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Remote opportunity – Open to candidates anywhere in the greater United States

SUMMARY:

The Medical Director, Medical Affairs will serve as one of the internal medical affairs experts for the USMA function and medical & scientific expert for assigned brand (s) under a therapeutic area. The medical director will ensure the team develops strong strategic input in pursuit of co-development of brand strategy. The medical director is responsible for building and growing strong internal relationships (e.g. US Brand Teams, Global Medical Affairs) as well as external relationships ensuring accurate, robust, and appropriate medical/scientific exchange of knowledge and clinical expertise. The medical director will work closely with Sr. Medical Director and serve as the internal medical/scientific US cross-functional and cross-Alliance (if applicable) point of contact (Global, Clinical Development, Health Outcomes, Scientific Communications, Regulatory, Brand Teams, etc.) driving corporate objectives and goals.

ESSENTIAL FUNCTIONS:

• By leading the Brand Medical Strategy the Medical Director will ensure the co-development of brand overall strategy in alignment with cross-functional and, if applicable, cross-alliance partners .
• Responsible for keeping intimately aware on evolving disease areas trends to continuously anticipate changes and assess impact to US and Global scientific and brand strategy.
• Builds strong networks in the US medical community by developing relationships with key opinion leaders in the scientific community; building productive relationships with investigators, thought leaders and centers of excellence across the scientific community.
• The Medical Director will work closely with Sr. Medical Director to define the most effective strategy team structure depending on business needs (i.e. Medical Strategy Teams, Brand Team Meetings, Global)
• Leads brand evidence generation plans working closely with Value Evidence and participates in the local clinical and IIT proposal process by the development and review of proposals and protocols of studies.
• Provides medical input and serves as first point escalation into Promotional Advertising Review Committee for all promotional and external materials, and participation in Labeling meetings, where appropriate, with sign-off authorization
• Provides US medical and scientific input to the pharmacovigilance group (may serve as member of the safety committee) regulatory documents and interactions
• Depending on size and needs of the team the medical director will lead, manage, coach, and develop team members (such as Associate Directors) to support high performance, and to align with strategic direction for Lundbeck

REQUIRED EDUCATION, EXPERIENCE and SKILLS:

• Accredited advanced clinical and/or scientific degree MD, PharmD, DNP, PhD.
• 6+ years of progressive medical/scientific affairs experience within the pharmaceutical, biotech industry or at a consulting firm that supports the pharmaceutical or biotech industry; at least 3 years driving medical strategy
• Strong experience of collaborating with cross-functional teams, global medical affairs, and commercial teams. Previous experience with alliance partners is a plus.
• Ability for building partnerships and working collaboratively with others to meet shared objectives.
• Strong interpersonal skills to work closely with both external physicians/scientists and in-house cross-functional teams
• High proficiency in driving decision-making, problem-solving ability and strong scientific analytical skills
• Excellent planning and organization skills.
• Ability to maintain the highest degree of confidentiality and integrity, representing the company’s high ethics, moral behavior, and professionalism.

PREFERRED EDUCATION, EXPERIENCE AND SKILLS:

• Medical Degree
• Clinical or Pharma experience in Therapeutic Area highly desired
• Clinical experience within academia or clinical practice desired
• Specialty MD training in Therapeutic Area (board certification or eligibility in psychiatry or neurology).
• Experience in product launches and/or conducting clinical studies
• Management and professional development of staff at several levels
• Experience with copy approval and promotional review
• Regulatory knowledge and exposure, including experience with FDA.

TRAVEL

• Willingness/Ability to travel up to 40% domestically. International travel may be required.

The range displayed is a national range, and if selected for this role, may vary based on various factors such as the candidate’s geographical location, qualifications, skills, competencies and proficiency for the role.Salary Pay Range:$230,000 – $280,000andeligibilityfor a25%bonustargetbased on company and inidual performance,and eligibilityto participate in the company’s long-term incentive plan.Benefits for this position include flexible paid time off (PTO), health benefits to include Medical, Dental and Vision, and company match 401k.Additional benefits information can be found onour site . #LI-LM1, #LI-Remote

Why Lundbeck

Lundbeck offers a robust and comprehensive benefits package to help employees live well and protect their health, family, and everyday life. Information regarding our benefit offering can be found on theU.S. career site (https://www.lundbeck.com/content/dam/lundbeck-com/americas/united-states/careers/Lundbeck_Benefits_Summary.pdf) .

Lundbeck is committed to working with and providing reasonable accommodations to disabled veterans and other iniduals with disabilities during our employment application process. If, because of a disability, you need a reasonable accommodation for any part of the application process, please visit theU.S. career site (https://www.lundbeck.com/us/careers/your-job/eeo-accommodations-policy) .

Lundbeck is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status, and any other characteristic protected by law, rule, or regulation. Lundbeck participates inE-Verify (https://www.lundbeck.com/content/dam/lundbeck-com/americas/united-states/careers/E-Verify_Participation_Poster_Eng_Es.pdf) .

About Lundbeck

Lundbeck is a global pharmaceutical company specialized in brain diseases. For more than 70 years, we have been at the forefront of neuroscience research.

We are tirelessly dedicated to restoring brain health, so every person can be their best. We are committed to fighting stigma and discrimination against people living with brain diseases and advocating for broader social acceptance of people with brain health conditions. Our research programs tackle some of the most complex challenges in neuroscience, and our pipeline is focused on bringing forward transformative treatments for brain diseases for which there are few, if any therapeutic options.

About Lundbeck

Lundbeck is a global pharmaceutical company specialized in brain diseases. For more than 70 years, we have been at the forefront of neuroscience research.

We are tirelessly dedicated to restoring brain health, so every person can be their best. We are committed to fighting stigma and discrimination against people living with brain diseases and advocating for broader social acceptance of people with brain health conditions. Our research programs tackle some of the most complex challenges in neuroscience, and our pipeline is focused on bringing forward transformative treatments for brain diseases for which there are few, if any therapeutic options.

Patient Advocate – Medical Assistant

Location: United States

Remote

Category

Clinical / Utililization Management

OVERVIEW

As a Patient Advocate, you will work in a high-volume call center environment making outbound calls to patients recently discharged from the hospital and answering inbound calls from a queue.

You will ask non-clinical triage questions to determine if the Nurse Coach program could be beneficial to athomerecovery or if other services are needed, such as transportation to doctors appointments.You will collect and document required data for end-to-end care to support the clinical program goals. For patients further along in the program, you will contact patients to ensure successful recovering athome.

Schedule Options:

Tuesday-Saturday 9am-6pm EST (Sun/Mon OFF) or Sun-Thursday 9am-6pm EST ( Fri/Sat OFF)

Hiring for multiple positions!

Location 100%Remote

Hourly Rate– $18/hr plus monthly bonus incentive program

Training & Nesting Period 3 to 5 Weeks

Training & Nesting Hours Monday Friday 8:30am 5:30pm EST

Available Shift After Training & Nesting: Tuesday-Saturday 9am-6pm EST (Sun/Mon OFF)ORSun-Thursday 9am-6pm EST ( Fri/Sat OFF)

Responsibilities

In this role, you will:

• Resolve non-clinical issues for patients, including answering questions and/or setting them up for a Nurse Coach assessment.
• Coordinate care for patients.
• Communicate with physicians and clinical staff regarding patient care.
• Support clinicians to ensure service levels and requirements are met.
• Escalate issues to Nurse Coaches or management as needed.
• Participate in and contribute to performance and process improvement activities.
• Perform other duties as needed.

This role is for you if:

• You can gain/build instant rapport with people over the phone.
• You have great empathy and the patience to deal with difficult callers or complex requests.
• You are results driven with strong attention to detail.
• You can comply with all company policies, including HIPAA/PHI policy.
• You strive to meet/exceed inidual performance goals in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.
• You are fun to work with! We are looking for team members who bring joy to the work they do.

QUALIFICATIONS

• High School Diploma or GED.
• 1 year of experience working in the healthcare or medical services industry as a Medical Assistant required.
• 1 year Customer Service experience in a call center environment preferred.
• Ability to navigate dual monitors and multiple applications.
• Intermediate keyboarding abilities (at least 30 WPM, data entry while active listening).
• Basic PC & Search Engine abilities (for example: use the mouse to click, troubleshooting, working with Microsoft Office including basic Word and Excel, opening a browser, typing in URLs in the right location, bookmarking a site, and navigating the use of back/forward buttons).

What we offer:

• Starting Pay for external hires is $18.00 / hour + Monthly Incentive Bonus Opportunity.
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
• Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demandVirtualFitness Training and more.
• Advancement Opportunities, professional skills training, and tuition /exam reimbursement.
• PayActiv – access earned income in between paychecks.
• Walgreens Discount – receive up to 25% off eligible items.
• Great culture with a sense of community.

Title: Hospital Coding Specialist III (Remote)

Location: WI-Beaver Dam

Job Description:

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!

Job Title:

Hospital Coding Specialist III (Remote)

Cost Center:

101651098 HIM-Facility Coding

Scheduled Weekly Hours:

40

Employee Type:

Regular

Work Shift:

Mon-Fri; day shifts (United States of America)

JOB SUMMARY

Hospital Inpatient Coding:

The Hospital Coding Specialist III accurately codes inpatient conditions and procedures as documented in the International Classification of Diseases (ICD) Official Guidelines for Coding and Reporting and in the Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG (Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related Groups) for complex, multi-specialty inpatient services. This inidual understands and applies applicable medical terminology, anatomy and physiology, surgical technology, pharmacology and disease processes. The Hospital Coding Specialist III reviews professional and hospital inpatient medical record documentation and properly identifies and assigns:

• ICD CM and PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures.
• MS-DRG /APR-DRG
• Present on admission indicators
• HAC (Hospital Acquired conditions) and when required, report through established procedures
• PSI conditions and report through established procedures
• Discharge Disposition code
• Works collaboratively with the Clinical Documentation Improvement Specialists to address documentation concerns and DRG assignments
• Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and DRG assignments as requested

JOB QUALIFICATIONS

Minimum Required: Medical Coding Diploma or American Health Information Management Association (AHIMA) approved Health Information Management Degree or related program.

Preferred/Optional: None

EXPERIENCE

Minimum Required: Three years of progressive inpatient coding experience in an acute care facility in addition to the following;

• Knowledge of medical terminology, anatomy and physiology, pharmacology, disease process, and surgical procedures
• Knowledge of accepted medical abbreviations and their meanings
• Knowledge in the use of specialized references such as the ICD medical dictionaries and texts, and medical journals
• Must have extensive knowledge of Coding Clinic and all official coding guidelines
• Advanced knowledge of hospital information systems, encoders and other technology to facilitate a successful work environment while maintaining maximum communication and adhering to HIPAA security standards
• Advanced knowledge Microsoft Outlook, Excel and Word functions
• Technical skills required to learn and navigate a variety of software systems and trouble shoot computer problems
• Strong written and verbal communication skills
• Ability to think and work independently, yet interact positively with team
• Advanced problem solving skills
• Attention to detail is crucial to this position

Preferred/Optional: Experience with electronic health record systems. Academic or level I or II trauma experience is a plus.

CERTIFICATIONS/LICENSES

The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position

Minimum Required: Active credential of Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) through the American Health Information Management Association (AHIMA) required at the time of hire.

Preferred/Optional: None

Given employment and/or payroll requirements of inidual states, Marshfield Clinic Health System supports remote work in the following states:

Alabama

Alaska

Arkansas

Florida

Georgia

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Michigan

Minnesota

Mississippi

Missouri

Nebraska

North Carolina

North Dakota

Ohio

Oklahoma

South Carolina

South Dakota

Tennessee

Texas

Utah

West Virginia

Wisconsin

Wyoming

Marshfield Clinic Health System will not employ iniduals living in states not listed above.

