by Irma Moore | Oct 28, 2024 | Uncategorized
As an Outpatient Coding Mentor/Trainer, your primary role will be the onboarding and mentorship of new coders as well as internal quality reviews aimed at identifying areas of improvement and education that would benefit the coding staff.
Every day in this role you will:
- Responsible for the training of all OP new hires in the modular coding department. Job shadowing, casework review, milestone evaluation, and progress reporting are all associated with this position.
- Responsible to conduct the quality review of production coders on a weekly, monthly quarterly and/or annual basis and based on QA results also fall under this position.
- Provide CE for performance management support as needed.
- Reporting on training progress, quality status, education interventions and additional ad hoc report upon request.
- Development and maintenance of training, education and quality materials and resources
To be successful in this role you must have:
- 5+ years outpatient coding experience
- Coding quality audit experience specific to outpatient coding
- Experience using multiple EMR systems, including but not Epic, Cerner, Power Chart, Meditech, etc.
- At least one of the following credentials are required: COC, CPC, CCS
- Proficient computer skills (including, but not limited to, spreadsheets, Internet, and email) are required.
- ProFee and/or inpatient coding experience desired
For this US-based position, the base pay range is $64,657.00 – $80,821.00 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.
If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.
CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent
by Irma Moore | Oct 28, 2024 | Uncategorized
Remote Position. Candidates must live in Delaware, New Jersey or Pennsylvania.
8:30am-5pm
The Specialist is responsible for obtaining and processing Elective, Urgent, and Emergent referrals and authorizations for physician based services and some office based services, including but not limited to cardiology, audiology test, laboratory testing.
The Specialist is also responsible for obtaining genetic testing approval and medication authorizations and other assigned outpatient services. The Specialist will work with partner hospitals for claim submission and registration accuracy. They will also ensure that patient responsibility estimates are created and communicated timely. Elective referrals and authorizations are obtained prior to the service date according to the department standard. Urgent/Emergent referrals and authorizations are to be initiated at the time of the service and must be completed according to insurance company guidelines. Referrals and authorizations are obtained prior to the date of service as per department standards. During the authorization/referral process the specialist will provide the insurance company and or pcp office with all required patient information by fax, phone, or online submission. They will partner with the Primary Care Provider to obtain all approvals as needed per insurance company requirements. This role is required to use all utilize all available resources to verify eligibility, benefits and patient out of pocket responsibilities. Estimates are prepared during the authorization process for in office testing and procedures.
The Specialist is also responsible for researching and notifying the servicing departments of co-payment responsibilities. It is the very important that the Specialist understand and interpret benefits correctly in order to communicate and estimate out of pocket responsibility according to the patients insurance benefit. Should a service date approach without prior authorization and or referral the specialist will follow the Administrative Approval process to ensure that patient responsibility is accounted for.
This position collaborates with: Hospital Authorization department, non Nemours physician offices, managed care department and Nemours Physicians, and Departmental Administrative Staff to ensure that accurate information is collected and distributed effectively and efficiently.
Qualifications:
- High School Diploma required
- Referral/authorization experience required
- CRCR preferred
Nemours Children’s Health offers a comprehensive and competitive benefit package which includes:
- Medical/Dental/Vision Insurance
- Tuition Reimbursement/Continuing Education Support
- 403(b) Retirement Plan
- Paid Time Off (PTO), VTO (Volunteer Time Off) and 6 paid holidays
- Professional/Clinical growth opportunities
About Us
As one of the nation’s premier pediatric health care systems, we’ve made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It’s a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.
Nemours aspires to have its workforce and providers reflect the rich diversity of the communities we serve. Candidates of diverse backgrounds, race and ethnicity, religion, age, gender, sexual orientation, and those committed to working with diverse populations and conversant in multicultural values are strongly encouraged to apply. Please click here to review Nemours Anti-Racism Statement (nemours.org).
by Irma Moore | Oct 28, 2024 | Uncategorized
Position Description:
Mathematica is currently seeking an Administrative Services Coordinator to join our Administrative Services Team. This is a highly visible role which requires extensive customer service skills, interaction with all levels of staff including executive and senior levels, as well as a high level of professionalism. Responsibilities include coordinating domestic and international travel and processing expense reports within a ticketing system. Support often includes collaborating with other departments such as Information Technology Services, Procurement, and Accounting. Exceptional attention to detail and first-class organizational skills are a must.
