Payment Receipts Specialist – Cash Posting (Remote: OR, WA, AK)

by Irma Moore | Jan 14, 2025 | Uncategorized

PeaceHealth is seeking a Payment Receipts Specialist – Cash Posting for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $18.76 – $28.14. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Must live in Oregon, Washington or Alaska.

Job Summary

Responsible for performing payment related tasks using a manual and/or computerized system which involves receiving, distributing, transferring, and accounting for funds; receipt of payments by cash, checks, credit card, electronic funds transfer.

Details of the position

• Performs daily cash posting and reconciliation of payments, adjustments and rejections from private and third-party payors.
• Performs reconciliation of accounts receivable and payment posting.
• Prepares deposits in accordance with departmental procedures.
• Processes and monitors the electronic remittance files to ensure accuracy.
• Maintains and/or enforce security procedures to ensure safety of funds.
• May research and resolve credit balances that occur due to overpayment at the time of posting.
• May assist customers by answering inquiries and providing information.
• Assists with departmental coverage as needed.
• Performs other duties as assigned.

What you bring

• High School Diploma Preferred: or equivalent
• Minimum of 2 years Required: Experience in medical office, billing or insurance account follow-up

Skills

• Billing/ Payment posting, provider level adjustments (Required)
• Knowledge of insurance processes and billing guidelines and regulations (Required)
• Knowledge of payer EOBs/835s and bank lockbox processes (Required)
• Knowledge of insurance processes and billing guidelines regulations (Preferred)
• Proficiency in use of 10-key (Required)
• Proficient use of computers including MS Office applications and payer portals (Required)
• Knowledge of insurance and reimbursement policies (Required)
• Strong data entry skills (Required)
• Skills in problem solving, organizational and time management (Required)
• Knowledge of basic accounts skills (Required)
• Ability to work under pressure and meet deadlines (Required)
• Excellent verbal and written communication skills (Required)
• Excellent attention to detail and ability to multi-task and to handle high volume workload (Required)
• Ability to process and reconcile provider level adjustments (Required)
• Ability to effectively and accurately post payments to meet department deadlines (Required)
• Knowledge of banking lockbox processes (Required)
• Ability to manage complex accounts to resolve debit and credit balances, missing payments, and unposted cash (Required)
• Knowledge of major insurance products such as Medicare, Medicaid, Workers Compensation and Commercial payers (Required)
• Detail oriented (Required)
• Ability to work remotely with minimal oversight, independently, as well as in a collaborative team setting (Required)

Working Conditions

Lifting

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.

Mental/Visual

• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

Data Entry (Remote)

by Irma Moore | Jan 14, 2025 | Uncategorized

About ABC Legal Services:

ABC Legal Service is proud to be the national leader in filing service of legal documents. We are growing and are looking for talented new team members to support our growth and solve exciting challenges!

We are a team of over 400 with offices in Los Angeles, Phoenix, Oklahoma City, Brooklyn, Chicago, and more. Seattle is our home and headquarters. We’ve been successful in this unique business for over 30 years and we continue to advance our technology and business processes to remain years ahead of what our competition is able to offer.

Job Overview: 

The e-File Specialist reviews and files legal documents utilizing online platforms and tools developed by ABC Legal. This role works closely with the e-Fulfillment and e-Filing team to collaborate on projects, resolve issues as they arise and meet common goals. This position is remote but must be located in the United States. 

Key Responsibilities: 

• Review and file legal documents using internal systems and email
• Participate in ongoing training to expand knowledge of industry and process
• Investigate discrepancies as they arise
• Complete additional projects as assigned

Qualifications: 

• No experience necessary; data entry experience a plus 
• Tech experience is strongly preferred 
• Must be able to read, write, and speak English
• High school diploma or GED required
• Ability to perform repetitive tasks with accuracy
• Exceptional attention to detail
• Desire and ability to be a team player
• Experience and basic proficiency with Microsoft Office
• Typing speed of at 50 to 60 wpm 

We know that a company’s success starts with its employees. We also know that an individual’s success starts with the right career opportunity. Join our team today!

