One stop solution to your remote job hunt!

By signing up you get access to highly customizable remote jobs newsletter, An app which helps you in your job hunt by providing you all the necessary tools.

Subscribe to our highly customizable newsletter to get remote jobs from top remote job boards delivered to your inbox.

Physician Coding Liaison II - Urgent Care

Advocate Aurora Health Remote.coabout 1 year ago

Apply Nowabout 1 year ago

location: remoteus

Apply Now

Physician Coding Liaison II – Urgent Care

Remote

Full time

10395 Revenue Cycle – Coding & HIM Clinician Support

Status:Full time

Benefits Eligible:Yes

Hours Per Week:40

Schedule Details/Additional Information:First Shift

This is a REMOTE Opportunity

Major Responsibilities:

Provides service line/specialty specific coding/documentation education and feedback related to coding changes (CPT including E&M, modifiers, ICD-10-CM, and HCPCS), annual code updates, payer requirements, and payer rejection resolution to assigned Physicians/APCs. Partners with CMOs to standardize coding processes across a specific specialty. Shares and/or presents coding/documentation education presentations to Chief Medical Officers (CMOs), Physicians/APCs, Senior Director Administrators across the organization. Coordinates with PSA Liaisons to provide adequate Physician/APC and/or clinical team member support.
Conducts orientations for all Physicians/APCs, residents/students and clinical team members on specialty specific coding and documentation related education. Performs new clinician documentation reviews for specialty specific coding, and documentation feedback, as requested.
Coordinates responses to Physicians/APCs, Locum Tenens, residents/student’s questions and feedback from various sources and partners, including Senior director administrators, CMOs, Medical Group Compliance, Internal Audit, Physician Compensation, Clinical Informatics/Clinical Informatics Educators, Quality Improvement Coordinators, and/or other external partners.
Queries Physician/APC, Locum Tenens, residents/students when prompted by Professional Coding Department production coders to assist in resolving coding and documentation questions. Relays any coding changes, feedback, and education to Physician/APC, Locum Tenens, residents/students and/or clinic leadership, as appropriate.
Monitors and works to resolve charge sessions requiring additional information for assigned clinicians and/or service line/specialty in the Epic work queues and/or other transfer work queues to ensure Clinicians are completing work timely to ensure proper supporting documentation for billing and timely filing.
Attends and provides service line/specialty specific coding and documentation information, as requested, to CMOs, Physicians/APCs and/or Clinic/Site Department meetings. These may be virtually and/or in-person. Virtually attends Physician/APC education that include coding and/or documentation topics, such as Documentation Specialist clinician low risk review meetings, Risk Adjustment/HCC meetings, and/or Medical Group Compliance reviews/meetings.
Collaborates with PSA Liaison to review and provide coding/documentation guidance on Epic order entry, diagnosis, and charge capture preference lists as well as SmartSets and templates.
Develops Physician/APC monthly service line/specialty newsletters to continually educate and communicate updates from various coding resources including specialty society organizations. Communicates new services performed by Physician/APCs to Professional Coding department leadership.
Identifies service line/specialty specific trending data and opportunities to capture revenue through documentation improvement. Attends service line/specialty specific coding and/or society conferences, as requested, to gain further knowledge that is uniquely relevant to that specialty and how coding, documentation, and billing are affected. Maintains expert knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.

Licensure, Registration, and/or Certification Required:

Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA), or
Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA), or
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or
Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC), or
Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC), and
Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC) needs to be obtained within 1 year.

Education Required:

Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist.

Experience Required

Typically requires 5 years of experience in expert-level professional coding and least 3 years educating/training licensed clinicians.

Knowledge, Skills & Abilities Required:

Specialty Medical Coding Certification must be held in the area(s) you will support.
Excellent communication (oral and written), adult education, and interpersonal skills. Ability to develop rapport and maintain positive, professional partnerships primarily with employed Physicians, APCs, CMOs, Senior director administrators, Medical Group Operations, and physician coding team members.
Advanced computer skills including the use of Microsoft office products, electronic mail, video/web conferencing, including exposure or experience with electronic coding and EHR systems or applications.
Excellent/comprehensive skills in organization, prioritization, problem solving, facilitation skills as well as the ability to have meaningful, albeit, difficult conversations with CMOs/Physicians/APCs and/or Senior Director Administrators.
Highly proficient in critical thinking and analytical skills with an extensive 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 work in multiple work environments (ie virtual, office, clinic/hospital, other).

Physical Requirements and Working Conditions:

Exposed to normal office environment.
Position requires travel which will result in exposure 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.

Related Remote Health Care Jobs

Employment Type: Full time

Shift: Day Shift

If you are looking for a career as a health care professional, where you are nurtured by collaboration and teamwork, open communication, and learning. We invite you to become part of an award winning health care system.

Position Highlights:
Quality of Life: Where career opportunities and quality of life converge
Advancement: Strong orientation program, generous tuition allowance and career development
Work/Life: Positions and shifts to accommodate all schedules

Position Summary:
Inpatient coding position
Analyzes physician/provider documentation contained in assigned health records (electronic, paper or hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures.
Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of
Internal Classification of Diseases,
Clinical Modification diagnosis and procedure codes, and
Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers.
Utilizes coding guidelines established by the Centers for Medicare/Medicaid Services (CMS), American Hospital Association (AHA) Coding Clinic, American Medical Association (AMA) for CPT codes and CPT Assistant, American Health Information Management Association (AHIMA) Standards of Ethical Coding, Revenue Excellence/Regional Health Ministry (RHM) coding policies and CHE Trinity Health Coding Manual (TBA).

Minimum Qualifications:
1. Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate’s degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required. Bachelor’s degree in Health Information Management (HIM) or related healthcare field is preferred.

2. Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technologist (RHIT), or Registered Health Information Administrator (RHIA) is required.

3. Two years of current acute care coding emergency department and observation or physician coding experience is required.

4. Current experience utilizing encoding/grouping software or CAC is preferred. Ability to utilize both manual and automated versions of the ICD and CPT coding classification systems is preferred.

5. Ability to use a standard desktop and windows based computer system, including a basic understanding of e-mail, internet, and computer navigation. Ability to use other software as required to perform the essential functions on the job. Familiarity with distance learning or using web-based training tools desirable.

All new employees are required to undergo and pass all applicable state and federally mandated pre-employment screening requirements.

Pay Range:$22.25 – $34.79

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

If you are looking for a career as a health care professional, where you are nurtured by collaboration and teamwork, open communication, and learning. We invite you to become part of an award winning health care system.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate ersity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A erse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Senior Coder - Inpatient

ChristianaCare Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Title: Senior Coder – Inpatient (Remote)

time type

Full time

job requisition id

JR69231

Job Details

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare!

ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of “America’s Best Hospitals” by U.S. News & World Report, we have an excess of 1,100 beds between our hospitals and are committed to providing the best patient care in the region. We are proud to that Christiana Hospital, Wilmington Hospital, our Ambulatory Services, and HomeHealth have all received ANCC Magnet Recognition®.

Scheduling Flexibility and Perks

The schedule and hours for this position are very flexible and we will work with you on work/life balance to build a schedule that works for you
This position is 100% remote and we encourage national candidates to apply
We provide equipment, coding books, continuing education credits as well as professional organization memberships to AHIMA or APC

Primary Function:

ChristianaCare is currently seeking a full-time Senior Coder to be responsible for accurate and timely assignment of ICD 10 CM/PCS and HCPCS/CPT codes, payment group classification assignment and data abstraction for reimbursement purposes and statistical information reporting on all Inpatient, Outpatient, Emergency Medicine, Ancillary and Diagnostics records, and/or any other patient records for which HIMS Department performs coding services. Meets or exceeds productivity and accuracy standards outlined in the HIMS Coding Policies and Procedures.

