Acadia Healthcare Remote jobs

RN Director of Quality - Addictions Champion Quality. Strengthen Safety. Advance Excellence Across Behavioral Health. Acadia Healthcare's Specialty Division is seeking a Project Director of Quality (PDQ) - a mission-driven, highly skilled healthcare leader dedicated to advancing patient safety and regulatory excellence across our national network of specialty treatment centers. This vital role supports Acadia's facilities focused on substance use disorder, eating disorder, and complex mental health treatment, ensuring that each site operates with an unwavering commitment to quality, compliance, and clinical integrity. The PDQ will serve as a trusted partner to facility and division leadership, often providing on-site interim Quality leadership during vacancies, transitions, or periods of heightened regulatory activity. A Rewarding Leadership Opportunity: Acadia offers a highly competitive compensation package, including base salary, annual performance bonus, and equity eligibility, along with a comprehensive benefits suite and travel support. This is an ideal opportunity for an accomplished clinical quality professional seeking both career growth and national impact within one of the country's leading behavioral healthcare organizations. Why This Role Matters: At Acadia Healthcare, we are united by one purpose - to deliver hope and healing through exceptional care. The Project Director of Quality plays a central role in realizing that mission across the Specialty Division, ensuring that each facility consistently meets and exceeds standards of regulatory compliance, accreditation, and performance improvement. You'll be the driving force behind continuous readiness, leading initiatives that safeguard patient safety, elevate outcomes, and reinforce fidelity to Acadia's evidence-based treatment programs. Responsibilities Key Responsibilities: Serve as the on-site Director of Quality for Specialty Division facilities as needed, overseeing all aspects of regulatory readiness, accreditation, and patient safety. Lead and strengthen Quality Assurance and Performance Improvement (QAPI) programs, using data to drive measurable improvements in outcomes and care consistency. Partner with facility and division leadership to ensure compliance with Joint Commission, CARF, CMS, and state regulatory requirements. Conduct proactive audits, rounding, and assessments to identify risk and support zero-deficiency survey outcomes. Provide education, coaching, and mentoring to facility leadership and staff to build sustainable internal quality systems. Support regulatory engagement and the development and submission of Plans of Correction as required. Lead and facilitate Root Cause Analyses, safety rounding, and implementation of corrective actions. Collaborate across Acadia's Specialty Division to share best practices and promote a culture of accountability and excellence. Travel extensively (up to 80%) to provide direct, hands-on support at facilities across the U.S. Qualifications You are a seasoned healthcare quality leader who thrives in behavioral health settings - particularly those focused on substance use, eating disorders, and mental health care. You bring both the technical expertise and emotional intelligence required to lead through influence, not just authority. Registered Nurse (RN) with a Bachelor of Science in Nursing (BSN) required Master's degree (MSN, MHA, MPH, or related field) strongly preferred Proven leadership in regulatory readiness, quality improvement, and accreditation management within behavioral healthcare Deep knowledge of Joint Commission and/or CARF standards, CMS Conditions of Participation, and state licensing regulations Demonstrated success developing and executing Quality programs that improve safety, outcomes, and compliance Exceptional communication, analytical, and leadership skills Ability and willingness to travel up to 80% to facilities nationwide Join Us This is more than a traveling leadership role - it's a chance to shape the culture of quality across Acadia's Specialty Division, influencing care that is safe, effective, and transformative. Be the standard-bearer for quality. Be the difference for those we serve. Join Acadia Healthcare and help define the next standard of excellence in behavioral health. AHCORP #LI-JR1 #Remote Not ready to apply? Connect with us for general consideration.

A leading health care company is seeking a Legal Counsel to join its Operations and Experience Legal team. This role involves providing legal advice and counsel on regulatory requirements in the health care industry. Candidates must possess a Juris Doctorate degree and an active law license in at least one US jurisdiction, with a minimum of 6 years of legal experience, including health plan expertise. The position offers the flexibility to work remotely from anywhere in the U.S. #J-18808-Ljbffr

Director, Liability Claims (Remote) (Job Number: 543619) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Under the general direction of the Division Vice President, Counsel, Liability Claims, the Director of Liability Claims is responsible for the coordination and administration of the Division's policies for Liability Claims and is responsible for the management of the Liability Claims department. Essential Functions Manages all aspects of professional and general liability claims. Develops strategies to defend the claims, negotiates claim settlements, evaluates the claims worth and works with re-insurance carriers and excess carriers in the management of claims. Attends mediations and trials Advises facility and regional personnel on the handling of internal investigations of professional and general liability claims according to the company's policies and procedures Retains and directs the defense counsel on pre-suits and suits. Compares and evaluates possible courses of conduct when handling claims and determine strategy Suggests settlement recommendations to management. Recommends changes in policies and procedures regarding professional and general liability Assists other Support Center departments and management on liability claims issues affecting them Runs monthly claims reports and analyzes claims activity Assists with the claims related activities, including development of, and training on, risk management policies and procedures Knowledge/Skills/Abilities Advanced knowledge of Litigation Management and Civil Litigation Managerial skills Proficient computer skills Multi-task oriented Strong interpersonal, communication, and organizational skills Ability to work with individuals at all levels of the organization Knowledge of long-term care industry Knowledge of state and federal regulations Approximate percent of time required to travel: Qualifications Education Bachelor's degree in related field, MBA preferred Licenses/Certifications None Experience 5-7 years risk management or claims management experience, preferably in health care, personal injury, or product liability fields. A combination of less experience and one of the certifications may qualify Louisville, KY or Franklin, TN preferred. Remote. Job: LegalPrimary Location: KY-Louisville-HR Shared ServiceOrganization: 4409 - HR Shared ServiceShift: Day

