One stop solution to your remote job hunt!

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

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

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

Description

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

Qualifications

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

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

Nurse Practitioner

Remote

UNITED STATES 

TELEMEDICINE – NURSE PRACTITIONERS

CONTRACTOR

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

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

WHAT YOU’LL DO:

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

WHAT WE’RE LOOKING FOR:

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

TECHNICAL REQUIREMENTS

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

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

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

Processor

ChromeOS: Intel Pentium

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

Memory

ChromeOS: 4GB of RAM or better

Non-ChromeOS: 6 GB of RAM or better

Operating System

ChromeOS: no minimum

MacOS

Windows 10 or better

Browser

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

Title: Medical Coding Auditor – Remote

Location: United States

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

Job Description:

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

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

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

Training will be conducted virtually from your home.

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

Primary Responsibilities:

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

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

Required Qualifications:

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

Preferred Qualifications:

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

Telecommuting Requirements:

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

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

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

Title: Lab Services Executive

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

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

Job Description:

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

Responsibilities;

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

Qualifications.

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

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

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

Title: Nurse Talent Operations Specialist

Location: United States

Remote

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

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

Responsibilities:

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

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

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

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

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

Requirements:

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

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

Working here is awesome because:

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

locations: Remote – USA

time type: Full time

job requisition id: R1439

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

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

QUALIFICATIONS

Required:

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

Preferred:

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

Title: Billing Quality Review Auditor

Location: United States – Remote Full-Time

Are you looking for an exciting opportunity?

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

The right person to join our team is…

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

This position is responsible for…

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

Your day will be very busy you will:

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

What your background will be:

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

Title: Director of Therapy

Location: Remote – U.S.

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

About the Director of Therapy at Headspace Health:

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

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

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

What you’ve accomplished:

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

Inpatient Audit Specialist

Job Locations: US-Remote

Requisition ID-2022-24648

Category: HIM / Coding

Overview

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

Details:

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

We Offer:

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

Responsibilities

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

Qualifications

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

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

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

There is no COVID vaccine requirement for this role

Coding/Reimbursement Specialist

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

Description

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

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

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

Responsibilities:

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

Qualifications

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

Licensure, Certifications, and Clearances:

• CPC or eligible preferred. CCS acceptable.

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

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

Our Values

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

Clinical Nurse Supervisor

locations: US-Remote

time type: Full time

job requisition id: JR4762

RESPONSIBILITIES

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

QUALIFICATIONS

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

Inpatient Facility Coder (Full Time) K

Job ID: 2022-2733

# of Openings: 1

Job Locations: US-Virtual/Remote

Category: Medical Coding

Minimum Hours: 40

Overview

Inpatient Facility Coding Specialist – Full Time

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

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

Eligible for a $5000 sign on bonus!

Responsibilities

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

Qualifications

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

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

Specialist I, Patient Educ Job

Location: Valencia, CA, US, 91355

Additional Location(s): US-CA-Valencia

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

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

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

About the role:

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

Your responsibilities will include:

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

What we’re looking for in you:

Basic Qualifications

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

Preferred Qualifications:

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

Requisition ID: 532762

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

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

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

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

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

School Social Worker

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

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

Position Overview:

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

Job responsibilities for School Social Workers:

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

Required Qualifications:

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

Benefits:

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

Required Skills:

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

Supervisor Hospital Coding Outpatient

locations: Remote

time type: Full time

job requisition id: R21808

Department: 10460 WI Revenue Cycle – Hospital Coding Administration

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

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

Major Responsibilities:

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

Licensure, Registration, and/or Certification Required:

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

Education Required:

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

Experience Required:

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

Knowledge, Skills & Abilities Required:

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

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

Title: Inpatient Medical Coding Auditor

Location: United States – Remote

time type: Full time

It’s Time For A Change…

Your Future Evolves Here

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

What You’ll Be Doing:

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

Responsibilities

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

The Experience You’ll Need (Required):

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

Finishing Touches (Preferred):

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

Technical requirements:

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

Compliance Nursing Supervisor

locations

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

time type: Full time

job requisition id: R-278568

Description

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

Responsibilities

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

Required Qualifications

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

Preferred Qualifications

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

Additional Information

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

Scheduled Weekly Hours

• 40

Hospitalist Coder Remote

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

Primary City/State:

Mesa, Arizona

Department Name:

Coding Ambulatory

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

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

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

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

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

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

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

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

POSITION SUMMARY

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

CORE FUNCTIONS

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

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

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

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

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

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

MINIMUM QUALIFICATIONS

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

PREFERRED QUALIFICATIONS

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

Additional related education and/or experience preferred.

