by Irma Moore | Feb 12, 2025 | Uncategorized
Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility.
This job is REMOTE.
FTE: 1.000000
Shift: Shift 1
Job Summary:
The Clinical Documentation Specialist is an experienced Clinical Documentation Nurse who has obtained knowledge and expertise in all patient populations across the enterprise to provide comprehensive Clinical Documentation Integrity (CDI) chart reviews. Facilitates modifications to clinical documentation to ensure appropriate reimbursement is received for the level of service rendered. Ensures the accuracy and completeness of clinical information used for measuring and reporting clinical and quality outcomes.
EXPERIENCE DESCRIPTION:
A minimum of 5 years of acute care nursing experience is required. A minimum of 1 year of CDI experience in a hospital setting is required.
EDUCATION DESCRIPTION:
Bachelor Degree in Nursing.
SPECIAL SKILLS DESCRIPTION:
Efficient use of MS Office products (Excel, Outlook, Word), WebEx and Epic (or similar EMR). Excellent communication, negotiation, troubleshooting, and presentation skills. Ability to read and correlate an extensive variety of medical / surgical medical treatments and monitoring to clinical conditions. Ability to interact with all levels of organization. Ability to document and maintain process documentation. Excellent follow-through from initiation to conclusion. Working knowledge related to MSDRG and APRDRG payer trends and rules. Working knowledge related DRG and CMI impacts. Working knowledge of coding guidelines and coding clinics.
LICENSURE DESCRIPTION:
Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact). Advanced certification related to CDI (CCDS, CDIP) is preferred.
Perks & Benefits at Froedtert Health
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:
- Paid time off
- Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
- Academic Partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan – 403b
- Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
- Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin’s only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.
by Irma Moore | Feb 12, 2025 | Uncategorized
- Employees can work remotely
- Company Description
- Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
- Job Description
- Under indirect supervision, the Coding Compliance Audit/Education Specialist audits medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines.
- Conduct audits (i.e. baseline, routine periodic, and focused) comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes with consideration of applicable federal and state laws, regulations, and guidelines.
- Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
- Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.
- Preparation of audit reports including summary of findings
- Conduct post-audit provider education with individual or large provider groups
- Schedule trainings with provider’s offices, individual providers and groups of providers
- Provides feedback, initial and ongoing education and training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision, timely submission, healthcare data accuracy, and coding principles.
- Communicates audit findings to providers to track education completion and escalation.
- Interacts professionally and effectively with physicians, leaders, staff, and internal teams.
- Provides coding assessment, consultation, education, and issue resolution to key stakeholders as requested.
- Able to have honest, difficult conversations with providers about compliance, documentation, and code assignment.
- Other duties as assigned
- Qualifications
- 5+ years of audit and provider education experience is preferred.
- Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines.
- Certified Professional Coder (CPC) and Certified Professional Medical Auditor (CPMA) required.
- Experience working with MDAudit and Athena is a plus.
- Must comply with all HIPAA rules and regulations.
- Excellent communication skills and the ability to work independently.
- The salary range for this role is $70,000.00 to $80,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
- Additional Information
- All your information will be kept confidential according to EEO guidelines.
- Technical Requirements (for remote workers only, not applicable for onsite/in office work):
- In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
- Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
by Irma Moore | Feb 12, 2025 | Uncategorized
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!
Job Title:
Medical Coder-Professional Surgical (Remote)
Cost Center:
101651260 System Support-Professional Coding
Scheduled Weekly Hours:
40
Employee Type:
Regular
Work Shift:
Mon-Fri; day shifts (United States of America)
Job Description:
JOB SUMMARY
The Medical Coder – Professional Surgical reviews, analyzes and assigns current international classification of disease (ICD) diagnosis codes, current procedural terminology (CPT) codes and other charges as appropriate to include, but not limited to anesthesia, clinic, bedside procedures, minor procedures, scope procedures, pain clinic, oral surgery procedures, all specialty outpatient and inpatient surgeries. The Medical Coder-Professional Surgical understands and applies applicable medical terminology, anatomy, physiology, surgical technology, pharmacology, and disease processes.
JOB QUALIFICATIONS
EDUCATION
For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.
Minimum Required: Successful completion of the following courses per department procedures, within one year of hire: current international classification of diseases (ICD), current procedural terminology (CPT) health care procedure coding system (HCPCS) or the Coding Basics computer based training and medical terminology or Coding certification.
Preferred/Optional: Associate degree in Medical Billing and Coding, Health Information Management or related field.
EXPERIENCE
Minimum Required: Experience working within medical field, medical records or, current procedural terminology (CPT) and health care procedure coding system (HCPCS).
Preferred/Optional: Experience in physician/professional surgical coding.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required: Coding certification awarded by the American Academy of Professional Coders (Certified Professional Coder (CPC) American Health Information Management Association (Certified Coding Specialist (CCS) or Certified Coding Specialist-Professional (CCS-P), within three years of hire.