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.

At Marshfield Clinic Health System, we are fully committed to addressing health equity, ersity and inclusion for our employees and providers, our patients, and the communities we serve. We believe that every inidual should have the opportunity to attain their highest level of health. We embrace ersity and welcome differences in who we are and how we think. We believe that any inidual or group should feel welcomed, respected and valued. View our Equity and Inclusion Statement here.

Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.

Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Nurse Care Manager (Senior Care Product) Field Based

WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Inidual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.

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

WellSense Health Planis recruiting for motivated, compassionate, mission-driven nurses to join our Senior Care Options (SCO) program clinical team. The SCO program is designed to deliver high-quality, compassionate care to seniors in their home. Were looking for nurses who are driven by a passion to serve the under-served and are committed to making a difference in elders lives.

The Care Manager serves a central role on an interdisciplinary team committed to helping seniors stay in their communities and maintain their independence. The Care Manager acts as the clinical link with the members Primary Care Team (PCT) which includes the Member, Caregiver(s), Primary Care Provider, community agency providers, pharmacists, social workers, and others involved with the Members care.

The Care Managers work is primarily conducted in the field and includesa variety of erse and complex face-to- face and telephonic care management responsibilities. The Care Manager provides care coordination for at-risk and complex iniduals through a member-centric, team-based approach. The Care Manager ensures the right care is provided in the right setting and at the right time.

Responsibilities include assessment, the development, implementation, and evaluation of the Inidual Plan of Care (IPC) and managing the members care through the health care continuum. Perform other duties as requested.

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

KeyFunctions/Responsibilities:

• Manages a panel of high risk, medically complex members
• Completes timely initial and on-going face-to-face comprehensive assessments with Member to evaluate Members medical, behavioral health, functional status, and socioeconomic needs
• Administers MDS-HC assessments and other required assessment tools
• Facilitates meetings of the PCT and serves as clinical subject matter expert and advocate for Member
• Develops and communicates an Inidual Plan of Care (IPC) with Member, caregiver(s), providers and other PCT members to address identified needs and ensures its implementation
• Utilizes evidence-based guidelines to develop Inidualized Plans of Care (IPC)
• Evaluates the effectiveness of the IPC and progress against goals and reviews the IPC as needed
• Utilizes evidence-based guidelines to assist Member in understanding their disease process and increase their capacity for self-management and optimal health
• Utilizes data to ensure that clinical interventions result in improved clinical outcomes and appropriate utilization of services at the right time, right place, and right setting
• Evaluates the effectiveness of alternative care services and ensures that cost effective, quality care is
• Facilitates Member and caregiver access to community resources relevant to the Members needs
• Documents clinical assessments and coordination of care in the medical management information system in a timely manner that meets regulatory and accreditation standards
• Provides culturally competent care coordination in keeping with the Members racial, ethnic, linguistic and sexual orientation
• Facilitates sharing of essential clinical or psychosocial information related to the Members care
• Must become knowledgeable in the full contractual requirements of the Care Management agreement with EOHHS and CMS (D-SNP Agreements)
• Must become proficient in contracts with vendors and agencies of whom the company outsources for the population
• Maintains HIPAA standards and confidentiality of protected health information
• Reports critical incidents and information regarding quality of care issues
• Serves and participates in pertinent committees and meetings as needed
• Assists with new staff training
• Must use a cell phone and provide on-call services, per a rotating schedule
• Regular and reliable attendance is an essential function of this position
• Other duties as assigned

Qualifications:

Education:

• Registered Nurse
• Bachelors degree or an equivalent combination of education, training and experience is required

Preferred/Desirable:

• 3 years experience in Medical Case Management working with the geriatric population, preferred
• Masters degree in nursing, geriatric NP, or health related/public health field preferred
• Certification in case management (CCM) preferred

Certification or Conditions of Employment:

• Active Massachusetts RN license required

Competencies, Skills, and Attributes:

• Strong knowledge and use of the MDS-HC assessments and other required assessment tools
• Excellent clinical and assessment skills
• Experience with the Medicaid, Medicare, and Senior population
• Experience with ASAPs preferred
• Ability to work collaboratively and build strong relationships with providers, Members, and the PCT
• Proficiency in InterQual Level of Care through the continuum
• Excellent working knowledge of Windows and Microsoft Office products
• Must have the ability to use a laptop, or tablet for accessing the company systems to include documentation in the medical management information system
• Flexible, independent, self-starter with an ability to thrive in a fast paced environment
• Demonstrates commitment to quality
• Projects positive, team-oriented demeanor
• Demonstrates strong interpersonal skills including effective listening and ability to support, motivate and guide others
• Strong oral and written communication skills; ability to interact within all levels of the PCT
• Demonstrated ability to successfully plan, organize and manage within a person centered integrated care team
• Detail oriented

Working Conditions and Physical Effort:

• Attendance and participation at PCT meetings required which may include early mornings or evenings
• Travel within the SCO geographic network required

About WellSense

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

Important info on employment offer scams:

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not reach out to iniduals via text, we do not ask or require downloads of any applications, or apps, and applicant screenings, interviews and job offers are not conducted over text messages or social media platforms. We do not ask iniduals to purchase equipment for, or prior to employment. To avoid becoming a victim of an employment offer scam, please followthese tips from the FTC.

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

Specialty Coder Inpatient Academic – REMOTE

locations

Remote

Oak Brook Support Center – 2025 Windsor Dr

time type

Full time

job requisition id

R99187

Department:

10407 Revenue Cycle – Facility Production Coding Inpatient

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

First shift Monday – Friday

This is a REMOTE opportunity. Desired Experience of coding challenging academic charts

Desired certification/s:

• Certified 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)
• This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software.
• Adhere to organizational and internal department policies and procedures to ensure efficient work processes.
• Responsible for coding high dollar and long length of stay cases for all patient types.
• Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate.
• Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government regulations.
• Maintain continuing education by attending webinars, reviewing updated CPT assistant guidelines and updated coding clinics. Knowledgeable in researching coding related topics and issues.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
• Collaborates with the Clinical Documentation Improvement and Quality teams, to ensure a match in the DRG and reconciles each Medicare case with the working DRGs from a CDI perspective.
• Responsible for clinician communication related to disease processes on a clinical level to ensure accurate coding.
• Participates in payer audits and meetings by acting as a resource for coding-related audits, as requested.
• Attends meetings with clinical teams regarding updates in codes for complex specialties.
• Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer.
• Meets and exceeds departmental quality (95% or more) and productivity standards (100%). Achieves productivity expectations to support discharged not final billed (DNFB).
• Performs any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Licensure, Registration, and/or Certification Required:

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)

Education Required:

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

Experience Required:

• Typically requires 7 years’ experience inpatient coding in acute care tertiary facility that includes experience in revenue cycle processes, Clinical Documentation Improvement, Research and health information workflows.

Knowledge, Skills & Abilities Required:

• Advanced profiency of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology.
• Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications.
• Excellent communication (oral and written) and interpersonal skills.
• Excellent organization, prioritization, and reading comprehension skills.
• Excellent analytical skills, with a high attention to detail.
• Ability to work independently and exercise independent judgment and decision making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to take initiative and work collaboratively with others.

Physical Requirements and Working Conditions:

• Exposed to a normal office environment.
• Must be able to sit for extended periods of time.
• Must be able tocontinuously concentrate.
• Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards.
• Operates all equipment necessary to perform the job.
• This job description indicates the general nature and level of work expected of the incumbent. It is not designed
• to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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: Certified Medical Assistant (Contract)

Location: Nationwide

Workplace: remote

Category: Clinical Contractors

JobDescription:

Everly Health’s mission is to transform lives with modern, diagnostics-driven care, and we believe that the future of healthcare is meeting people where they are. Headquartered in Austin, Texas, Everly Health is the parent company to Everlywell, Everly Health Solutions, Natalist, and Everly Diagnostics. We’ve set a new standard of people-focused, diagnostic-driven care that puts patients at the center of their own health journey.

Our infrastructure guides the full testing experience with the support of a national clinician network that’s composed of hundreds of physicians, nurses, genetic counselors, PharmDs, and member care specialists. Our solutions make world-class virtual care more attainable with rigorous clinical protocols and best-in-class science to tackle some of the healthcare industry’s biggest problems.

We are looking for a certified medical assistant who is passionate about expanding access to care by providing assistance to our clinician teams to ensure an effective daily flow of the clinical practice in a telehealth setting.

Who You Are:

• Ensures completion and reconciliation of patient intake information.
• Ensures up-to-date EMR patient records and chart completion.
• Facilitates medical documentation.
• Provides follow-up with patients after consultation as appropriate.
• Manages clinical staff inbox with provider and enterprise oversight.
• Responsible for indexing of clinical patient records as requested.

Skills Required:

• High School diploma or equivalent.
• Completion of a nationally recognized accredited medical assistant training program.
• Must be in compliance with HIPAA regulations and our privacy policies.
• 1+ year of telehealth experience a plus.
• Must be tech savvy.
• Able and willing to learn/adjust to changes in protocols and/or workflows.
• Familiarity with EMR software.
• Athena EMR experience required

Benefits:

• Flexible schedule
• Professional Liability Insurance

Standard Shift:

• Day shift between the hours of 8:00am-8:00pm for a minimum of 16 hours a week.

Job Type:

• Full-time

Title: Clinical Data Abstractor

Location: United States

JobDescription:

At Carta Healthcare, we believe in a multidisciplinary approach to solving problems. Our mission is to automate and simplify the work that burns out clinical staff, so they can focus on patient care. Our AI Enabled Technology offers a complete solution (people, process and technology) to support the Healthcare Registry Data Market. We design products that transform the way hospitals use data to deliver care. We make analyzing data fast, easy, and useful for everyone. We give clinicians time back to focus on research and care that improve patient lives by reducing paperwork. Carta Healthcare is a remote organization with headquarters in San Francisco and Portland, Oregon.

To learn more about our AI Enabled Solutions and more about our company, please visit www.carta.healthcare

Were looking for Clinical Data Abstractors who will work under the direction of the Lead Data Abstractor to abstract and code information in the prescribed format to satisfy the requirements of the target registry by reviewing patient records and abstracting key data elements.

With the support of our software, Atlas, the Clinical Data Abstractor identifies and validates specific information abstracted and reported from various reports, medical records and electronic files. This critical role completes assignments within a designated time frame, with high accuracy and according to specifications.

We are pleased to offer flexible work schedules and a fully remote work environment. This will initially be a part-time role.

Required Qualifications :

• 2+ years direct Clinical Registry Abstraction experience for a Health System or Hospital
• Current abstracting experience. Actively abstracting within the past 12 months in one or more of the following clinical registries:
• CathPCI
• Chest Pain MI
• EPDI / ICD
• NCDR
• LAAO
• TVT
• AFib
• GWTG
• NSQIP – SCR Certified
• TQIP – CSTR Certified
• STS
• VQI
• Knowledge of basic medical terminology, proficiency in EMR, and exposure to a healthcare environment is appropriate.
• Ownership approach to workload, ability to work independently
• Organized with a high attention to detail and commitment to accuracy
• Team player who is collaborative with excellent communication skills
• Remote training and onboarding compatible
• Wants to grow with the company and believes in the mission

Responsibilities:

• Data collection and entry for multiple registries for Carta Healthcare clients
• Collaborate with nurse practitioners, physician assistants, physicians, other medical professionals to complete patient encounters
• Ensure quality submission of all data in specified registries maintaining a high accuracy threshold.
• Communicate with Carta team and reporting hospitals to streamline data management
• Provide data analysis to reporting hospital managers, as appropriate
• Keeps up to date on mandated regulatory/publicly reported data requirements as specified by federal, state, payer and other agencies.
• Any or other additional responsibilities as assigned

Bonus points:

• Prior experience working remotely
• Experience working with a SaaS, Healthtech or Software company
• RN or LPN credentials

The target wage range for this role is $28.00 -$32.00 per hour. Compensation decisions are dependent on multiple factors including but not limited to skills, experiences, licensure and certifications.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire. All applicants are required to residewithinthe continentalUnited States.

