL REQUIREMENTS

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

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

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

Processor

ChromeOS: Intel Pentium

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

Memory

ChromeOS: 4GB of RAM or better

Non-ChromeOS: 6 GB of RAM or better

Operating System

ChromeOS: no minimum

MacOS

Windows 10 or better

Browser

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

Please let us know during the interview process if you have concerns with any of these requirements.

Manager, Biller/Coder+ (CPC)

• Remote, USA, United States
• Employees can work remotely
• Full-time
• Department: 953 – Virtual Products – Scribe and Coder

Company Description

Privia Health is a national physician platform transforming the healthcare delivery experience. We provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and population health management programs, Privia works in partnership with health plans, health systems, and employers to better align reimbursements to quality and outcomes.

Job Description

The Manager, Biller/Coder+ oversees the BILLER+ and CODER+ offerings under the Privia+ brand. This person is accountable for the success of these programs and manages the day-to-day operations for a growing customer base. This includes, but is not limited to, creating and maintaining SOP documentation, ensuring compliance at every step in the process, providing direction to a cross-functional team, and holding team members and vendor partners accountable to meet SLAs and performance expectations. The ideal candidate has operational and project management skills, experience managing a global workforce, and deep subject matter knowledge of physician revenue cycle, physician professional coding (Pro-Fee) and physician practice workflows in a multi-specialty physician practice environment.

Primary Job Duties:

• Responsible for overall operational and programmatic success of BILLER+ and CODER+, including vendor partnerships, operational performance, and client satisfaction
• Manage a global workforce of employed staff and vendor contracted billing and coding teams to ensure delivery on production targets, turnaround times, quality and other SLAs
• Develop, review, and approve all Standard Operating Procedures (SOPs) regarding operations, escalations, team alignment, and any other relevant operational area
• Serve as the primary escalation point for addressing operational and performance issues with vendors, partner organizations, and internal staff
• Partner with Implementation to ensure successful customer go-lives, for large or complex customer implementations
• Provide updates and reporting on key performance metrics to leadership
• Regularly communicate program updates, new features and other important information to customers and internal stakeholders
• Solicit feedback from customers on opportunities to improve or enhance programs
• Identify and/or collaborate with RCM leadership on opportunities to improve the programs through workflow, technology and/or partnerships
• Minimal travel to client sites for onboardings and performance management (as needed)
• Perform other duties as assigned

Qualifications

• Demonstrate knowledge and expertise of physician revenue cycle, physician professional coding and physician practice workflows
• Experience managing a global revenue cycle team of direct reports and vendor partners
• Ability to work effectively with clinicians and staff to implement change
• Strong analytical and project management skills
• Experience working in a revenue cycle management role within a multi-specialty physician practice setting strongly preferred
• Experience with athenahealth PMS/EHR preferred
• Relevant coding experience and certifications (CPC required – CPMA, CRC preferred)
• Must comply with HIPAA rules and regulations

Pro Fee Quality Reviewer

• Virtual, United States
• Client Services
• 19531

Job Description

Overview

Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 12,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and erse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies.

Responsibilities

The Remote Pro Fee – Coding Quality Reviewer shall report directly to the Quality Review Supervisor and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as performed by the Guidehouse coding team by utilizing ICD-10 CM, CPT and HCPCS coding classification systems. Review of patient records will be conducted via facility EMR, scanning technology or other established method. This position will perform any and all related job duties as assigned.

Duties and Responsibilities:

• Ensure 5% coding quality review (or percentage stipulated in client contract) of each coder’s work is conducted monthly for those facilities the reviewer is assigned. Coding quality review will be conducted to identify abstracting, ICD-10-CM, CPT, modifier, and HCPCS coding errors for codes assigned by the coding team (see quality review policies for review details).
• Reviewer will run coder productivity reports (where applicable) to pull random sample accounts for review and to ensure review percentages are met per facility contract.
• Review coding and abstracting on all patient types assigned for review to include the following: inpatient, ambulatory surgery, ER, clinic, diagnostics and evaluation and management levels to assure 95% coder accuracy (or accuracy percentage as stipulated by client contract).
• Become familiar with any facility specific coding guidelines and know where to access on the Navigant portal.
• Required to read all Coding Clinic and CPT Assistant updates and stay abreast of all new coding guidelines.
• Ensure code recommendations are supported with AHA Coding guidelines, Coding Clinics, CPT Assistant and/or other official coding references.
• Perform chart reviews and coding recommendation notifications (to ensure appropriate turnaround times) to coding team in a timely manner (same day review conducted).
• Enters review findings daily for each account reviewed in quality review software or no less than within 24 hours of conducting the review.
• Communicates in a professional, non-threatening mentorship manner with the coding team in coding quality recommendation discussions.
• Follows review escalation policy when coder/review disagreements occur (see quality review policy/procedures).
• Notify VP of Quality when coding risk areas and error trends are identified for a specific facility and/or coder.
• Assist Coders in answering coding/abstracting questions resulting from the quality reviews.
• Reviews monthly and quarterly coder quality reports and performs intensification reviews for Coders who fall below the stipulated accuracy rate as part of the corrective action plan.
• Maintain a working knowledge of ICD-10-CM and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
• Ability to maintain average review productivity standards as follows:
• Emergency Department (without E/M): 7 charts per hour
• Emergency Department with E/M: 4 charts per hour
• Diagnostics: 12-15 charts per hour
• Surgeries (any service line): 3-4 charts per hour
• Pro Fee Evaluation/Management Level (any setting or service line without procedure): 5 charts per hour
• Pro Fee Evaluation/Management Level (any setting or service line with procedure (major procedure): 3 per hour
• Claim Edit Review: 10-15 per hour
• Complete review activity summary daily (productivity summary) for each facility and submit to QC Supervisor and Director on a weekly basis (utilized to calculate quality review FTEs assigned to each facility).
• Review and be familiar with the annual review criteria standards as well as DRG review calendar (if appropriate to assignment).
• Assist as needed in the review of external coding audit company findings and formulates a response to be used in the defense of the codes assigned.
• Participates in client conference calls and mandatory monthly quality team stand-up calls. Responsible to review the minutes of monthly quality stand up calls if not able to dial into the conference call (minutes are posted on the portal).
• Provide company support for the creation, maintenance and ongoing operation of an efficient and accurate Quality Improvement Plan that is compliant with Local, State, and Federal Government Regulations.
• Work with the Coding Solutions Division to provide on-going coding education resulting from the Quality Reviews. This will involve direct one-on-one correspondence between the coder and reviewer.
• Maintain open lines of communication serving as a liaison between client, Coders, and Coding Solutions Division to ensure that all parties are kept up to date on specific hospital guidelines/policies.
• Participate in company Coding Solutions Division Meetings as requested.
• Reviewer must be able to work independently while maintaining specific productivity standards.
• Basic computer skills are needed to handle connection issues, downloads and to review specific programs.
• Reviewer downtime must be reported immediately to the IQC Supervisor and Director to ensure adequate work flow.
• Access to the facility system or any other system that prohibits you from completing your work assignment should be reported immediately to the IQC Supervisor and Director and Guidehouse support help desk (via phone and/or email notification with a copy to the QC Supervisor/Director)
• Reviewers must maintain their current professional credentials while working for Guidehouse.
• Reviewers are responsible for maintaining HIPAA compliant work stations (reference HIPAA work station policy).
• Reviewers are responsible for maintaining patient privacy at all times (reference company handbook policy).
• Reviewers are responsible for signing a confidentiality statement.
• It is the responsibility of each reviewer 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.
• Communication in emails should be professional and collaborative at all times (reference e-mail policy).

Qualifications

• Must hold one of the following credentials: (CPC, CPMA, CCS-P).
• Three years of previous coding / review experience.
• Must have experience with: multispecialty E&M Coding and Auditing, Multispecialty Surgery Coding and Auditing with an emphasis in Orthopedics and General Surgery
• Abide by all client policies and procedures.
• Abide by all Guidehouse policies and procedures.
• Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.

Information System Requirements:

• Computer and monitors provided by Guidehouse.
• Internet Access with DSL or high-speed connectivity.
• Remote office location that meets HIPAA privacy requirements.

Additional Requirements

• The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

  The salary range for this role is $38.00 – $41.00 , may vary based on experience and location.

Disclaimer

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.

Rewards and Benefits

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 and Adoption Assistance
• 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

Telephonic Nurse Case Manager

REMOTE

Job Type

Full-time

Description

A Telephonic Nurse Case Manager is responsible for providing telephonic medical case management for Worker’s Compensation and Liability Injury Management programs. Case Management is a collaborative process to promote quality cost effective outcomes, which enhance the physical, psycho-social, and vocational health of iniduals. This includes assessing, planning, implementing, coordinating, and evaluation of service options. The goal of the Case Manager is to assist the injured worker in receiving appropriate, cost effective medical care for their injury in a timely manner, and to expedite their return to work.

Position Logistics: Non-Exempt, Full-time, eight (8) hour work day, Monday – Friday, Travel may be required.

Please note: This position requires a compact RN license and NY state RN license in good standing (or ability to acquire NY state RN license)

Responsibilities may include, but are not limited to:

• Once a file is identified as needing a Telephonic Case Manager, the TCM ensures telephonic case management activities are processed in accordance with EK’s standard. Activities may include:

o Completing referrals within computer database from either injury report or information gathered from the web-based system

o Performs 3-point contact on new files and, depending on account, forwards within 24 or 72 hours from date of referral

o Reviewing and evaluating all medical correspondence and provider reports obtained to determine work status of IWs or patients

o Reviewing treatment plan history and direction of file with client, when necessary

o Providing a 24-hour update after all significant activity

o Evaluating clinical status of claimant and researches for alternative options to treatment as warranted

o Communicating with the claim’s examiners regarding directives, and provides updates on file status

o Arranging transportation services when necessary and authorized

o Evaluating therapy facilities and their progress on specific cases

o Preparing comprehensive notes following any discussions had with IW, medical providers, claims examiners, and employers in the case file in EK TCM Ahshay and client system, per policy standards and procedure

o Completes initial reports every 14 days and every 30 days thereafter, according to account profile and service type.

o Ability to handle a variable case load dependent on service and client type

• Utilizes the nursing process in conjunction with URAC standards, EK Standards and client guidelines to manage and move files forward.

o Assessment:

§ Perform a complete nursing evaluation

§ Collect relevant data to the patient’s physical and mental status, functional capability, personal and environmental factors

§ Analyze the collected data to determine problems, strengths and needs of the patient

o Planning:

§ Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation

§ Upon authorization, implement this plan of care with patient, physician and health care providers

o Implementation:

§ Make regular personal contact to oversee the contracted services in order to maintain quality of care

§ Arrange for care/services as needed (home care, procedures, medication, equipment or supplies)

§ Monitor the plan of care with modifications or changes suggested to the patient and physician as the need arises