Key responsibilities include:
• Coordinates and schedules company-wide travel arrangements for staff and clients at all levels of the organization
• Processes expense reports for staff (including collecting and consolidating receipts and requests for travel advances) using ticket request system
• Create Expense Authorizations (EA) for staff and clients at all levels of the organization for travel, conference, and meetings.
Position Requirements:
• College degree, high school diploma or GED
• 3-5 years of administrative or other related experience
• Proficiency in Microsoft programs such as Outlook, Word, and Excel. Experience using Microsoft Outlook to reserve rooms and coordinate cross-office meetings
• Adobe Acrobat DC proficiency.
• Ability to prepare correspondences, coordinate travel arrangements, and organize meetings
• Ability to prioritize multiple tasks and meet deadlines
• Excellent written and verbal communication skills
• The ability to deal tactfully and diplomatically with others
• Wise judgment dealing with sensitive and confidential matters
• Flexibility to handle multiple priorities, sometimes simultaneously, under deadlines
• Accuracy in detail and strong organizational skills
• Ability to work independently for long periods of time
• Familiarity with ticket-based service requests systems such as ServiceNow, Deltek for expense and Concur for travel is a plus
• Excellent team player
This position offers an anticipated annual base salary range of $45,000-$52,000. This position may be eligible for a discretionary bonus based on company and individual performance.
Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding using data science and analytics. Our work yields actionable information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica offers our employees competitive salaries, and a comprehensive benefits package, as well as the advantages of being 100 percent employee owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in tandem with the company’s growth and financial strength. You will also be part of an independent, employee-owned firm that is able to define and further our mission, enhance our quality and accountability, and steadily grow our financial strength.
Read more about our benefits here: https://www.mathematica.org/career-opportunities/benefits-at-a-glance
Available locations: Washington, DC; Princeton, NJ; Cambridge, MA; Chicago, IL; Oakland, CA; Remote
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
by Irma Moore | Oct 28, 2024 | Uncategorized
Description
Introduction
Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Charge Entry Specialist WFH with Work from Home you can be a part of an organization that is devoted to giving back!
Benefits
Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan with 10% off HCA Healthcare stock
- Family support through fertility and family building benefits with Progyny and adoption assistance.
- Referral services for child, elder and pet care, home and auto repair, event planning and more
- Consumer discounts through Abenity and Consumer Discounts
- Retirement readiness, rollover assistance services and preferred banking partnerships
- Education assistance (tuition, student loan, certification support, dependent scholarships)
- Colleague recognition program
- Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
- Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Work from Home family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Charge Entry Specialist WFH to help us reach our goals. Unlock your potential!
Job Summary and Qualifications
Seeking a Charge Entry Specialist for our practice who provides clerical expertise to ensure all patients receive high quality, efficient care. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
*Within 50 miles of Garland, TX Clinic preferred *
What you will do in this role:
· You will receive and review charge documents for accuracy and coordinates with front office staff on all payment/billing issues
· You will enter charges into practice management system.
· You will balance Charge Summary to tickets keyed before finalizing/updating charges in the system
· You will extract information from medical records, operative notes, hospital admissions, consults, progress notes and discharges to ensure completeness and accuracy
· You will assist with identifying quality issues with registration and scheduling activities
What Qualifications you will need:
· Minimum of 1 year of coding, billing, and/or charge entry experience in the healthcare field is required
· Knowledge of medical terminology and coding is highly preferred
· Familiarity with third party billing requirements and payment policies is also highly preferred
Supporting HCA Healthcare’s 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
by twochickswithasidehustle | Oct 28, 2024 | Uncategorized
Job Description
Posted Wednesday, October 16, 2024 at 11:00 PM | Expires Tuesday, December 17, 2024 at 10:59 PM
Dayforce is a global human capital management (HCM) company headquartered in Toronto, Ontario, and Minneapolis, Minnesota, with operations across North America, Europe, Middle East, Africa (EMEA), and the Asia Pacific Japan (APJ) region. Our award-winning Cloud HCM platform offers a unified solution database and continuous calculation engine, driving efficiency, productivity and compliance for the global workforce. Our brand promise – Makes Work Life Better TM– Reflects our commitment to employees, customers, partners and communities globally.
Location: Work is what you do, not where you go. For this role, we are open to remote work and can hire anywhere in the United States. This candidate will be required to work PST hours.
About the opportunity
Dayforce is currently seeking a Payroll Specialist III to join our Dayforce Managed Team. We service our US Large Enterprise clients (multiple thousands of employees) by supporting the complete employee life cycle including payroll, workforce management, benefits, and contact center; allowing the client to focus on their core business.