Carta Healthcare is dedicated to building a erse and inclusive company because we serve health systems across the country; weve seen how our product and impact are strengthened the more we reflect that ersity. In addition, we have found and strongly believe that erse teams are higher-performing, and we embrace the varied perspectives that our team members share with each other. As such, we are an Equal Opportunity Employer.

#LI-Remote #BI-Remote

Triage Oncology Registered Nurse- Remote

locations

United States

time type

Full time

job requisition id

JR12571

Country:

United States of America

Location:

Florida – Remote

WHY JOIN FCS

At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages.

Offering competitive salaries and comprehensive benefits packages to include tuition reimbursement, 401-K match, pet and legal insurance.

A LITTLE BIT ABOUT FCS

Since 1984, Florida Cancer Specialists & Research Institute & Research Institute (FCS) has built a national reputation for excellence. With over 250 physicians, 220 nurse practitioners and physician assistants and nearly 100 locations in our network. Utilizing innovative clinical research, cutting-edge technologies, and advanced treatments, we are committed to providing world-class cancer care. We are recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award, FCS offers patients access to more clinical trials than any private oncology practice in Florida. Our patients have access to ground-breaking therapies, in a community setting, and may participate in national clinical research studies of drugs and treatment protocols. In the past five years, the majority of new cancer drugs approved for use in the U.S. were studied in clinical trials with FCS participation prior to approval.

Through our partnership with Sarah Cannon, we are one of the largest clinical research organizations in the United States. Often, FCS leads the nation in initiating research studies and offering ground-breaking new therapies to patients.

Come join us today!

SUMMARY:

A Triage Nurse is a professional registered nurse with oncology-specific clinical knowledge that offers inidualized care and clinical guidance to patients, families, and caregivers to assist with ongoing healthcare needs.

PRIMARY TASKS AND RESPONSIBILITIES:

• Under general supervision, following established policies, procedures, and professional guidelines, provides care to patients by triaging oncology patient calls regarding treatment, surgery, and appointment information.
• Monitor and provide patient symptom management.
• Manage high risk, complex patient care with the goal of minimizing emergency department and inpatient readmission.

• Assess barriers to care to address patient, care giver, or family needs to achieve optimal patient outcome.
• Provide patient-centered inidualized ongoing education, resources, and referrals to internal and external resources to patient and caregivers.
• Assist the physician and PA-C/ARNP with specific patient/family interaction needed to resolve clinical issues.
• Complete requested clinical documentation as needed.
• Establish and maintain professional role boundaries with patients, caregivers, and the multidisciplinary care team in collaboration with manager as defined by job description
• Facilitate communication among members of the multidisciplinary cancer care team to prevent fragmented or delayed care that could adversely affect patient outcomes.
• Reviews, evaluates, and reports diagnostic tests to assess patient’s condition.
• Provides patient education and clinical direction by answering questions following chemotherapy, radiation, and infusion treatments and post-surgery.
• Work as an integral team player and is expected to adhere to and abide by the rules and regulations set forth by the Florida State Board of Nursing.

EDUCATION/CERTIFICATIONS & LICENSES:

• Registered Nurse multistate or Florida single state licensure required
• Minimum of Associate Degree in Nursing, Bachelors Degree preferred.
• Certification as an Oncology Certified Nurse (OCN) preferred

EXPERIENCE:

• Three (3) years or more of experience as an RN
• Two (2) years or more of oncology experience required

CORE COMPETENCIES, KNOWLEDGE/SKILLS/ABILITIES:

• Strong organizational skills
• Ability to prioritize and reprioritize quickly
• Ability to develop collaborative relationships both internally and externally
• Strong written communication skills
• Strong telephonic assessment and communication skills
• Ability to work autonomously and with a virtual team in a remote work environment
• Strong oncology side effect/ triage management
• Proficient in Microsoft Word, Excel, Outlook
• Possess high level critical-thinking skills

VALUES:

• Patient First Keeping the patient at the center of everything we do
• Accountability Taking responsibility for our actions
• Commitment & Care Upholding FCS vision through every action
• Team Working together, one team, one mission

Expectations for all Employees

Every FCS employee is expected to regularly conduct themselves in a professional and respectful manner, to comply with all labor laws, workplace policy and workplace practices. Employees are expected to bring issues of any forms of workplace harassment, discrimination or other potential improprieties to the attention of their management or the human resources department.

EEOC

Florida Cancer Specialists & Research Institute (FCS) is committed to helping iniduals with disabilities to participate in the workforce and ensure equal opportunity to compete for jobs. If you require an accommodation to submit a resume for positions at FCS, please email FCS Recruitment ([email protected]) for further assistance. Please note this email address is intended to request an accommodation as part of the application process. Any other correspondence will not receive a response.

FCS is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability or any other legally protected status.

SCREENINGS Background, drug, and nicotine screens

Safeguarding our patients and each other is an important part of how we deliver the best care possible to the communities we serve. All offers of employment at Florida Cancer Specialists & Research Institute are contingent upon clear results of a thorough background screening. Additionally, as a condition of employment, FCS requires all new hires to receive various vaccinations, including the influenza vaccine, barring an approved exemption. In addition, FCS is a drug-free workplace, and all new hires will be subject to drug/ nicotine testing.

Title: Psychiatric Mental Health Nurse Practitioner (PMHNP) – Pennsylvania

Location: Remote (United States)

JobDescription:

Our Company:

At Cerebral, we’re on a mission to democratize access to high-quality mental health care for all. We believe that everyone everywhere deserves to get the care they need, and are striving to make care convenient and accessible, while tackling the stigmas that surround mental illness.

Since launching in January of 2020, Cerebral has scaled to provide mental health services to more than 700,000 people in all fifty US states. With support from investors like SoftBank, Silver Lake, Access Industries, Bill Ackman, WestCap, and others, and impactful leaders like you, well continue to democratize mental health care and double down on clinical quality and deliver exceptional client outcomes for years to come. With a heavy focus on clinical quality and safety in all that we do, weve accomplished excellent outcomes for hundreds of thousands of clients:

• 82% of clientsreport an improvement in their anxiety symptoms after using Cerebral.
• 75% of clientswho report improvement in their depression see improvement within 60 days.
• 50% of clientswho initially report suicidal ideation no longer harbor suicidal thoughts after treatment with Cerebral.

This is just the beginning for Cerebral, and we wont stop building, growing, and iterating until everyone, everywhere can access high-quality, evidence-based mental health care without high costs and/or long wait times. Were looking for mission-driven leaders who share these values, and we need your help as we transform access to high-quality mental health care in the United States and beyond.

The Role:

We are hiring a full-time Psychiatric Mental Health Nurse Practitioner! Cerebral provides evidence-based treatment for adults seeking mental health care. Our telemedicine prescribers collaborate with Therapists and Psychiatrists to support clients during their mental health journey. This PMHNP role provides direct patient care for a panel of clients and allows for flexibility when client sessions can be scheduled. You can see clients during traditional business hours, evenings, or on weekends. This PMHNP will work within our clinical coverage team, providing additional support to clients between their sessions. This includes checking the client ticketing queue x3 daily during normal business hours.

We are looking for clinicians with state licenses from the following states: California, Illinois, New Jersey, New York, Pennsylvania, Oklahoma, and/or Minnesota.

Who you are:

• You are PMHNP licensed and in good standing
• Board certification (AANP or ANCC)
• Minimum of a Master’s degree in nursing, specializing in psychiatric mental health
• Comfortable assessing and formulating evidence-based treatment plans for clients with mental illness
• Maintain a strong evidence-based clinical skill set while practicing & implementing outcome-focused care within the clinical coverage team
• Empathetic and intuitive listening
• Strong verbal and written communication
• Knowledgeable in crisis response
• Comfortable working autonomously in a telemedicine environment
• Tech-savvy with the ability to navigate various systems & tools with ease (this includes, but is not limited to Google Workspace, proprietary EMR, etc.)
• Passionate about our mission of improving access to high-quality mental health care
• An entrepreneurial spirit or previous experience within a startup or fast-paced environment is preferred

How your skills and passion will come to life at Cerebral:

• Hold thoughtful and engaged sessions with clients; 30 minute initial sessions and 15 minute follow up sessions
• Provide a minimum of 36 hours of weekly availability for client-facing care that includes client sessions and clinical coverage during normal business hours
• Maintain and provide direct care to a panel of clients
• Respond to client clinical questions and needs as part of our clinical coverage program; this includes checking the client ticketing queue x3 daily during normal business hours so our clients have additional support between their sessions
• You will work collaboratively with other mental health care partners at Cerebral to ensure the most beneficial level of evidence-based treatment plans for our clients
• Work alongside other like-minded clinicians that have a common goal to positively impact the lives of others, and create an environment that leads to favorable outcomes for clients

What we offer:

• Mission-driven impact:
  • Shape the future of the #1 largest and fastest growing online mental health care company in the world
  • Build a platform that is improving the lives and well-being of hundreds of thousands of people
  • Join a community of high achievers who have a passion for promoting mental health
• Path to develop & grow:
  • Readily available psychiatrists and clinician leadership for case consultations to ensure you always receive the support you need
  • Access to innovative technology to support you in delivering the highest quality of care to your clients
  • Access to UpToDate for continued education (free CEU offering)
• Remote-first model:
  • Flexibility to choose the hours and schedule that work best for you
  • Work virtually from anywhere in the United States
• Culture & connectivity:
  • Highly-responsive and supportive team of clinical and operational management
  • Decreased administrative time for clinicians through ongoing technology improvements and automations
  • Fully integrated, data-enabled EMR with embedded clinical decision support, monthly prescriber metric reports, and task management system
  • Opportunity to participate in strategic development initiatives to improve our clinical quality and safety and/or clinical processes across the organization

The national base salary range (OR the national hourly range for nonexempt positions) offered for this position is outlined below. Cerebral is committed to equal pay for equal work; however, business reasons may dictate variations in pay that are attributed to objective factors, such as a candidate’s qualifications and years of experience.

National Base Salary Range: $110,000$135,000 USD

Who we are (our company values):

• Client-first Focus– relentless focus on advancing the quality of care, clinical experience, and patient safety
• Ethics & Integrity– do what is right and demonstrate ethical principles, even when no one is watching
• Commitment– accountable for fully delivering on commitments to our clients and each other
• Impact & Quality– make a positive impact and deliver high quality outcomes, based on data and evidence
• Empathy– act compassionately, listen to seek understanding, and cultivate psychological safety with clients and colleagues
• Collaboration– achieve our goals together as a united team, strengthened by mutual openness, trust, and ersity of thought
• Thoughtful Innovation– continuously evolve our ability to deliver on our mission, prioritizing long-term, strategic bets over short-term gains

Cerebral is committed to bringing together humans from different backgrounds and perspectives, providing employees with a safe and welcoming work environment free of discrimination and harassment. As an equal opportunity employer, we prohibit any unlawful discrimination against a job applicant on the basis of their race, color, religion, gender, gender identity, gender expression, sexual orientation, national origin, family or parental status, disability, age, veteran status, or any other status protected by the laws or regulations in the locations where we operate. We respect the laws enforced by the EEOC and are dedicated to going above and beyond in fostering ersity across our workplace.