The Supervisor is responsible for the supervision and leadership of the Patient Account Representatives, both on-site and telecommuters. Directly responsible for the interviewing, hiring, training, scheduling, and monitoring of staff as well as all aspects of A/R Management and Performance Management. Attend meetings and respond timely to all requests, including completion of accounts referred to the Supervisory Desk. Identify performance deficiencies and opportunities and implement action plans as appropriate. Effectively maintain a work environment which promotes communication to stimulate the morale, engagement, and growth of subordinates. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. * Responsible for all aspects of the day-to-day supervision and leadership of Patient Account Representatives, including but not limited to the Performance Management metrics of collections, productivity, quality and aging. Interview candidates and make hiring recommendations and decisions. Complete monthly quality evaluations. Monitor staff scheduling and adherence to time and attendance protocol. Responsible for all aspects of A/R Management, including but not limited to maintaining workload balance, ensuring maximum efficiency, eliminating rework, and reducing cost. Promptly identify issues and develop action plans to mitigate or resolve. * Train, develop, motivate and assist subordinates in reaching new levels of skills, knowledge and attitude. Effectively maintain a work environment which stimulates and motivates the morale, engagement and growth of subordinates. Identify performance deficiencies and opportunities and implement action plans as needed. * Review and respond timely to requests, including emails, telephone calls, issues, account research and resolution as needed by staff, management and clients. Timely completion of accounts referred to the Supervisory Desk by staff or management. * Effectively communicate and interact with subordinates, management and clients. Conduct, attend and participate in meetings, conference calls and training sessions, including Management Meetings, Team Meetings, as well as one-on-one monthly meetings with subordinates to provide consistent performance feedback. Complete the mid-year and year end Performance Management review. SUPERVISORY RESPONSIBILITIES If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. No. Direct Reports (incl. titles) Patient Acct Reps, Sr Patient Acct Reps, Lead Patient Acct Reps KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Very good written and verbal communication skills * Strong interpersonal skills * Strong technical skills, including PC and MS Office Suite knowledge * Proficient in building a strong team to meet performance goals * Effectively manages multiple tasks * Displays sound judgment and reasoning abilities * Creative and innovate thinking * Achieves results with accuracy and precision * Advanced knowledge of healthcare A/R * Excellent working knowledge of Patient Financial Services operations with specific focus on Inpatient and Outpatient Managed Care and Commercial payors (i.e., Medicare regulations and compliance; HIPAA) * Proficient in Microsoft Office (Word and Excel) * Advanced writing skills * Ability to provide advanced customer service * Ability to train and coach staff * Ability to multi-task * Strong leadership and organizational skills Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School diploma and/or equivalent education * 4-7 years experience preferred * Advanced knowledge of UB-04, EOB interpretation, CPT and ICD-9 codes. * Supervisory experience or demonstrated leadership. 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. * Ability to sit and work at a computer terminal for extended periods of time 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. * Office/Teamwork Environment As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $51,626.00 - $77,438.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 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, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. 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: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Utilization Management Manager REMOTE Pacific Region (Job Number: 549924) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryThe Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. This position blends strong relationship-building skills with clinical knowledge to navigate complex payer requirements, streamline the authorization process, and support seamless patient transitions. From start to finish, this role drives the authorization process-reviewing prospective, retrospective, and concurrent medical records; coordinating with referring hospitals to secure prior authorizations; and partnering with case management teams at ScionHealth facilities to complete concurrent review authorizations. Acting as a navigator and liaison between Business Development, facility administration, managed care organizations, and payors, the specialist ensures determinations are communicated promptly and accurately to all relevant stakeholders. By combining attention to detail with proactive collaboration, the Utilization Management Manager safeguards revenue integrity, reduces delays, and supports the organization's mission of delivering exceptional patient care. This role actively contributes to quality improvement, problem-solving, and productivity initiatives within an interdisciplinary model, demonstrating accountability and a commitment to operational excellence. Essential FunctionsExtrapolates and summarizes essential medical information to obtain authorization for admission and continued stay to/at ScionHealth Level of Care. Prepares recommendations to sumbit timely request for reconsideration of denial determination in attempt to have denied authorization requests overturned. Ensures authorization requests are processed timely to meet regulatory timeframes. Reviews medical necessity assessments completed by case management, evaluating documentation for specific criteria related to severity of illness, and level of care appropriateness. Generates written appeals to medical necessity-based payor denials for denials prior to admission and concurrent review authorizations. Appeal letters may be processed on behalf of the physician, combining clinical and regulatory knowledge in efforts to have consideration of authorization. Documents authorization information in relevant tracking systems. Effectively builds relationships with business development team, admissions team/clinical staff and managed care team, to coordinate the patient admission functions in keeping with the mission and vision of the hospital. Supports review of patient referral for clinical and financial approval and/or escalation to leadership for approval following the Care Considerations grid. Coordinates and facilitates pre-admission Prior Authorizations for patients from the referral sources:Identifies /reviews medical record information needed from referring facility. Applies appropriate clinical guidelines to pre-authorization determination process. Communicates specific patient needs for equipment, supplies, and consult services as related to prior authorization requirements. Acts as a liaison with the Business Development team through every stage of the authorization process through determination. Initiates appeals process as appropriate. Facilitates and coordinates physician-to-physician communication as appropriate to support the denial management process. Communicates to appropriate teams, including business development and facility administration when clinical authorization and financial approval is complete, following standard authorization process. Provides hospital team with needed prior authorization information on pending / new admissions. Coordinate with managed care payor on all coverage issues and supports the LOA process as requested. Coordinates and facilitates Concurrent Review Authorizations for patients actively in-house at a ScionHealth facility Identifies /reviews medical record information needed from facility. Applies appropriate clinical guidelines to concurrent review authorization process. Review medical necessity review information provided by the case management team and communicates any additinoal questions or information requests Acts as a liaison with the Case Management team through every stage of the concurrent review authorization process through determination. Initiates appeals process as appropriate. Communicates with Medical Advisors or case managers of managed care company as necessary; including during Care Coordination / Managed Care calls Maintains a knowledge of areas of responsibility and develops and follows a program of continuing education. Participates in continuing education/ professional development activities. Learns and develops full knowledge of the CAAT Admission Processes and actively seeks to continuously improve them. Knowledge/Skills/Abilities/ExpectationsStrong relationship building skills and a spirit to serve to ensure effective communication and service excellence. Knowledge of regulatory standards and compliance guidelines. Working knowledge of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare and Medicaid rules, regulations, coverage guidelines, NCDs and LCDs. Working knowledge of Medicare, Medicaid and Managed Care payment and methodology. Extensive knowledge of clinical symptomology, related treatments and hospital utilization management. Excellent interpersonal, verbal and written skills to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers. Critical thinking, problem solving, and decision-making capabilities with the ability to discern, collect, organize, evaluate, and communicate pertinent clinical information with effective verbal and written skills. Technical writing skills for appeal letters and reports. Effective time management and prioritization skills. Computer skills with working knowledge of Microsoft Office (Word, Excel, PowerPoint, and Outlook), word-processing and spreadsheet software. Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members. Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards. Communicates and demonstrates a professional image/attitude for patients, families, clients, coworkers and others. Adheres to policies and practices of ScionHealth. Must read, write, and speak fluent EnglishMust have good and regular attendance. Approximate percent of time required to travel: N/AQualifications EducationPostsecondary non-Degree (Cert/Diploma/Program Grad) of an Accredited School of Nursing required Associate's Degree in healthcare or related field required Bachelor's Degree in healthcare or related field preferred Equivalent combination of Education and/or Experience in lieu of education (3+ years in a related field) may be considered. Licenses/CertificationsHealthcare professional licensure preferred. In lieu of licensure, 3+ years of experience in relevant field required. Some states may require licensure or certification. Experience3+ years of experience in a healthcare strongly preferred. Experience in managed care, case management, utilization review, or discharge planning a plus. Job: Accounting/FinancePrimary Location: NV-Las Vegas-Pacific Region OfficeOrganization: 4273 - Pacific Region OfficeShift: Day

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The DBA is responsible for the overall database delivery of the Enterprise Data Warehouse for the Medicaid agency. It is a critical role involving expertise in working with Medicaid data itself, security, supporting and maintaining hardware and software, and ensuring we are achieving optimal performance. For example, the DBA is expected to provide a wide range of expertise including the ability to help a user to fetch data (requiring business knowledge) and the technical ability to support a major Teradata upgrade. This role requires regular onsite presence in Springfield, Illinois to perform backup/restore and support onsite maintenance by Teradata (and its subcontractors). This position will be part of our Data Engineering function and data warehousing and analytics practice. Data Engineering Functions may include database architecture, engineering, design, optimization, security, and administration; as well as data modeling, big data development, Extract, Transform, and Load (ETL) development, storage engineering, data warehousing, data provisioning and other similar roles. Responsibilities may include Platform-as-a-Service and Cloud solution with a focus on data stores and associated eco systems. Duties may include management of design services, providing sizing and configuration assistance, ensuring strict data quality, and performing needs assessments. Analyzes current business practices, processes and procedures as well as identifying future business opportunities for leveraging data storage and retrieval system capabilities. Manage relationships with software and hardware vendors to understand the potential architectural impact of different vendor strategies and data acquisition. May design schemas, write SQL or other data markup scripting, and helps to support development of Analytics and Applications that build on top of data. Selects, develops, and evaluates personnel to ensure the efficient operation of the function. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Manage, monitor, and maintain OnPrem Teradata hardware/software including patches, replacements, and upgrades with support from Teradata * Support data governance, metadata management, and system administration * Plan and execute tasks required to ensure the Teradata system is operational including occasional evening and weekend support for Teradata maintenance * Provide direction to developers on Operational, Design, Development, and Implementation projects to ensure best use of the Teradata system including review/approval of database components (such as tables, views, SQL code, stored procedures) * Performing database backup and recovery operations - using the BAR DSA and NetBackup * Developing proactive processes for monitoring capacity and performance tuning * Providing day-to-day support for the EDW users problems like job hands, slowdowns, inconsistent rows, re-validating headers for tables with RI constraints, PPIs, and configuration * Maintaining rules set in the Teradata Active System Management (TASM) and supporting workload management * Maintaining the Teradata Workload Manager with the proper partitions and workloads based on Service Levels * Supporting the database system and application server support for the Disaster Recovery (DR) build/test, annual drill, and quarterly maintenance as needed * Actively monitoring the health of the Teradata system and Teradata Managed Servers (TMS) using Viewpoint and other tools and application servers and make preventive or corrective actions as needed * Maintaining access rights, role rights, priority scheduling, and reporting using dynamic workload manager, Database Query Log (DBQL), usage collections and reporting of ResUsage, AmpUsage, and security administration etc. * Coordinating with the team and customers in supporting database needs and making necessary changes to meet the business, contractual, security, performance, and reporting needs * Supporting internal or external audit process and address vulnerabilities or risk proactively * Prepare and support IRS and internal audit * Coordinating with Teradata to perform Teradata system hardening and delivery of Safeguard Computer Security * Evaluation Matrix (SCSEM) Reports as needed, addressing issues in the hardening and vulnerability scan report * Generating and maintaining capacity management, Space, and CPU reports on analyzing the Spool, CPU, I/O, Usage, and Storage resources and proactive monitoring to meet performance and growth requirements * Reviewing and resolving Teradata alerts and communicating any risk / issues or impact to the management, team, and business users through appropriate communication strategy * Effectively reporting status, future roadmap, proactive process improvements, automation, mitigation strategies, and compensating controls to the management and clients * Leading database or data related meetings and projects/activities delivering quality deliverables with minimal supervision/direction * Sharing knowledge, coaching/mentoring other members in the team for backups * Performing additional duties that are normally associated with this position, as assigned * Responsible for front-end tool (OpenText Bi-Query) and model maintenance and administration 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: * 7+ years of experience as a Teradata DBA on Version 15+ (preferably 17+) and experience leading Teradata major upgrade/floor sweep * 5+ years of experience as primary/lead DBA with solid leadership and presentation skills * 5+ years of experience writing complex SQL using SQL Assistant/Teradata Studio * 3+ years of experience with Teradata 6800/1800 system or IntelliFlex * 3+ years of experience extracting, loading, and transforming structured/unstructured data using Teradata Utilities (FastLoad, Multiload, FastExport, BTEQ, TPT) in a Unix/Linux environment * 3+ years of experience performance tuning in a large database (>5TB) or data warehouse environment, using advanced SQL, DBQL and Explain plans * 3+ years of experience analyzing project requirements and developing detailed database specifications, tasks, dependencies, and estimates * 3+ years of experience identifying and initiating resolutions to customer facing problems and concerns associated with a query or database related business need * Data warehouse or equivalent system experience * Demonstrated excellent verbal/written communication, end client facing, team collaboration, mentoring skills, and solid work ethics * Demonstrated solid culture fit through integrity, compassion, inclusion, relationships, innovation, and performance Preferred Qualifications: * Teradata