• Retirement plan with company matching
• Medical, Dental, and Vision insurance
• PTO 
• 11 paid holidays per year
• Referral program

Starting Pay: $14.00 to $18.00 per hour

Schedule: Full-time, Monday through Friday, 8am to 5pm PST 

Quality Officer III (Medicare)

by Irma Moore | Jan 14, 2025 | Uncategorized

The Quality Officer 3 is responsible for ensuring accuracy and integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher level skill set due to the complexity and risk relative to Medicare patients. Quality Officer 3 must also sustain an excellent organizational average accuracy rate. Adherance to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines set forth by RWJBH, American Hospital Association (AHA) and the American Medical Association (AMA) must be maintained.

Qualifications:

Required:

• Bachelor s degree or equivalent in experience.
  • 5+ years acute care coding and/or auditing experience with a concentration on inpatient Medicare records is required with a Bachelor s degree.
  • 9+ years acute coding and/or auditing experience required without a Bachelor s degree.
• Extensive knowledge of ICD-10-CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required.
• Knowledge of Medicare and Medicaid billing and coding regulations.
• Must have excellent interpersonal, oral, and written communication skills.
• Must be capable of critical thinking and analysis and written conveyance of same.
• Must have excellent organizational and time management skills.
• Must maintain a professional demeanor.
• Must be able to work independently and cooperatively with minimal supervision.
• Must foster positive relationships with fellow co-workers and the coding team.

Certifications and Licenses Required:

• CCS required
• ICD-I0-CM/PCS proficiency required.

Preferred:

• CPC-H, RHIT, RHIA and/or RN also encouraged.

Scheduling Requirements:

• Position is primarily remote with occasional onsite requirement.

Essential Functions:

• Ensures the accuracy and integrity of ICD-10-CM/PCS, CPT coding when applicable and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines.
• Critically analyzes each Medicare inpatient medical record to apply appropriate coding, DRG judgements, SOI, ROM and POA.
• Independently manages SMART pending queues for all acute care RWJBarnabas facilities. Reviews ICD-10-CM/PCS coding and DRG assignment of medical records as flagged by SMART.
• Independently manages EPIC SMART WQ s to assure proper workflow of identified accounts.
• Directs coders with appropriate case-specific recommendations. Educates and coaches coders in the application of coding principles, code assignment and sequencing, DRG assignment and clinical disease processes. Coding advice must be clearly and concisely written with appropriate clinical indicators cited. Additional facilities that may join the System receive the same education and coaching from the Quality Officers to ensure a unified methodology within the RWJBH organization. This results in improved outcomes in DRG assignment, coder education and DNB lag time within all facilities.
• Sustains an excellent organizational average accuracy rate by leveraging advanced knowledge of coding practices leading to exceptional results.
• The Quality Officer s coding analysis is reviewed by the Coding Specialists on a biannual basis. The consequences of incorrect judgments affecting the DRG may include an increased monitoring, until quality scores of 90% or better for two consecutive months are obtained. The consequences of incorrect coding resulting in erroneous DRGs includes under reporting and/or over reporting. Incorrect coding may result in an incorrect reporting of diagnoses and procedures to the patient s EHR which may affect the patient s future care, insurance claims and coverage. When accounts are not reviewed and released in a timely manner, there is a detrimental impact to the reimbursement flow for the facility (DNB).
• Productivity Standards must be met for all Quality Officers. Failure to meet productivity standards will result in progressive disciplinary action.
• Provides Guidance to Quality Officer 1 and 2 as requested.
• Independently monitors SMART queues to ensure all records imported by SMART are reviewed and properly directed, with/or without coding or other recommendations, or released to billing as appropriate and within department accepted timelines.
• Works as a team with other Quality Officers to ensure SMART review goals are met for all RWJBarnabas facilities.
• May review ICD-10-CM/PCS coding associated with RAC audits and/or other additional medical records as needed, and provides appropriate written feedback including rationale, research, and coding guidelines to management and/or the Coding Specialists.
• Reviews Discharge Status, Admission and Discharge Dates, and other related demographic information coded and entered by affiliate staff for accuracy and completeness. Communicates the need for Case Management review to the RWJBarnabas facilities when appropriate.
• Reviews Present on Admission (POA) indicators for all diagnosis coded and entered by coders for accuracy and completeness.
• Reviews Physician Queries submitted by staff for necessity, accuracy and completeness and communicate recommendations to the sites as appropriate.
• Participates in the review of other payers as directed.
• Independently reports problems with any and all computer system to RWJBarnabas IT&S or SMART helpdesk for resolution.
• May perform classroom training in ICD-10-CM/PCS and CPT coding for affiliate staff when needed at the internal RWJ Barnabas Coding School which may be held to train new facility coders.
• Maintains proper computer and written records of all review activity.
• Effectively communicates coding recommendations and rationale to Coding team.
• Performs regulatory coding research as needed.
• May be required to perform other related duties.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Additional Information:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered,