Principal Duties and Responsibilities:

Reviews and interprets Inpatient, Outpatient, Ancillary, Diagnostics and Emergency Medicine or other patient type records in order to assign appropriate ICD 10 CM/PCS diagnosis and procedure codes and/or HCPCS/CPT procedure codes as required based on record type and CCHS reporting practices.
Performs coding and abstracting tasks to support accurate and timely billing, data quality and statistics, and calculation of severity of illness and risk of mortality reporting.
Follows UHDDS definitions, CMS regulations, and Official and Internal Coding Guidelines.
Utilizes information on diagnostic reports (i.e., radiology, pathology, EKG reports, laboratory values, doctors’ orders, and administrative medication forms) to accurately code patient charts in accordance with the Official Coding Guidelines.
Completes daily work assignment as directed by Coding Support.
Works within service line structure where applicable based on patient type.
Serves as a mentor to newer coders in the Coder Position or coders who are being trained in a new coding discipline.
Abstracts pertinent data, determines, and sequences codes for diagnoses and procedures, and enters all information into the coding and abstracting system.
Utilizes coding and abstracting system as a communication tool, as outlined in the HIMS Coding DNFB Tagging procedures, including but not limited to placing accounts on hold in order to ask questions to management and initiate queries.
Receives feedback and reviews charts with a member of the Coding Management Team for accurate code assignment.
Provides all necessary coded and abstracted information required for final coding and billing of accounts within productivity expectations by work type in order to support department and organization goals for DNFB dollar amounts and bill hold days.
Reviews prepopulated patient demographic information fed via HL7 from source system into coding system and makes necessary abstracted data changes in coding system as required for accurate posting to CCHS billing system.
Utilizes coding system to calculate all inpatient encounters in both MS DRG and APR DRG groupers to support the accurate reporting of coded data for severity of illness and risk of mortality.
Utilizes coding system to sequence CPT codes invoking the APC grouper methodology to arrive at the proper CPT code hierarchy.
Submits timely, accurate, and concise daily productivity reports in accordance with department policy and practice.
Attends and participates in coding section and department meetings, inservice training sessions, seminars and workshops.
Reports errors as identified in patient identification, account or encounter information, documentation or other medical record discrepancies as they are noted during daily work performance.
Supports the Coding Management team by working on special coding projects as assigned.
Works with the HIMS Coding Systems Analyst under the direction of HIMS management to achieve the IT initiatives of the HIMS department. This may include systems testing and report reconciliation as needed in our coding and billing systems as well as other IT project support as deemed necessary by the coding management team.
Works with the HIMS Coding Support Team under the direction of HIMS management to achieve the revenue cycle goals of the HIMS department. This may include working through aged coding accounts, accessing our billing system, and coding system reports and queues as deemed necessary by the coding management team.

Education and Experience Requirements:

CCS credential required
College Degree in Health Information Management, Completion of AHIMA Approved Certificate Program, or one-year coding experience in the acute care setting coding Inpatient, Observation, Emergency Medicine or Same Day Surgery is required.
Associate or Bachelor Science degree in Health Information Technology preferred.
An equivalent combination of education and experience may be substituted.

Christianacare Offers:

Full Medical, Dental, Vision, Life Insurance, etc.
403(b) with company match.
Generous paid time off.
Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

EEO Posting Statement

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Professional Fee E/M Coder

Atos Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Location: Irving United States

Job Description:

Job Applicant Privacy Notice

Professional Fee E/M Coder

Publication Date: Nov 13, 2024

Ref. No: 522606

Location:

Irving, TX, US, 75063

Who we are.

We are a team of passionate experts with a clear ambition: applying digital technology to advance what matters for our clients and society.

Together we create reliable and responsive digital foundations for the world’s businesses, institutions, and communities.

Learn more on Advancing what matters

The future is our choice

At Atos, as the global leader in secure and decarbonized digital, our purpose is to help design the future of the information space. Together we bring the ersity of our people’s skills and backgrounds to make the right choices with our clients, for our company and for our own futures.

Professional Fee E/M Coder

Location: Remote (US Wide)

Experience Required

Minimum of 1 Coding Certification from AHIMA or AAPC; RHIA, RHIT, CPC, CCS, COC
3+ years Coder work experience
2+ years of Oncology coding experience. EPIC/3M 360 CAC

Ability to level/audit/abstract documentation for E/M level for:

Outpatient E/M
Inpatient E/M
Observation
Telehealth
Critical Care
Emergency Medicine
Prolonged services

In-office procedure coding
Neoplasm coding experience
Knowledge of global periods
Knowledge and use of modifiers
LCD/NCCI
Teaching Physician rules and regulations Production Standard of 13-20 charts per hour.

Rewards and benefits:

Law and Superior Benefits
Wellbeing programs & work-life balance – integration and passion sharing events.
Opportunities for professional growth and career advancement.
Benefits platform -culture, shopping, sport, etc.
Continuous learning programs and online courses.
Possibility to participate to charity and eco initiatives.

Future career path:

After your 1st year in Atos you can apply to any position to keep growing as a professional.

If you’re ready to embark on this exciting adventure with us, sign in on jobs.atos.net.

For any questions, please contact our recruiter Juan Estrada / [email protected]

Join our phenomenal team to grow together!

#LI-US #LI-REMOTE

Learn more about us

At Atos, we embrace ersity as the ultimate engine of ingenuity for our clients, and we constantly strive to create a culture where people feel supported and encouraged. Read more about our commitment here.

Whether it is fighting climate change, promoting digital inclusion, or ensuring trust in data management – tech for good sits at the core of our identity. With numerous global recognitions for our ESG practices, we are committed to building a better future for all by harnessing the power of technology. Learn more here

Coder II - OP Physician Coding (Ortho Specialty)

Baylor Scott & White Health Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Coder II – OP Physician Coding (Ortho Specialty)

Remote, United States

Full Time

JOB SUMMARY

The Coder 2 is proficient in three or more types of outpatient, Profee, or low acuity inpatient coding.
The Coder 2 may code low acuity inpatients, one time ancillary/series, emergency department, observation, day surgery, and/or professional fee to include evaluation and management (E/M) coding or profee surgery.
- For professional fee coding, team members in this job code will be proficient for inpatient and outpatient, for multi-specialties.
Coder 2 utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding.
- Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.)
The Coder 2 will abstract and enter required data.

WORK MODEL

100% Remote

SALARY

The pay range for this position is $26.27 (entry-level qualifications) – $39.41 (more experienced) The specific rate will depend upon the successful candidate’s specific qualifications and prior coding experience.

ESSENTIAL FUNCTIONS OF THE ROLE

Examines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.
Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
Communicates with providers for missing documentation elements and offers guidance and education when needed.
Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges.
Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
Reviews and edits charges.

KEY SUCCESS FACTORS

Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
Sound knowledge of anatomy, physiology, and medical terminology.
Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.

Must have one of the following Certifications:

Registered Health Information Administrator (RHIA)
Registered Health Information Technologist (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician-based (CCS-P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Certified Inpatient Coder (CIC)
Certified Interventional Radiology Cardiovascular Coder (CIRCC)

BENEFITS

Our competitive benefits package includes the following:

Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

EDUCATION – H.S. Diploma/GED Equivalent
EXPERIENCE – 2 Years of Experience
CERTIFICATION/LICENSE/REGISTRATION – : Must have ONE of the coding certifications as listed:
- Cert Coding Specialist (CCS)
- Cert Coding Specialist-Physician (CCS-P)
- Cert Inpatient Coder (CIC)
- Cert Interv Rad CV Coder (CIRCC) – Cert Outpatient Coder (COC)
- Cert Professional Coder (CPC)
- Reg Health Info Administrator (RHIA)
- Reg Health Information Technician (RHIT).

Multispecialty Outpatient Medical Coder

Guidehouse Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Multispecialty Outpatient Medical Coder

US – Remote (Any location)

Full time

Travel Required:

None

Clearance Required:

Ability to Obtain NACI

The Multispecialty Surgery Coder III will Code for Multispecialty Surgery physicians primarily Single Path Coding. Multi-specialty surgical coding experience, any Trauma, Urology, ENT, Plastics, GenSurg, OB/GYN, Cardiovascular, Interventional Radiology, etc. Ability to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

This position is full time as and 100% remote.

Responsibilities:

Demonstrates the ability to perform quality surgical coding and multispecialty chart types as assigned
Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
Achieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility
Ability to maintain average productivity standards as follows
Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary
Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met
Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility
Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
Responsible for coding or pending every chart placed in their queue within 24 hours
It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
Coders are responsible for checking the Guidehouse email system at least every two hours during coding session
Coders must maintain their current professional credentials while working for Guidehouse
Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content
Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
Communicates problems or coding principle discrepancies to their supervisor immediately
Communication in emails should always be professional

What You Will Do:

Demonstrates the ability to perform quality E/M coding and surgical as appropriate on assigned Hospitalist encounters.

Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing
Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards
Achieves and maintains 97% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility
Ability to maintain average productivity standards as follows
Works the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary
Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines
Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met
Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility
Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request
Responsible for coding or pending every chart placed in their queue within 24 hours
It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard
Coders are responsible for checking the Guidehouse email system at least every two hours during coding session
Coders must maintain their current professional credentials while working for Guidehouse
Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility
Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)
It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content
Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services
Communicates problems or coding principle discrepancies to their supervisor immediately
Communication in emails should always be professional (reference e-mail policy)

What You Will Need:

High School Diploma/GED or 3 years of relevant equivalent experience in lieu of diploma/GED, or post-high school education through a university or technical school program resulting in completion of ONE of the following:
Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology
Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision
One of the following recognized professional coding certifications: Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist – Physician (CCS-P)
3 years Multi-Specialty Surgery Coding experience, both IP and OP coding for physician claims
EMR experience
Must maintain credential throughout employment

What Would Be Nice To Have:

Certified Inpatient Coder (CIC)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA)
Certified Coding Specialist (CCS)
Recognized E&M coding certifications: Certified Evaluation and Management Coder (CEMC), or National Alliance of Medical Auditing Specialists’ (NAMAS) Certified Evaluation and Management Auditor (CEMA)
Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
Knowledge & experience with Federal & State Coding regulations and Guidelines to include DHA or Military Health Coding experience
Multiple EMR and/or Practice Management systems experience
Single path coding experience

What We Offer:

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

Benefits include:

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

Outpatient Medical Coder

Cooper Thomas Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Remote Part-Time Outpatient Medical Coder

HIM | Remote Home Office | Part Time

Job Description

Remote VA Experienced Outpatient Medical Part Time Coders

Summary

Cooper Thomas, LLC, a leading provider of medical coding services to the Department of Veterans Affairs (VA), has immediate openings for experienced Outpatient Coders. Applicants must have at least 2 years of experience for part-time remote coding positions, with the opportunity for a flexible schedule. Previous experience with VA is required, whether as a VA employee or with another VA contractor. You must be able to pass an initial entrance exam and code at a minimum of 95% accuracy. This work will be performed remotely in your home office. Preference will be given to those candidates who meet the qualifications below and have an active Background Investigation, PIV Card, eToken, and Contractor/Moonlighter Account.

Ask about our productivity and quality incentives to maximize your pay.

We are looking for coders who can commit to a minimum of 20 hours per week, scheduled at your discretion from Monday through Sunday weekly.

Qualifications

· Must be able to perform the full scope of multi-specialty OP clinic, ED, minor procedures, radiology, rehabilitation, and lab encounters utilizing ICD-10, CPT, and HCPCS codes.

· At least two (2) years of VA or other relevant coding experience, either as a VA employee or with another Government contractor supporting VA

· Ability to code a minimum average of 10.0x Outpatient encounters per hour with 95% accuracy

· Must produce copies of and maintain active credentials as a certified coder or auditor

· Ability to follow site-specific coding guidelines

· Familiar with E/M leveling for OP and ED visits using 95′, 97′ and 2022 guidelines

· Familiar with E/M calculator and ability to use this tool proficiently

· Familiar with 3M Encoder for ICD10 and CPT coding

· Knowledge in anatomy and physiology, medical terminology, pathology and disease processes, pharmacology, health record format and content, reimbursement methodologies and conventions, rules and guidelines for current classification systems (ICD, CPT, HCPCS).

· Must be able to complete work within the required TAT of 5 days from the date of assignment.

Accepted Coding Credentials

American Health Information Management Association (AHIMA):

· Registered Health Information Administrator (RHIA) / Registered Health Information Technician (RHIT)

· Certified Coding Specialist (CCS) / Certified Coding Specialist-Physician (CCS-P)

American Academy of Professional Coders (AAPC):

· Certified Professional Coder (CPC)

· Certified Outpatient Coder (COC)

· Certified Professional Medical Auditor (CPMA)

Minimum Education

· High School Diploma or equivalent

Cooper Thomas, LLC is a leading provider of health information management services. Established in Washington, DC in 2003, Cooper Thomas offers a competitive salary, opportunities for quality bonuses, and the opportunity for growth. The selected candidate will be required to undergo a background investigation. Veterans encouraged to apply. Equal opportunity employer.

IMPORTANT NOTE: To apply, please go to the “Careers” section of our website at www.cooperthomas.com, and follow the instructions to register and apply.

Coding Specialist

Signify Health Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Coding Specialist

Remote

How will this role have an impact?

Under the supervision of the Manager of Coding, this position is responsible for ICD-10 coding of Health Risk Evaluations of Medicare and Medicaid members that are performed by the Signify Health physicians and reviewing the Health Risk Assessments/Evaluations to insure completeness, accuracy and compliance with CMS guidelines.

What will you do?

Reviews health risk assessments/evaluations to determine completion and compliance with CMS guidelines on a timely basis.
Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes identified in the health risk assessments/evaluations.
Reviews health risk assessments/evaluations to accurately and completely assign all ICD-9/10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis.
Communicates timely and effectively with supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations.
Understanding the relationship between IC-9/10 coding and HCC (hierarchical condition category) coding.
Utilizes advanced, specialized knowledge of medical codes and coding protocol by providing guidance to the Director of Coding to ensure the organization is following Medicare coding protocol for payment of claims.
Demonstrate a commitment to integrating coding compliance standard into coding practices. Identify, correct and report coding problems.
Maintain adequate knowledge of compliant coding procedures related top Medicare Risk Adjustment.
Maintain coding credentials
Complete special projects as assigned by management, which require defining problems, and implementing required changes.
Follows all legal and policy requirements for HIPAA protected data.
Actively demonstrates teamwork at all times.
Ability to work overtime.
Is able to meet and maintain required accuracy and efficiency standards.

We are looking for someone with:

Must hold an active CPC,COC, CCS, CCS-P.

Current coding certification in good standing.

CRC required

ICD-10 Coding Certification will be required

Minimum of 1 year of experience of ICD-10 coding.

Prior work experience in the healthcare field specifically related to coding is preferred.

Experience and knowledge of Medicare HCC coding.

Experience with medical record documentation.

Prior medical chart auditing/quality experience preferred.

Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

The base salary hiring range for this position is $16.44 to $28.08. Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience. Certain roles may be eligible for incentive compensation, equity, and benefits.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Eligible employees may enroll in a full range of medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer education assistance, free development courses, paid time off programs, paid holidays, a CVS store discount, and discount programs with participating partn

About Us:

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across iniduals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for iniduals who need help the most. This leads to better outcomes and a better experience for everyone involved.

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million iniduals each year while helping payers and providers more effectively implement value-based care programs.

To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.

#SignifyHealth

#LI-RD1

Nurse Practitioner

Twin Health Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Nurse Practitioner

Remote, USA

Working here

Our team is passionate, talented, and driven by our purpose to improve the health and happiness of our members. Our culture empowers each Twin to do what’s needed to create impact for our members, partners, and our company, and enjoy their experience at work. Twin Health was awarded Innovator of the Year by Employer Health Innovation Roundtable (EHIR) (out of 358 companies), named to the 2021 CB Insights Digital Health 150, and recognized by Built In’s 2022 Best Places To Work Awards. Twin Health has the backing of leading venture capital funds including ICONIQ Growth, Sequoia, and Sofina, enabling us to scale services in the U.S. and globally and help solve the global chronic metabolic disease health crisis. We have recently announced broad and growing partnerships with premier employers, such as Blackstone and Berkshire Hathaway. We are building the company you always wished you worked for. Join us in revolutionizing healthcare and building the most impactful digital health company in the world!

Excited to join us and do your part in improving people’s health and happiness?

Opportunity

As a Twin Advanced Practice Provider, you make a difference in people’s lives by providing treatment, management, and guidance to empower your members seeking to achieve complete diabetic reversal and overall health improvement across multiple conditions, using artificial intelligence, machine learning, and a health coach, RN, and provider care management model. This role is to support members in multiple states through remote care management.