Vantage Certified Master * 5+ years logical and physical data modeling experience * 5+ years with Erwin or other data modeling software * 3+ years maintaining and creating models using OpenText BI-Query * 3+ years identifying and initiating resolutions to customer problems and concerns associated with a Data Warehouse or equivalent system * 3+ years working with end users/customers to understand requirements for technical solutions to meet business needs * 3+ years collaborating with technical developers to strategize solutions to align with business requirements * 3+ years defining standards and best practices and conducting code reviews * Experience working with project teams in metadata management, data/IT governance, business continuity plan, data security * Experience in Application Server Hardware/Software Administration (Windows/Linux) * Experience working in matrix organization as an effective team player * Experience working in agile environment such as Scrum framework and iterative/incremental delivery/release. * Experience in tools like DevOps and GitHub * Experience with State Medicaid / Medicare / Healthcare applications * Experience working in large Design Development and Implementation (DDI) projects * Experience upgrading to Teradata IntelliFlex * Knowledge/experience with Cloud databases such as Snowflake and migration from on Prem to Cloud project * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

CHSPSC, LLC seeks an IT Imaging Support & Process Analyst to assist with leading escalated support activities and provide process improvement initiatives. The role will be involved with the facilitation of application services management processes pertaining to analyzing value, evaluating risk, prioritizing projects and onboarding new technology requests to ensure alignment with organizational strategies for the imaging service line. Key responsibilities include: Alignment with the imaging team to address escalated support issues Review transition materials from the Project Management Office for application product ownership Develop and maintain application support plans Document current state and contribute to the direction of the application lifecycle management (LCM) roadmap to reduce costs, mitigate risks, and drive growth and revenue Participate in imaging related efforts such as Disaster Recovery exercises, Cyber Table Top exercises, etc. Present to executive leadership on support-related issues Understand current processes and propose more efficient methods Strategic analysis of the enterprise application portfolio including lifecycle management, application rationalization, consolidation and standardization to achieve the department objectives of the organization including reducing variation of redundant or unused applications Understand the definition, implementation and support of portfolio management standards, policies and processes Understand the data driven decisions pertaining to IT project investments Participate in the structure, attributes, taxonomies and nomenclature of service line elements and categories within the repository toolset (ServiceNow) to ensure completeness and accuracy of the list of enterprise IT business applications Collaborate with business partners, technology leaders and department directors to identify and promote adoption of enterprise standards and rationalization of application systems to achieve economic and patient experience improvement goals Provide expertise on decisions and priorities regarding the overall enterprise application portfolio Track application and vendor trends and maintain knowledge of new technologies to support the organization's current and future needs Maintain an awareness of industry standard best practices and apply relevant methodologies for process improvement Participate in application rationalization feasibility analysis and proposals for management and business partners which support the organization's clinical and economic objectives Review and support applications' advantages, risks, costs, benefits and impact on the enterprise business process and goals Develop and maintain productive relationships of trust both within and outside CHS and embrace the authoritative role in respect to maintaining enterprise standards and align others to the strategic direction Collaborate with Audit teams to respond to and mitigate audit findings and manage audit controls related to application systems and LCM Educate peers and business partners on department methodologies and drive adoption of standard process Support and evaluate portfolio risks and recommend mitigation plans Support business impact analysis and application criticality assessments Partner with key business and delivery stakeholders to conduct application and service line reviews including scope, metrics, expenses and net promoter scores to determine the disposition of existing and proposed solutions Communicate timely and accurate status to appropriate levels and stakeholders including the development and delivery of status reports and presentations Required: Results oriented mentality to drive accurate deliverables with appropriate time to market while taking responsibility for the outcomes Customer focused to align services with customer needs Creativity in developing and executing innovative strategies to meet unique customer needs Excellent verbal and written communication, presentation and customer service skills Ability to handle pressure to meet business requirement demands and deadlines Expertise in analyzing and presenting large volumes of data to senior leadership Critical thinking in developing proposals with sound analysis and achievable outcomes Ability to prioritize tasks and quickly adjust in a rapidly changing environment Exceptional analytic problem solving skills Ability to work independently and in a team environment Organizational awareness and the ability to understand relationships to get things accomplished more effectively Preferred: Experience with APM, CMDB and CSDM components within the ServiceNow platform Application product ownership experience Strong relationship management experience Project management experience/certification 4 or more years in an application portfolio/services management role Lean / Six Sigma Green Belt ITIL certifications Qualifications and Education Requirements: Bachelor's degree in Clinical Informatics, Health Science, Information Systems, Computer Science or a related discipline, or 2 years of relevant experience

UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together. Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities: Join a 30+ radiologist group that is based at our Main Campus location with a possible rotation to an outlying satellite clinic. We are seeking a board-certified radiologist interested in general radiology to include: * Radiography * General fluoroscopy and procedures * Proficiency with interpretation of ultrasound and general body CT preferred. 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: * Graduate of an approved radiology residency program in the United States. * Licensed in the State of Texas. * Board Certified and/or Board Eligible. Preferred Qualifications: * Bilingual (English/Spanish) fluency Compensation for this specialty generally ranges from $423,500 to $682,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Scheduling Specialist is responsible for supporting scheduling functions across assigned hospitals, clinics, or centralized patient access centers and will be the first point of contact for patients. This focuses on managing patient appointment scheduling, helping with general patient needs, and accurately communicating patient needs to the clinical staff through centralized call center operations. The Scheduling Specialist ensures communications and appointments are accurate, timely, and compliant with organizational policies while fostering effective communication with clinicians, patients, and leadership. As a Scheduling Specialist at Community Health Systems (CHS) - Patient Access Center, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental, and vision insurance, paid time off (PTO), 401(k) with company match, tuition reimbursement, and more. Essential Functions * Completes accurate patient appointment scheduling across multiple clinics, depending on assignment. * Receives inbound communication from clinicians, patients, and staff via phone, text, email, and/or