high-quality academic medicine in a compassionate and equitable manner, while delivering

a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer

Inpatient Hospital Coder (REMOTE) – $10,000 SIGN ON BONUS!

by Irma Moore | Jan 14, 2025 | Uncategorized

Description

Tenet Healthcare has immediate needs for remote, home-based Corporate Coders to support the hospital business. Corporate Coders can be based anywhere in the country with home internet access. Position will support the Tenet/USPI corporate office located in Dallas, TX.

The Corporate Coder (“CC”) functions under the direction of the Health Information Corporate Coding Manager. The CC is responsible for accurate coding and abstracting of clinical information from the medical record. The CC is responsible for maintaining standards for coding data quality and integrity, as well as productivity within established guidelines. The CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC’s and/or other projects where indicated.

*$10,000 SIGN ON BONUS + Quarterly incentive bonus based on productivity and quality!*

Requirements:

• Successful completion of at least one AHIMA (American Health Information Management Association) certified program with achievement of the correlating professional credential preferred (RHIA, RHIT, and / or CCS, etc.)
• Associates or higher-level degree in a Health Information Management discipline.
• Minimum of four years of Medicare inpatient acute care hospital experience
• Supervisory or team lead experience preferred
• Familiarity with 3M-360 software a plus
• This role requires excellent verbal and written communication skills

A pre-employment coding proficiency assessment will be administered.

Compensation

• Pay: $26.40-$39.00 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Observed holidays receive time and a half.

Benefits

The following benefits are available, subject to employment status:

• Medical, dental, vision, disability, AD&D and life insurance
• Paid time off (vacation & sick leave)
• Discretionary 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
• For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act is available.

Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

#LI-DM42403008688

Pay Range: $26.40 – $39.00 hourly **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

Actuarial Analyst – Remote

by Irma Moore | Jan 14, 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.

In joining the Optum Advisory Services Trend Analytics Consulting team: you will be part of a team that is leader in health care cost analytics, with a proven track record of supporting health plans across the country though a diverse staff of Actuaries, Data/Research Analysts, and Business/Technology Consultants.  Our consulting team has continued to expand capabilities and consulting presence by identifying, developing, and executing on new and exciting business opportunities.  

As a member of our high-performing team, you’ll help support Optum’s growth and financial goals while you help shape our future. As an Analytics Services Analyst, you will be empowered, supported, and encouraged to use your analytical expertise as you perform financial analysis and build models that improve health plan competitiveness. We offer a competitive study program with paid time off to study, expense reimbursement for study materials and pay raises for passing exams.