___________________

Cerebral, Inc. is a management services organization that provides health information technology, information management system, and non-clinical administrative support services for various medical practices, including Cerebral Medical Group, PA and its affiliated practices (CMG), who are solely responsible for providing and overseeing all clinical matters. Cerebral, Inc. does not provide healthcare services, employ any healthcare provider, own any medical practice (including CMG), or control or attempt to control any provider or the provision of any healthcare service. Cerebral is the brand name commonly used by Cerebral, Inc. and CMG.

Title: Certified Hospital Inpatient Medical Coder (Remote)

Location: Denver Colorado United States

Job Description:

Remote Hospital Inpatient Coder

This is a full-time, remote/work from home, hourly position on the UCHealth Inpatient Coding team. Potential opportunity for eligible out-of-state applicants. Flexible work schedule. All required hardware/software provided, including dual monitors, keyboard, mouse. Assigns ICD-10-CM and PCS codes using computer-assisted-coding tools, and applies appropriate coding classifications for assigned service lines.

Job duties

• Responsible for accurately assigning and sequencing ICD-10 CM and PCS codes and POA indicators, identifying query opportunities, and abstracting data based on medical record documentation for all acute care hospital patient types.
• Appropriately applies official coding guidelines and relevant coding references to all inpatient coding scenarios.
• Collaborates with CDI, Quality, and leadership to capture necessary quality measures.
• Enhances coding knowledge and skills with continuing education.

Requirements

• High School diploma or GED
• Coding-related certification from AHIMA or AAPC
• 1 year of Inpatient coding experience OR 3 years of Outpatient coding

Preferred

• Certified Coding Specialist (CCS) highly desired
• 3+ years of hospital inpatient coding experience highly desired
• Level I Trauma coding experience
• Epic experience
• 3M encoder experience
• Computer-assisted coding

The pay range for this position is: $24.11 – $36.17 / hour. Pay is dependent on applicant’s relevant experience.

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

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

• Full medical, dental and vision coverage
• Retirement plans to include 403(b) matching
• Paid time off. Start your employment at UCHealth with PTO in your bank
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition and continuing education reimbursement
• Wellness benefits
• 5-year incentive bonus
• Full suite of voluntary benefits such as identity theft protection and pet insurance
• Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may also qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year

Loan Repayment: UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.

At UCHealth, we do things differently

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

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

Be Extraordinary. Join Us Today!

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

AF123

Certified Coder – REMOTE

Molina Healthcare Job ID 2024925

JOB DESCRIPTION

Job Summary

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

KNOWLEDGE/SKILLS/ABILITIES

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

JOB QUALIFICATIONS

Required Education

Associates degree or equivalent combination of education and experience

Required License, Certification, Association

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

Preferred Education

Bachelor’s Degree in related field

Preferred Experience

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

Preferred License, Certification, Association

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

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

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

Pay Range: $17.85 – $38.69 / HOURLY

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

About Us

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

Nurse Practitioner – Southeast

Location: Remote US

Saving Lives with Early Detection

The mission of HALO Diagnostics (HALO DX) is to improve human health and wellbeing via local and easy access to advanced diagnostics. HALO Diagnostics has a unique approach bringing together pioneers in the fields of radiology and other medical disciplines, molecular diagnostics and software development to create unparalleled levels of services and patient outcomes. Leveraging technology and collaborating with our own physicians and centers, we will make an impact on a personal level for each patient and their family, as well as raise the standard for improved accuracy in diagnostics.

Join HALO Precision Diagnostics as a Nurse Practitioner. Thisremote+travel(30-50%) full-time opportunity has aflexible, largely Monday – Friday 8am – 5pm PST schedule. We are hiring a crucial team member to support our genetic testing, imaging and laboratory teams. You will have the opportunity to counsel patients on hereditary cancer risks, screen patients for hereditary cancers, collaborate with clinicians based on medical guidelines, and provide metrics on program performance with your team. This opportunity comes with benefits, including stock options in a growing health-tech company focusing on early detection and precision-focused healthcare.

Nurse Practitioners with experience in hereditary cancer genetics, oncology, urology, men’s/women’s health, and radiology highly preferred.

Required: Graduate of accredited NP program, NP licensure

Why join us we offer you the following!

• The ability to save lives with early detection!
• A Monday Friday schedule
• Full benefits including medical/dental/vision/life – most are paid 100% by the company
• Stock options
• Paid vacation / holidays and sick time
• 401k plan
• Advancement and training opportunities
• Pay Range: $120,000-165,000

Title: Clinical Documentation Integrity Coder – HCC (remote)

Location: Remote

JobDescription:

About Our Company

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

About our Growth

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

Visit www.vytalizehealth.com for more information.

Why you will love working here

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

Your opportunity

The CDI Specialist supports clinical documentation to ensure complete, accurate, and compliant coding for Medicare and Medicare Advantage beneficiaries. Proficient in ICD-10-CM coding and risk adjustment methodologies, you optimize coding integrity, conducting chart reviews specifically addressing the CMS-HCC model. This role emphasizes production coding with a focus on enhancing clinical documentation through compliant risk adjustment chart review programs.

As a CDI Specialist, you significantly contribute to ensuring accurate and compliant documentation, aligning beneficiaries health burden with risk scores for appropriate Medicare reimbursement. Your expertise in precision and excellence supports the organization’s commitment to providing high-quality healthcare services.

What you will do

Clinical Documentation Enhancement:

• Validate and ensure the completeness, accuracy, and integrity of coded data.
• Support and enhance clinical documentation to ensure comprehensive, accurate, and compliant coding for Medicare and Medicare Advantage beneficiaries.

Coding Proficiency:

• Demonstrate proficiency in ICD-10-CM coding, CPT codes, HCPCS codes, and risk adjustment methodologies to optimize coding integrity.
• Comply with HIPAA laws and regulations.

Chart Reviews:

• Review and accurately code medical records and encounters for ICD-10 diagnoses and procedures codes related to Risk Adjustment and HCC coding guidelines.

Production Coding:

• Oriented towards production coding, with a primary emphasis on improving clinical documentation through effective risk adjustment coding.
• Maintain productivity standards averaging 30 charts per day.

Documentation Alignment:

• Ensure documentation aligns with regulatory guidelines and standards, emphasizing precision in risk adjustment processes.
• Stay up to date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.

Contribution to Accuracy:

• Contribute significantly to accurate and compliant documentation, aligning beneficiaries health burden with risk scores for appropriate Medicare reimbursement.

Quality Assurance:

• Ensure exemplary attention to detail and completeness, ensuring coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
• Uphold a commitment to precision and excellence, maintaining at least a 95% coding accuracy rate.

EHR Knowledge and Proficiency:

• Demonstrate knowledge and expertise in various Electronic Health Record (EHR) systems to optimize chart reviews across multiple platforms.

What will make you successful in this role

• Minimum of 2 years HCC/Risk Adjustment coding experience required, 3+ years preferred.
• Strong communication skills, including clear verbal and written communication, effective collaboration, and the ability to convey complex coding concepts.
• Knowledge of medical records coding procedures and ICD-10/CPT Coding Systems required.
• Must hold a Certified Risk Adjustment Coder (CRC) and Certified Professional Coder (CPC) certification.

Perks/Benefits

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

We are interested in every qualified candidate who is eligible to work in the United States. However, we are not able to sponsor visas.

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com

Title: Psychiatric Mental Health Nurse Practitioner or Physician Assistant

Location: Remote United States

Type: Full-Time

Workplace: remote

Category: Psychiatry

JobDescription:

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

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

About this role:

Equip Health is seeking a passionate, driven Psychiatric Nurse Practitioner to join its rapidly growing clinical care team caring for children and adults with eating disorders in a 100% virtual Telehealth platform. Psychiatric Nurse Practitioners are essential members of Equips treatment team, working alongside a therapist, peer mentor, medical provider, dietitian and family mentor to help people recover from an eating disorder.

Responsibilities:

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

Time Expectations:

• Your time will be ided between:
• Team meetings: 2 hours per week. Treatment Team Meeting and Medical/Psychiatric Team Meeting
• Inidual supervision: 0.5 -1hr/week
• Clinic Time: 65% of your Clinic Time is devoted to sessions with patients.
• Administrative Time: 20% of your Clinic Time is scheduled to respond to between-session messages or hold unanticipated sessions
• There is no call requirement; major and minor holidays are off without patient obligations
• Hours are in EST

Requirements:

• Board Certification as a Psychiatric Mental Health Nurse Practitioneror Licensed Physician Assistant
• Maintain an active license to practice in the state(s) that their patients reside and/or be willing to become licensed in other states (paid by Equip)
• Demonstrate a commitment to providing excellent evidence-based care, advancing clinical skills, and a passion for professional development
• Communicate effectively with patients and patients carers, and respond to messages within a timely mannerBe curious, enjoy learning, and participate enthusiastically in a multidisciplinary team
• Comfort and experience treating patients with emotion dysregulation, suicidal ideation, substance use, trauma, mood disorders, anxiety disorders, personalIty disorders, attention deficit/hyperactivity disorder, and substance use disorders. Equip uses a HAES and gender affirming approach to care
• Ability to provide care 2 evenings per week (Till 7 pm in EST)
• Monday – Friday 40 hours

Bonus if you have the following:

• Fluent in English and Spanish
• 1-2 years of clinical experience
• Experience treating patients with eating disorders

The pay range for this position in the US is $125,000 – $150,000/yr; however, base pay offered may vary depending on job-related knowledge, skills, and experience. We are open to compensation negotiations. This role can be located anywhere in Eastern USA.

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

Compensation and Benefits:

Equip offers competitive compensation and benefits programs as well as, career development opportunities, and exciting team retreats to ensure community and connection. The Talent Acquisition team will provide candidates with our benefit guide and share compensation information beyond posted bands. Below we have highlighted a list of some of our most popular benefits.

Short and long term incentives, including yearly bonus potential

Remote work from home

Flexible PTO & Leave programs

Health, dental, and vision insurance

Wellness and reproductive care programs

401k retirement savings plan

Home office set-up stipend

Co-working monthly stipend

Equal Employment Opportunity:

At Equip, we believe that our erse perspectives are our biggest strengths and that embracing them will create real change in healthcare. As an equal opportunity employer, we provide equal opportunity in all aspects of employment, including recruiting, hiring, compensation, training and promotion, termination, and any other terms and conditions of employment without regard to race, ethnicity, color, religion, sexual orientation, gender identity, gender expression, familial status, age, weight, disability and/or any other legally protected classification protected by federal, state, or local law.

Supervisor, Medical Review Coding (Outpatient)

United States (Remote)

Full time

job requisition id R-2024-02-00081

ABOUT PERFORMANT:

At Performant, were focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most quality of care and healthier lives for all.

If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture then Performant is the place for you!

ABOUT THE OPPORTUNITY:

Hiring Range: $77,350.00 $90,000.00

TheSupervisor, Medical Review Coding(Outpatient) leverages their breadth of outpatient and/or inpatient coding knowledge, medical claims and coding audit expertise, and experience leading others to manage staff and operational results for a remote team of coders and other audit roles, performing coding audits. Responsible leveraging first-hand experience and knowledge of claims auditing, for supporting management with strategy activities such as needs assessments, capacity planning, preparing staffing models, ensuring required staffing levels, cost/benefit analysis, and establishing productivity and quality standards.