Responsibilities

Engage with collaborative team of healthcare professionals including health coaches, physicians, chief medical officer, and other colleagues
Conduct health assessments including review of laboratory results, medical history, and psychosocial history
Assess symptoms and treat as appropriate, collaborating with Twin Health member’s primary care provider
Willingness to deliver care using telemedicine and to document in Twin’s clinical platform
Manage a high risk population and work collaboratively between the care team and member to understand social determinants of health and population specific needs
Willingness to learn and understand the Twin Model of Care to support reversal of diabetes and other chronic conditions
Basic understanding of business objectives and service level agreements that support both financial, clinical, and quality success and outcomes
Collaborate with Twin medical team to provide excellent customer service and experience, focusing member care around multiple chronic conditions
Provide patient education to promote habits that will prevent diseases and maintain good health as outlined by Twin Health Program
Discussing and reviewing patients’ medical history, symptoms, allergies, and current medications.
Asking patients situation-specific questions to assess symptoms
Prescribing suitable medications to patients and providing proper dosage and administration instructions per Twin Health Policy
Maintaining accurate records of patients’ contact details, medical history, prescribed medications, allergies, diagnoses, and progress
Additional duties as assigned

Qualifications

Advanced Practice Registered Nurse license, licensed in multiple states.
3-5 years of experience as an advanced practice provider.
Clinical experience and passion in working with multiple different populations including underserved groups
Experience managing patients remotely across different geographic areas and states
Eager to collaborate with a wonderful team of internal medicine and family medicine physicians and health coaches
Board-certified in family or internal medicine or a related field
Proven experience working as an advanced practice provider
Sound medical knowledge
The ability to consult with patients through virtual communication channels
Excellent analytical and problem-solving skills
Exceptional communication skills
A patient and compassionate disposition
Detail-oriented
Interest in working with underserved groups
Experience using technology and data to guide care decisions
Fluent in English and Spanish preferred

Compensation and Benefits

The compensation for this position is $120,000 annually.

Twin has an ambitious vision to empower people to live healthier and happier lives, and to achieve this purpose, we need the very best people to enhance our cutting-edge technology and medical science, deliver the best possible care, and turn our passion into value for our members, partners and investors. We are committed to delivering an outstanding culture and experience for every Twin employee through a company based on the values of passion, talent, and trust. We offer comprehensive benefits and perks in line with these principles, as well as a high level of flexibility for every Twin.

A competitive compensation package in line with leading technology companies
As a remote friendly company we are committed to providing opportunities for all who join to further build relationships, increase cross-functional collaboration, and celebrate our accomplishments.
Opportunity for equity participation
Unlimited vacation with manager approval
16 weeks of 100% paid parental leave for delivering parents; 8 weeks of 100% paid parental leave for non-delivering parents
100% Employer sponsored healthcare, dental, and vision for you, and 80% coverage for your family; Health Savings Account and Flexible Spending Account options
401k retirement savings plan

Nurse Care Manager

Included Health Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Title: Nurse Care Manager

Location: United States

Job Description:

Targeted Care Navigation Local Nurse Care Managers provide comprehensive, in-home care management services to high-risk patients. This role focuses on preventing hospital readmissions, improving health outcomes, and ensuring patients receive the support and resources they need to manage their conditions effectively. The Nurse Care Manager will work closely with patients, their families, and other healthcare providers to develop and implement personalized care plans that address each patient’s unique needs.

The Targeted Care Navigation Local Nurse Care Manager will work directly with members in their local communities to bring better health and quality of life to these iniduals and families. They will be a part of an integral team including a Community Health Worker and an Included Health Virtual PCP

Responsibilities:

Conduct in person visits to assess patient health status, educational, and psychosocial needs of the patient and their family. This will be at patient’s homes, hospitals, or accompanying to medical appointments.
Together with patients and our multidisciplinary care team, generate a comprehensive inidualized plan of care and targeted interventions to help patients achieve desired goals
Provide education and support to patients and families on managing chronic conditions, medications, and lifestyle changes
Identify and address barriers to care, including social determinants of health, and connect patients with community resources and support services with the support of a remote Licensed Social Worker and Local Community Health Worker.
Collaborate with patients, the remote Included Heath team, community physicians, family members, and other members of the health care team in order to ensure coordinated care.
Continually monitor patient response to the plan of care, and revise the care plan as indicated.
Implement systems of care that facilitate close monitoring of high-risk patients to prevent and/or intervene early during acute exacerbations.
Maintain required documentation for all care management activities.
Participate in case conferences and care coordination meetings to ensure a holistic approach to patient care.
Participate in member engagement initiatives, including outreach to local provider and hospital groups.
Stay current with best practices and evidence-based guidelines in chronic disease management and care coordination.
Provide compassionate, longitudinal follow-up care, building supportive relationships.
Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family.

As a condition of employment, the successful applicant for this position must be fully vaccinated against the flu (including annual booster) and provide acceptable proof of vaccination against Hepatitis B, Varicella, and MMR. Although not required, Included Health highly encourages the successful applicant to be fully vaccinated against COVID-19 (including annual booster).

In accordance with its policies, Included Health provides reasonable accommodations, absent undue hardship, to those who are unable to be vaccinated, either because of a sincerely held religious belief or a disability. If granted a reasonable accommodation from a vaccination requirement, the successful applicant will be required to be masked when providing services within patients’ homes.

Required Qualifications:

Current Bachelor of Science in Nursing (BSN)
Must reside in and have an active RN license in good standing with your state (AZ, TX, or IL) medical board
BLS certification
Current driver’s license, reliable transportation, car insurance, and an acceptable driving record with willingness to travel within approximately 50 miles to meet in person with patients in their homes or other medical facilities including hospitals, and local physician offices.
2+ years of experience with adult medicine and pediatric patients in primary care/ambulatory care, home health agency, skilled nursing facility, or hospital medical-surgical setting, within the past five years
Strong clinical assessment, physical exam, and critical thinking skills. Comfortable discussing a wide variety of medical conditions.
Broad knowledge of chronic conditions, evidence based guidelines, prevention, wellness, health risk assessment, and patient education
Demonstrate excellent communication–both verbal and written. Proficient at writing medical information in easy-to-understand, patient-centric language.
Able to work independently with strong internal drive, yet able to actively communicate challenges and/or concerns to leadership.
Excellent interpersonal and facilitation skills
Excellent time-management skills and an ability to adapt to changing needs/priorities
Be highly empathetic with the ability to understand cultural and socioeconomic issues affecting patients and excellent at building rapport with patients and families from erse backgrounds.

Valued Qualifications:

Current CCM Certification (in states where not required)
5+ years of experience in nursing
Comfortable with technology and experience working remotely or with innovative care teams
Experience working with patients in their homes
Bilingual: Spanish and English
Ability to have flexible schedule, position may require weekend work

Physical/Cognitive Requirements:

Driving to member’s homes up to 5 days per week over wide geographical area
Prompt and regular attendance at assigned work location.
Ability to remain seated in a stationary position for prolonged periods.
Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, computer and other office-related equipment.
No heavy lifting is expected, though occasional exertion of about 20 lbs. of force (e.g., lifting a computer / laptop) may be required.
Ability to interact with leadership, employees, and members in an appropriate manner.

$66,850 – $86,910 a year

The United States new hire base salary target ranges for this full-time position are:

Zone A: $66,850 – $86,910 + equity + benefits

This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health’s commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.

Starting base salary for the successful candidate will depend on several job-related factors, unique to each candidate, which may include, but not limited to, education; training; skill set; years and depth of experience; certifications and licensure; business needs; internal peer equity; organizational considerations; and alignment with geographic and market data. Compensation structures and ranges are tailored to each zone’s unique market conditions to ensure that all employees receive fair and competitive compensation based on their roles and locations. Your Recruiter can share details of your geographic alignment upon inquiry.

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

Remote-first culture

401(k) savings plan through Fidelity

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

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

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

12 weeks of 100% Paid Parental leave

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

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

11 Holidays Paid with one Floating Paid Holiday

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

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

About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community – no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com. Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.