call center platforms to address scheduling needs, and handle urgent or emergent requests. * Assesses caller needs to identify urgent clinical matters for immediate warm transfer to clinic staff. For non-urgent requests (refills, clinical questions), accurately documents and route communications to the appropriate staff via the EMR. * Verifies patient demographics and insurance information, ensuring compliance with applicable requirements. * Research patient requests within the medical record, provide necessary information, and resolve inquiries effectively while maintaining patient confidentiality. * Monitors EMR in-baskets, call center systems, and related technology (as needed) to manage communication workflows effectively. * Provides timely and professional service to patients, providers, and facility staff, ensuring positive experiences and adherence to standards. * Performs other duties as assigned. * Complies with all policies and standards. * This is a fully remote opportunity. Qualifications * H.S. Diploma or GED required * Bachelor's Degree in Healthcare Administration, Business Administration, or a related field preferred * 1-3 years of experience in scheduling, operations, or healthcare administration required * 1-3 years of experience in physician/provider scheduling, patient appointment scheduling, or call center operations Knowledge, Skills and Abilities * Proficiency in scheduling software, EMR systems, and Microsoft Office Suite. * Excellent verbal and written communication skills with strong customer service orientation. * Delivers prompt, courteous, and knowledgeable support to customers. * Strong problem-solving skills and attention to detail. * Ability to manage multiple priorities in fast-paced hospital, clinic, or call center environments. * Knowledge of healthcare industry standards, patient confidentiality, and compliance protocols. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. * Performs second level coder reviews on accounts that are sent back from Revint, Iodine, coding audits, and coding/billing editor. * Provides coders with education and guidance on correct coding based on second level reviews. * Assists coding manager and coding department with coder questions, coding reviews, and coding inquiries. Codes inpatient accounts when coverage is needed. * Monitors and assists coding manager with DNFC management to goals. * Attends Tenet coding educations and maintains coding credentials. Under general supervision and with aid of Official Coding Guidelines, the Corporate Coding Coordinator codes diagnoses and procedures of inpatient accounts according to ICD-10-CM/PCS. The Corporate Coding Coordinator is responsible for assisting the Corporate Coding Manager with second level coding reviews and educates coders on correct coding. Assists the coding department with coding questions, reviews, or inquiries. Required: * 3-5 years acute hospital coding experience. * Skilled and working knowledge of MS Office suite. * Ability to analyze coding related reports and take action. * Associates Degree in Health Information Management. * RHIT or CCS certification. Preferred: * 5 plus years' experience in a large, complex, multi-system acute care hospital organization. * Bachelor's Degree in Health Information Management. * RHIA and CCS certification. A pre-employment coding proficiency assessment will be administered. Compensation * Pay: $30.00-$45.00 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. 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. #LI-CM7 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: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast. is 100% remote. Highlights of this role include: • Ability to verify benefits information for assigned facility. • 1 weekend day shift Friday, Saturday, Sunday • Experience monitoring and processing patient referrals (may include fax referrals). • Respond to inquiries about facilities within policy timeframes. • Support Acadia Healthcare admissions departments throughout the country. As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need. This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity. Responsibilities ESSENTIAL FUNCTIONS: Manage Referral Management Portals Monitor all faxed referrals Monitor all webforms and call center handoffs/rollover referrals Utilize facility admissions/exclusionary criteria to process incoming types of referrals Respond to inquiries about the facility within facility policy timeframes. Document calls inside of Salesforce and follow-up as needed Complete Prior Authorization Pre-Admit the patients in billing system Coordinate with local admissions department regarding bed availability Facilitate intake, admissions, and utilization review process for incoming patients. Perform insurance benefit verifications, disseminating the information to appropriate internal staff. Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals. Coordinate admission and transfer between levels of care within the facility. Communicate projected admissions to designated internal representative in a timely manner. Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission. STANDARD EXPECTATIONS: Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality. Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team. Qualifications EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: Bachelor's or Master's degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN Knowledge of admission/referral processes, techniques, and tools Familiarity with behavioral health issues and services Solid understanding of financial principles and insurance reimbursement practices Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application. LICENSES/DESIGNATIONS/CERTIFICATIONS: Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates. SUPERVISORY REQUIREMENTS: This position is an Individual Contributor We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws. AHCORP Not ready to apply? Connect with us for general consideration.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The Revenue Cycle Director, Advisory Services is the overall project lead across our complex revenue cycle engagements, and is responsible for determining overall approach and structure of analysis for engagement and key deliverables. The Director serves as the driving force to assist healthcare provider clients across a range of complex traditional, strategic, and/or clinical revenue cycle projects. The Director assigns work streams to team members, sub-leads, and to his/her self that reflect skills and development needs while meeting the needs and timelines of the client. This role focuses on practice economics and will direct the team to follow the practices needed to ensure both quality and profitability. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Lead day-to-day activities for large, high complexity consulting projects with healthcare provider clients, providing project management, change management, and best practice expertise + Serve as member of Optum Advisory Sales, Utilization, and Profitability leadership team, comprised of all team members GL30+ to drive and support business development, successful and timely execution of projects, etc. + Serve as formal people manager to 1-3 Consultant and/or Project Lead level staff across GLs 27, 28, and 29 + Serve as principal point of day-to-day contact for client project lead across both diagnostic and implementation engagements alike + Gather needed data/information for the engagement and conduct appropriate analyses (e.g., cost/benefit analysis, benchmarking, requirements analysis, gap analysis) Cultivate the client's perception of Optum as a trusted partner and strategic advisor (e.g., build credibility, demonstrate full understanding of their business, leverage other resources within OptumInsight) + Drive high levels of client satisfaction by driving results that meet or exceed the client's expectations + Demonstrate strong relationship management skills and ability to handle challenging interpersonal situations with physicians, executives, colleagues, and peers + Collaborate with the client to confirm their expectations regarding key outcomes for the engagement + Identify/understand the client's business issues and size the financial impact associated with key performance improvement opportunities through financial analysis and scenario modeling + Identify and manage stakeholders to