Coder Educator Phys Pract

by Irma Moore | Aug 27, 2024 | Uncategorized

Do you have excellent Coding and Auditing skills for E&M and Surgical Specialties? Are you a great Public Speaker?  Do you enjoy Providing Education? If so this is the opportunity for YOU!!!!

Come and join an innovative and highly trained team who collaborates with multiple departments to ensure correct documentation and coding. Our Coding Educators play a critical role at Banner Health.

Become a forward-looking a Remote – Medical Coding Educator: Physician Practice professional supporting our Physicians Practices and Coding Teams. This requires a CCS or RHIT or RHIA Certification(s) are preferred, but with 3+ years in E/M and Surgical Specialties Coding a CPC or CCS-P is sufficient as well.

You’ll be a key contributor to a nationally recognized, award-winning health care provider that shares your passion for positive change. In fact, for the third time in four years, Truven Health Analytics has named Banner Health one of the Top 15 Health Systems in the U.S.–one of the top five large health systems! In most of our Coding roles, there is a Coding Assessment given after each successful interview. Banner Health provides your equipment when hired.

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

The hours are flexible as we have remote Coders across the Nation. Generally any 8 hour period  between 6am – 7pm can work, with production being the greatest emphasis.  Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you’ll find many options for contributing to our award-winning patient care.

POSITION SUMMARY
This position assists with the development of education/training materials, conducts and coordinates training and development of Health Information Management staff and other Banner staff as appropriate, including physicians/providers, and provides technical staff training in the usage of information systems components of the medical records database system. Creates and maintains all department training materials, tools and/or records. Conducts new hire skill assessments, department specific orientation, and initial training for work tasks and functions. Provides continuing education and annual regulatory updates.

CORE FUNCTIONS
1. Assesses and identifies skills, competencies and areas of learning and instruction needed for new hires, staff and department management. Assists with the development of education and training within specified area, which may include preparation of related educational materials.

2. Plans and coordinates the orientation programs for new hires to provide an introduction to the department and facility, to define employment expectations and standards, to provide prerequisite knowledge required, and to train in the basic job skills.

3. Develops and maintains an education calendar and individual continuing education and orientation record for each member of the assigned work group. Develops and conducts programs with educational materials, procedures and exercises that are task/function specific using a variety of learning and evaluation strategies for all staff.

4. Provides for onsite support of trainees, and acts as a knowledge resource for all staff. Problem-solves and troubleshoots issues involving HIMS electronic applications. This may include monitoring and reviewing clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete.

5. Works in regional/system-wide teams to develop Health Information Management Systems and Services educational materials and activities, and promotes standardized practices throughout the region and/or company.

6. May collect and/or coordinate the collection of data, compile reports and graphs and present findings at Medical Staff Committee meetings, Clinical Documentation Specialist meetings and/or other appropriate department, facility and system level meetings. May also coordinate and perform clinical pertinence and inter-disciplinary chart reviews, ensuring the reviews meet government and regulatory standards.

7. Maintains a current knowledge relating to Health Information Management Systems by attending educational workshops/conferences, reviewing professional publications, establishing personal networks, and/or participating in professional societies. This may also include performing ongoing research to ensure compliance with clinical documentation and/or regulatory guidelines and standards.

8. Works independently under general supervision and utilizes analytical and creative thinking skills, and influencing abilities. Training responsibilities include, but are not limited to, all HIMS staff and staff assigned to related work teams, as well as physicians/providers. Customers include Health Information Management, Financial Services and Clinical Documentation leadership and staff, as well as other members of the integrated healthcare team.

MINIMUM QUALIFICATIONS

Must possess a current knowledge of business and/or healthcare as normally obtained through the completion of a bachelor’s degree in business administration, healthcare administration or related field, plus advanced training in Health Information Management requirements and systems and in adult learning principles.

In the acute care coding environment, requires a Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). In the ambulatory coding environment, requires Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), with RHIA, RHIT or CCS certification preferred. Requires the knowledge typically acquired over three or more years of work experience in healthcare information management. Must be well versed in regulatory requirements for medical record documentation, as well as Medical Staff Rules and Regulations where applicable. Must have demonstrated education and training skills. Medical terminology and an understanding of the laws and regulations associated with medical records functions are required. Must be able to function as part of a team, using effective interpersonal and instructional skills. Must possess excellent written, verbal, and customer service skills, and have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels.

Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware.

PREFERRED QUALIFICATIONS

Previous training/teaching experience and customer service education experience preferred. Creativity and knowledge of adult learning principles preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Coding Specialist -Outpatient Facility, Remote, Health Information Management

by Irma Moore | Aug 27, 2024 | Uncategorized

Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. Baptist Health is supported by philanthropy and committed to its faith-based charitable mission of medical excellence.

Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.

This year, and for 24 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, based on employee feedback. We’ve also been recognized as one of America’s Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.

But really, the reason we’re excited to come to work is the people.

Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it’s like to be in their shoes. Many of us have been patients here and have had family members as patients here. We’re committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we’re all in.

Description

 Accurately codes Emergency and Outpatient Diagnostic records for the classification of all diseases, injuries, procedures, and operations using the ICD10CM and CPT4 coding system for BHSF facilities. Ensures compliance of coding rules and regulations according to Regulatory Agencies (CMS, OIG). Works as a team to meet departmental goals and AR goals. Abstracts prescribed data elements from the medical records. Estimated pay range for this position is $23.56 – $30.63 / hour depending on experience.

Qualifications

Degrees: High Schoo Diploma or Equivalent

Licenses & Certifications: AHIMA Certified Coding Specialist- CCS or RHIT

Additional Qualifications: Required completion of an AHIMA accredited certified coding specialist program and Coding Certificate, preferred Certified Coding Specialist (CCS).

Required completion of a medical terminology and anatomy and physiology college course within past five years.

Knowledge of encoder system, outpatient prospective payment system, APCs.

Knowledge of National Local Coverage Determinations (NCD and LCD) Policies. 

Competency in Word and Excel.

 Ability to communicate effectively with coworkers, management staff and physicians.

Minimum Required Experience: 3 years

Job

Corporate

Primary Location

Remote

Organization

Corporate

Schedule

Full-time

Job Posting

Aug 20, 2024, 11:00:00 PM

Unposting Date

Ongoing

EOE

Manager Coding

by Irma Moore | Aug 27, 2024 | Uncategorized

Overview

The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.

Responsibilities

• Work with the Director, Coding Services to oversee CMS-HCC and HHS- HCC coding production and quality including the management of staff, hiring, promoting, evaluating, and training, disciplining, and mentoring at the client team level.
• Facilitates all production meetings with Reporting, Data Capacity operations planning, and leadership to develop coding and abstraction production plans. Communicates production plans, quality goals and project priorities to internal Coding teams as well as external vendor partners in preparation for on-boarding and/or scheduling of all client projects, including on and offshore coding.
• Resolve issues that impact coding production and the full utilization of coding abstraction services for MRA, CRA and Medicaid. This will involve working closely with chart retrieval staff, IT, Production Analytics, HR, Trainers, and the QA team.
• Utilize Coding forecast and coding output data to monitor coding productivity and quality; address coders work performance concerns through meeting with the Coder and/or coding vendor leadership to develop an action plan as needed regarding production and quality accuracy standards.  This includes the development of monitoring tools as needed to continually assess staff progress toward goal achievement.
• Constructs and communicates internal system reports for all coders (Coder I, Coder II, QA I and QA II and Team Leads) in the Clinical Coding Department. These reports cross production and quality accuracy. Reports are reviewed daily, weekly, monthly, quarterly, and yearly as needed.
• Ensures completion of various chart types (physician, hospital outpatient, hospital inpatient) from both a production and quality accuracy perspective.
• Frequently meets with clients to provide meaningful updates on project progress; works closely with client success and coding quality to ensure successful deliverables.
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction. Required
• Complete all responsibilities as outlined in the annual performance review and/or goal setting. Required
• Complete all special projects and other duties as assigned. Required
• Must be able to perform duties with or without reasonable accommodation. Required

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. Required

Qualifications

• Bachelor’s degree, Coding certification; RHIA, RHIT, CRC, CCS, CCS-P, CPC, CPC-H (Nationally certified medical coder as certified by either AAPC or AHIMA) or 4 years equivalent work experience.
• 5+ years of HCC medical coding, record abstraction experience, including supervisory experience.
• Ability to establish, monitor and enforce staffing schedules and production schedules.
• Ability to analyze data to identify trends, outliers or areas that need attention from both a production and quality perspective, and implement changes as needed.
• Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required.
• Excellent written and verbal skills including coaching and interpersonal skills, and client interaction.
• Strong knowledge of medical terminology and anatomy and physiology.
• Analytical and critical thinking skills to understand data to influence decision making.
• Computer and technology literate.
• Manage multiple client deliverables and competing deadlines simultaneously.
• Awareness and adherence to HIPAA privacy and security regulations.
• Must remain flexible to provide assistance in any emergent situations and/or projects.
• Must be able to perform duties with or without reasonable accommodation.
• Work is performed in an office setting with some possible travel.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $78,000 to $90,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 8/23/2024

Applications are assessed on a rolling basis. We anticipate that the application window will close on 10/20/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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#LI-SL1 

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Cotiviti is an equal employment opportunity employer. Cotiviti recruits, hires and promotes individuals based on their qualifications for a specific job. Cotiviti values its diverse workforce and its selection of employees is made without regard to race, color, creed, sex, age, religion, pregnancy, childbirth or pregnancy-related conditions, national origin, sexual orientation, marital status, genetic carrier status, military service, veteran status, disability, or any other category of class protected by federal, state or local laws. All employment decisions and personnel actions, such as hiring, promotion, compensation, benefits, and termination, are and will continue to be administered in accordance with, and to further the principle of, equal employment opportunity.

