by twochickswithasidehustle | Jun 25, 2023 | Uncategorized
JOB DESCRIPTION
Job Summary
Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.
KNOWLEDGE/SKILLS/ABILITIES
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims.
- Manages a caseload of claims. Procures all medical records and statements that support the claim.
- Makes recommendations for further investigation or resolution.
- Reduces defects via pro-active identification of error issues as it relates to pre-payment of claims through adjudication and trends and recommending solutions to resolve these issues.
- Supports all department initiatives in improving overall efficiency.
- Meets department quality and production standards.
JOB QUALIFICATIONS
Required Education
HS Diploma or GED
Required Experience
1-3 years
Preferred Education
Associate degree or equivalent combination of education and experience
Preferred Experience
3-5 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
APPLY HERE
by twochickswithasidehustle | Jun 25, 2023 | Uncategorized
Job Description
Job Summary
Provides application, hardware and software technical support for the Care Connections and Clinical Informatics teams.
Knowledge/Skills/Abilities
- Assists in the hardware and software support of clinical, practice management and operational workflows.
- Participates in the system implementation life cycle including but not limited to planning, implementation, training, and post implementation support.
- Assists in problem/issue resolution related to hardware and software applications.
- Minimum 2 years of experience
- Excellent customer service, active listening, and verbal and written communication skills, professional phone voice.
- Working knowledge of Microsoft Office (Outlook, Word, Excel) or other comparable software
- Empathy/passion for working with senior, disabled, low income populations
- Experience diagnosing hardware and software issues
- Adept with configuring smartphones, iPhone and Android
- Strong phone, verbal and written communications skills
- Attention to detail and problem-solving skills
- Experience coordinating with multiple departments
- Ability to work in a fast-paced environment
- Ability to multi-task, set priorities and manage time effectively
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Job Qualifications
REQUIRED EDUCATION:
HS Diploma or GED
PREFERRED EDUCATION:
Associate Degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
- 4+ years of experience
- Preferred Clinical IT background
- Experience with EHR applications, a plus
- Bilingual (English/Spanish), a plus
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
Pay Range: $34,103 – $66,500 a year*
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
APPLY HERE
by twochickswithasidehustle | Jun 25, 2023 | Uncategorized
Interwell Health is a kidney care management company that partners with physicians on its mission to reimagine healthcare—with the expertise, scale, compassion, and vision to set the standard for the industry and help patients live their best lives. We are on a mission to help people and we know the work we do changes their lives. If there is a better way, we will create it. So, if our mission speaks to you, join us!
The Renal Service Coordinator (RSC) plays a key role in our members’ kidney care journey. While coordinating care through each stage of Chronic Kidney Disease (CKD), the Renal Service Coordinators demonstrate compassion and empathy, providing support and encouragement to navigate the healthcare system. Renal Service Coordinators partner with the patient to improve their health outcomes, such as by reducing hospitalization. The Renal Service Coordinators work in collaboration with the Nurse Case Managers, as they are assigned a variety of care coordination tasks.
The work you will do:
- In collaboration with the Nurse Case Manager, the RSC telephonically coordinates the care and follow-up for late-stage Chronic Kidney Disease (CKD) patients to ensure a planned transition into Renal Replacement Therapy (RRT)
- The RSC will provide assistance with scheduling resources and care coordination services needed to provide specialized care.
- The RSC coordinates late-stage CKD education, vascular access management, and treatment option initiatives that improve patient outcomes and reduce patient hospitalizations.
The skills and qualifications you need:
- One to two years of related experience in clinical patient care or case management required.
- A combination of hemodialysis, PD, transplantation, CKD education, case management, and Transplant nutritional training is highly valued.
- Excellent written and verbal communication skills.
- Ability to communicate and maintain effective interpersonal relationships at various levels of the organization.
- Must be highly self-motivated, dependable, organized with basic computer skills, and have a secure private office area that allows for protection of PHI.
- Must have adequate internet service allowing for a minimum of 20 MBPS Upload speed
Our mission is to reinvent healthcare to help patients live their best lives, and we proudly live our mission-driven values:
– We care deeply about the people we serve.
– We are better when we work together.
– Humility is a source of our strength.
– We bring joy to our work.
We are committed to diversity, equity, and inclusion throughout our recruiting practices. Everyone is welcome and included. We value our differences and learn from each other. Our team members come in all shapes, colors, and sizes. No matter how you identify your lifestyle, creed, or fandom, we value everyone’s unique journey.
Oh, and one more thing … a recent study shows that men apply for a job or promotion when they meet only 60% of the qualifications, but women and other marginalized groups apply only if they meet 100% of them. So, if you think you’d be a great fit, but don’t necessarily meet every single requirement on one of our job openings, please still apply. We’d love to consider your application!