Clinical Research Coordinator

at Vault

Remote

About Us:

At Vault, we believe quality healthcare is a human right. Our mission is to make better health outcomes more accessible and affordable for everyone. Our platform makes this possible by bringing remote diagnostics and specialty care to patients in their homes, on their home screens, and within their hometown communities wherever they choose. We are reimagining the 21st century healthcare experience for patients, practitioners and providersmaking the promise of better health more attainable through our end-to-end healthcare platform.

The Opportunity:

Vault Health is seeking an experienced Clinical Research Coordinator (CRC) who will oversee the day to day operations of clinical studies. The CRC will develop, implement, and coordinate research and administrative procedures for the successful management of clinical studies.

Responsibilities:

• Responsible for coordination of a designated study or group of studies.
• In research projects, oversees the recruitment of subjects, implementation of study procedures, and the collection and processing of data.
• Adhere to Research SOPs, Good Clinical Practice and study protocols.
• Ensure scientific integrity of data and protect the rights, safety and wellbeing of patients enrolled in clinical studies.
• If applicable, participate in the virtual informed consent process.
• If applicable, schedule patient visits and procedures consistent with protocol requirements.
• Keeps accurate and up-to-date records.
• Ensure all serious and non-serious adverse events are documented and reported.
• Work with the regulatory team to ensure all regulatory documents are filed and maintained.
• Ensures availability of supplies and/or equipment for studies
• Liaisons with agencies and pharmaceutical companies, laboratories, and equipment and supply companies, as needed.
• Other duties as assigned

Qualifications:

• Bachelor’s degree, preferably in science, public health, health education or a related field.
• Ambitious iniduals with strong organizational and analytical skills will be considered. 1-3 years experience in research or related experience is preferred but not required.
• Qualified candidates must be able to effectively communicate with all levels of the organization.

Work Environment:

Vault is a high growth, fast paced organization. The ability to be productive and successful in an intense work environment is critical. Willingness and ability to travel domestically (and potentially internationally) is required, it is anticipated that this will be less than 15 % of work time.

Who You Are:

• Dynamic, gregarious inidual with a constant focus on the patient experience
• Background in the life sciences / healthcare / clinical trials space with an understanding of the space
• High comfort level with ambiguity; adapting to change, learning, and growth
• Proactive, forward-looking, flexible and creative team player who enjoys collaborating and getting things done without an ego
• Open to receiving and giving feedback
• Highly effective written and verbal communication skills
• Organized, with a strong ability to multitask and shift priorities when needed
• Entrepreneurial approach to responsibilities

Vault Health is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, age, disability, or veteran status.

Licensed Practical Nurse Patient Care Manager

locations: US-Remote

time type: Full time

Responsibilities

• LPN Patient Care Manager will support of Florida Cancer Specialists (FCS) values by providing care management services to clients and families to help in the coordination of care and the management of a patient’s inidual health needs through and beyond the course of treatment.
• The LPN Patient Care Manager works under the supervision of the RN Patient Care Managers.
• LPN Patient Care Manager will assist the RN Patient Care Managers with the management of patient caseloads by providing prompt response to telephone inquiries and other issues of a clinical nature as requested.
• Will work as an integral team player providing support to the RN Patient Care Managers as needed and is expected to adhere to and abide by the rules and regulations set forth by the Florida State Board of Nursing.
• Prescription refill experience desired.

Qualifications

• A Valid Florida LPN license.
• One (1) year of clinical oncology experience preferred.
• One (1) year of experience in Care Management preferred.
• Strong organizational and interpersonal skills.
• Must possess the ability to utilize a clinical reasoning process for planning, implementing and evaluating the patient’s plan of care while ensuring that coordination of services are done in a timely manner.
• Demonstrates sound knowledge and actions in the care and decision making for the oncology patient population and seeks guidance appropriately.
• Strong/Proficient computer skills, Microsoft Office (word, excel, outlook) required.

Coding Consultant Outpatient

Requisition ID

2022-25499

# of Openings

1

Category (Portal Searching)

HIM / Coding

Overview

Our people, process and technology give healthcare organizations an HIM edge. If you share our commitment to providing service that is second-to-none, we invite you to join our team of industry leading HIM specialists, healthcare veterans and thought-leaders nationwide. If you are passionate about

what you do, then you belong with the leading provider of full suite HIM solutions.

CIOX Health Coding/HIM Consulting/EMR Abstraction Division is looking for HIM professionals to join our rapidly growing team! We are currently hiring Remote Outpatient coders for full-time employment opportunities.

Responsibilities

• 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

• 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.