§ Coordinate information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any is involved)

o Evaluation:

§ Determine the progress and the effectiveness of the care

§ Prepare a monthly report of the patient’s progress and specific cost savings

§ Evaluating clinical files ongoing and ensuring care is medically necessary

• Accurately and efficiently identifying properly requested files for Triage and processes for determination of telephonic or field case management.
• Evaluating clinical files ongoing and ensuring care is medically necessary
• Identifying cases that are not utilizing the MPN or PPO network providers, and appropriately redirects IW to the network providers
• Ensuring productivity and timeliness of reviews follow EK and client departmental policies, standards and procedures
• High level of comfort with computer based activities including typing, managing all activities within a web based platform and leveraging technology to attend visits or assessments virtually, when appropriate, by means such as Zoom, Facetime and telemedicine platforms.
• Identifying and recommending referrals to Field-Based Case Management and EK Specialty Programs.
• Handling all medical information and reports as confidential information, ensuring accuracy of files and notepad entries
• Attending in-service meetings and continuing education seminars, as appropriate
• Utilizing effective oral communication, written communication and organization skills and demonstrates the ability to prioritize case activities
• Professional interaction with EKHS staff, members of the medical community, and all customers of EKHS; both in oral and written forms
• All work is done within the scope of practice for a Registered Nurse in in the state where case management services
• May act as preceptor for new or covering Telephonic Case Managers as requested by management
• Participate in EKHS Nursing teleconferences and staff meetings as scheduled.
• Adherence to EKHS Employee Handbook
• Other duties as assigned

Requirements

Qualifications:

• Graduate of an accredited school of nursing
• Valid state-appropriate RN license in good standing with no restrictions
• Compact RN License
• May be required to obtain additional state RN licenses (NY)
• Possesses and can demonstrate the professional and technical skills needed
• Experience in Field or Telephonic Case Management, Workers’ Compensation or Liability experience highly preferred, but not required
• Experience in Home Health Care, Occupational Health considered a plus
• Certified Case Manager (CCM), Certified Occupational Health Nurse (COHN or COHN-S) or Certified Rehabilitation Registered Nurse (CRRN) highly preferred, but not required.
• High comfort level with computers and computer programs (MS Word, MS Excel, Email)
• Excellent Written and Oral Communication Skills
• Excellent Interpersonal Skills
• Strong Organization Skills
• High comfort level with computers and computer programs (MS Word, MS Excel, Email)
• Ability to work independently with minimal supervision
• Ability to meet deadlines in a high pressure, time sensitive environment
• Ability to lift up to 20 lbs

Physical Requirements: Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.

*Requires DSL, fiber, or cable internet connection from home 10 mbps preferred or better *

Title: Pro Fee Coder – Interventional Radiology

Job Description

Overview

Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 12,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and erse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies.

Responsibilities

The Remote Interventional Radiology Pro Fee Coder must be proficient in E/M coding for all Interventional Radiology cases. 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 100% remote.

Responsibilities:

• Demonstrates the ability to perform quality coding on ancillary charts, clinic charts, and emergency room records.

• 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. • Ability to maintain average productivity standards as follows • 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. • Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met. • Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility. • Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. • Responsible for coding or pending every chart placed in their queue within 24 hours. • It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard. • Coders are responsible for checking the Guidehouse email system at least every two hours during coding session. • Coders must maintain their current professional credentials while working for Guidehouse. • Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. • Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) • It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content. • Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services. • Communicates problems or coding principle discrepancies to their supervisor immediately. • Communication in emails should always be professional (reference e-mail policy).

Qualifications

• Minimum 3-5 years outpatient professional coding experience in Interventional Radiology.

• 2-3 years coding both Cardio and Neuro Interventional Radiology procedures.

• CPC certification from AAPC • High School Diploma • 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 • Excellent verbal, written and interpersonal communication skills • Advanced knowledge of Excel, Word and PowerPoint • High level of accuracy • Strong Working Knowledge & experience with Federal & State Coding regulations and Guidelines

Preferred Qualifications:

• CIRCC credential from AAPC

• EPIC experience

Additional Requirements

The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.

The pay range for this position is $25-$27 per hour and may vary depending on experience and location.

Medical Dental & Billing Specialist (Remote)

Job Category: OBS-Billing Services Location: Remote/Virtual

OCHIN is a rapidly growing national nonprofit health IT organization with two decades of experience transforming health care delivery to drive health equity. We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our mission.

OCHIN provides leading-edge technology, data analytics, research, and support services to more than 600 community health care sites, reaching nearly 6 million patients nationally. We believe that every inidual, no matter their race, ethnicity, background, or zip code, should have fair opportunity to achieve their full health potential. Our work addresses differences in health that are systemic, avoidable, and unjust. We partner, learn, innovate, and advocate, in order to close the gap in health for iniduals and communities negatively impacted by racism or other structural inequities.

At OCHIN, we value the unique perspectives and experiences of every inidual and work hard to maintain a culture of belonging.

Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 800 erse professionals, working remotely across 40+ states. We offer a generous compensation package and are committed to supporting our employees’ entire well-being by fostering a healthy work-life balance and equitable opportunity for professional advancement. We are curious, collaborative learners who strive to live our values everyday: leadership, collaboration, excellence, innovation, inclusion, and stewardship. OCHIN is excited to support our continued national expansion and the increasing demand for our innovative tools and services by welcoming new talent to our growing team.

