You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform clinical/coding medical claim review to ensure compliance with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history, state regulations, contractual obligations, corporate policies and procedures and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services.
Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion
Review medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review
Review cases with Medical Director to validate decisions and identify opportunities to create medical policy in the absence of guidelines
Assist with research of health plan coding questions
Identify potential billing errors, abuse, and fraud
Identify opportunities to flag potential cases which may warrant a prepayment review (versus an automatic system denial or payment)
Education/Experience: Associate’s degree in related field or equivalent experience. Coding certification and 2+ years of experience in medical billing & coding, coding/data analysis, accounting/business or physician/hospital data management or RN/LPN and 2+ years of related clinical experience. Experience in provider communication and education preferred.
License/Certification: LPN, RN, CPC, CPC-H, CPC-P, CPC-A, CCS, CCS-P, RHIT, RHIA, CPMA, or ParamedicPay Range: $26.50 – $47.59 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Baptist Health Medical Group is looking for an A/R Representative to join our team. This is a remote position that requires residency in KY or IN
Under the direction of the Medical Group’s CBO Supervisors and Managers, the A/R Rep is responsible for CBO related duties such as billing, follow-up, claim edits, credits, provider enrollment review, and other billing-related projects, cash posting and payer underpayment resolution, customer service, and/or administrative functions.
Essential Duties:
Consistently manage and prioritize claim edit work queues to ensure all accounts are corrected and submitted timely and accurately.
Review previous notes, correspondence, and document actions taken on account in the Practice Management System.
Follows up on unpaid claims, identifies overpayments, and initiates refunds and adjustment process to ensure accurate and timely submission.
Perform account reconciliations and analysis to ensure accuracy and completeness of invoices.
Maintains working knowledge of payor policies applicable to assigned work group.
Works closely with the supervisor or manager in the department to report denial trends and follow up with the payer.
Works Customer Service inquiries from patients and others to include written requests, emails, and/or answer phones.
Works with all other revenue cycle departments and practices to resolve any outstanding encounters
Maintain productivity and quality standards as set by CBO leadership.
Maintains an acceptable average “Quality Review” score as set by CBO quality and productivity policy.
Maintains an acceptable productivity average of 90% or greater.
Maintains working knowledge of payor policies applicable to assigned work group.
Maintain billing/coding knowledge of assigned specialty and identify trends to report up to leadership.
Minimum Education, Experience, Training and Licensures Required
High school graduate or GED certificate required; Associate degree preferred
3+ years of Ambulatory/Provider Billing in a multi-specialty practice preferred
1-2 years EPIC Practice Management experience preferred
Proficient with standard Windows applications (e.g., MS Office application suite, advanced skilled using MS Excel functions)
High level proficiency in use of basic computer applications (e.g., Internet Explorer, word processing, email applications)
Advanced keyboarding skills
Monday-Friday, 1st shift
If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!
A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote work options. If you’re looking to leverage your abilities – you belong at Banner Health.
Looking for a motivated, experienced Inpatient Facility | Acute Care | Remote Medical Complex Coder, with CPC or CCS and/or RHIT or RHIA Certifications, to join our talented Acute Care HIMS Coding Team. Candidate should have experience coding all service lines including, but not limited to: Trauma, ICU, Cardiac, Transplant, Orthopedics, High-Risk OB, NICU, and more. Must have ICD-10-PCS coding experience, and ideally 3+ years experience coding in an acute care facility coding setting.
Banner Health uses the number of accounts for specific patient types and specialties in combination with the Case Mix Index and case financial information to formulate productivity standards, which are currently more stringent than most national standards identified. Quality standards are set at a DRG accuracy rate of 95% or higher among other quality measures. Meeting Accounts Receivable goals supports Banner Financial goals.
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, MD,MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY.
The hours are flexible as we have remote Coders across the Nation. Generally any 8-hour period between 7am – 7pm can work, with production being the greatest emphasis.