RN Daytime Triage

Allina Health Remote.co3 days ago

Apply Now3 days ago

location: remoteus

Apply Now

Title: RN Daytime Triage

Location: United States

R-0059875

Job Description:

Number of Job Openings Available: 1

Department: 62000635 Allina Health Group Daytime RN Triage

Shift: Day (United States of America)

Shift Length: 8 hour shift

Hours Per Week: 32

Union Contract: Non-Union

Weekend Rotation: Every 3rd

Job Summary:

Allina Health is a not-for-profit health system that cares for iniduals, families and communities throughout Minnesota and western Wisconsin. If you value putting patients first, consider a career at Allina Health. Our mission is to provide exceptional care as we prevent illness, restore health and provide comfort to all who entrust us with their care. This includes you and your loved ones. We are committed to providing whole person care, investing in your well-being, and enriching your career.

Key Position Details:

Employee is required to live within one hour of Apple Valley, MN.

Fully remote position, including orientation, occasional onsite requirements
0.8 FTE, 8-hr day shifts, every third weekend and holiday rotation required
Cross trained to process medication refills
Benefit eligible position

Job Description:

Nursing is the diagnosis and treatment of human response to actual or potential health problems. This includes establishing an intentional therapeutic relationship between a registered nurse and a patient and family. As a leader and the integrator of care, the professional nurse has the responsibility, authority, and accountability for planning, coordinating and evaluating the patient’s care needs.

Provides patient care support for centralized nursing program, outpatient and home care services. This includes Triage services, Anti-coagulation, and refill. Iniduals in this role will work in an outpatient clinic setting.

Principle Responsibilities

Assessment.
Collects, prioritizes and synthesizes comprehensive data pertinent to the patient’s health or situation.
Collects and prioritizes data in a systematic and ongoing process that involves the patient, family, other health care providers and environment as appropriate.
Integrates data relevant to the situation to identify needs, patterns and variances.
Uses appropriate evidence based assessment techniques and instruments in data collection.
Diagnosis.
Analyzes assessment data to determine nursing diagnoses.
Interprets assessment information to identify each patient’s needs relative to age, developmental stage and culture.
Formulates, revises and resolves nursing diagnoses that reflect the current patient status.
Validates and communicates nursing diagnoses with the patient, family and other health care team members.
Documents nursing diagnoses in compliance with the patient care guidelines.
Outcomes Identification.
Identifies expected outcomes inidualized to the patient.
Establishes, in the collaboration with the family, patient, realistic and measurable patient expected outcomes based on nursing diagnoses, patients present and potential capabilities, goals, available resources and plan for continuity of care.
Planning.
Develops a plan that prescribes interventions to attain expected outcomes.
Develops an inidualized plan considering patient characteristics or the situation as appropriate in conjunction with the patient, family and others.
Establishes a plan that provides for continuity of care.
Incorporates evidence based nursing practice takes into consideration current statutes, rules and regulations when developing the plan of care.
Implementation.
Implements the identified plan.
Implements interventions in a safe, timely, appropriate manner.
Utilizes evidence-based interventions and treatments specific to the diagnoses as appropriate.
Coordinates implementation of the plan of care if appropriate
Documents interventions according to documentation guidelines.
Evaluation.
Evaluates the patient’s progress towards attainment of the outcome.
Evaluates the patient’s/family’s understanding of and response to the plan of care.
Utilizes systematic and ongoing assessment data to revise diagnoses, outcomes and the plan of care.
Involves the patient, family, and health care team members in the evaluation process when appropriate.
Documents revisions in diagnoses, outcomes and the plan of care according to documentation guidelines.
Quality of Practice.
Systematically enhances the quality and effectiveness of nursing practice.
Participates in quality improvement activities related to nursing practice.
Incorporates available QI data to improve nursing practice and outcome.
Education.
Attains knowledge and competency that reflects current nursing practice.
Participates in educational activities related to nursing practice.
Acquires and applies the knowledge gained from educational experiences to current nursing practice.
Professional Practice Evaluation.
Evaluates one’s own nursing practice in relation to professional practice standards and regulatory guidelines.
Engages in self-evaluation of practice on a regular basis, identifying strengths and goals for professional development.
Obtains informal feedback regarding one’s own practice from patients, peers, professional colleagues, and others.
Collegiality.
Contributes to the professional development of peers, colleagues, and others.
Shares knowledge and skills in practice settings.
Provides immediate and ongoing positive and constructive feedback to colleagues regarding their performance.
Contributes to a supportive and healthy work environment.
Collaboration.
Collaborates with patient, family, and others in the conduct of nursing practice.
Partners with others to effect change and generate positive outcomes through knowledge of the patient or situation.
Ethics.
Acts in an ethical manner.
Maintains a therapeutic and professional patient-nurse relationship with appropriate professional role boundaries.
Serves as a patient advocate assisting patients in developing skills for self-advocacy
Uses available resources to help formulate ethical decisions.
Research.
Integrates research findings in practice.
Utilizes the best evidence, including research findings, to guide practice decisions.
Resource Utilization.
Incorporates factors related to safety, effectiveness, cost, and impact on practice in planning and delivering patient care.
Utilizes resources related to standards of care in a safe, effective and ethical manner.
Manages resources to assure they will be accessible to other in the future.
Leadership.
Provides leadership in the professional practice setting and the profession.
Functions as a professional role model.
Promotes a positive work environment.
Participates in shared decision-making.
Environmental Health.
Practices in an environmentally safe and healthy manner.
Attains knowledge of environmental health concepts, such as implementation of environmental health strategies.
Promotes a practice environment that reduces environmental health risks for workers and healthcare consumers.
Communicates environmental health risks and exposure reduction strategies to healthcare consumers, families, colleagues and communities.
Charge Nurse (only when acting in this role).
Demonstrates ability to coordinate and direct unit operation so the patient and family needs are met and resources are efficiently utilized in a safe manner.
Promotes an environment that encourages inidual growth, nurtures professional practice and fosters teamwork.
Collaborates effectively with unit staff, leadership and other disciplines.
Preceptor (only when acting in this role).
Demonstrates ability to identify the orientee’s learning needs and plans appropriate learning experiences.
Demonstrates ability to implement an inidualized orientation plan for the orientee.
Demonstrates ability to validate clinical competence of orientee.
Facilitates development of organizational and prioritization skills of orientee.
Demonstrates ability to evaluate interpersonal sills of orientee.
Serves as a professional role model.
Facilitated socialization of orientee into the organization and work group.
Other duties as assigned.

Required Qualifications

Associate’s or Vocational degree in nursing
Minimum 3 years RN experience

Preferred Qualifications

Experience in triage, anticoagulation, or remote nursing support

Licenses/Certifications

Licensed Registered Nurse-MN Board of Nursing required
Licensed Registered Nurse-WI Dept of Safety & Professional Services required by completion of orientation

Physical Demands

Sedentary:
Lifting weight Up to 10 lbs. occasionally, negligible weight frequently

Manager, Government Corporate Accounts

STERIS Remote.co8 days ago

Apply Now8 days ago

location: remoteus

Apply Now

Title: Manager, Government Corporate Accounts (Remote)

Req ID: 46773

Job Category: Sales

Location: Mentor, OH, US, 44060

Workplace Type: Remote

Job Description:

At STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe.

How You Will Make a Difference:

Do you have a proven track record for navigating key decision makers and building rapport? The Manager, Government Corporate Accounts will play a pivotal role in developing and nurturing strategic relationships within the healthcare sector, leveraging key decision-makers and influencers to drive growth and enhance customer experiences.

As an Manager, Government Corporate Accounts expands the STERIS enterprise footprint and presence in the assigned market. Leverages corporate key decision makers and influencers in supply chain, clinical and administration by providing a comprehensive sales strategy and team approach to the STERIS total portfolio solution.

This is a remote based customer facing position. To support and service our customers in this assigned territory candidates must be based out of one of the following state/city: Candidate must be able to travel 50% and can live anywhere in the US.