Key Responsibilities:

• Regularly performs limited volume of Inpatient coding reviews on medical records to maintain subject matter expertise, and additionally as needed to support business needs.
• Performs audit quality assurance reviews to supplement QA team activity as necessary based upon business need or special projects.
• Contributes to the resolution of quality review rebuttals.
• Performs appeals review/activity to supplement Appeals team based upon business need.
• Actively identifies and recommends opportunities for cost savings and improving outcomes that can have a direct impact to the company’s profitability.
• Effectively contributes to the development of medical review guidelines and training.
• Supports audit management and segment specialists with activities for new concept implementation, maintenance of medical review guidelines for existing concepts.
• Use data, reports and experience to proactively identify potential backlogs and align resources to meet business needs and SLAs.
• Oversee and review audit determinations in order to ensure consistency in decision-making.
• Collaborate with other departments to resolve operational problems.
• Proactively monitors and in alignment with applicable management ensures activity required to meet team staffing levels necessary for assigned business segment objectives.
• Provides support as needed to ensure auditors are equipped with tools and resources required to perform audits.
• Supervise daily activities of coding audit staff members.
• Provide audit guidance to medical review staff; identify trends and present solutions.
• Routinely provides production and quality performance-based progress reports, coaching, and constructive feedback to staff.
• Manages team Time and Attendance (time off/use of accruals, attendance, attendance points and timecards for hourly staff, etc.) in accordance with applicable policies and procedures.
• Collaborates with HR for applicable corrective action as applicable.
• Complete and conduct performance reviews for assigned staff.
• Conduct team meetings with direct reports on a regular basis.
• Provide leadership to team members, provide solutions, and resolve conflicts.
• Escalate to management and collaborate with HR as applicable to bring appropriate solutions to employee matters.
• Provide reporting and updates to management as required and appropriate for operational and staff activity and results.
• Participates in and contributes to applicable department meetings.
• May participate to client-facing meetings; research and analyze issues; present findings and solutions; and/or provider training.
• May support management with activities to monitor inventory and activity of 3rdparty/subcontractors.
• Become subject matter expert for assigned business segment(s).
• Maintain current knowledge and changes that affect our industry and clients as it pertains to medical practice, technology, regulations, legislation, and business trends.
• May support training material/tools and best practices development.
• Identify needs and ensure team receives necessary training.
• Support training activities for new audit staff or provide supplemental training for existing staff as needed.
• Contributes to positive team environment that fosters open communication, sharing of information, continuous improvement, and optimized business results.
• Receives feedback and adjusts work priority for self and team as necessary.
• Leads by example and conducts work in accordance with company policies, government regulations and law.
• Perform other incidental and related duties as required and assigned to meet business needs.

Knowledge, Skills, and Abilities Needed:

• Strong knowledge of medical documentation requirements and an understanding CMS, Medicaid and/or Commercial insurance programs, particularly the coverage and payment rules and regulations.
• Thorough working knowledge of CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding.
• Proficiency with MCS 1500/UB 04 forms
• Working knowledge of encoder
• Proven ability to review, analyze, and research medical billing, documentation, and coding issues
• Reimbursement policy and/or claims software analyst experience
• Familiarity with interpreting electronic medical records (EHR)
• Basic understanding of accounting principles for accounts payable and receivable as it relates to medical billing.
• Willing and able to lead, communicate ideas, take initiative and drive the team to achieve organizational goals.
• Experience in developing, documenting and implementing process and procedures.
• Experience in inventory management, resource planning and report generation.
• Skill in analyzing information, identifying trends and presenting solutions.
• Understands inventory management objectives, activities, and key drivers in achieving operational goals.
• Demonstrated ability to consistently apply sound judgment and good effective decision making.
• Excellent communication skills, both verbal and written; ability to communicate effectively and professionally at all levels within the organization, both internal external.
• Demonstrated ability to collaborate effectively in a variety of settings and topics.
• Excellent editing and proofreading skills.
• Demonstrated ability to successfully develop, lead, and motivate a team to high performance; effectively provides constructive feedback and coaching for successful outcomes.
• Ability to independently organization, prioritize and plan work activities effectively for self and others; develops realistic action plans with the ability to multi-task effectively.
• Excellent time management and delivers results balancing multiple priorities.
• Strong analytical skills; synthesizes complex or erse information; collects and researches data; uses experience to compliment data.
• Leverages strong critical thinking, questioning, and listening skills to research and effectively resolve complex issues.
• Demonstrated ability to identify areas of opportunity and create efficiencies in workflows and procedures.
• Demonstrated ability to be proactive; identifies and resolves problems in a timely manner; develops alternative solutions.
• Ability to create documentation outlining findings and/or documenting suggestions.
• Strong general technical skills, including, but not limited to Desktop and MS Office applications (Intermediate Excel Skills), application reporting tools, and case management system/tools to review and document findings.
• Solid technical aptitude with demonstrated ability to quickly learn and adapt to new systems and tools.
• Ability to be flexible and thrive in a high pace environment with changing priorities.
• Adaptable to applying skills to erse operational activities to support business needs.
• Self-starter with the ability to work independently in remote setting withminimum supervision and direction in the form of objectives.
• Serves as positive role model; and demonstrates characteristics that align and contribute to a collaborative culture of continuous improvement and high performing teams.
• Limited travel may be required.
• Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Required and Preferred Qualifications:

• Current certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P
• High School Diploma or GED Required
• Not currently sanctioned or excluded from the Medicare program by OIG
• 2+ years of performing medical record audits in a provider setting, or in a payer setting for a health insurance company.
• 5+ years of DRG coding for hospital, physicians office or other acute inpatient facility setting (Inpatient/SNF Facility), AND 2+ years of facility Outpatient services, OR equivalent demonstrated experienced gained through prior experience conducting applicable Inpatient/Outpatient coding reviews (less years of experience may be considered for internal candidates based upon demonstrated skills and results).
• 3+ years relevant supervisory or leadership experience in similar business environment (preferably experience overseeing remote staff).
• Prior experience in payer edit development, and/or reimbursement policy experience a plus.

WHAT WE OFFER:

Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview.

Physical Requirements & Additional Notices:

If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employees responsibility to maintain this Internet access at their home office location.

The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each inidual job may vary.

• Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.
• Regularly reads and comprehends information in electronic (computer) or paper form (written/printed).
• Regularly sit/stand 8 or more hours per day.
• Occasionally lift/carry/push/pull up to 10lbs.

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.
• Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.
• Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures.
• Other requirements may apply.

All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Performant is committed to the full inclusion of all qualified iniduals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performants Human Resources team to discuss further.

Our ersity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a erse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED

Title: Billing Specialist

Location: Remote

JobDescription:

Within Health is a Virtual company for Eating Disorders. As this company was started in 2021 we are looking for a quality team member to join our Revenue Cycle team.

**MUST HAVE EATING DISORDER OR INSTITUTIONAL CLAIMS FOR MENTAL HEALTH EXPERIENCE**

Job Summary:

The Billing Specialists primary responsibility is to oversee the billing process for clients. Ensure timely and accurate submission and processing of client invoices and insurance claims. The Billing Specialist will also research and resolve all provider and client inquiries in a timely and customer-focused manner.

Major Areas of Responsibility:

• The primary function is to take ownership of the error free completion of the entire weekly bill cycle to include:
• Checking eligibility and benefit verification for services provided as needed
• Conduct client and guarantor welcome orientations on the insurance/private pay/balance billing process
• Maintain communication with clients on the billing process, status of their claims
• Manage the status of client accounts and balances and identify inconsistencies
• Create, send and collect on bi-weekly invoices for balance billing and SCA, private pay clients
• Follow up, collect, charge and post large client balances
• Professionally answer and respond to calls, and emails from patients, payers, and other team members re: claims, balances, eligibility, etc., promptly.
• Accurately prepare, review, and submit claims within timely filing to various insurance companies electronically, or in some case via paper using correct revenue, HCPCS, CPT and ICD10 codes
• Post insurance and patient payments from ERAs or EOBs within a timely matter.
• Follow-up on open, denied, underpaid, overpaid and non-paid claims and re-submit, send back, appeal as needed
• Write, compile medical records, etc. for appeals, retrospective reviews, authorizations as needed; and follow up accordingly.
• Collaborate with clients and insurance companies, team members to resolve billing inconsistencies and errors.
• Review patient accounts for trends that indicate where additional assistance might be needed.
• Constructively handle patient complaints and report to your supervisor immediately.
• Support billing team as needed when inidual tasks are completed, or if help needed to complete a project.
• Monitor your daily, weekly performance and submit daily delegations to billing manager.
• Plan, organize, direct and control to meet all billing objectives.
• Maintain and track your personal calendar, calls, and deadlines.
• Motivate yourself to perform well.
• Communicate potential opportunities for optimization.
• Constantly strive toward continuing professional growth
• Accurate and timely processing of all adjustments (debits and credits), initiated by either external (client-related) or internal (Shared Services) requests
• Timely research and resolution of all billing inquiries to the assigned mailboxes utilizing the highest level of customer service

QUALIFICATIONS:

• High school diploma or equivalent require, some college preferred
• 3 years experience in billing, preferably in the Staffing or Medical field
• 3-5 years of demonstrated analytical sense with excellent attention to detail
• Medical billing experience, specifically insurance company follow up and balance billing
• Understanding of billing on UB-04 forms and revenue, CPT, HCPCS, ICD10 codes
• Compliance of HIPAA, understanding of medical terminology
• Strong attention to detail and efficient data entry
• Strong organization, time management and prioritization abilities
• Excellent communication and Customer Service skills
• Strong computer skills, including knowledge of EMRs, PM systems, and Microsoft Office suite

Physical and Environmental Requirements:

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

Wage Range: $50-$60k/Year

Pathology Support Coordinator

Remote

PRIMARY RESPONSIBILITIES:

• Review select cases for accuracy of tissue request and escalate to PAs when needed, complete accurate data entry.
• Assist other PSCs in resolving issues with their cases and provide feedback on the quality of their work.
• Ensure that necessary notes and holds are placed on cases for non-conforming samples, discrepancies and/or missing information so that timely follow-up by the Customer Care team is made.
• Compose professional emails/faxes using proper grammar and spelling to communicate with other departments for case escalation and/or case status updates.
• Perform outbound calls to pathology labs for specimen information (confirmation of accession numbers, specimen locations, pathology fax numbers, address confirmation, etc
• Attend interdepartmental meetings if needed and provide feedback on the current process or workflow.
• Monitor errors and metrics for all tissue cases
• This role works with PHI on a regular basis both in paper and electronic form and have an access to various technologies to access PHI (paper and electronic) in order to perform the job
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.
• Must maintain a current status on Natera training requirements.
• Performs other duties as assigned.

QUALIFICATIONS:

• High School Diploma (or equivalent) required.
• 2+ years of medical industry related experience.
• Previous computer experience is required.
• Previous data entry experience is required.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Trained on all product types and able to accession with high accuracy and efficiency consistently.
• Ability to handle most escalations, discrepancies, and holds.
• Firm understanding and knowledgeable in all aspects of the
• Accessioning process and SOPs
• Typing speed of at least 45wpm with high accuracy
• Excellent oral and written communication skills required
• Excellent critical thinking skills and the ability to use good judgment
• Ability to perform required duties with a high degree of accuracy and attention to detail
• Positive attitude and ability to work well with others

#LI-REMOTE

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

Remote USA

$19.04$23.80 USD

Title: NP Clinical Documentation Specialist (Remote)

Location: Remote

Job Description:

Nice to meet you, were Vesta Healthcare.