Position Overview

The Billing Specialist supports the mission of OCHIN by providing high quality billing services to one of more OCHIN Billing Services (OBS) member clinics. The Billing Specialist will primarily focus on payor follow-up and denial management, recognize potential high-risk accounts, and develop techniques to improve collections and streamline processes. The OBS team member will discuss difficult or unique collection problems with the Billing Supervisor, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement with the assistance of their immediate supervisor. This position will enhance the billing department’s reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.

COVID-19 Vaccination Requirement

To keep our colleagues, members, and communities safe, OCHIN requires all employeesincluding remote employees, contractors, interns, and new hiresto be vaccinated with a COVID-19 vaccine, as supported by state and federal public health officials, as a condition of employment. All new hires are required to provide proof of full vaccination or receive approval for a medical or religious exemption before their hire date.

Essential Duties

Medical Billing

• Provide efficient and effective account receivable services on behalf of our member clients to maximize their reimbursement and support OCHIN revenue cycle performance indicators for financial health
• Accurately bill Medicare, Medicaid, self-pay/uninsured, and commercial insurance, processing claims in accordance with payer requirements and organization policy
• Assist with the collection of receivables by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends
• Post patient payments, electronic remits, and paper explanation of benefits (EOBs).
• Correct claim and charge errors
• Thoroughly research and resolve credit balances
• Answer phone calls from patients and responsible parties regarding account balances and/or other matters. Provide compassionate and empathetic customer service
• Perform other specific projects related to billing, data entry, and computer operations as required

Account Maintenance

• Perform registration updates in Epic
• Maintain complete and accurate billing and accounts receivable records
• Send correspondence to member clinic/Client in accordance with their policies and procedures

Additional Responsibilities

• Establish and maintain positive working relationships with patients, payers, team members, clients, and other stakeholders. Maintain confidentiality of patient information, organization data and information always in compliance with HIPAA regulations
• Continuously improve understanding of collection processes and strategies by working with colleagues within OBS and OCHIN Collaborative. Other duties as assigned

Qualifications

• 1 year of progressive experience in similar or relevant role preferred. 2 years of applicable experience desired
• Minimum of a high school diploma or GED is required. Some higher education is preferred
• Previous FQHC/RHC experience preferred
• CA billing experience highly preferred
• Knowledge of Medical Terminology is preferred in this role
• Working knowledge of Medicare, Medicaid, MVA, Workers Comp and private insurance billing and reimbursement processes, legal requirements knowledge

Bilingual Preferred (English/Spanish)

• Dual language differential of 10% of base rate for intermediate to advanced in skills to speak, write and read dual languages, regardless of what language.

Desired Certifications include:

• Medical coding from AAPC (CPC Certificate)
• AHIMA (CCS Certificate)
• Current certification from ADCA (CDC certificate)
• HFMA (CRCR certificate)
• Experience using EPIC practice management system, strongly preferred

Work Location and Travel Requirements

This position is 100% remote. Work from home requirements are:

• Ability to work independently and efficiently from a home office environment
• High Speed Internet Service
• It is a requirement that employees work in a distraction free workplace

Travel may be required based on business requirements for OCHIN

We offer a comprehensive range of benefits. See our website for details: https://ochin.org/employment-openings

Equal Opportunity Statement

OCHIN is proud to be an equal opportunity employer. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills for the benefit of our staff, our mission, and the communities we serve.

As an Equal Opportunity and Affirmative Action employer, OCHIN, Inc. does not discriminate on the basis of race, ethnicity, sex, gender identity, sexual orientation, religion, marital or civil union status, age, disability status, veteran status, or any other protected characteristics. All aspects of employment are based on merit, performance, and business needs.

Coding Supervisor

locations Remote – US

time type Full time

job requisition id R28176

Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.

Overview of Position

The purpose of this position is to provide day to day operational support on coding edits in resulting in affing re-alignment based on volumes, on-boarding, scheduling, time and attendance, productivity, and quality. Assist Coding Managers by providing updates on daily workflow, overseeing client pathways, and reporting needs to ensure TAT, productivity and key performance metrics are met. First escalation point for all coding issues identified by client, coders, and offshore vendors. Initiation of corrective action (forms, delivery, etc.).

What will be my duties and responsibilities in this job?

• Daily operational oversight of all coding volume (incoming, back-end charge hold, edits, denials) to ensure TAT is met by adjusting staffing, re-purposing coder/client support, investigating file/workflow issues, answering coder questions, ensure TAT is maintained and if TAT will not be maintained, appropriate escalations are followed
• Create, maintain and be primary owner of client pathways for new client implementations and existing clients. Responsible for updating accordingly and ensuring all changes are communicated and staff (onshore/offshore) is trained when appropriate.
• Productivity monitoring – running reports weekly to monitor production for all coding employees. This includes all aspects of production monitoring – assessing whether production issues exist at an employee level or at a client level – workflow shadowing. Resolve production issues inidually via corrective action when appropriate or at a client level by escalating modification of production hourly rate/dedicated staff.
• Manage coders time – PTO approvals to ensure client coverage is met, Kronos timekeeper oversight
• New client implementation support – Assists in the management of new client implementations including vendor certification, new coder hire (recruitment), certification of coders, vendor proficiency, preparation of workflows, pathways, and reporting.
• On-boarding of new employees – hiring, interviewing, provisioning, coding certification (SCC)
• Initiation and oversight from development and full execution of corrective action process
• Other duties as assigned

What are the requirements needed for this position?