What You Will Do:

Identify opportunities to increase existing business and secure new Customer agreements, managing a range of 15 to 20 accounts, with responsibility for a minimum of $15 million in annualized business.
Achieves all revenue, gross margin and business targets representing the assigned STERIS enterprise footprint.
Ensures customer needs are communicated through proper internal channels
Assures integration into customer’s business via membership and attendance to Customer group associations and functions
Conducts regular check-ins and businesses reviews with AVP to review objectives, progress, successes and development opportunities
Develop and implement strategies and tactics necessary to expand the STERIS “enterprise” through successful account penetration at levels of the assigned Customer groups.
Facilitates the development and expansion of the business by developing and nurturing strategic relationships, industry associations within healthcare.
Monitors and reports external business trends back to their team
Develops and maintains cooperative relationships with field sales, marketing and internal support functions of the organization by consistently sharing information, responsibilities, decision-making and recognition with others to maximize sales growth.
Develops, implements and monitors activities with key Customers with direct focus on improving the Customer Experience.
Engages, collaborates and supports internal teams focused on project business.
Identifies and expands partnership opportunities with 3rd party Customers supporting and influencing key Customers.
Develops and supports distribution opportunities aligned with Business Unit objectives.
Helps identify the key business implications or changes in existing processes, programs, and priorities to drive growth in the assigned Customer group.
Networks with key industry leaders, corporate partners, and key influencers within area of responsibility
Interacts regularly with marketing, sales and internal support leaders to ensure process improvements are implemented effectively.
Ensure the success of existing and new products and services through focused programs at key corporate accounts and as a field sales support mechanism.
Identify and develop alternative market opportunities through corporate contacts that are not a part of field sales normal call patterns
Attends and promotes STERIS at strategic trade shows, conventions, and industry affairs.

We Take Care of You:

Base salary plus commission
Car stipend and mileage reimbursement
Business travel and related expenses paid via company credit card
Cell phone stipend
Excellent healthcare/ dental/ vision benefits
401(k) with a company match
A robust sales training program
Excellent opportunities for advancement

What You Need to be Successful:

Four-year Degree; MBA preferred
10+ years of demonstrated success in medical sales; Five (5) years STERIS sales preferred. Competitive or related experience considered; plus 3+ years of management experience (marketing, corporate accounts, system project management)
High level of business and financial acumen based on strategies to drive business unit revenue and goals.
Possess extensive knowledge of STERIS products and services (technical and clinical).
Demonstrated sales management and negotiation experience in medical device, capital products, and services
Demonstrated ability to lead and/or influence a cross functional team and operate successfully in a highly complex medical device environment.

Must be able to be compliant with hospital/customer credentialing requirements

#LI-BS1

Skills

Pay range for this opportunity is $98,750.00 – $130,000.This position is eligible for commission.

Minimum pay rates offered will comply with county/city minimums, if higher than range listed. Pay rates are based on a number of factors, including but not limited to local labor market costs, years of relevant experience, education, professional certifications, foreign language fluency, etc.

Employees (and their families) may enroll in our company-sponsored medical, dental, vision, flexible spending, health savings account, voluntary benefits, supplemental life/AD&D plans and the company’s 401k plan. Employees are covered by an employee assistance program (also available to household members) and long-term disability. Full-Time Employees are also eligible for short-term disability. Full-time Employees will also receive Paid Time Off (PTO) based on years of service and paid Holidays. Part-time employees working 20 or more hours receive a pro-ration of the full-time PTO allocation and paid Holidays based on their standard hourly work week. Full-Time employees are eligible for four weeks of paid parental leave. Part-time employees also receive paid parental leave, pro-rated based on their standard hourly work week.

STERIS is an Equal Opportunity Employer. We are committed to equal employment opportunity and the use of affirmative action programs to ensure that persons are recruited, hired, trained, transferred and promoted in all job groups regardless of race, color, religion, age, disability, national origin, citizenship status, military or veteran status, sex (including pregnancy, childbirth and related medical conditions), sexual orientation, gender identity, genetic information, and any other category protected by federal, state or local law. We are not only committed to this policy by our status as a federal government contractor, but also we are strongly bound by the principle of equal employment opportunity.

Req ID: 46773

Job Category: Sales

Location:

Mentor, OH, US, 44060

Workplace Type: Remote

STERIS Sustainability

Life at STERIS

Payer Operations Specialist

Carda Health Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Title: Payer Operations Specialist (Remote)

Location: US

Type: Contract

Job Description:

About Carda

Rehab is a pain. So much so that only 10% of qualifying Cardiac and Pulmonary patients attend. At Carda Health, we’ve reimagined rehab. Our program allows patients to complete inspiring, convenient, life-saving therapy remotely.

Who are we?

We are a team of clinicians, data scientists, mathematicians and repeat entrepreneurs. And a few recovering financiers. Our belief is that technology and data, when applied to the right problem, transforms people’s lives and changes even the most entrenched industries. Carda was founded by Harry and Andrew, two friends from Wharton who share a family history of heart disease and experience with poor access to care. We now work with some of America’s largest and top-ranked hospitals and most innovative insurers. We are fortunate to be backed by some of the best investors in the business who have also backed the likes of Livongo, Hinge, Calm, MDLive, and others.

Who are you?

You are motivated by the prospect of working at a fast-growing start-up. You are excited about the details but able to connect them back to bigger company goals. You are passionate about enabling others to do their jobs better and more efficiently – in this case expanding access to life-changing therapies. If you exhibit one characteristic above all others it is that of ownership. It personally bothers you when processes don’t work and you do everything in your power to prevent this from happening. You are a great collaborator and communicator who has experience both managing teams and working across teams to implement key initiatives. You are able to complete tasks and implement processes in ? of the time of a peer.

What will you do?

The Business Operations Analyst will have executional and strategic responsibilities. You will have the opportunity to gain exposure to a myriad of experiences working at a venture backed startup from an early stage. Your primary focus or driving goal will be ensuring that revenue (insurance claims and patient collections) is maintained as well as handling any compliance concerns related to revenue and business operations. The key driver of our revenue is insurance claims so experience in Revenue Cycle Management (RCM) and a willingness to learn are critical to succeeding in this role. This role requires collaboration across the Carda team including everyone from our C-suite executives to our clinicians.

In a little more detail:

Communicate with patients daily to clarify insurance coverage and answer billing related questions
Work with our billing company to complete tasks on claims that fail validation
Work with Excel to manage reporting on claims and claims operations
Work within our EMR and homegrown practice management system to correct patient data found to be inaccurate during the claim routing or adjudication process
Assist with insurance verification/ eligibility determination questions
Maintain updates in our billing system(s)
Other duties as assigned

What we look for:

A year of experience in an administrative medical setting working with patients
Strong interpersonal skills
Attention to detail
Highly organized
Knowledge of Medicare and Medicare Advantage Plans

Sr Admin - Medical Records

Maximus Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Sr Admin – Medical Records (Remote)

General information

Job Posting Title

Sr Admin – Medical Records (Remote)

City

Remote

Country

United States

Working time

Full-time

Description & Requirements

Maximus is currently hiring a Sr. Admin – Medical Records to support the Independent Medical Review (IMR) program.

At Maximus, we are committed to cultivating a positive and inclusive work environment, and we are pleased to offer the following:

Comprehensive Insurance Coverage – Medical, Dental, Vision, Life insurance, and enjoy discounts on Auto, Home, Renter’s, and Pet insurance.
Future Planning – Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
Paid Time Off Package – Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.
Holistic Wellness Support – Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
Recognition Platform – Acknowledge and appreciate outstanding employee contributions.
Diversity, Equity, and Inclusion Initiatives – Join a workplace committed to fostering ersity and inclusion.
Tuition Reimbursement – Invest in your ongoing education and development.
Employee Perks and Discounts – Additional benefits and discounts exclusively for employees.
Maximus Wellness Program and Resources – Access a range of wellness programs and resources tailored to your needs.
Professional Development Opportunities: Participate in training programs, workshops, and conferences.

Essential Duties and Responsibilities:

– Correctly identify the party from which the medical records were submitted.

– Ensure correct documents are provided to the physician reviewer and submit assigned reports accurately and timely.

– Examine case file to ensure all relevant information has been submitted.

– Review documents to determine completeness and eligibility and report identified errors appropriately and timely.

– Correctly identify non-medical records and make appropriate decision on the need for further review of these documents.

– Index hundreds of pages of medical records completely, accurately, and efficiently.

– Perform other duties as may be assigned by management.

– Perform data entry tasks with accuracy.

Minimum Requirements

– High School Diploma or Equivalent required; Associate degree preferred.

– 4 to 6 years of related experience required.

– Medical-related experience preferred.

– 2- 4 years of relevant experience in healthcare administrative customer service experience.