Preferred/Optional: Coding certification awarded by the American Academy of Professional Coders (Certified Professional Coder (CPC), American Health Information Management Association (Certified Coding Specialist (CCS) or Certified Coding Specialist-Professional (CCS-P), at time of hire.
Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states:
Alabama
Alaska
Arkansas
Florida
Georgia
Idaho
Illinois (except Chicago)
Indiana
Iowa
Kansas
Kentucky
Michigan
Minnesota
Mississippi
Missouri
Nebraska
North Carolina
North Dakota
Ohio
Oklahoma
South Carolina
South Dakota
Tennessee
Texas
Utah
West Virginia
Wisconsin
Wyoming
Marshfield Clinic Health System will not employ individuals living in states not listed above.
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
by Irma Moore | Feb 12, 2025 | Uncategorized
Description
Position at GoHealth Urgent Care
JOB SUMMARY
Under limited supervision, the Coding Leads work with the Manager in the daily operations of the Coding Department. Works with Coders in answering questions and follow up emails to providers. Maintains department spreadsheets. Review, analyze and assign final EM levels, any office procedures and all diagnoses reflected in the provider chart notes according to CMS guidelines and GoHealth UC protocols. Works with our partners and markets to resolve problems, research new programs, updates protocols. Helps train new coders.
JOB REQUIREMENTS
Education
High School Diploma or GED required
Associate degree preferred
Work Experience Required
Minimum of 5 years outpatient EM/office procedure coding
Minimum 1 year working with coders in auditing/education
Knowledge of revenue cycle
Required Licenses/Certifications
Medical Coding Certificate – RHIT or CPC certification
CD10 Proficiency
Additional Knowledge, Skills and Abilities Required – Federal laws and regulations affecting coding requirements:
Working knowledge of payor guidelines, ie-modifier usage, timely filing
Strong Knowledge of Excel
Knowledge of billing practices
Denial Management
Knowledge of Epic and eCW EMR required
Excellent Communication Skills
Additional Knowledge, Skills, and Abilities Preferred:
Experience working with computer assisted coding
ESSENTIAL FUNCTIONS
Duties May Include:
• Point person for the Market Specialists, outsourced coding and CAC emails and questions
• Review and analyze CAC and Market processes for continued department improvement.
• Point person for research in new market programs and processes that include coding changes.
• Review’s pending WQ’s for timely follow up by coders.
• Review Code Correct Errors for trends. Report patterns and potential coding changes.
• Trains new coders in each Market and CAC system.
• Works with off shore team to ensure GH processes and protocols are followed.
• Maintains Market Specific Guide’s and ensure contact list is up to date in the assigned Market.
• Works to ensure a smooth process in each Market
• Meets weekly with the Market Specialist, keeps ticket spreadsheet current w/in 2 weeks.
• Accurately follows CMS coding guidelines and GoHealth Protocols to ensure compliance with federal and state regulatory bodies
• Alerts Coding Manager to any market trends for additional coder/provider training
• Provide feedback to Coding Manager on any Market issues
• Reviews Coder Time/Productivity Quarterly as sent by Manager
• Is the Coder point person for coding/GH Process Questions.
• Approves all Time Off and ensures the coders add their time off to the Coders Time Off Calendar.
• Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct. Reports compliance problems appropriately.
• Meets with Manger/Coders to review yearly goals.
• Maintains Coder productivity spreadsheets.
• Codes weekly in each of the assigned Markets
• Attends seminars and in-services as required to remain current on coding issues
• Maintain current coding certificate
• Performs other related duties as assigned
by Irma Moore | Feb 12, 2025 | 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.
The Clinical Coding Analyst researches and interprets healthcare correct coding using regulatory requirements and guidance related to CMS, CPT/AMA and other major payer policies. They also use internal business rules to prepare written documentation of findings through medical record review. The Coding Analyst possesses an overall understanding of all coding principles, including facility and physician coding and provides health care payers with a total claim management solution. Typically, 90% of a Coding Analyst’s time is spent performing coding and documentation review and 10% spent performing other tasks as assigned.
This position is full-time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 6:00pm. It may be necessary, given the business need, to work occasional overtime.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Conduct coding reviews of medical records and supporting documentation against submitted claims, for individual provider and facility claims, to determine coding and billing accurate for all products
- Process and/or review claims in a timely manner utilizing client specific coding and billing requirements that meet or exceed production and quality goals
- Participate in process improvement activities and encourage ownership of and group participation in improvement initiatives
- Analyze medical documents to evaluate potential issues of fraud and abuse
- Document coding review findings within investigative case tracking system and maintains thorough and objective documentation of findings
- Serve as a coding resource and provide coding expertise and guidance to entire investigation team
- Identify and recommend opportunities for cost savings and improving outcomes
- Coordinate activities with varying levels of leadership including the investigative team, legal counsel, internal and external customers, law enforcement and regulatory agencies, and medical professionals through effective verbal and written communications as needed
- Research and interpret correct coding guidelines and internal business rules to respond to customer inquiries, and monitors CMS and major payer coding and reimbursement policies
- Must be able to take and pass Coding Assessment
What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at: http://uhg.hr/uhgbenefits
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- High School Diploma / GED (or higher)
- Must have one or more of the following coding credentials: RHIA, RHIT, CCS-P, CCS, CPC, or COC
- 3+ years of experience in medical coding with primary focus in facility and physician coding
- 3+ years of experience in reviewing, analyzing, and researching coding issues.