• High School diploma or equivalent
• Professional Coding Certification CPC or CCS, CCS-P required
• 2+ years of production coding experience
• 1+ years as a Lead Coder, Coordinator or providing supervision of Coding staff

What other skills/experience would be helpful to have?

• Experience with Excel and MS Office products
• Ability to work with minimal supervision in a fast-paced environment
• Must be organized and able to multitask
• Good communication skills

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

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

How much should I expect to travel?

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

ED Coder Remote

Requisition ID2022-49993

Facility

COR – 6901 Havana

Location

US-CO-Centennial

Shift

Days

Work Type

Full-Time

FTE

1.000

FLSA Status

Non-Exempt

Minimum Pay

USD $24.03/Hr.

Hiring Maximum Pay

USD $34.53/Hr.

Category

Finance/Revenue Management

Department: Name

SC RM CODING SVC HB

Welcome to Centura Health

Welcome to Centura Health – the largest health ecosystem in Colorado and Kansas. Welcome to living your mission among thousands of people on fire to live theirs too. Welcome to options and possibility where you can chart the direction and flow of your career. Welcome to the freedom to believe in what you believe, and welcome to a family guided by shared values and a commitment to extending the healing ministry of Christ. Welcome to extremely important industry challenges and opportunities to solve complex problems. Welcome to highly intelligent teams and overflowing community. And welcome to wholeness of mind, body and spirit. Welcome to Centura Health.

Pay Range

$24.03 – $34.53/hr

Flourishing Begins Here

You have a purpose, unique talents and NOW is the time to embrace it, live it and put it to work. At Centura Health, we value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.

This is an intermediate coding position that codes and abstracts Outpatient records for data retrieval, analysis, reimbursement and research. Codes and enters diagnostic and procedure codes into the designated coding and abstracting system utilizing the 3M encoder, as appropriate. Meets quality and productivity coding standards and demonstrates the ability to navigate an EMR. Ability to code designated outpatient type at any Centura facility.

What You Bring/Job Requirements

In addition to bringing your whole self to the workplace each day, qualified candidates will need the following:

• A minimum of 2-year coding experience, preferably in an acute care setting, or Completion of the Centura internal coding program
• Must demonstrate competency of outpatient coding guidelines and APC assignment
• Basic knowledge of Microsoft Office applications and emails and troubleshooting computer problems
• Experience successfully working in a remote environment, preferred
• High School Diploma or GED, required.
• Associate’s Degree, Preferred.
• Current AHIMA credentials (i.e. RHIA, RHIT, CCS, CCS-P) or AAPC credentials (COC, CIC, CPC-H, CPC), required or must be certified within one year of hire

Physical Requirements – Sedentary Work – prolonged periods of sitting and exert/lift up to 10 lbs. force occasionally

Remote employees must live/work in one of the following states to be employed by Centura Health/Centura Staffing, LLC:

Alabama

Arizona

Arkansas

Colorado (Centura Health)

Florida

Georgia

Idaho

Indiana

Iowa

Kansas (Centura Health)

Kentucky

Louisiana

Missouri

Mississippi

Nebraska

New Mexico (Centura Health)

North Carolina

Ohio

Oklahoma

South Carolina

South Dakota

Tennessee

Texas

Utah

Virginia

West Virginia

Wyoming

Your Connected Community

When people and places align, incredible things happen. Just like the 21,000+ amazing associates who work here, every community within Centura Health’s connected ecosystem has its own unique history, story and personality.

Caring for Your Whole Well Being

We’re committed to delivering whole person care and understand that a comprehensive benefits package will enrich the lives of our associates at work and at home. At Centura Health, we offer incredible benefits that impact mind, body, and spirit to eligible associates. Our total rewards are designed with your well-being in mind and may include:

• 401K, which includes matching when eligible
• Three Health Insurance Plan Options including covering eligible dependents
• Two Dental Insurance Plan Options including covering eligible dependents
• Vision Insurance including covering eligible dependents
• Daycare & Medical Flexible Spending Account Options
• Leaves of Absence, Short Term Disability, and Long Term Disability
• Life Insurance and Spouse & Child/Dependent Life Insurance Coverage Options
• Voluntary Benefits including Hospital Indemnity Coverage, Critical Illness, Accident, Permanent Life insurance, and Norton LifeLock
• Paid Time Off & Sick Pay
• Shift Differentials
• Employee Wellness Resources
• Employee Assistance Programs
• Tuition Reimbursement
• Relocation assistance based on location
• Associate Discounts for Phone, Cell Phone Plans, Auto Insurance, Home Insurance, Auto Buying, Pet Insurance, and much more…

The pay rate for this position is listed above and varies based on experience, skills, and comparison to others who are already in this role. *If you do not see the pay range for this position listed, you are on a third party job board. All of our pay ranges are clearly posted on our careers site www.centura.org/careers. Please visit our Careers page and apply today!

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Everyone Thrives Here

You’re different, and we love it. Your perspectives, your ways, what you are on a mission to go and do – we’re all different at Centura Health, but we’re also all equally connected and supported. We are here to cultivate YOU in an environment which not only lifts you up, but propels you forward.

To help you thrive, we take pride in providing exceptional benefits to support a healthy work, home, and life balance. Be sure to consider our generous company benefits package as part of the total compensation for this role. You can find a list of our benefits HERE.

Centura Health is an Equal Opportunity Employer, Male/Female/Veteran/Disabled. Offers of employment are contingent upon successful completion of a pre-employment health and drug screen and background check.