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

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

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

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

The ideal teammate would be

A detail-oriented, clinically trained Nurse Practitioner who can provide expertise, education and guidance on clinical practice and documentation to improve our clinical outcomes as well as increase capture of pertinent diagnosis codes and quality measures. A role model and facilitator for the clinical team and a support the leadership team with execution on the departments vision for quality and appropriate code capture. An inidual that is self-directed and possesses advanced analytical skills, critical thinking, creativity, and the ability to anticipate and identify opportunities and potential problems. Someone who is an educator and enjoys supporting fellow Nurse Practitioners to improve their documentation. This is a salaried 40 hours per week position, Monday through Friday 9:00am to 6:00pm EST.

The ideal teammate would be able to:

• Develop, design, revise and execute our comprehensive clinical documentation accuracy and HCC documentation program
• Collaborate extensively with Nurse Practitioners, collaborating physicians, nursing staff, other care team members, and coding staff to improve the quality and completeness of documentation/auditing of care provided and coded for coordination, abstraction, and submission of accurate data required for billing and improved clinical outcomes
• Facilitate modifications to clinical documentation to ensure appropriate reimbursement based on clinical severity and services rendered to patients
• Support timely, accurate, and complete documentation of clinical information used for measuring and reporting clinician and team outcomes/productivity
• Continuously monitor metrics with an eye to increase/improve quality, satisfaction, and savings
• Communicate with and educate all clinical staff concerning accurate and effective clinical documentation
• Complete accurate and timely review to ensure the integrity of the documentation compliance resulting in accurate diagnosis and procedure classification used for reimbursement and quality metrics
• Recognize opportunities for documentation improvement and sound judgment in decision making keeping reimbursement considerations in balance with regulatory compliance
• Strategically educate clinicians and staff regarding the need for accurate and complete documentation in the health record that includes regulations and compliance guidelines
• Solve complex problems and takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information
• Meet patient and patient family needs; take responsibility for a patient’s safety, satisfaction, and clinical outcomes; use appropriate interpersonal techniques to resolve difficult patient situations and regain patient confidence

Would you describe yourself as someone who has:

• Masters Degree with current active Nurse Practitioner license (required)
• 3+ years of clinical documentation improvement experience, coding experience or equivalent (required)
• Active Certified Risk Adjustment Coder Certification (CRC) (required)
• 5+ years of adult/geriatric care experience (required)
• 1+ year of experience working with advanced practice providers as well as other clinical and non-clinical staff (required)
• Experience with risk adjustment and value based care delivery systems
• Motivated self-starter and creative problem-solver who is comfortable working in a fast-paced, dynamic environment
• Experience with Powerpoint/Excel and/or Google Slides/Sheets
• Experience working in a remote environment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k with 4% match

We look forward to speaking with you!

Pay range is $125,000-$130,000 based on experience. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

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

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

Title: Enterprise Sales Director, Healthcare (Remote)

Location: Remote

Type: Full Time

Workplace: remote

Category: Healthcare

JobDescription:

Description Ushur is transforming the way enterprises communicate and engage with customers. Fueled by consumers self-service demands, enterprises are modernizing customer engagement and experience models. Ushur is fast becoming the platform of choice for Customer Experience Automation, enabling these enterprises to leapfrog their digital native counterparts and deliver delightful customer and employee experiences.With cutting-edge Conversational AI, Machine Learning andIntelligentProcess Automation technologies, Ushur has enabled Fortune 100 enterprises including some of the worlds most well known brands in healthcare, insurance, banking and financial services sectors to automate their customer engagement. Cloud-native, 100% no-code and purely workflow-driven, Ushur empowers citizen developers within business operations teams to build AI-powered, fully-automated and omni-channel experience to digitally transform customer journeys end-to-end.

Responsibilities

• Develop a set of strategic account plans assigned to you for your select verticals and region that includes how you will engage leaders responsible for digital transformation, customer experience and operations
• Become a trusted advisor to Clients by understanding their needs and business objectives, demonstrating industry awareness and co-creating high impact business solutions with the Ushur platform
• Focus relentlessly on bringing new Clients into the Ushur family and expand the business inside existing Client accounts
• Collaborate internally with Sales Consultants and Industry Market Leaders to create industry relevant presentations and demonstrations for the target market and function
• Develop proposals, business cases and ROI model for and with Clients
• Partner with Customer Success Teams to ensure Client success with Proofs of Concept and Programs in Production
• Acquire and maintain a working knowledge of the Ushur Platform

Requirements

• 4-5 years proven success selling SaaS-based Enterprise Software Solutions with at least 3+ years of experience selling to Health Plans and other Healthcare Organizations in the Fortune 1000
• A demonstrated track record where you consistently have met or exceeded annual quota
• Subject matter expertise in healthcare with rich experience working with health plans and benefits
• Possess a deep understanding of how technology is leveraged both within health plans and how they interact with their members, brokers and other key stakeholders
• Familiar with how health plans and healthcare companies select technology and solution providers
• Experience at a fast-paced high growth startup environment
• Capable of presenting sophisticated technology solutions at the C-level
• Superb written and oral communications skills
• Ability to own the entire sales cycle from Lead Generation to Contract Close
• Bias to action, high sense of urgency and energy

Compensation: The pay range for this position is $240,000-$300,000 OTE (on target earnings) plus equity. However, base pay offered may vary depending on skills, experience, job-related knowledge and location. Benefits Great Company Culture. We pride ourselves on having a values based culture that is welcoming, intentional, and respectful. Our internal NPS of over 65 speaks for itself – employees recommend Ushur as a great place to work! Bring your whole self to work. We are focused on building a erse culture, with innovative ideas where you and your ideas are valued. We are a start up and know that every person has a significant impact! Rest and Relaxation. Unlimited PTO, wellness days, paid holidays, and more! Health Benefits. Comprehensive health, dental, and vision. We offer a variety of plans to meet the needs of you and your loved ones. We care about your Future. Access to 401(k) so you can contribute and generous stock options. Keep learning. One of our core values is Growth Mindset – we believe in lifelong learning. Whether you are a previous student, or currently enrolled in higher education, we can help cover some of those expenses and support your ongoing development and career growth. Flexible Work. In-office, work-from-home, or hybrid, depending on position and location. We seek to create an environment for all of our employees where they can thrive in both their professional and personal lives.

Title: Physician (Remote)

Location: Remote

Type: Remote / Independent Contractor

Workplace: remote

Category: Clinical

Job Description:

Plume is a passion-fueled, mission-driven, trans-founded company focused on radically increasing access to healthcare for the transgender and gender-nonconforming communities. Our vision is to transform healthcare for every trans life and build a virtual care home for the trans community.

As a rapidly expanding organization, we are now proudly available to more than 1 million transgender iniduals in 45 states. We are an organization formed through the lived experience of trans people and fierce allies and we welcome other heart-forward, talented iniduals to join our team on this journey.

We are currently hiring Independently Contracted Physicians (MD/DOs) to serve our members. We welcome all state licenses but are specifically in need of folks with Texas, California, Arkansas, North Carolina, Florida, Missouri, Tennessee, Kentucky, Michigan, Indiana, Wisconsin, Oklahoma, and Georgia licenses at the moment.

About the role:

As an independently contracted clinician with Plume, you will join our awesome team of erse clinicians who provide GAHT (gender-affirming hormone therapy) and depression/anxiety management for our adult patients throughout the United States. As we expand our clinical services, we are looking specifically for providers with broad, primary care experience.

You will provide longitudinal care for a panel of patients so your time will be spent onboarding new patients and providing follow-up care for them (lab management, prescription management, answering clinical questions).

This is a completely virtual work-from-home role with flex scheduling. You schedule your hours when you want to work. We require a minimum of 10 hours of synchronous time per week. We have a large support team that takes care of patient account logistics so you can focus on clinical care.

We are a healthcare startup, so we are seeking folks excited about changing the paradigm of medical care so patients and clinicians are truly centered. We heavily leverage technology, so being comfortable with computers and electronic medical record systems in a rapidly changing environment is critical to do this work.

Must-Haves:

• At least two active licenses and in good standing with your professional board
• At least one DEA License
• Experience providing primary care services to adult patients
• Experience and comfort in collaborating with erse teams
• Comfortable with 100% remote patient care
• Strong technical background (familiarity with EMRs, email communication, app-based platform use, etc.)
• Strong organization and communication skills
• Availability of 10 hours per week for synchronous visits

Nice-To-Haves:

• At least 5 active licenses – preference for Texas, California, Arkansas, North Carolina, Florida, Missouri, Tennessee, Kentucky, Michigan, Indiana, Wisconsin, Oklahoma, and Georgia.
• Ability to commit at least 20 hours of synchronous time per week
• Experience with telehealth and preferably direct-to-consumer (DTC) telehealth/startup work
• Experience prescribing GAHT
• Experience prescribing behavioral health medications (depression and anxiety)
• Familiarity with and experience using established GAHT guidelines, including an informed consent model of care
• CAQH profile

Compensation & Benefits:

• Working for an amazing company that is changing the world
• MD/DO Providers are paid per appointment at the following rates:
• $37.50 per 15 min visit
• $68 per 30 min visit
• 50% of the regular rate for no-shows or visits canceled within 24 hours.
• Quarterly Bonus Opportunities
• License Reimbursements for Providers who offer 20 hours of synchronous time per week

Plume is an equal-opportunity employer. Trans and gender-nonconforming iniduals are strongly encouraged to apply, particularly those who identify as people of color. We positively encourage applications from suitably qualified and eligible candidates regardless of age, color, disability, national origin, ancestry, race, religion, gender, sexual orientation, gender identity and/or expression, veteran status, genetic information, or any other status protected by applicable law.

Read more about Plume at www.getplume.co

Title: Registered Dietitian (Remote)

Location: Remote (US)

Type: Part-Time

Workplace: remote

Category: Clinical

JobDescription:

This requisitionis an advertisement for part-time positions that Foodsmart hires for regularly throughout the year. It is a way for Foodsmart to build a database of qualified, interested iniduals for a particular job function so that when there is a need to fill that type of role, the hiring process will be faster. By applying to an Evergreen Requisition, you are expressing your interest for a particular job function within Foodsmart. Please see our other Registered Dietitian postings for specific states in which we are currently hiring. Who Is Foodsmart? At Foodsmart, were knee-deep in changing the food and nutrition landscape and were leveraging technology and our team of bright minds with big hearts to make it happen. We believe that eating well should be within reach for all, not some. That food should be accessible and affordable and the foundation of good health. And that we have a role to play in addressing the nutrition insecurity that plagues too many, and that has a direct impact on our health and susceptibility to illness. We know the Foodsmart approach works, and we know it matters because we have the clinical outcomes published in major journals, serve >20% of the Fortune 500 and 4 out of 5 major health plans, and have the community engagement to back it up. And because were all Foodsmart customers. We are working parents. We are doctors. We are patients. We have busy lives, tight budgets and need to feed picky eaters. We have lived in households that used SNAP and clipped coupons. So we built a platform that truly changes health outcomes and improves lives. Our registered dietitians work with iniduals to offer personalized nutrition guidance and connect them to the Foodsmart digital platform available on mobile and web, to create sustainable behavior change and deliver real results. Our integrated healthy food marketplace, including partners such as Walmart, Instacart, Grubhub, and others, allow iniduals to go from meal planning to grocery delivery in minutes saving them time and money. We are a Series C startup based in San Francisco but support a remote working model. Are you ready to join our team and help solve one of the biggest problems facing the world today? Learn more at www.foodsmart.com About You Foodsmart is seeking Registered Dietitians (RDs) to support the comprehensive nutrition care mission of Foodsmart Nutrition Network, which is grounded in evidence-based clinical nutritional standards including use of a whole food plant based (WFPB) diet. Our Foodsmart RDs leverage Foodsmart’s digital platform to provide a broad range of nutrition and health-related consultations, educational sessions, and training to Foodsmart’s clients, partners, and users. Populations Served In this role, you will work with members from various health plans, including Medicaid populations. Foodsmart creates lasting and sustainable change in Medicaid communities by tackling the root causes of food and nutrition insecurity. We provide members with personalized guidance, access to affordable healthy food options, and access to SNAP benefits if they qualify. In turn, we see improved food and nutrition security, more health equity, and better engagement and enrollment.