A Coding Assessment will be given after a successful interview to be completed within 48 hours. Banner Health provides your equipment when hired. You will be fully supported in during initial training by both the Banner Coding Education team and your hiring manager, with continued support throughout your career here!
*This position is for facility-based inpatient coding. Interested in Outpatient and/or Physician coding? Check some of our other Coder positions!
POSITION SUMMARY Provides coding and abstracting for mid-tiered complexity range of acute care services at all Banner hospitals. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or procedures on inpatient records using ICD CM and PCS coding classification systems. Completes MS-DRG and APR-DRG assignments on inpatient records as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.
CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides timely and accurate coding in accordance to department specific productivity and quality standards thorough assignment of ICD CM and PCS codes, MS-DRGs, APR-DRGs and POAs for mid-tiered complexity range of acute care services at all Banner hospitals.
2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the patient encounter. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists. Refers inconsistent patient treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment.
3. Provides coding quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards. Ability to address related and complex matters independently with regard to interpretation of coding guidelines.
4. May provide mentoring for less experienced staff members.
5. Works under general supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address related and complex matters independently with regard to interpretation of coding guidelines prior to referral to senior manager, educator or Coding Quality Analyst.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge and specialized formal training in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a health care field.
Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).
Requires three or more years of inpatient coding experience in Acute Care inpatient facility or healthcare system.
Must demonstrate a level of knowledge and understanding of ICD CM and PCS coding principles as recommended by the American Health Information Management Association coding competencies.
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems.
PREFERRED QUALIFICATIONS
Associates degree in a job-related field or experience equivalent to same.
Previous experience in large, multi-system healthcare organization.
Additional related education and/or experience preferred.
Department:UW MEDICINE ENTERPRISE RECORDS & HEALTH INFOJob Location:Remote/HybridPosting Date:01/22/2025 Closing Info:Closes On 02/22/2025Salary:$5,749 – $8,228 per month Other Compensation: Union Position:YesShift:First Shift Benefits:As a UW employee, you will enjoy generous benefits and work/life programs. For a complete description of our benefits for this position, click here.
UW Medicine Enterprise Records and Health Information has an outstanding opportunity for an INPATIENT CODER.
WORK SCHEDULE 100% FTE, Days Mondays – Fridays 100% Remote
POSITION HIGHLIGHTS Implements the mission and goals of Enterprise Records and Health Information, and incorporating a “patients are first” service culture. Performs daily activities related to of abstract Diagnosis Related Group (DRG) coding and billing Analyzes the medical record to assign International Classification of Diseases (ICD), Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines
DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding, billing, release, and tracking to management of access, retention, and destruction. ERHI provides advice and resources related to the lifecycle management of all UW Medicine records ERHI is an integral part of the Enterprise Revenue Cycle and has a unique role in the organization that supports both clinical and operational activities
PRIMARY JOB RESPONSIBILITIES Performs chart analysis and assigns ICD-CM and ICD-PCS codes using 3M computer assisted coding (CAC) to compute the final DRG assignment to diagnoses and procedures in an integrated system to ensure the appropriate coding for the facility inpatient billing and reimbursement Reviews patient records upon admission and at discharge to the inpatient Rehabilitation Unit; assigns codes to each record to assure proper Case Mix Group (CMG) assignment and appropriate reimbursement to the facility for Medicare Rehab patients Abstracts and/or reviews necessary patient data within 3M CAC and Cerner to ensure data integrity, accurate reimbursement, proper case mix and hospital decision support. Identifies the need for documentation clarity and works with the Clinical Documentation Improvement (CDI) department to review clinical documentation and/or request provider documentation clarification Maintains four day turnaround times for inpatient coding based on the discharge date and understand charge lag impacts, especially for high dollar accounts and long length of stays (LOS).
REQUIRED POSITION QUALIFICATIONS High school diploma or equivalent and three years of coding experience or equivalent education/experience. Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC).