Virtual Clinical Intake/Triage Nurse

REMOTE

Atlanta, Georgia, United States

Clinical

Full time

Description

Ria Health is on a mission to bring effective evidence-based treatment for alcohol use disorder to all Americans. Our team consists of empathetic mission-driven professionals coming together to support the quality and availability of our national telehealth alcohol treatment program. We are seeking an Enrollment Counselor to join our rapidly growing team. Ria Health, recognized as the leading national telehealth provider specializing in alcohol use disorder (AUD) treatment, recently raised $18 million in Series A led by SV Health Investors, LLC. The investment will further the momentum of commercial partnerships that include regional and national health plans, including Anthem Blue Cross Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health.

JOIN THE RIA HEALTH TEAM!

Join the team that integrates medical care, behavioral support, and technology tools to help members achieve their personal goals in treating alcohol misuse. Ria Health is a Center of Excellence that delivers a Joint Commission accredited program that leverages evidence-based pharmacotherapy, psychosocial support, and an engaging care delivery platform to help members achieve lasting improvements in their quality of life. Ria’s published outcomes data set the standard for effectiveness in alcohol treatment. The Ria program is delivered through telehealth and by a care team of Physicians, Nurse Practitioners, and Coaches with clinical expertise to manage care and outcomes for Ria Health members.

WORK AT RIA HEALTH AS A VIRTUAL CLINICAL INTAKE/TRIAGE NURSE

Our Clinical Intake/ Triage Nurse works in collaboration with both enrollment and clinical teams to support positive patient onboarding outcomes to the Ria Health program.

• Welcomes patients to our program/complete screening for AUD and determines if appropriate for the program as according to CIWA-AR screening.
• Prompt the patient to download the Ria app and sign in to Zoom
• Educates patients on breathalyzer use and frequency
• Educates patients on Ria Health Medication Formulary and use of Anti-Craving medications, expectations/side effects.
• Completes Initial Medical Intake and enters data into Ria Health EMR for clinicians to review.
• Completes scheduling of First Medical Appointment.

Requirements

Education/Experience:

• RN, Preference will be given to candidates who have all (or close to) 50 state licenses.
• 3-5 years of experience related to the clinical scope.
• Preferred telemedicine experience of at least one year.
• Tech-savvy and understands the importance of data security.
• Provide excellent medicare care and enjoy communicating with patients through video, messaging, and phone calls.

Other Qualifications:

Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner. Must be able to work well with others. Strong verbal and written communication skills are required. Must be detail-oriented and organized. High integrity, including maintenance of confidential information. Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.

Benefits

Make an impact at a critical time

The pandemic has caused a global crisis; there has been a tremendous increase in anxiety, trauma, and stress for millions of people, increasing the misuse of alcohol. As a result, Ria Health has experienced a 500% increase in demand from patients seeking a specialized treatment program for alcohol misuse. We seek team members motivated to provide high-quality, patient-centered, evidence-based care through telemedicine that improves the health and wellbeing of the people we support.

ENJOY RIA HEALTH BENEFITS

• Join a team of Mission driven professionals dedicated to offering a next-generation solution in the treatment of heavy alcohol use and addiction
• Experience professional growth within a rapidly expanding tech-healthcare company
• *Work remotely anywhere in the United States
• Career opportunities include full-time, part-time, and on a contract basis
• Competitive compensation
• Telehealth training and development
• Unlimited PTO for full-time team members

EQUAL EMPLOYMENT OPPORTUNITY

Ria Health provides equal employment opportunities to all employees and applicants for employment. It prohibits discrimination and harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Ria Health Vision:

A world with accessible, compassionate, and effective treatments to reduce the burden of all those who suffer from Alcohol Use Disorder.

Ria Health Mission:

We combine medical science, technology, and human compassion to deliver private, evidence-based, telehealth alcohol treatment programs for anyone who wants to drink less and live better.

Ria Health Values:

Compassion we promote a culture of empathetic care and communication. We actively listen, we always encourage, and we provide support.

Integrity We are honest, open, ethical, and fair. We hold ourselves accountable when we make mistakes.

Teamwork working together, we will achieve great things.

Embrace Change we work to drive improvement over perfection, measuring and questioning the status quo to make progress and enhancement.

Always Learning We celebrate curiosity and discovery through development and research.

REMOTE Patient Services Coordinator – $1,000 Sign On Bonus!

Job Locations Remote

Job ID 2022-14003

Category Customer Service Center

Min USD $17.00/Hr.

Max USD $22.00/Hr.

Overview

Be part of the New Order in Post-Acute Care. CareCentrix is committed to making the home the center of patient care.

As Care Coordinator you will be responsible for tracking and monitoring turnaround times to assure service requirements are met. You will participate in the collection and documentation required to manage patient cases of care from beginning to end.

Responsibilities

In this Job, you will:

• Provide focused resolution, support, and information to patients.
• Manage cases and requests for services in a timely and accurate manner.
• Collect, verify, and confirm non-clinical information and escalate issues as needed.
• Negotiate with providers as needed working within the URAC guidelines.

This is the job for you if:

• You love helping people solve problems and resolve issues.
• You want to help guide patients to select the right site of care and length of stay.
• You embrace values of accountability, consistency, engagement, empowerment, respect, and outstanding service.

Qualifications

You should get in touch if:

• You have a high school diploma or the equivalent.
• You have a minimum of two years of strong customer service, business operations, insurance, quality improvement, or healthcare operations experience.
• You are proficient with basic Microsoft Office applications.
• You have some answers but not all of them. You know every healthcare problem is unique and approach problems with questions not answers. –
• You are fun to work with!