What Does Success Looks Like In This Role?

• You are completing at least 6 follow-up visits with your patients
• You are receiving an NPS of 80% and above
• You find value in developing lasting relationships with your patients to support them towards sustainable behavior change and improved health outcomes

Responsibilities

• Provide inidualized medical nutrition therapy (MNT) via remote sessions to patients with a variety of health and lifestyle needs
• Document care in electronic medical record according to Nutrition Care Process
• Assist patients in getting the most utility out of Foodsmart’s digital platform
• Manage a panel of clients/patients with a variety of chronic health conditions and backgrounds
• Communicate effectively and empathetically with clients/patients through HIPAA-compliant video calls and electronic messaging

Required Skills

• Active credentialing as a Registered Dietitian by the Commission on Dietetic Registration (CDR) and Licensed Dietitian
• Must have at least one state licensure
• Willingness to apply for additional licensure in at least one other state
• Minimum of one (1) to two (2) years of professional experience in providing nutritional counseling
• Ability to work in the U.S.

Preferred Skills

• Multilingual (native level) language capabilities
• Multiple active state licenses or certifications
• Experience delivering services via a telehealth platform

Compensation

• $12/unit for Medical Nutrition Therapy (MNT). Each unit for MNT is 15 minutes, so you’d earn $48 for a visit that lasted for one hour. Most of our visits are one hour
• RDs who offer over 20+ hours of weekly availability for at least a year qualify for CDR fee reimbursement ($70)

Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law.

Manager, Coding Validation & Quality Assurance

locations

Remote

time type

Full time

job requisition id

33530

Position:Manager, Coding Validation and Quality Assurance

Department: Clinical Documentation

Schedule: Full Time / Remote

POSITION SUMMARY:

Responsible for the professional development of the coding staff and for providing a hospital-wide educational program to assist coders in continued coding and documentation education. Performs quality assurance reviews of inpatient and outpatient records to assess and report on the effectiveness of training programs and quality of coders. Provides in-service training and feedback to coding staff regularly, including coding changes and updates. Designs and implements programs on coding and clinical documentation audit and education to improve performance and efficiency. Partners with CDCI management to develop appropriate guidelines regarding IP and OP coding. Enforces correct application of Official Coding Rules and Regulations and follows appropriate guidelines including Coding Clinic. The Manger, Coding Validation and Quality Assurance may help represent the Clinical Documentation Coding Integrity (CDCI) Department at clinical meetings when requested to serve as a resource for coding guidelines and interpretation.

REQUIREMENTS

EDUCATION:

Bachelors degree or equivalent combination of formal education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

CCS and AHIMA Certified ICD-10 Trainer credentials required.

Additional RHIA, RHIT, RN, or other coding credential is preferred.

EXPERIENCE:

Must have at least five years of experience in coding; experience must include education/mentoring/training. Minimum of five years acute care hospital experience coding with ICD-9/10-CM/PCS and CPT-4, academic medical setting or trauma center preferred. Minimum of three years management experience required; five years preferred.

Prior experience working claim edits and denials.

KNOWLEDGE AND SKILLS:

• Command of the ICD-9/10-CM and CPT4/HCPCS coding conventions, E&M coding, diagnosis-related groupings (DRG) and ambulatory patient groupings (APG) methodology. Work also requires concepts of human anatomy, physiology and pathology.
• Excellent skill in providing hands-on education to CDCI staff based on audit finding and need.
• Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to work with accuracy and attention to detail.
• Ability to solve problems appropriately using job knowledge and current policies/procedures.
• Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
• Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
• Must possess extensive knowledge of hospital inpatient and outpatient reimbursement methodologies.
• Work requires in-depth knowledge of medical terminology, ICD-10-CM/PCS and CPT-4 Coding conventions and knowledge of the various DRG systems (CMS DRGs, AP-DRG, and APR-DRGs). Work also requires basic concepts of human anatomy, physiology and pathology.
• Strong knowledge of health records, computer systems, Microsoft applications, data integrity, and processing techniques required.
• Ability to mentor, guide and motivate direct reports through demonstration of best practices and leading by example.
• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
• Ability to solve problems appropriately using job knowledge and current policies/procedures.
• Ability to maintain and enforce strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
• Must possess extensive knowledge of payer claim edits and payer denials. Work requires in-depth knowledge of medical terminology, ICD-10-CM and CPT-4 Coding conventions (including E&M coding), Ambulatory Patient Classifications (APC), Ambulatory patient Groupings (APG) methodologies, and Fiscal Intermediary Local Coverage Determinations, CMS National Coverage Determinations and various other applicable coding regulations and law.

IND123

Equal Opportunity Employer/Disabled/Veterans

Title: RN Supervisor, Clinical Operations

Location: United States

Job Description:

Company Overview

Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patients healthcare experience, both in and out of the doctors office. Founded in August, 2019, we are obsessed with eliminating wasteful friction patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles.

Opportunity overview

Coheres Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The RN Supervisor, Clinical Operations position is a crucial role in our organization. In this role, you are responsible for coaching, mentoring, evaluating and developing the RN Reviewer team. The RN Supervisor will use established operational tools to ensure all RN staff are meeting or exceeding performance metrics and quality standards established by the leadership team.

As an RN Supervisor, you will work closely with the leadership team at Cohere and report to the Director/Manager of Clinical Operations. You will be responsible for providing daily operational guidance to the RN Reviewers to allow them to meet or exceed operational objectives and metrics. You will leverage both your creative skills and communication skills to promote a high performing clinical team.

The RN Supervisor will be highly organized in order to plan daily operational activities and provide oversight of the RN Reviewer team. You will use your professionalism, personality, and communication skills to inspire the team to meet or exceed all performance standards. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities.

Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that erse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

What will you do

• Oversee the RN Reviewer team including one RN Team Lead
• Establish a plan for the day and communicate to all staff daily
• Manage the daily timeliness report and ensure all cases meet expected turnaround times
• Monitor the nurse productivity reports daily and provide feedback to the nurses, managing performance to ensure consistency
• Lead weekly team meetings
• Capture process efficiency ideas from the team and work with the appropriate stakeholders to recommend and lead changes needed to improve nurse efficiency.
• Meet inidually with all direct reports on bi-weekly cadence to develop solid work relationships with each team member and to share any performance feedback, positive and constructive.
• Working with the RN Reviewer Leads, track hourly nurse productivity, keeping the Director/Manager informed on productivity results as needed.
• Train and Develop new RNs who join the team.
• Oversee daily newsletter publication
• May be asked to help with other projects as needed.

Your background & responsibilities

• Registered Nurse with an active and unencumbered license to practice
• 2-3 years of supervisory/management experience
• Knowledge of NCQA/CMS requirements
• Experience using MCG, CMS NCDs/LCDs, clinical criteria guidelines
• Prior Authorization or Utilization Management experience
• Excellent computer skills and familiarity with a Mac.
• Experience supervising and training in a remote work environment.
• Ideal shift will be between the hours of 10AM-8PM EST

We cant wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, its personal.

The salary range for this position is $75,000 to $85,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Inidual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

#LI-Remote

Manager, Patient Account Specialist

Remote, United States |Billing

Description

Position at GoHealth Urgent Care

JOB SUMMARY

This Position is responsible for the day-to-day management of patient account receivables payments and billing customer service. This includes the supervision of the of the billing customer service call center and email / website inquires along with third-party vendor relations supporting relevant functions. Also included is management of cross-departmental work needed to adequately address patient concerns regarding claim processing or patient account billing along with overall customer service.

JOB REQUIREMENT

Education

High School Diploma or GED required.

Bachelors degree in Business Administration or related field preferred

Work Experience

5 years of healthcare experience required.

3 years of progressive management experience required

Required Licenses/Certifications

CPAR Certified Patient Account Representative preferred

Additional Knowledge, Skills and Abilities Required

Strong knowledge of the Accounts Receivable process

Excellent phone, communication, organizational skills, computer skills and mathematical skills Ability to maintain patient confidentiality. Strong knowledge of process and understanding of practice management systems

Additional Knowledge, Skills, and Abilities Preferred

Epic or eClinicalWorks experience

Experience with Microsoft Excel and Word

ESSENTIAL FUNCTIONS

Maintain Daily communication with direct reports and team leads.

Maintain a high level customer service and collaboration when working with other revenue cycle departments, payors, legal, compliance, the GoHealth customer experience team, health system partners, and center operations Establish and maintain a high level customer service approach to working with all patients Handle all level 4 support calls with centers and patients With support of other leadership; interview, hire, and review team members Implement audits of teams adherence to script, customer service and system documentation Produce and maintain key metrics for statement collection rates, medium collection rates and hard collection rates Recommend team for structured quarterly bonus calculation Provide training for all staff With other leaders, establish policies for patient collection process and maintain those policies Implement and maintain ACD (Automatic Call Distribution) for inbound patient calls Works with vendors to resolve any issues Establish monthly calls with vendors to discuss performance

Required knowledge, skills and ability:

Customer service skills:

Ability to represent the Department in a professional manner when interacting with customers, patients, co-workers, and health system partners Ability to handle service issues timely and professionally Ability to follow through with customers completely and in a timely manner

Communication Skills:

Ability to communicate effectively to patients about the financial aspects of their care Ability to communicate effectively to patients, centers, and staff regarding departmental policy

Keyboard skills:

Ability to type proficiently Ability to effectively utilize spreadsheets

Teamwork:

Ability to function effectively as extension of the Centers and other GoHealth departments Be flexible and open-minded in thought processes Maintain focus under pressure Share relevant information with other team members proactively

Medical Terminology & Insurance

Ability to understand basic medical terminology Ability to calculate deductible and co-insurance correctly Abilty to read and understand carrier Explanation of Benefits

All other duties as assigned.

Note: this job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.

Certified Medical Coder

Location: United States – Remote

Nice to meet you, were Vesta Healthcare.

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

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

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

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

The ideal teammate would be

Someone whos passionate about our mission to help older adults live fulfilling lives in their home and who gets excited about diagnosis codes! They are current on their understanding of CMS guidelines and coding protocol. This person wants to be part of a team working together to change the way older adults age at home.