– Strong analytical skills

– Detail and solution oriented

– Ability to work independently

– Excellent written and oral communication skills

– Proficiency in Microsoft Office suite

Preferred Requirements

-Experience in data entry and conducting reviews for data accuracy.

Home Office Requirements

– Maximus provides company-issued computer equipment

– Reliable high-speed internet service

– Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

– Minimum 5 Mpbs upload speeds

#NYMC #LI-Remote

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and erse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate’s education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus’s total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant’s salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Minimum Salary

$22.00

Maximum Salary

$22.00

Centralized Coding Specialist

LifePoint Health Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Centralized Coding Specialist – Remote-7410-7798

Pacific Medical Data Solutions

Description

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

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

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

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

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

The Centralized Coding Specialist will spend the bulk of their time making sure that their clients are fully supported from a charge entry, coding, and billing perspective. You will be responsible for reviewing a patients medical record after a visit and translating the information into codes that insurers use to process claims.

You will make sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations, complying with medical coding guidelines and policies. Following up and clarifying any information that is not clear.

Clearinghouse knowledge and working experience is also a plus You would be working in a team environment with guidance from the Manager Coding and Integrity. This position also works closely with the AR department for coding related issues.

Perform Evaluation and Management coding, procedure, ICD-10 and HCPC quality reviews as well as other projects related to physician coding compliance. Demonstrates a thorough understanding of complex coding, and reimbursement, as they relate to physician practices and clinic settings.

Keeps informed regarding current coding regulations, professional standards and company/department policies and procedures and effectively applies this knowledge.

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

Qualifications

ESSENTIAL FUNCTIONS

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

Other Functions

1. Maintains regular and predictable attendance.

2. Performs other essential duties as assigned.

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

Education:High school diploma or equivalent required.Bachelors Degree preferred or equivalent experience

Experience:3-5 years of medical coding experience

License or Certification:

This position requires credentialing through AHIMA, and/or AAPC

The following certifications are accepted:

CPC
CEMC
CPMA
CRC
CPB
Specialty certification
CCS-P
RHIT

Skills and Abilities:

This position requires an understanding and knowledge of physician documentation requirements in a clinic setting to capture patients acute and chronic conditions
Ability to create and follow written procedure.
Ability to provide professional written communication and excellent customer service.
Technical proficiency with computers, basic Microsoft software, and medical software systems (PM/EHR)
Strong organizational skills
Excellent communication skills and ability to work in a team environment.
Strong technical and computer skills (PM/EHR Software, Excel, Outlook, MS Office, Web)
Ability to learn new systems, software, and client specialties quickly.
Self-starter with little to no supervision

Benefits

At Lifepoint, our Mission of Making Communities Healthier extends to our employees. We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program.

We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.

We also offer a flexible, remote work environment.

Pay range:$23-25/hour DOE Thefinal agreed upon compensation is based on inidual education, qualifications, experience, and work location. This position is bonus eligible.

Primary LocationColorado-Denver

ScheduleFull-time

Work ScheduleDay shift, 7-10 hr/shift, weekdays only

Clinical Nursing Coordinator

CareMetx Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Clinical Nursing Coordinator

Fully Remote • Remote Worker – N/A

Description

From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.

Clinical Nursing Coordinator: Job Description

POSITION SUMMARY:

The RN in this role is responsible for providing and documenting call center services for patients with rare or chronic disorders, on behalf of manufacturer clients. These clients, secured by CareMetx, provide specific guidelines for required nursing services. Nurse Educators do not provide medical advice or work clinically within this role, and do not interact directly with healthcare providers or offices. The nurse reports to the Sr. Director Operations.

PRIMARY DUTIES AND RESPONSIBILITIES:

Ability to work in call center environment, utilizing computer equipment, hardware and software, to successfully execute all job responsibilities
Executes assigned responsibilities as agreed upon by the manufacturer client and company leadership
Educates patients, physicians and families on prescribed, FDA approved therapies, according to manufacturer client needs and requirements
Utilizes reviewed and approved call scripts for communicating key messaging to patients?
Provides HIPAA compliant feedback and analysis to the manufacturer client as contractually required
Adheres to and is compliant with mandatory HIPAA requirements
Adheres to all company policies and procedures
Effectively communicates with patient, family, provider, manufacturer and team members
Responsible for maintaining required nursing licenses and relevant certifications?
Ability to manage time efficiently and prioritize job responsibilities?
Conveys a strong professional image and positive attitude at all times
Performs related duties as assigned.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

Active RN licenses must be free of disciplinary actions and/or restrictions?
Minimum of 2 + years nursing experience
Consideration will be given to RN’s living in Nursing Licensure Compact ‘home states’
Bachelor’s degree preferred; Associate’s degree commensurate with experience
Prior call center or telehealth nursing experience preferred

MINIUMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

Knowledge and familiarity with call center and telehealth processes

Knowledge of biologic therapies, specialty pharmacy, and managed care processes

Proficient in Technology: Microsoft Office – particularly Word and Excel, Zoom, MS Teams, WebEx, Salesforce, Telephone systems)

Excellent interpersonal skills – demonstrates initiative, problem solving skills, acts as a team player
Excellent oral and written communication skills
Excellent organizational skills – ability to prioritize and adjust to shifting priorities
Excellent judgment/ decision Making skills
Compassionate and patient-focused
Ability to sit for extended periods of time
Ability to connect to the internet from remote location, as needed
Ability to perform all work duties from remote location, as needed
Ability to perform administrative responsibilities accurately and on time
Willingness to work multiple US time zones as needed
Ability to travel for national training meetings approximately 15%
Ability to work independently as well as with a team
Ability to work flexible hours, as needed?
Ability to perform other program and company priorities, as needed

Physical Demands

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

While performing the duties of this job, the employee is regularly required to sit.
The employee must occasionally lift and/or move up to 10 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Schedule

Must be flexible on schedule and hours
Some travel may be required

CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.

At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.

CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.

Content and Curriculum Manager, Nursing

Kaplan Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Content and Curriculum Manager, Nursing

Job Description

For more than 80 years, Kaplan has been a trailblazer in education and professional advancement. We are a global company at the intersection of education and technology, focused on collaboration, innovation, and creativity to deliver a best-in-class educational experience and make Kaplan a great place to work.

The future of education is here and we are eager to work alongside those who want to make a positive impact and inspire change in the world around them.

The Nursing Content Manager leads key content and curriculum development projects in order to revise or develop new nursing products. She or he determines the appropriate team to recruit and manage for the execution of the project and works with implementation specialists to manage projects to ensure completion is timely, obstacles are removed, and any new processes are created and documented in order to achieve success. As a subject matter expert in nursing education, the content manager also ensures the quality of the product, alignment with customer expectations, and adherence to learning science principles.

Primary Responsibilities

Content creation and development using multiple platforms on a project-by-project basis. This includes tracking, training, and metric reporting/presenting.
Use of situational leadership and G.R.O.W. coaching to manage and develop content developers and content specialists.
Collaborate with Kaplan teams to keep student success the focus of our delivery efforts. This includes customer service teams (NC, AM, Contact Center, Sales), academics, learning science, marketing, publishing, and technology.
Actively pursue opportunities to continue to learn best practices in product development through research, professional development, and alternate learning opportunities. Sharing your learning with the team and broader KNA through thought leadership activities.

Education & Experience

MSN in Nursing (required)
5+ years in nursing education and content development
Considerable knowledge of current literature, trends, and developments in the design and development of nursing education/products.
Excellent computer (Microsoft Office & Google Suites) and presentation skills.
Open-minded team player with a positive attitude, sense of humor, energy, and dedication to collaborate and learn new systems/platforms/processes for authoring/reporting.
Understanding and ability to provide training and assistance to internal team members with content development, platform/software usage, and navigation of Kaplan sites.
Strong communication, public relations, and interpersonal skills for effective oral and written communication. Including the ability to develop/implement policy and procedures.
Ability to provide leadership and supervise the planning, development, and establishment of new, modified, and/or improved projects. Including goal setting, research, data analysis, promotion, scoping, and independently prioritizing toward a deadline.

Preferred Qualifications

DNP or PhD in Nursing or Education (preferred), Specialty/Certification (in nursing, instructional design, leadership, project management, and/or education).