- Intermediate level of proficiency in Microsoft Office skills including Outlook, Excel, and Word (Open/Edit/Create/Save/Send)
- Ability to work full-time, Monday – Friday between 6:00am – 6:00pm including the flexibility to work occasional overtime given the business need
Preferred Qualification:
- Associate Degree (or higher) OR equivalent in Health Information Management
- Experience with reimbursement policy and/or claims
Telecommuting Requirements:
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
- Self-starting and independent, able to stay focused while working remotely
- Ability to establish good customer relationships with trust and respect
- High level of attention to written communication
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $23.70 to $46.35 per hour based on full-time employment. 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.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
by Irma Moore | Feb 12, 2025 | Uncategorized
Planet Technologies, the Nation’s leading Microsoft services provider to the public sector, is looking for a highly motivated individual to join our growing team as a Help Desk Specialist, Dynamics. In this role, you will be supporting impactful projects that benefit our country.
The Help Desk Specialist will provide CRM and Non-CRM Tier 2/Tier 3 Support services, troubleshoot, analyze, maintain, and manage software applications, including custom Microsoft .Net applications using Microsoft SQL Server Reporting Services (SSRS) Reports and Microsoft Dynamics CRM framework).
Responsibilities
- Resolve reported customer support issues in accordance with service level agreements.
- Maintain and support legacy data synchronization between CRM and legacy non-CRM-based systems.
- Support, troubleshoot, analyze, maintain, and manage software applications, including highly customized Dynamics CRM-based systems.
- Perform Dynamics CRM migration services (i.e. migrate from CRM 365 on premise to the next available framework version on premise or in cloud).
- Troubleshoot and analyze data and data integrations issues related to SQL Server, Dynamics CRM and Oracle-based systems.
- Manage access into the CRM environment, including management of CRM licenses and user accounts.
- Maintain and support browser-based online customer Portals and third party developed custom plug-ins associated with Dynamics CRM applications.
- Troubleshoot and analyze data and data integrations issues related to SQL Server and Oracle-based systems.
- Interact and work with Tiers 1 & 3 support, infrastructure teams and customers to resolve reported support issues.
- Perform Queue Manager function in TrackIt or its upcoming replacement.
- Timely update all assigned helpdesk tickets and ensure adherence to the pending SLAs.
- Design artifacts that follow the technical standards and guidelines established.
- Work with team members to define solutions and implement those solutions according to the COR approved design.
- Support global infrastructure and system patching.
- Actively transfer knowledge to other members of the support team.
- Troubleshoot on average of 80 help-desk requests per week.
Skills Required
- Experience providing Dynamics CRM Tier 2/Tier 3 Support services in a remote-based Call center environment
- Ability to support, troubleshoot, analyze, maintain, and manage software applications, including highly customized Dynamics CRM-based systems.
- Previous experience with Dynamics CRM migration services (migrate from CRM 365 on premise or in cloud).
- Experience working in a Queue Manager function like TrackIt or other automated systems
- Proven success adhering to helpdesk SLA’s, supporting internal customers effectively in a timely manner and tracking artifacts
- Collaborative working relationship with other support team members and the knowledge of when and how to escalate
Planet Technologies is the leading provider of Microsoft Consulting Services to public sector and commercial organizations. Planet has significant experience in deploying business intelligence, cloud services, unified communications, and systems management with an emphasis building, deploying, and managing custom solutions that transform the business operations of federal government agencies.
Planet Technologies does not discriminate in employment opportunities, terms and conditions of employment, or practices. All qualified applicants will receive consideration for employment without regard to race, age, gender, religious or political beliefs, national origin or heritage, disability, sexual orientation, protected veteran status, or any characteristic protected by law. Federal Agency Clearance Requirements may require up to a 10-year background investigation – US Citizenship (clearable) is required.
Salaries for Support positions at Planet Technologies range from $60,000 and $130,000. Several factors will impact final pay offered to a successful candidate including but not limited to the type and years of experience within the job, clearance level, the type of years and experience within the industry, education, training, etc.
Visit www.go-planet.com to learn more about us. Details about our benefits can be found here Planet Technologies Benefits Guide 2024-2025.
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