engage in applicable engagement activities (e.g., obtain buy-in, identify interviewees, provide needed information, influence others) + Establish optimal communication cadence with client and demonstrate sufficient executive presence to lead onsite presentations with C-Suite executives + Develop and present superior quality client deliverables + Identify/develop solutions to meet client needs (e.g., analytics, workflows, system selection and implementation, test plans, training plans) + Develop work plans for the engagement (e.g. project plans, staffing plans, budgets) and obtain appropriate buy-in and approvals + Manage engagement execution (e.g., status updates, reporting, risk management) and profitability, by managing successful project delivery within allotted project budget (managing billable hours utilized across the team) + Ensure engagement quality through running to criticism with both team members and clients alike, regularly seeking proactive feedback and adjusting course as needed based on feedback provided + Present engagement deliverables to applicable stakeholders (e.g. presentations, blueprints, staffing analytics, diagnostic findings and recommendations) + Prepare customized client recommendations to realize improvement opportunities identified based on industry best practices and emerging 'best-in-class' approaches and facilitate implementation of recommendations + Apply knowledge of change management principles to drive implementation of engagement objectives + Leverage project documents and deliverables to provide re-use/transferability for other engagements (e.g., de-identifying content, cataloguing deliverables, storing documents in appropriate shared folders) + Identify lessons learned and communicate to appropriate stakeholders across both internal team and client, as appropriate + Maintain ongoing contact with clients to identify and address emerging issues/concerns + Leverage and contribute to the applicable knowledge repositories (e.g., Microsoft Teams, SharePoint, asana, analysis tools, project toolkits) + Contribute to practice-level initiatives including business development and thought leadership beyond client project work + Stay current on important issues in the healthcare industry (e.g., political/ economic market forces, costs, capabilities, initiatives, legal/regulatory requirements) + Share professional and domain knowledge with peers and colleagues to build overall organization capabilities + Effectively delegate project work to internal team members + Coach and mentor junior staff and provide development support in enabling junior staff to grow professionally and develop new skill sets 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:** + 7+ years of healthcare revenue cycle consulting experience + Epic Revenue Cycle experience with certification in either HB Resolute or PB Resolute + Epic Revenue Cycle implementation experience + Client relationship management experience + Deep revenue cycle content expertise, with knowledge across both acute care and professional revenue cycle + Proficiency in MS Office Suite -Word, PowerPoint, Excel + Proven aptitude to support business development initiatives and working closely with teams to drive growth opportunities including speaking with clients at the Director and c-suite level + Proven solid critical thinking, relationship building, and storytelling skills + Proven ability to lead and motivate cross-functional teams + Proven ability to drill down to the root cause of client challenges and deploy creative problem solving + Proven exceptional written and verbal communication skills + Proven ability to drive quantifiable results + Willingness to travel domestically, up to 60% **Preferred Qualifications:** + Experience managing projects/teams that achieved budget, timeline and deliverable goals + Experience mentoring junior level staff + Solid healthcare industry knowledge + Proven to possess analytical reasoning and solution-focused problem solving + Proven ability to lead and motivate cross-functional teams *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. **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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers, hospital staff, and clinical specialists to secure timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists with process improvement initiatives, and serves as a key liaison to reduce denials and optimize patient outcomes. Essential Functions Submits initial assessments, continued stay reviews, and payer-requested documentation, ensuring compliance with policies, regulations, and payer requirements to establish medical necessity. Communicates with commercial payers to provide concise and accurate information to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist. Monitors and updates case management software with documentation of escalations, avoidable days, authorization numbers, denials, and payer interactions to ensure accurate records. Coordinates Peer-to-Peer discussions for unresolved concurrent denials, ensuring the process aligns with hospital, corporate, and payer requirements. Documents outcomes in case management systems. Reviews and closes out cases after patient discharge, ensuring all required documentation is complete and understandable for billing and future audits. Places cases on hold as necessary to resolve pending authorizations or reviews. Maintains performance metrics aligned with Key Performance Indicators (KPIs) for the Utilization Review Service Line. Serves as a key contact for facility and payer representatives, fostering effective communication and collaboration to resolve issues promptly. Participates in training initiatives within the department, supporting onboarding and skill development for team members. Responds promptly to phone calls, faxes, and insurance portal requests, providing high standards of customer service and satisfaction. Escalates issues to the manager as appropriate and provides recommendations for improving operational efficiency and outcomes. Ensures accurate and timely communication of hospital stay authorizations, denials, and delays to all relevant stakeholders. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Bachelor's Degree preferred 0-2 years of work experience in utilization review, hospital admissions or registration required 1-3 years of work experience in an office, processing center, or similar environment preferred Knowledge, Skills and Abilities Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. Proficiency in case management systems and technology resources for authorization tracking and documentation. Excellent communication and interpersonal skills to interact effectively with payers, clinicians, and administrative staff. Critical thinking and problem-solving skills to analyze and resolve authorization and denial issues. Strong organizational skills to manage multiple priorities and meet deadlines. Attention to detail for accurate documentation and process adherence. Ability to train and support team members, fostering a collaborative and productive environment.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** This position is a Medicaid Subject Matter (SME) Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. This role provides the guidance and direction to support a large data warehouse implementation and maintenance & operations. The selected SME will provide the required decisions for the business and technical team members to modify, change, enhance or correct within the system, related to claims, provider, and recipient data. Roles in this function will partner with stakeholders to understand data requirements and support development tools and models such as interfaces, dashboards, data visualizations, decision aids and business case analysis to support the organization. Additional roles include producing and managing the delivery of activity, value analytics and critical deliverables to external stakeholders and clients. This is a telecommute position with some ( You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations + With the specialized knowledge of the Medicaid and Children's Health Insurance Programs (CHIP), lead and guide internal and external stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient eligibility, provider enrollment, and third-party liability + Proactively identify and understand state Medicaid agency data needs and determines the