The ideal teammate would be able to:

• Independently perform analysis of claims on a pre and post-payment basis utilizing clinical, coding and claims processing background to ensure claims are coded correctly according to CPT and ICD-10 guidelines
• Review pertinent medical records to validate/invalidate potential issues identified on claims
• Thoroughly document identified issues to support claim adjustments (including supporting medical record, clinical or coding rationale)
• Identify and document upstream process gaps driving incorrect payment
• Responsible for the security and privacy of any and all protected health information that may be accessed during normal work activities
• Leverages clinical and coding expertise to assure proper documentation is available in the medical record and that it is complete for coding requirements and claim submission
• Reports non-entered charges and reconciles errors for claim submission
• Identifies opportunities to educate, medical staff and professionals regarding documentation
• Meet expectations regarding productivity, code assignment accuracy, deadlines and documentation consistency
• Collaborate with the clinical team and Director of Revenue Cycle to resolve queries and ensure progression of the claim through the revenue cycle management process
• Adapt to new platforms and coding situations quickly and enjoy learning new processes

Would you describe yourself as someone who has:

• 1+ years of ICD-10 coding experience (required)
• Active Professional Medical Coding Certification (CPC, CCS, etc.) (required)
• Experience (1+ year(s)) with chart extraction for risk adjustment coding (highly preferred)
• ICD-10 Coding Certification (preferred)
• Experience with eClinicalWorks electronic medical records system (preferred)
• Experience with medical record documentation, medical chart auditing/quality experience (preferred)
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

In addition to amazing teammates, we also offer:

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

Pay range is $50,000-60,000 annually. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

Remote RN Case Manager, Outpatient (Must have California RN License)

Location: Remote-US, California US

Job Number6401

Workplace Type:Fully Remote

Remote-US,California

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether thats in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career with us.

Overview of the Role:

Alignment Health is seeking a remote, telephonic, RN case manager to join the outpatient case management team. As an RN case manager, you will be responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. You will also deliver care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. Thecase manager will assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. The Case Manager will connect with members telephonically.

Responsibilities:

• Coordinate care by serving as a resource for the member, their family and their physician.
• Ensure access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
• Complete comprehensive assessments within their scope of practice that includes assessing the member’s current health status, resource utilization, past and present treatment plan and services.
• Collaborates with the member, the PCP and other members of the care team to implement a plan of care.
• Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners and specialists on the development of care management treatment plans.
• Provide education and self-management support based on the members unique learning style.
• Assists in problem solving with providers, claims or service issues.
• Works closely with delegated or contracted providers, groups or entities to assure effective and efficient care coordination.
• Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.

Required Skills and Experience:

• Minimum 1-3 years’ clinical experience,
• Minimum 2 years case management experience; or any combination of education and experience, which would provide an equivalent background.
• Health plan experience preferred
• Must have and maintain an active, valid, and unrestricted RN license inCalifornia
• Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
• Extensive knowledge of the management of chronic conditions
• Bilingual English and Spanish, Chinese, or Vietnamese preferred
• Excellent verbal and written communications skills
• Team player who builds effective working relationships
• Able to work independently
• Experience using standardized clinical guidelines required
• Strong organizational skills
• Strong proficiency in Microsoft Office suite (Word, Excel, PowerPoint, etc.)

Pay range: $78,000 – $118,000 annually.

Please note: All clinical positions are contingent upon successful engagement with Alignment Healths COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where iniduals receive fraudulent employment-related offers in exchange for money or other sensitive personal information.Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company.If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission athttps://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team, please [email protected].

Title: Intake Specialist

Location: Remote – United States

JobDescription:

About Us

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

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

About the Role

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

Preferred Qualifications:

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

Minimum Requirements:

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

What We Offer

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

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

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

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

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

Title: Registered Nurse

Location: Remote – Work From Home

JobDescription:

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

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

Job Summary:

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

Major Area of Responsibility:

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

Qualifications:

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

Physical and Environmental Requirements:

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

Pay Range: $85-90k/Year

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

Location: Remote

JobDescription:

Nice to meet you, were Vesta Healthcare.

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

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

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

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

The ideal teammate would be able to:

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

Would you describe yourself as someone who has:

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

In addition to amazing teammates, we also offer:

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

Pay range is $125K – $130K annually. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

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

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

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

CERTIFIED CODER – REMOTE

Molina Healthcare

Job ID 2024266

JOB DESCRIPTION

Job Summary

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

KNOWLEDGE/SKILLS/ABILITIES

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

JOB QUALIFICATIONS

Required Education

Associates degree or equivalent combination of education and experience

Required License, Certification, Association

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

Preferred Education

Bachelor’s Degree in related field

Preferred Experience

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

Preferred License, Certification, Association

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

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

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

Pay Range: $17.85 – $38.69 / HOURLY

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

About Us

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

Job Type: Full Time

REMOTE Full Time NY Licensed Nurse Practitioner (NP)

at Vesta Healthcare

Remote

Nice to meet you, we’re Vesta Healthcare.

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

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

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

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

The ideal teammate would be able to:

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

Would you describe yourself as someone who has:

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

In addition to amazing teammates, we also offer:

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

Pay range is $125K – $130K annually. (The referenced salary range is based on the Company’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

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

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

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

Licensed Triage Nurse Practitioner

Nice to meet you, we’re Vesta Healthcare.

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

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

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

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

The ideal teammate would be able to:

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

Would you describe yourself as someone who has:

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

In addition to amazing teammates, we also offer:

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

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

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

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

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

Coding Specialist III

Remote – USA

Full time

R3122

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

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

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

Essential Duties & Responsibilities:

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

Minimum Qualifications:

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

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

Medical Billing Associate

Location: Remote United States

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

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

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

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

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

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

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

Role title: Medical Billing Associate

Location: Remote

What You’ll Bring:

Insurance Verification:

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

Billing/General

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

What excites us:

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

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

Remote IP Coding 

Location: EMERYVILLE California

JobDescription: Job Description & Requirements 

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

JOB SUMMARY:

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

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

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

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

OTHER REQUIREMENTS

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

EDUCATION AND SKILLS

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

SALARY AND BENEFITS

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

We encourage minority and female applicants to apply.

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

Job Benefits

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

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

About the Company

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

FULL AND PART TIME OPPORTUNITIES

About This Role

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

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

Why Join Us?

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

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

We also offer:

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

What You’ll Do

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

What You’ll Need 

To succeed in this role, you’ll need:

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

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

About Us

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

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

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

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

Our commitment to ersity, equity, and inclusion

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

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

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

Remote Same Day Surgery Coder 

Location: EMERYVILLE California; United States

Job Description & Requirements

Pay Rate: $25.00 – $38.00 

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

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

Other responsibilities include:

*Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third party requirements regarding documentation and billing.

• Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.

• Ability to maintain average productivity standards.

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

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

• Coders must maintain their current professional credentials.

# OF WEEKS: 52 weeks

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

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

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

SYSTEMS: 3M & EPIC.

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

Job Benefits

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

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

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

The Opportunity

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

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

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

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

Position Summary

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

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

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

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

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

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

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

DUTIES & RESPONSIBILITIES:

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

REQUIRED SKILLS:

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

Qualifications

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

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

Posting Category

Healthcare

Opportunity Type

Regular

Country

United States of America

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

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

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

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

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

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

The Opportunity

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

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

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

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

Position Summary

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

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

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

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

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

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

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

DUTIES & RESPONSIBILITIES:

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

CPC (Certified Professional Coder) Certification Required

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

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

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

Provide support for Human Resource guidance.

Complete, review, manage and monitor department budget.

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

Performs other duties as assigned.

REQUIRED SKILLS:

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

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

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

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

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

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

Qualifications

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

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

Posting Category

Healthcare

Opportunity Type

Regular

Country

United States of America

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

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

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

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

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

Location:  US Locations Only; 100% Remote

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

Essential Duties:

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

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

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

• Protecting the security of patient information

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

• Maintaining knowledge of Medicare Part A and Part B insurance

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

• Other duties as assigned

Skills and Abilities Required:

• High level of critical thinking

• Exceptional sales skills

• Computer proficiency with the ability to learn new applications

• Ability to accurately type 40 words per minute

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

• Ability to clearly articulate thoughts and ideas

• Active listening skills

• Meet productivity requirements established by the company

Physical Requirements:

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

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

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

Work Environment

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

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

Required Education:

High School Diploma or equivalent

Location: US Locations Only

Location:  US Locations Only; 100% Remote

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

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

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

Responsibilities

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

Qualifications

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

Job Type: Full-time (Remote)

Location: US Locations Only

UTILIZATION REVIEW NURSE

(REMOTE)

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

Summary

UTILIZATION REVIEW NURSE (remote)

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

Essential Functions:

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

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

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

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

Qualifications/Requirements:

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

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

Certification or Licenses: Maryland Registered Nurse License REQUIRED

Experience:

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

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

Additional Information

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

Licensed Clinical Social Worker

Job description

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

Nurse Case Manager

remote type

Hybrid

locations

United States – Remote

time type

Full time

job requisition id

R2415557

Medical Case Manager – CT08GE

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

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

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

RESPONSIBILITIES include but are not limited to:

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

QUALIFICATIONS:

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

Key Competencies:

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

Additional Competencies:

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

Additional Information:

Start date: 4/29/2024

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

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

Compensation

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

$67,680 – $101,520

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

Title: Clinical Trial Nurse Navigator

Location: USA-

Why LLS

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

Overview

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

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

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

Additional Position Information

Reports to: Director of Clinical Trial Support Center

Responsibilities

Duties and Responsibilities:

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

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

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

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

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

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

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

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

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

#LI-Remote

Qualifications

Education, Experience, and Qualifications:

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

+ Current RN licensure required

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

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

+ Spanish speaking preferred

Position Requirements:

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

+ Excellent ability to communicate verbally and in writing

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

+ Demonstrated commitment to independent learning and skill enhancement

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

Physical Demands & Work Environment:

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

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

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

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

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

Disclaimer

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

Job LocationsUS-(REMOTE – Work from Home)

Job ID 2024-8009

# of Openings 1

Category Hidden (58428)

FLSA Status Exempt

Type Full Time Regular

Credentialing Coordinator Remote

Job Category: Managed Care

Requisition Number: CREDE020819

Full-Time

USA Remote

United States

Job Details

Description

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

ESSENTIAL FUNCTIONS:

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

Other assigned duties as required

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

ABILITIES:

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

Title: Assistant, Nurse

Location: USA-

Cardinal Health

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

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

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

Job Summary

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

Qualifications

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

Responsibilities

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

What is expected of you and others at this level

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

Training and Work Schedules:

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

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

Remote Details:

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

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

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

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

Bonus eligible: No

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

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

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

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

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

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

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

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

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

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

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

View Cardinal Health on YouTube

Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Title: Coordinator Quality Coding, Inpatient

Location: CO-Denver

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

Job Duties

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

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

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

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

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

Requirements

+ + High School Diploma or GED

+ Coding-related certification from AHIMA or AAPC

+ 3 years of relevant coding experience

Preferred

+ Associate’s Degree

+ CCS

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

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

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

+ Full medical, dental and vision coverage

+ Retirement plans to include 403(b) matching

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

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

+ Tuition and continuing education reimbursement

+ Wellness benefits

+ 5 year incentive bonus

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

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

Loan Repayment:

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

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

At UCHealth, we do things differently

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

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

Be Extraordinary. Join Us Today!

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

Remote Inpatient Coder

Location: FRANKLIN Tennessee; United States

Job Description & Requirements

Pay Rate: $30.00 – $40.00

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

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

#OF WEEKS: 26 Weeks

SHIFT/HOURS: Flexible M-F some Weekends

EXPECTED HOURS: 40

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

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

***Must Have Cerner****

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

Facility Location

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

Job Benefits

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

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

About the Company

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

Clinical Data Coder/Specialist-Temp

Remote

Position Summary:

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

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

Essential Duties and Responsibilities:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Qualifications:

Minimum Qualifications:

– Bachelor degree in relevant field is preferred

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

– Certified coder designation/ certification by AHIMA or AAPC required

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

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

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

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

Preferred Qualifications:

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

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

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

Remote USA

$20$30 USD

OUR OPPORTUNITY

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

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

WHAT WE OFFER

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

For more information, visit www.natera.com.

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

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

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

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

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