What we offer:

• Starting Pay for external hires is $17.00/hr + Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
• Profit Sharing, generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
• Advancement opportunities, professional skills training, and tuition Reimbursement
• Great culture with a sense of community.

CareCentrix maintains a drug-free workplace.

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.

Title: SSM – Hospital Outpatient Coder – National Remote

Location: Dallas TX US

Job Category: Clinical

Job Type: Full-time

$3,000 Sign On Bonus For External Candidates

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

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

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

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

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

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

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

Primary Responsibilities:

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

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

Title: Remote Medical Scribe

Location: United States

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

Role Description:

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

Core Responsibilities:

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

What are we looking for?

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

What does being Oaky look like?

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

Why Oak Street?

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

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

Multi-Specialty Coder

Remote

Full Time

Audit Services

Mid Level

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

The ideal candidate will possess the following:

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

Job Duties:

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

Certification Requirements:

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

What We Offer:

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

Medical Coder

Requisition ID

2022-27959

# of Openings

1

Category (Portal Searching)

HIM / Coding

Overview

Who we are…

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

What we offer

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

Details:

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

We Offer:

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

What we need

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

Responsibilities

What You Will Do…

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

ADDITIONAL JOB COMPONENTS:

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

Qualifications

What Helps You Stand Out…

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

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

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

There is no COVID vaccine requirement for this role

Digital Registered Nurse

ABOUT US

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

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

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

ABOUT THE ROLE

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

Here’s what you’ll do:

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

HOW WE WORK

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

ABOUT YOU

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

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

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

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

HOW WE CARE FOR YOU

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

Title: Medical Bill Review Nurse I

Location: Virtual, AZ, US +12 more

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

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

Qualifications:

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

• Microsoft Office experience

Preferred Skills:

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

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

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

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

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

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

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

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

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

Remote Working: Yes Schedule: Full Time

Linkedin Recruiter Tag: #LI-LC1

RN Case Manager – Remote

Remote

The Role:

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

The Company:

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

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

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

Responsibilities:

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

Minimum Requirements

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

Preferred Requirements

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

Skills & Abilities

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

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

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

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

Remote, United States | Medical Coding

Description

Position at GoHealth Urgent Care

JOB SUMMARY

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

JOB REQUIREMENTS

Education

• High School Diploma or GED required
• Associates Degree preferred

Work Experience Required

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

Required Licenses/Certifications

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

Additional Knowledge, Skills and Abilities Required

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

Additional Knowledge, Skills, and Abilities Preferred

• Experience working with computer assisted coding

ESSENTIAL FUNCTIONS

Duties May Include:

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

Clinical Documentation Coder- Remote position

Full time

job requisition id R040576

Building Location: Business Service Center

Department: 46290 Clinical Documentation

Job Description:

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

Experience:

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

Education Qualifications:

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

Licensure/Certification Qualifications:

For Department 46290 – Clinical Documentation only

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

Senior Clinical Data Manager – REMOTE

Location: Remote

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

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

About You:

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

A glimpse into the day to day:

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

Qualifications:

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

Other Required:

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

Preferred:

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

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

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

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

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

Coding Consultant Outpatient

Job Locations: US-Remote

Requisition ID: 2022-27687

# of Openings: 2

Category: HIM / Coding

Overview

Who we are…

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

What we offer

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

Details:

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

We Offer:

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

What we need

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

Responsibilities

What You Will Do…

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

Qualifications

What Helps You Stand Out…

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

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

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

Coding Audit Specialist, Radiology and MIPS

Location: United States –Remote – Full-Time

At Zotec Partners, our People make it happen.

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

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

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

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

What you’ll do:

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

What you’ll bring to Zotec:

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

Reproductive Nurse (Contract)

All US – Remote

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

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

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

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

As a Maven provider, you will:

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

We’re looking for you to bring:

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

We offer our providers:

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

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

Benefits & Perks:

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

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

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

Location:  US Locations Only; 100% Remote

Position Summary

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

CC I – intake coordinator

CC II – referral coordinator (includes labs/imaging)

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

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

Position Objective

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

Shifts Available

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

Functional Responsibilities and Duties:

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

Supervisory Responsibility

This position has no supervisory responsibilities.

Education

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

Competencies/Experience

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

Work Environment

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

Physical Demands

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

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

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

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

Equal Employment Opportunity Statement

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

Location: US Locations Only

Professional Fee Women’s Health E/M Coder

Job ID 2022-2797

# of Openings 3

Job Locations US-Virtual/Remote

Category Medical Coding

Minimum Hours Varies

Overview

Professional Fee Women’s Health E/M Coding Specialist

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

Responsibilities

Coding Information

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

Position Requirements

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

EPIC experience is required.