The ideal candidate will have significant experience in the area of payroll and a strong working knowledge of benefits, workforce management and tax. They will also have the ability to interface with clients and to use critical thinking skills to resolve complex problems.
What you’ll get to do
- Responsible for ensuring all aspects of the payroll cycle, including tax, benefits, garnishments, etc. are processed, reconciled, audited and transmitted accurately and timely
- Ensure accurate and timely processing of payroll impacting changes, tax forms, payments and payroll processing for assigned clients
- Responsible for quality control and auditing to ensure accuracy and low error or defect percentage
- Work with cross-functional internal partners to resolve client payroll matters and employee inquiries
- Provide Payroll support services to clients according to Dayforce contract, legislative requirements and business needs
- Establish and maintain a deep understanding of customer’s requirements and their changing needs to ensure services delivered are as per contractual obligations and in accordance with customer SLAs.
- Create, update and review standard operating procedures and performs quarterly document reviews
- Have an “I own it” attitude about deliverables and projects from start to finish
- Manage client and consumer related tasks within the case management system ensuring all documentation is complete, accurate, and timely
- Proactively manage quarter, and year-end payroll auditing and processing
- Think and act ahead, spot opportunities and act accordingly and proactively contribute to process improvements
Skills and experience we value
- Must be available to accommodate shifts within operating hours (between 8 a.m. and 9 p.m.)
- Must be available to stay later or adjust shift based on client assignment
- Hours will usually be 9a-6p PST but require schedule flexibility to work within above listed hours
- 2+ years of End to End payroll processing experience in a high-volume payroll operation (1,500-6,000+ employees)
- Experience in the payroll outsourcing or consulting industry preferred
- Experience and a clear understanding of payroll, benefits and taxation and an understanding of applicable legislative requirements
- Ability to resolve client’s issues and provide superior customer service to internal and external partners
- Excellent verbal and written communication skills with the ability to communicate clearly, technically, and effectively with customers and internal partners
- Good analytical, organizational, and problem-solving skills
- Proficiency in Microsoft Word, intermediate Excel, and PowerPoint
What would make you really stand out
- Experience with Dayforce HCM or similar cloud payroll technology
- Multi-client payroll processing experience
- 2k+ employee payroll processing experience (working with Enterprise sized customers)
- Industry related certifications or desire to obtain within two years of employment
- Strong working knowledge of quality control and auditing standards
by twochickswithasidehustle | Oct 28, 2024 | Uncategorized
Description
From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.
Job Title: Reimbursement Specialist
POSITION SUMMARY:
Under the general supervision of the operational program leadership, the Reimbursement Specialist is responsible for various reimbursement functions, including but not limited to benefit investigations, prior authorization support, and call triage. The Reimbursement Specialist responds to all provider account inquiries, appropriately documents all provider, payer and client interactions into the CareMetx Connect system and ensures that the necessary data for prior authorization request are obtained.
PRIMARY DUTIES AND RESPONSIBILITIES:
Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
Completes and submits all necessary insurance forms in a timely manner as required by all third party payors for prior authorizations. Tracks and follow up on prior authorization request.
Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
Maintains frequent phone contact with provider representatives, third party customer service representatives, and pharmacy staff.
Reports any reimbursement trends/delays to supervisor.
Processes any necessary insurance/patient correspondence.
Provides all necessary documentation required to expedite prior authorization request. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
Coordinates with inter-departmental associates as necessary.
Communicates effectively to payors to ensure accurate and timely benefit investigations.
Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.
Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
Typically receives little instruction on day-to-day work, general instructions on new assignments.
Other duties as assigned – Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Qualifications
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
- High School, Diploma, or GED required
- Previous 1+ years of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, and/or related experience.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
- Ability to communicate effectively both orally and in writing.
- Ability to build productive internal/external working relationships.
- Strong interpersonal skills.
- Strong negotiating skills.
- Strong organizational skills; attention to detail.
- General knowledge of pharmacy benefits, and medical benefits.
- Global understanding of commercial and government payers preferred.
- Ability to proficiently use Microsoft Excel, Outlook and Word.
- Ability and initiative to work independently or as a team member.
- Ability to problem solve.
- Strong time management skills.
- Customer satisfaction focused.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit.
- The employee must occasionally lift and/or move up to 10 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Schedule
- Must be flexible on schedule and hours
- Overtime may be required from time to time
- Must be willing to work weekends if required to meet company demands
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply. At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services. CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.
Salary Description
$30,490.45 – $38,960.02
Recent Comments