APPLY HERE
by twochickswithasidehustle | Jun 25, 2023 | Uncategorized
Interwell Health is a kidney care management company that partners with physicians on its mission to reimagine healthcare—with the expertise, scale, compassion, and vision to set the standard for the industry and help patients live their best lives. We are on a mission to help people and we know the work we do changes their lives. If there is a better way, we will create it. So, if our mission speaks to you, join us!
Clinical Documentation reviewer will assist risk adjustment manager in data collection, and reporting of relevant data to support the chart review accurate coding program. The position will collaborate with risk adjustment team for education and improvement plans to ensure optimal documentation and program effectiveness while adhering to the IWH corporate compliance programs and following regulatory requirements.
The work you will do:
- Evaluate chart review performance and provide analysis to assist physicians and/or staff in improving and supporting coding and documentation best practices.
- Assist with Practice Support of Chart Review Process and Education
- Identify areas of improvement that will be used to plan provider education and create action plans for practices to address deficiencies.
- Prepare documents to present to practices or for follow-ups such as chart note examples, provider documentation trends, provider educational materials or coding guidelines
- Develop provider educational materials and tools to support providers in improving coding accuracy and specific documentation to capture patient severity of illness (presentations, webinars, audit trends, flyers, and coding tip sheets, etc.)
- Provide coding education to physicians, advanced practitioners, staff as needed
- Ensure compliance with all applicable federal, state and/or county laws and regulations related to coding and documentation guidelines for risk adjustment.
- Promotes transparency and collaborates with project team members to ensure effective coordination
The skills and qualifications you need:
- Certified Professional Coder (CPC).
- Certified Risk Adjustment Coder (CRC) Preferred.
- Bachelor’s degree in related field of study preferred.
- 3+ years of experience with Risk Adjustment HCC coding or abstraction.
- 2+ years of ICD-10 Coding, Chart Review Auditing.
- Comprehensive understanding of HCC coding rules & regulations.
- Excel, Word, PowerPoint. Must be proficient with Excel functions to develop data trends (pivot tables, graphs, etc).
Our mission is to reinvent healthcare to help patients live their best lives, and we proudly live our mission-driven values:
– We care deeply about the people we serve.
– We are better when we work together.
– Humility is a source of our strength.
– We bring joy to our work.
We are committed to diversity, equity, and inclusion throughout our recruiting practices. Everyone is welcome and included. We value our differences and learn from each other. Our team members come in all shapes, colors, and sizes. No matter how you identify your lifestyle, creed, or fandom, we value everyone’s unique journey.
Oh, and one more thing … a recent study shows that men apply for a job or promotion when they meet only 60% of the qualifications, but women and other marginalized groups apply only if they meet 100% of them. So, if you think you’d be a great fit, but don’t necessarily meet every single requirement on one of our job openings, please still apply. We’d love to consider your application!
APPLY HERE
by twochickswithasidehustle | Jun 25, 2023 | Uncategorized
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Administrative Assistant II- REMOTE
Job Description SummaryProvides administrative support to managers and work groups. Works independently and handles a wide variety of office duties and special projects.
(SUPPORT LEVEL: TLA5)
Job Description
- Answers the telephone and screens incoming calls and communications.
- Personally answers questions and communications (written and/or electronic) within scope of assigned responsibility and departmental/company guidelines.
- Forwards other more complex questions or correspondence, along with appropriate documentation, to manager or other appropriate staff member.
- Independently handles a wide variety of general office procedures and administrative duties such as setting-up and maintaining filing systems, composing and proofreading documents, collecting and compiling data, and coordinating the flow of reports, invoices, or records.
- Maintains schedules and coordinates meeting with multiple staff members.
- Uses word-processing, spreadsheet software, or graphics software to create detailed presentations or confidential documents.
- May maintain, manipulate or utilize a moderately complex computerized database and/or spreadsheet to record and compile data.
- Coordinates or independently completes special projects according to managers general instructions.
- May assist manager or other staff members with more complex and detailed projects
- Composes, prepares and signs routine, non-technical correspondence in own or supervisors name.
- Performs other general office duties as assigned.
Responsibilities
- 4+ years of administrative assistant experience.
- Ability to type an average of 40 WPM.
- Ability to multi task and meet deadlines.
- Ability to understand and follow instructions, policies and procedures.
- Demonstrated history of reliability and punctuality.
- Demonstrated proficiency with Microsoft Office Product Suite (Word, Excel, PowerPoint). Ability to quickly learn and use new software applications as needed.
- Maintain a positive attitude with excellent interpersonal skills.
- Maintain sensitive and confidential information.
- Must be flexible and adaptable to change.
- Organized with strong attention to detail.
- Strong verbal and written communication skills, both in person and on the telephone.
Work Experience
Work Experience – Required:Administrative Support
Work Experience – Preferred:
Education
Education – Required:GED, High School
Education – Preferred:Bachelors
Certifications
Certifications – Required:
Certifications – Preferred:Potential pay for this position ranges from $20.36 – $30.53 based on experience and skills. Pay range may vary by 8% depending on applicant location.
APPLY HERE
Recent Comments