recommended solution to meet them with credible reason, justification and validated proof of concepts + Direct technical and business teams on healthcare topics understanding and utilizing healthcare data appropriately + Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies 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:** + 10+ years of experience in information technology with 5+ years of experience working directly with/for State Medicaid agencies or equivalent supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems + 2+ years of experience working CMS Federal Reporting MARS, PERM, T-MSIS, Quality of Care CMS Core Measure or similar projects + Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered + Understanding of claims, recipient/eligibility, and provider/enrollment data processes + Proven ability to create and perform data analysis using SQL, Excel against data warehouses utilizing large datasets + Proven excellent verbal/written communication and presentation skills, manager/executive/director-level client facing, team collaboration, and mentoring skills + Proven solid culture fit, demonstrating our culture values in action (Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance) + Ability to travel to Springfield, IL two (3) to three (4) times per year or as needed **Note:** Core customer business hours to conduct work is M-F 8 AM - 5 PM CST. **Preferred Qualifications:** + 2+ years of experience in HEDIS, CHIPRA or similar quality metrics + Experience with data analysis using Teradata Database Management System or other equivalent database management system + Experience using JIRA, Rally, DevOps or equivalent + Experience in large implementation or DDI project + Located within driving distance (3 - 5 Hours) of Springfield, IL *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. **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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with Lafayette Home Office, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Revenue Cycle Analyst you will perform all revenue cycle reporting and analysis for revenue cycle leadership, operational teams, and accounting. This analysis consists of daily, weekly, monthly, ad ad-hoc reports using real-time data and information (financial, statistical and other data). The results of the analysis are then used to provide revenue cycle leadership and operations management (DVPs and other operations management) with real-time feedback. As the Revenue Cycle Analyst, you will have no direct report staff and solicits feedback from both Decision Support leadership and VP of Revenue Cycle. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Perform financial and reimbursement analysis to ensure accurate reimbursement and billing compliance * Conduct data mining to compile reports and provide healthcare analytics support for decision-making related to AR inventory reduction, denial management, and operational improvements * Compile and prepare data for use in forecasts, budgets, modeling, and analysis as requested * Compile statistical data for internal reports and regulatory agencies * Assist in creating a data warehouse with needed information (process started; work with IT to complete) * Collaborate with the revenue cycle team to regularly measure and improve business performance * Produce daily, weekly, and monthly revenue cycle reports in a timely, accurate, and consistent manner * Work with revenue cycle leadership to develop key performance indicators and improve reporting * Prepare variance analysis on under-performing agencies/PODs related to days unbilled, production issues, etc., and suggest operating improvements * Maintain excellent communication with supervisor, revenue cycle management personnel, and home office personnel * Actively participate in Monthly Operational Review meetings * Complete ad-hoc analysis projects as required (problem payer work, issue resolution, collection effectiveness measures, etc.). 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: * Bachelor's Degree * 2+ years in a healthcare-related field * 2+ years in relevant Professional Accounting/Financial Analysis experience * Demonstrate superior analytical skills, both financial and statistical * Demonstrated a natural sense of urgency in all actions * Demonstrated ability to use modern accounting and financial software platforms and databases * Demonstrated solid proficiency in Microsoft Office applications. Preferred Qualifications: * Proven solid oral and written communication skills. * Excellent interpersonal skills * Ability to work alongside other management personnel to achieve high levels of operating performance. * Demonstrated ability to influence other personnel to produce improved operating outcomes. * Self-starter and self-motivated, able to consistently demonstrate these qualities in a fast-paced environment. * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The Associate General Counsel works with the health plan, state regulatory and enforcement agencies, and trade associations to foster effective communication and collaborative relationships. This role ensures regulatory alignment by coordinating with internal colleagues to maintain operational and procedural compliance with state and federal requirements. This individual will work with internal teams and regulators to address inquiries, clarify regulatory requirements, and facilitate constructive dialogue on the interpretation and application of health insurance laws, regulations, and regulatory guidance. This individual will also assist in the collection, analysis, and presentation of written discovery in administrative enforcement matters and relevant information for required reports, including license filings, appeals and complaints reporting, surveys and routine scheduled examinations. The Associate General Counsel will provide strategic guidance and triage complex compliance issues escalated by internal teams to ensure timely and effective resolution. The ideal candidate will demonstrate solid regulatory expertise, exceptional communication skills, and the ability to manage cross-functional initiatives in a dynamic regulatory environment. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities Execute delivery of legal services and related support to Employer and Individual business Collaborate with colleagues across the UnitedHealth Group legal department Proactively identify and resolve legal and related matters Assist in the review, preparation and negotiation of various products, documents and contracts Develop best practices for addressing emerging legal and business risks Support the development and delivery of new products and pharmacy initiatives Counsel senior management on strategic business initiatives Foster key regulatory relationships 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 Juris Doctorate degree with an active license to practice law in at least one state 4+ years of professional legal experience Demonstrated relevant legal experience in health, law, commercial insurance, pharmacy, litigation, provider or health care legal support Demonstrated expertise, judgement and presence to advise senior leadership on legal matters Ability to provide timely and responsive legal support for business partners Preferred Qualifications Experience with regulatory agencies and administrative experience with state insurance regulations Excellent understanding of health insurance and/or managed care industry Legal experience in commercial health insurance Demonstrated understanding of business problems and ability to evaluate and determine appropriate legal course of action to meet business unit needs Proven success in collaborating across a large, matrixed business and legal environment Advanced negotiation skills Ability to build and maintain rapport with superiors, peers, subordinates, and external company contacts Ability to drive results Ability to gain acceptance from others on a plan or idea and achieve bottom line results for the company Ability to work effectively in an ambiguous environment Ability to work in a fast-paced, results-oriented workplace Ability to prioritize and work effectively under time constraints Soft Skills Excellent work ethic Well-developed written and verbal communication skills Comfortable taking ownership and accountability for projects *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. We are seeking a highly motivated and experienced Product Manager to lead the definition and development of future clinical workflows and tools for our cloud-based Enterprise Viewer. This viewer is a critical application used by clinicians across inpatient and outpatient settings, as well as by patients, to view medical images from a wide range of specialties. In this role, you will collaborate closely with physicians and clinical stakeholders to understand evolving needs and translate them into a strategic product roadmap. You'll play a key role in shaping the future of enterprise imaging and delivering solutions that improve clinical care, patient outcomes, and drive clinical efficiency. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Define Product Strategy: Partner with leadership to establish a forward-looking product vision that aligns with organizational goals and clinical needs * Workflow Innovation: Lead discovery efforts with clinical teams to understand current pain points and design future-state workflows across multiple specialties * Roadmap Development: Build and maintain a product roadmap that prioritizes high-impact initiatives, balancing clinical value, technical feasibility, and business objectives * Cross-Functional Collaboration: Work closely with engineering, design, marketing, and sales teams to ensure successful product development and launch * Stakeholder Engagement: Build solid relationships with physicians, department heads, and internal teams to gather feedback and ensure alignment * Market Intelligence: Monitor industry trends, competitive landscape, and regulatory changes to inform product decisions * Performance Tracking: Define and track key performance indicators (KPIs) to measure product success and inform continuous improvement 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: * 5+ years of experience in healthcare information technology or clinical technology * 3+ years of experience in full-cycle Product Management * Experience working directly with clinical stakeholders across multiple specialties * Experience working with EHR technology * Experience working in a clinical care environment * Proven ability to collaborate in large, matrixed environments * Experience supporting both inpatient and outpatient clinical workflows including the use of EHR technology within the workflow * Experience supporting cloud technologies and backend infrastructure Preferred Qualifications: * Familiarity with cloud platforms such as Google Cloud Platform (GCP) and Software as a Service * Proven exceptional communication skills, with the ability to translate complex clinical and technical concepts for diverse audiences * Experience delivering patient care in an inpatient setting * Understanding of imaging and healthcare data standards such as DICOM and HL7 * Demonstrated ability to make data-driven decisions using product performance metrics * Proven solid stakeholder management and relationship-building skills * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Director of Physician Relations is responsible for developing, strengthening, and managing strategic relationships with community physicians, nurse practitioners, physician assistants, and their care teams to drive referral growth and promote Summit Rheumatology as the preferred provider for rheumatology services. This role is essential in enhancing Summit's visibility and trust among referring providers, ultimately contributing to the growth of both Summit Rheumatology and FlexCare Infusion Centers This is a full-time position with typical working hours of Monday through Friday, 8:00 a.m. to 5:00 p.m. Hours and work shift may change in accordance with business needs. Exempt employees must have the ability to be on-call and available, as business needs require. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges Primary Responsibilities: * Cultivate and maintain positive, long-term relationships with key community providers and their care teams * Serve as the primary point of contact for referral sources, providing ongoing support, education, and resources related to Summit Rheumatology services * Promote Summit Rheumatology as a trusted partner for rheumatology needs by building credibility and addressing referring providers' concerns and preferences * Develop and implement targeted outreach strategies to increase referral volume to Summit Rheumatology * Align referral growth efforts with FlexCare services such as infusion therapy and specialty pharmacy to support coordinated growth between the two organizations * Collaborate with internal stakeholders to identify high-potential partnerships and emerging referral opportunities * Act as a liaison between Summit Rheumatology and key external stakeholders, including providers, staff, and pharmaceutical representatives * Facilitate effective communication and relationship-building activities to strengthen trust and alignment * Coordinate provider engagement efforts to ensure Summit is positioned as the go-to rheumatology resource * Track and analyze referral patterns and provider engagement data to inform outreach initiatives and refine strategies * Monitor referral outcomes and maintain accurate records of provider interactions and feedback * Provide regular reports and insights to leadership on referral trends and growth opportunities Competency: * Proven ability to build and sustain productive, professional relationships with healthcare providers and stakeholders * Solid understanding of referral dynamics, specialty care coordination, and the healthcare landscape * Excellent communication, interpersonal, and organizational skills * Ability to work independently, travel locally for provider meetings, and manage multiple priorities 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: * 5+ years of experience in physician relations, healthcare business development, or provider outreach * Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) * Driver's License and access to a reliable transportation Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,000 to $130,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Collections Specialist I is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. As a Collections Specialist-Correspondence at Community Health Systems (CHS) - SSC Nashville, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. **Essential Functions** + Performs follow-up on outstanding insurance balances within the required timeframe by working correspondence documents from insurance payors. + Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process. + Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication. + Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information. + Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts. + Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances. + Ensures proper application of account dispositions and follows self-pay policies and procedures. + Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with all policies and standards. + Daily pulling of electronic lockboxes from banking websites as well as indexing of incoming correspondence. + Triaging non patient related correspondence and providing to appropriate stakeholders for review. **Qualifications** + H.S. Diploma or GED required + Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred + 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required + Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred **Knowledge, Skills and Abilities** + Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution. + Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software. + Knowledge of insurance contracts, denials management, and accounts receivable workflows. + Excellent problem-solving and analytical skills to research and resolve outstanding claims. + Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams. + Strong attention to detail with the ability to document account activity accurately. + Ability to work independently in a fast-paced environment while meeting productivity and quality standards. + Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. But we're not only about work. We know employing a skilled and engaged team of professionals is vitally important to our success, so we make sure to offer competitive benefits, recognition programs, professional development opportunities and a fun and engaging team environment. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.