Review encounter documentation to confirm reported services.
Resolve pre-bill edits to confirm correct coding (modifier, diagnosis, CPT, and HCPCS review).
Educate providers on correct coding and documentation guidelines.
Northwestern Medicine is committed to prioritizing every patient interaction to cultivate a positive workplace. Because of its patient-first approach, the company stands as a leader in the healthcare industry with competitive benefits that take care of its employees.
Have a complete working knowledge of assigned application and department workflows.
Act as the primary support contact for the application and coordinate issues.
Perform workflow analysis, data collection, and report issues associated with the software.
Hill Physicians Medical Group is shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions, and anticipates the needs of its members. We're regularly recognized as one of the “Best Places to Work in the Bay Area” and one of the “Healthiest Places to Work in the Bay Area."
Document requirements in business requirement documentation standard format.
Recommend technology to solve complex business problems.
UChicago Medicine has been at the forefront of medicine since 1899. They provide superior healthcare with compassion, mindful that each patient is a person, an individual. UChicago Medicine is growing and is an equal opportunity employer.
Auditing to ensure new provider and care center information is accurate.
Conducting Care Center audits based on the number of providers.
Identifying, monitoring, and managing denial management trends.
Privia Health is a technology-driven, national physician enablement company. They collaborate with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. Their platform is led by industry talent and cloud-based technology.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure necessary documentation is present.
Participates in audits to evaluate code accuracy and develops methodologies to improve coding issues.
Northside Hospital is an award-winning and state-of-the-art healthcare provider that is continually growing. By constantly expanding the quality and reach of our care we hope to create even more opportunity for the best healthcare professionals in Atlanta and beyond.
Performs builds, testing, validation, maintenance and ongoing support of the Epic Radiant module.
Works across interdisciplinary workgroups to accomplish set goals as a team, fostering positive business relationships.
Provides Epic and other applications software support, file maintenance, and build for break-fixes, optimizations, special updates, upgrades, and implementations.
Emory Healthcare is dedicated to fueling professional journeys with comprehensive benefits, valuable resources, and ongoing mentorship. They foster a supportive environment, enabling employees to reach new heights in their careers and achieve their aspirations. It is a large organization with various opportunities for career advancement and development.
Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
Collaborates with a variety of internal and external clients, including health care executives, physicians, provider office personnel, and payer representatives from various health plans to streamline and optimize accurate diagnosis code capture.
Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” and they recognize that work is a part of life, not separate from it, and foster a flexible environment.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Demonstrate knowledge of Epic implementations, upgrades, and optimizations.
Plan, design, test, implement and support the needs of Epic EHR.
Serve as subject matter expert in assigned applications and provide counsel.
Baker Tilly is a leading advisory, tax, and assurance firm, providing clients with coast-to-coast and global advantages. They operate in major U.S. regions and global financial centers, with 43,000 professionals worldwide and a combined revenue of $5.2 billion.
Performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record.
Trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function.
Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of their team, you'll have the opportunity to join their quest for better health care, no matter where you work within the Northwestern Medicine system.
Formulates and defines systems scope and objectives based on user needs and understanding of business applications and industry requirements.
Devises or modifies procedures and application configurations to solve complex problems considering software capacity and desired results.
Acts as a team leader for projects with a moderate budget or of a short to intermediate duration.
UChicago Medicine has been at the forefront of medicine since 1899 and provides superior healthcare with compassion. They are working to advance medical innovation, serve the health needs of the community, and move collective knowledge forward.
Responsible for the design, build, testing, training, and support of the Electronic Health Record (EHR) system.
Play a pivotal role in the optimization and configuration of the EHR system.
Collaborate with cross-functional teams to ensure the effective utilization of Epic applications to enhance patient care and operational efficiencies.
Prime Healthcare is an award-winning health system headquartered in Ontario, California. They operate 51 hospitals and have more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually with nearly 57,000 employees and physicians.
Provides billing support for the Sandstone Care billing team.
Responsible for verification of benefits, billing data, claims submission, claim corrections, claim re-submissions, claim follow up and appeals.
Generates revenue by making payment arrangements, collecting accounts, monitoring and pursuing delinquent accounts.
Sandstone Care is committed to providing accessible, affordable, and high-quality mental health and addiction treatment services. They strive to create a diverse and inclusive workplace where all employees feel valued, respected, and empowered.
Contacts insurance companies to determine pre-certification requirements.
Obtains pre-authorization prior to the scheduled complex service.
Liaisons with physicians to obtain additional information.
Piedmont Healthcare is a company focused on healthcare services. They appear to be a large corporate entity, offering a range of opportunities within the revenue cycle and healthcare sectors.
Researches and analyzes data to answer questions and find trends.
Reviews carrier websites, regulations, and policies related to coding and reimbursement.
Prepares and presents quality reports, reviews, and analysis.
OSU Physicians provides exceptional patient care while fostering a collaborative work environment. They include more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders.
Responsible for the design, build, testing, training, and support of the Electronic Health Record (EHR) systems Hospital Billing (HB) application.
Play a pivotal role in the optimization and configuration of EHR system and collaborates with cross-functional teams.
Independently prioritize work assignments, meet deadlines and manage multiple projects and/or priorities.
Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians and is headquartered in Ontario, California.
Partners with Revenue Cycle stakeholders to define KPIs and translate needs into analytics requirements.
Develops scalable analytics content using Power BI and Microsoft Fabric ecosystem.
Translates data into clear insights and manages multiple initiatives independently.
Emory Healthcare fuels their employees' professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs, and a supportive environment. They enable their employees to reach new heights in their careers and be what they want to be.
Analyze user requirements and develop training plans for EPIC and clinical applications.
Communicate effectively with technical staff and end-users to ensure understanding.
Prepare and present training materials and conduct classes on patient-care systems.
Arkansas General's purpose was not mentioned in the job posting. It seems that they have a supportive team culture with a focus on continuous learning.
Coordinate day-to-day virtual Business Office workflow for revenue cycle operations.
Maintain documentation and organized records for survey review.
Verify insurance eligibility, confirm authorizations, and document financial clearance processes.
Signet Health provides management and consulting services for hospitals and health systems. They focus on improving financial, operational, and clinical performance. The company emphasizes a collaborative and supportive work environment.