UW Medicine – Where your Impact Goes Further UW Medicine is Washington’s only health system that includes a top-rated medical school and an internationally recognized research center. UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.
All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored. Nearly 29,000 healthcare professionals, researchers, and educators work in the UW Medicine family of organizations that includes: Harborview Medical Center, UW Medical Center – Montlake, UW Medical Center – Northwest, Valley Medical Center, UW Medicine Primary Care, UW Physicians, UW School of Medicine, and Airlift Northwest.
Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.The University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or [email protected].Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.
At Ping Identity, we believe in making digital experiences both secure and seamless for all users, without compromise. We call this digital freedom. And it’s not just something we provide our customers. It’s something that inspires our company. People don’t come here to join a culture that’s built on digital freedom. They come to cultivate it.
Our intelligent, cloud identity platform lets people shop, work, bank, and interact wherever and however they want. Without friction. Without fear.
While protecting digital identities is at the core of our technology, protecting individual identities is at the core of our culture. We champion every identity. One of our core values, Respect Individuality, reminds us to celebrate differences so you are empowered to bring your authentic self to work.
We’re headquartered in Denver, Colorado and we have offices and employees around the globe. We serve the largest, most demanding enterprises worldwide, including more than half of the Fortune 100. At Ping Identity, we’re changing the way people and businesses think about cybersecurity, digital experiences, and identity and access management.
Job Summary
Ping Identity is seeking a senior-level technical writer to join our extraordinary documentation team. Reporting to one of the technical documentation managers, you’ll be working on technical content for various audiences within a Docs-as-Code environment.
You will:
Collaborate with subject matter experts, engineers, and product teams to define, design, create, and maintain core documentation for Ping Identity’s products and services
Deliver documentation for cloud-based services and on-premise software aimed at different audiences, including end-users, admins, developers, integrators, and DevOps
Investigate, research, and learn our products and the standards they depend on
Translate complex technical concepts into clear, concise, and user-friendly content, including real-life examples and use cases
Work with AsciiDoc in a Docs-as-Code authoring and publishing environment using git
Follow the software development life cycle process closely to anticipate and ascertain documentation needs
You have:
At least five years spent technical writing, preferably in a senior role
Experience with markdown languages, version control tools, and integrated development environments (IDEs)
Experience managing multiple projects simultaneously, meeting deadlines and quality standards with minimal supervision
Ability to learn unfinished, new, complex software fast with little help
Prior experience or exposure to software development, including familiarity with Agile development methodologies
Experience with Jira and Confluence or similar project management platforms
Demonstrated ability to collaborate effectively face to face and remotely
You have the advantage if you have experience:
Working in a Docs-as-Code environment
Scripting/programming, such as Java, Bash, Python, or JavaScript
Working with command-line tools
Building, installing, configuring, and debugging client and server software
Documenting identity and access management applications for power users
Documenting for a developer audience, especially API documentation
Adapting and demonstrating a willingness to learn new technologies and tools
Working with graphic design tools for creating visual aids
$120,000 – $140,000
In accordance with Colorado’s Equal Pay for Equal Work Act (SB 19-085) the approximate compensation range for this role in Colorado is listed above. Final compensation for this role will be determined by various factors, such as knowledge, skills, and abilities.
Life at Ping:
We believe in and facilitate a flexible, collaborative work environment. We’re growing quickly, but remain true to the innovative, can-do startup values that got us here. Most importantly, we keep hiring talented, smart, fun, and genuinely nice people because that’s who we want to succeed with every day.
Here are just a few of the things that make Ping special:
A company culture that empowers you to do your best work.
Employee Resource Groups that create a sense of belonging for everyone.
Regular company and team bonding events.
Competitive benefits and perks.