On our team you will have the opportunity to:

• Solve problems through issue identification, research and data gathering; Accurate and insightful analysis; Relevant and actionable recommendations
• Develop Written communications, persuasive presentations & compelling deliverables
• Build and leverage relationships with colleagues and clients

All while working in an environment that allows:

• Effective project & time management; Flexibility in your work schedule 
• Participation in team problem solving; Contribution to team effectiveness

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

Primary Responsibilities:

The analyst in this role will work with detailed health care claims data to build and maintain analytical models to support financial analysis; Help to identify root causes and proposing solutions on how to solve issues; Apply their technical skills to complex analyses to draw key insights that reflect an understanding of the overall consulting engagement;  Effectively create visually appealing, client-ready, and accurate deliverables; Successfully construct logical storylines and manage client questions in areas of content knowledge.

• Extract, analyze, aggregate, and interpret data
• Perform quantitative analysis of health care claims utilization and cost data
• Design, build, and maintain actuarial financial forecasting models
• Participate in client relationships and communications
• Prepare information for clients, build reports, and assist with project scheduling and coordination of tasks
• Develop, review, and analyze detailed data sets leveraged for client reporting/analytics
• Execute creative problem solving and critical thinking on the job
• Take accountability for work within a fast paced, exciting environment

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:

• Passed 1 or more Actuarial Exams
• Experience working with formulas, calculations, charts, graphs in MS Excel
• Ability to quickly learn and use computer software tools effectively
• Ability to complete new analyses by determining necessary steps without detailed instruction
• Reside in (or willing to relocate to) Minnesota and able to work out of the Optum Eden Prairie, MN office

Preferred Qualifications:

• Experience working in either SAS, SQL, Python, Power BI
• Actuarial experience and/or exposure in dealing with health care claims experience and/or Pharmacy claims experience (i.e. understanding of costs, expected claims, diagnosis codes, procedure codes, pharmacy terminology)
• Experience working in a consultancy or healthcare field
• Demonstrated ability to communicate effectively, including written and verbal forms of communication
• Proven analytical, organizational, and critical thinking skills
• Demonstrated flexibility to manage changing priorities/requirements/deadlines 

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

The salary range for this role is $59,500 to $116,600 annually 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.    

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.

Business or Data Analyst – Remote

by Irma Moore | Jan 14, 2025 | Uncategorized

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

The Business/Data Analyst will be responsible for collecting, analyzing, and interpreting large datasets to provide actionable insights and support data-driven decision-making processes for all Texas and Florida markets. This role involves working closely with various departments to understand their data needs, developing and maintaining databases, and creating comprehensive reports and visualizations.

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

Primary Responsibilities:

• Data Collection and Analysis: Gather data from multiple sources, clean and organize it for analysis
• Database Management: Develop and maintain databases and data systems to ensure data integrity and efficiency
• Reporting and Visualization: Create detailed reports and visualizations to present findings to stakeholders
• Trend Analysis: Identify trends and patterns in complex data sets to provide actionable insights
• Collaboration: Work with management and other departments to prioritize business and information needs
• Process Improvement: Identify and define new process improvement opportunities
• Technical Expertise: Provide technical expertise on data storage structures, data mining, and data cleansing
• Training and Support: Teach business users how to interact with data visualizations and interpret results

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:

• Understanding statistical concepts like hypothesis testing, regression analysis, and probability
• Proficiency in data analytics tools (e.g., SQL, Python, R)
• Proficiency in data visualization tools (e.g., Tableau, Power BI, MS Office)
• Proficiency in database management
• Proven solid analytical and problem-solving skills with the ability to interpret complex data sets
• Proven excellent written and verbal communication skills to effectively present findings and recommendations
• Proven high attention to detail and accuracy in data analysis and reporting

Preferred Qualifications:

• Relevant certifications such as Certified Business Analysis Professional (CBAP) or Microsoft Certified: Data Analyst Associate
• Experience in a data analysis or business analysis role
• Solid understanding of health insurance policies, with a specific focus on Medicare Advantage (Part C) plans
• Basic understanding of machine learning and predictive modeling

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

The salary range for this role is $71,600 to $140,600 annually 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.

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.