Pay Transparency Nondiscrimination Provision
Cotiviti will not discharge or in any manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)

Sr. Director of Affordability and Innovation – Remote

by Irma Moore | Aug 27, 2024 | Uncategorized

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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

Primary Responsibilities:

• Develop Medical Spend Insights capability that uncovers the root causes and drivers of health plan medical costs, and effectiveness and impact of PI coverage
• Lead research projects and ad hoc analyses in support of affordability projects
• Develop relationships across finance and affordability teams for UHG, and client teams for Commercial PI to understand key affordability concerns for research, and collaborate with on areas of unmanaged spend
• Generate affordability research and analysis, identifying trending areas and root causes for development into affordability content
• Provide research to support the Insights to Action team’s work
• Work with solutions and valuation personnel to size projects and establish financial value for new affordability and innovation solutions
• Coordinate with analytic engineering and data teams  for data acquisition, analysis, summarization, visualization and trend identification for large medical spend insights projects
• Manage large analysis projects to identify drivers and areas of affordability opportunity, and help predict impacts of current and known changes
• Manage team of 8+ analysts with focus on employee development and production of insights as well as data, providing  mentoring, leadership, technical guidance and direction to analysts
• Establish technical best practices and processes for team

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

Required Qualifications:

• High School diploma
• Credentialed Actuary OR 7+ years of equivalent experience with statistical and analytics tools, processes and concepts
• 10+ years of healthcare payer experience
• 10+ years researching, analyzing industry and competitive trends, emerging market opportunities, threats and strategic areas of interest and growth
• 10+ years of experience managing, mentoring and developing an interdisciplinary team
• 10+ years working in affordability and/or Payment Integrity, preferably for UHG or another large payer
• Experience in investigating, identifying and using a variety of novel data sets to achieve goals 
• Familiarity with data elements used in Payment Integrity – medical code sets (CPT, HCPCS, ICD-CM, ICD-PCS, etc.), network contract reimbursement methodologies, benefits, etc.
• Skilled in data analysis and visualization techniques- such as Excel, Power BI, Tableau, SAS, SQL, R, Python, Databases, Data Analysis, Statistics 

Preferred Qualifications:

• Ability to be persuasive, and an engaging communicator comfortable engaging with all levels of personnel to tell stories with data
• Demonstrated financial literacy – ability to bridge between finance, executive, analytical and operational teams
• Proven solid interest in and orientation toward innovation in healthcare and affordability
• Proven track record of collaborating with larger teams to innovate, manage risk and deploy initiatives
• Demonstrated agile mindset, with Agile development experience 
• Ability to be a change agent- able to manage organizational and strategic change efforts
• Ability to introduce disruptive ideas
• Ability to direct others to resolve highly complex or unusual business problems that affect major functions or disciplines
• Demonstrated servant leadership orientation

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.  
  
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

Medical Biller

by Irma Moore | Aug 27, 2024 | Uncategorized

The Central Business Office has an exciting opportunity for a Full-Time Medical Biller to work Remote. The Medical Biller compiles amounts owed to medical facility and maintains order, invoice, and payments records.

• Assists patients, insurance companies, and laboratories with inquiries regarding billing issues.
• Reviews records for patient information, insurance information, service descriptors, diagnosis codes and managed care authorization requirements, and coordinates corrections.
• Prints daily appointment voucher report and reconciles all vouchers to report.
• Enters, reviews, and retrieves patient account information from system and ensures accuracy.
• Submits completed batches to appropriate billing offices daily.
• Follows up on claims submitted routinely to monitor payment status.
• Transmits coded patient treatment information to payers and other recipients.
• Coordinates insurance reimbursements with care providers.
• Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

MINIMUM QUALIFICATIONS 

• High School diploma or equivalent
• Minimum 1 year of relevant experience
• General knowledge of office procedures and operations.
• Skill in data entry with minimal errors.
• Ability to communicate effectively in both oral and written form.
• Ability to understand and follow instructions.
• Skill in completing assignments accurately and with attention to detail.

Department Specific Functions

• Reviews and releases all physician charges from the assigned WQ’s in a timely fashion.
• Reviews encounters received for all pertinent information: patient demographic information, guarantor and insurance information, place of service, referrals, claim info record, and managed care authorization requirements.
• Runs insurance eligibility and fixes registration issues.
• Manually enters paper vouchers received for missing charges.
• Reviews and fixes erroneous and/or rejected charges.
• Distributes credits from patient payments as needed.
• Assigns charges to cases and phases.
• Performs other duties as assigned.

Any appropriate combination of relevant education, experience and/or certifications may be considered.

#LI-NN1

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida’s only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We’re the challenge you’ve been looking for.

Patient safety is a top priority. As a result, during the Influenza (“the flu”) season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer – Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:Full time

Employee Type:Staff

Pay Grade:H3