Global volunteering and community initiatives
Our Benefits:
Generous PTO & Holiday Schedule
Parental Leave
Progressive Healthcare Options
Retirement Programs
Opportunity for Education Reimbursement
Commuter Offset (Specific locations)
Ping is the collective sum of all our individual experiences, backgrounds and influences and we pride ourselves in growing and learning together. We are committed to building an inclusive and diverse environment where everyone’s individuality is respected and everyone has an Identity. In recruiting for new colleagues, we welcome the unique contributions you can bring and encourage you to be your best self.
We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
At Ping Identity, we believe in making digital experiences both secure and seamless for all users, without compromise. We call this digital freedom. And it’s not just something we provide our customers. It’s something that inspires our company. People don’t come here to join a culture that’s built on digital freedom. They come to cultivate it.
Our intelligent, cloud identity platform lets people shop, work, bank, and interact wherever and however they want. Without friction. Without fear.
While protecting digital identities is at the core of our technology, protecting individual identities is at the core of our culture. We champion every identity. One of our core values, Respect Individuality, reminds us to celebrate differences so you are empowered to bring your authentic self to work.
We’re headquartered in Denver, Colorado and we have offices and employees around the globe. We serve the largest, most demanding enterprises worldwide, including more than half of the Fortune 100. At Ping Identity, we’re changing the way people and businesses think about cybersecurity, digital experiences, and identity and access management.
Job Summary
Ping Identity is seeking a Technical Writer III to join our extraordinary documentation team. Reporting to one of the technical documentation managers, you’ll be working on technical content for various audiences within a Docs-as-Code environment.
You will:
Collaborate with subject matter experts, engineers, and product teams to define, design, create, and maintain core documentation for Ping Identity’s products and services
Deliver documentation for cloud-based services and on-premise software aimed at different audiences, including end-users, admins, developers, integrators, and DevOps
Investigate, research, and learn our products and the standards they depend on
Translate complex technical concepts into clear, concise, and user-friendly content, including real-life examples and use cases
Work with AsciiDoc in a Docs-as-Code authoring and publishing environment using Git
Follow the software development life cycle process closely to anticipate and ascertain documentation needs
You have:
At least three years spent technical writing
Experience with markdown languages, version control tools, and integrated development environments (IDEs)
Experience managing multiple projects simultaneously, meeting deadlines and quality standards with minimal supervision
Ability to learn unfinished, new, complex software fast with little help
Prior experience or exposure to software development, including familiarity with Agile development methodologies
Experience with Jira and Confluence or similar project management platforms
Demonstrated ability to collaborate effectively face to face and remotely
You have the advantage if you have experience:
Working in a Docs-as-Code environment
Scripting/programming, such as Java, Bash, Python, or JavaScript
Building, installing, configuring, and debugging client and server software
Documenting identity and access management applications for power users
Documenting for a developer audience, especially API documentation
Adapting and demonstrating a willingness to learn new technologies and tools
$90,000 – $110,000
In accordance with Colorado’s Equal Pay for Equal Work Act (SB 19-085) the approximate compensation range for this role in Colorado is listed above. Final compensation for this role will be determined by various factors, such as knowledge, skills, and abilities.
Life at Ping:
We believe in and facilitate a flexible, collaborative work environment. We’re growing quickly, but remain true to the innovative, can-do startup values that got us here. Most importantly, we keep hiring talented, smart, fun, and genuinely nice people because that’s who we want to succeed with every day.
Here are just a few of the things that make Ping special:
A company culture that empowers you to do your best work.
Employee Resource Groups that create a sense of belonging for everyone.
Regular company and team bonding events.
Competitive benefits and perks.
Global volunteering and community initiatives
Our Benefits:
Generous PTO & Holiday Schedule
Parental Leave
Progressive Healthcare Options
Retirement Programs
Opportunity for Education Reimbursement
Commuter Offset (Specific locations)
Ping is the collective sum of all our individual experiences, backgrounds and influences and we pride ourselves in growing and learning together. We are committed to building an inclusive and diverse environment where everyone’s individuality is respected and everyone has an Identity. In recruiting for new colleagues, we welcome the unique contributions you can bring and encourage you to be your best self.
We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
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