We offer a competitive benefits package including:

Remote work provides a flexible work/life balance

Comprehensive Retirement Package automatically enrolled in The Company Contribution Plan (8-10% annual company contribution based on tenure)

Our Gift of Knowledge Program provides tuition assistance and substantial discounts for our employees and close family members

Competitive health benefits and new hire eligibility start on day 1 of employment

Generous Paid Time Off includes paid holidays, vacation, personal, and sick paid time-off, plus one (1) volunteer day and one (1) ersity and inclusion day to participate and give back to our local communities

And so much more!

For full-time positions, Kaplan has two Salary Grades, this position is a Salary Grade B: $64,000 – $202,600. Actual compensation for this role is determined by several factors including but not limited to job level, candidate’s skills, experience, and education, among other factors determined by the business.

#LI-DK1

#LI-Remote

Location

Remote/Nationwide, USA

Additional Locations

Employee Type

Employee

Job Functional Area

Content/Material Creation

Business Unit

00092 Kaplan Health

At Kaplan, we recognize the importance of attracting and retaining top talent to drive our success in a competitive market. Our salary structure and compensation philosophy reflect the value we place on the experience, education, and skills that our employees bring to the organization, taking into consideration labor market trends and total rewards. All positions with Kaplan are paid at least $15 per hour or $31,200 per year for full-time positions. Additionally, certain positions are bonus or commission-eligible. And we have a comprehensive benefits package, learn more about our benefits here.

Diversity & Inclusion Statement:

Kaplan is committed to cultivating an inclusive workplace that values ersity, promotes equity, and integrates inclusivity into all aspects of our operations. We are an equal opportunity employer and all qualified applicants will receive consideration for employment regardless of age, race, creed, color, national origin, ancestry, marital status, sexual orientation, gender identity or expression, disability, veteran status, nationality, or sex. We believe that ersity strengthens our organization, fuels innovation, and improves our ability to serve our students, customers, and communities. Learn more about our culture here.

Kaplan considers qualified applicants for employment even if applicants have an arrest or conviction in their background check records. Kaplan complies with related background check regulations, including but not limited to, the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. There are various positions where certain convictions may disqualify applicants, such as those positions requiring interaction with minors, financial records, or other sensitive and/or confidential information.

Kaplan is a drug-free workplace and complies with applicable laws.

Medicare Nurse Reviewer

Medical Mutual Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Title: Medicare Nurse Reviewer

Location: United States

Job Description:

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and inidual plans.

Under limited supervision, the Medicare Nurse Reviewer applies medical necessity guidelines in making authorization determinations for inpatient admissions, concurrent, and retrospective reviews in collaboration with physician reviewers. Applies evidence-based discharge planning so that patients have a safe and timely transition to next appropriate level of care.

Note: This position allows you the flexibility to work at home. We are looking for applicants that have a strong clinical utilization management background. Medicare experience is a plus.

Responsibilities

Evaluates clinical information using established national decision support criteria, company policies, and inidual patient considerations to ensure the provisions of safe, timely, and appropriate covered healthcare services.
Independently conducts basic to complex post-acute care admissions, concurrent, and retrospective reviews, including skilled nursing facility, acute physical rehabilitation, and long-term acute care hospitals, to ensure compliance with criteria guidelines, member eligibility, benefits and contracts.
Plans, implements, and documents, discharge planning activities based on the members’ specific clinical condition, health plan benefits, and optimal care delivery. Acts as a resource to the provider community, explaining processes for accessing the Company’s website to identify network providers for next level of care and post-discharge follow-up care
Promotes effective resource management by directing member care to accessible cost-effective post-acute network providers and services at appropriate level of care. Coordinates with other Pharmacy and Care Management departments to facilitate the timely provision of covered health care services.
Participates with designated external vendors and Assistant Medical Directors, social workers and case managers to determine potential high dollar member costs, discharge planning interventions that ensure delivery of consistent and quality health care services.
Keeps up to date on utilization management regulations, policies and practices.
If assigned to Preceptor/Trainer task: Orients, trains and provides guidance to more junior or less experienced staff. Supports implementation of new procedures, processes or clinical systems.
Performs other duties as assigned.

Qualifications

Graduate of a registered nursing program approved by the Ohio State Nursing Board. Bachelor’s degree preferred.
3 years as a Registered Nurse with a combination of clinical and or utilization/case management experience, preferably in the health insurance industry.
Acute inpatient level of care in Medical/Surgical/Critical Care/ ambulatory care experience preferred.
Registered Nurse with current State of Ohio unrestricted license.
Intermediate Microsoft Office skills and proficiency navigating windows and web-based systems.
Knowledge of, and the ability to apply fundamental concepts related to HIPAA compliance and related regulations.
Knowledge of clinical practices and efficient care delivery processes.
Ability to occasionally travel offsite for on-going training.
Ability to occasionally work weekends and extended hours as needed.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That’s why we offer an exceptional package that includes:

A Great Place to Work:

We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.

Excellent Benefits and Compensation:

Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance – insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay idends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and inidual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

#LI-REMOTE

Healthcare Revenue Cycle SNF Billing Consultant II

Wipfli Remote.co10 days ago

Apply Now10 days ago

location: remoteus

Apply Now

Healthcare Revenue Cycle SNF Billing Consultant II

Job Locations: US

Job ID

2024-6404

Overview

Now is the time to join us!

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a erse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

Who are you?

We are seeking Case Manager RN to join our team on a part-time basis, working up to 29 hours per week. In this role, you will provide telephonic case management between providers, patients and caregivers to help ensure cost-effective, high-quality healthcare for health insurance plan participants. This position offers flexibility and is ideal for candidates looking for reduced hours while making an impact within the team.

In this role you will wear many hats, but your knowledge will be essential in the following:

Telephonically manage cases on a long- or short-term basis per established Company guidelines, policies and procedures, as well as other standardized criteria in the healthcare industry.
Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs.
Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals.
Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions.
Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care.
Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance.
Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis.
Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports.
Establish and maintain working relationships with healthcare providers, client/group, and patients to provide emotional support, guidance and information.
Evaluate and make referrals for wellness programs.
Maintain complete and detailed documentation of case managed patients in Eldorado and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30-day intervals for high-risk cases and 90 days interval for low risk cases ensuring confidentiality according to Company policy and HIPAA
Perform Utilization Review for assigned members.
Serve as mentors to LVNs and provide guidance on complicated cases as it relates to clinical issues.

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

Qualifications

What you bring to the Personify Health team:

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

Graduation from an accredited RN program and possession of a current California RN license.
Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience.
Prefer case management experience, emergency room, critical care background or some other area of clinical care that is pertinent to case management.

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

Knowledge of medical claims and ICD-10, CPT, HCPCS coding.
Ability to critically evaluate claims data and determine treatment plan; discharge planning experience.
Ability to work independently making decisions and problem solving
Knowledge of community resources and alternate funding programs.
Computer proficiency or working knowledge of Microsoft Office Suite.
Excellent interpersonal, communication and negotiation skills.
Strong customer orientation.
Good time management skills and highly organized.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to ersity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $32.00 to $38.00. Note that compensation may vary based on location, skills, and experience.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#LIRemote

#WeAreHiring #PersonifyHealth #TPA #HPA #Selffunded

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to [email protected]. All of our legitimate openings can be found on the Personify Health Career Site.

Application Deadline: Open until position is filled.

Multispecialty Surgery Coder III

Guidehouse Remote.co12 days ago

Apply Now12 days ago

location: remoteus

Apply Now

Remote Multispecialty Surgery Coder III

locations

US – Remote (Any location)

Full time

Job Family:

Health

Travel Required:

None

Clearance Required:

Ability to Obtain NACI

Responsibilities:

• Demonstrates the ability to perform quality surgical coding and multispecialty chart types as assigned.

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

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

• Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews either within the facility.

• Ability to maintain average productivity standards as follows

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

• Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines.

• Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.

• Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility.

• Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request.

• Responsible for coding or pending every chart placed in their queue within 24 hours.

• It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard.

• Coders are responsible for checking the Guidehouse email system at least every two hours during coding session.

• Coders must maintain their current professional credentials while working for Guidehouse.

• Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility.

• Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy)

• It is the responsibility of each coder to review and adhere to the coding ision policy and procedure manual content.

• Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.

• Communicates problems or coding principle discrepancies to their supervisor immediately.

• Communication in emails should always be professional