Qualifications

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

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

Title: RN Case Manager: Special Needs Plan

Location: United States – Remote – Full-Time

Job Description

A bit more about this role:

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

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

A day at Devoted could include:

Working with members

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

Working with other providers and resources

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

Improving how we work

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

Attributes to success:

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

Desired Skills and experience:

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

Title: Coder II Inpatient Coding – Remote Work From Home

Location: United States

Job Description

Overview

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

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

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

Responsibilities

Job Summary

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

Qualifications

Education

• High School Diploma or GED Required

Experience

2 years Inpatient:

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

Outpatient:

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

Required

Licenses and Certifications

Inpatient:

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

Outpatient:

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

Hospital Inpatient Coder (SSM) – National Remote

Location: United States

Requisition Number: 2103388

Job Category: Medical & Clinical Operations

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

$3000 Sign On Bonus For External Candidates

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

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

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

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

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

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

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

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

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

Primary Responsibilities:

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

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

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

Nurse Practitioner/Physician Assistant – Connected Care Program

REMOTE 

CLINICAL STRATEGY AND SERVICES CLINICAL TEAM 

FULL-TIME

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

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

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

Responsibilities

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

Requirements

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

Schedule

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

Title: Medical Coder – Remote

Location: United States

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

$3000 Sign On Bonus For External Candidates

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

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

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

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

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

Primary Responsibilities:

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

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

Required Qualifications:

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

Preferred Qualifications:

• 1+ years of experience in a cardiology specific environment

Telecommuting Requirements:

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

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

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

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

Title: Clinical Administrative Coordinator – National Remote

Location: United States

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

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

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

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

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

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

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

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

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

Primary Responsibilities:

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

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

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

Title: Nursing Scientist

Location: United States – Remote

Full Time

Job Overview

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

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

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

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

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

Responsibilities

Position Responsibilities:

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

Qualifications

Experience Required/Preferred:

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

Education Required/Preferred:

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

Knowledge, Skills & Abilities:

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

Patient Care Coordinator

Non-clinical

United States

Texas

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

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

Responsibilities:

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

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

Desired Competencies:

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

Qualifications:

Medical office reception experience, including:

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

We Offer:

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

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

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

Radiology Medical Coder

time type

Full time

job requisition id

R28665

Radiology Medical Coder

Overview of Position

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

What will be my duties and responsibilities in this job?

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

What are the requirements needed for this position?

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

What other skills/experience would be helpful to have?

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

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

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

How much should I expect to travel?

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

#li-remote

#ChangeHealthcareCareers

#HiringNow

#RemoteWork

#WorkFromHome

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

COVID Vaccination Requirements

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

Equal Opportunity/Affirmative Action Statement

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

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

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

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

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

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

Remote – Other

Full time

R010232

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

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

Responsibilities

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

Qualifications

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

#LI-BF1

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

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

Audit Specialist

Job LocationsUS-Remote

Requisition ID

2022-27110

# of Openings

10

Category (Portal Searching)

HIM / Coding

Overview

Who we are…

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

What we offer…

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

What we need…

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

Details:

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

We Offer:

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

Responsibilities

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

Qualifications

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

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

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

ProFee Medical Coding Auditor – Part Time

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

Overview

ProFee Medical Coding Auditor – Part Time

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

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

Responsibilities

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

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

Qualifications

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

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

Title: Telemedicine Nurse Practitioner (Remote)

Location: United States

CONTRACTOR

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

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

WHAT YOU’LL DO:

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

WHAT WE’RE LOOKING FOR:

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

Additional Details

TECHNICAL REQUIREMENTS

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

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

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

Title: Ancillary – Medical Coder

Remote

Location: Dallas TX US

Job Category: Clinical

Job Type: Full-time

Travel Percentage: -1

Job Description:

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

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

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

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

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

Primary Responsibilities:

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

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

Additional Job Detail Information

Requisition Number

2090927

Business Segment

OptumInsight

Employee Status

Regular

Job Level

Inidual Contributor

Travel

No

Additional Locations

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

Overtime Status

Non-exempt

Schedule

Full-time

Shift

Day Job

Telecommuter Position

Yes

Coder – Outpatient(REMOTE)

locations: Remote – US

time type: Full time

job requisition id: J198466

Company : Allegheny Health Network

GENERAL OVERVIEW:

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

ESSENTIAL RESPONSIBILITIES

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

QUALIFICATIONS:

Minimum

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

Preferred

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

Informatics Nurse Specialist

Remote

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

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

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

SCOPE OF ROLE

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

ROLE RESPONSIBILITIES

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

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

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

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

PROFESSIONAL COMPETENCIES

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

LICENSURES AND CERTIFICATIONS

• Valid RN licensure in at least 1 state

Professional Cardiology E/M Coding Specialist

Job ID 2022-2761

# of Openings 1

Job Locations US-Virtual/Remote

Category Medical Coding

Minimum Hours 20

Overview

Professional Cardiology E/M Coding Specialist – Part Time

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

Responsibilities

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

Qualifications

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

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

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

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

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

Description

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

Qualifications

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

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Nurse Practitioner

Remote

UNITED STATES 

TELEMEDICINE – NURSE PRACTITIONERS

CONTRACTOR

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

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

WHAT YOU’LL DO:

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

WHAT WE’RE LOOKING FOR:

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

TECHNICAL REQUIREMENTS

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

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

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

Processor

ChromeOS: Intel Pentium

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

Memory

ChromeOS: 4GB of RAM or better

Non-ChromeOS: 6 GB of RAM or better

Operating System

ChromeOS: no minimum

MacOS

Windows 10 or better

Browser

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

Title: Medical Coding Auditor – Remote

Location: United States

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

Job Description:

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

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

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

Training will be conducted virtually from your home.

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

Primary Responsibilities:

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

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

Title: Lab Services Executive

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

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

Job Description:

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

Responsibilities;

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

Qualifications.

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

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

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

Title: Nurse Talent Operations Specialist

Location: United States

Remote

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

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

Responsibilities:

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

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

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

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

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

Requirements:

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

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

Working here is awesome because:

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

locations: Remote – USA

time type: Full time

job requisition id: R1439

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

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

QUALIFICATIONS

Required:

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

Preferred:

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