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Banner Health Remote jobs - 142 jobs

  • Facility Coding Inpatient DRG Quality Analyst

    Banner Health 4.4company rating

    Remote

    Department Name: Coding-Acute Care Compl & Educ Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $29.11 - $48.51 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. Interested in joining our Coding team? We have great opportunities, whether you're looking for entry-level or have been coding for years! Requirements for each position noted below. Not the right fit for you? Keep looking! We have a lot different teams with different focuses (Facility vs Profee). In this Inpatient Facility-based HIMS Coding Quality Associate position, you bring your 5 years of acute care inpatient coding background to a team that values growth and development! This is a Quality position, not a day-to-day coding production role but does require coding proficiency and recent Hospital Facility Coding experience. This position is task-production-oriented ensuring quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. Schedule: Full time, Monday-Friday 8am-5pm during training. Flexible scheduling after completion of training. Location: REMOTE, Banner provides equipment Ideal candidate: 5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume); DRG and PCS Coding, Auditing experience; Bachelors degree or equivalent; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. Interested in joining our Coding team? We have great opportunities, whether you're looking for entry-level or have been coding for years! Requirements for each position noted below. Not the right fit for you? Keep looking! We have a lot different teams with different focuses (Facility vs Profee). Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the quality of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation and accurate MS-DRG, Ambulatory Payment Classification (APC) or ICD-10 assignments on health records. Provides guidance and expertise in the interpretation of, and adherence to, the rules and regulations for code assignment based on documentation for all levels of complexity to include accounts encountered in Banner's Academic, Trauma, high acuity and critical access facilities, as well as specialized services such as behavioral health, oncology, pediatric. Acts as subject matter expert regarding experimental and newly developed procedure and diagnostic coding. CORE FUNCTIONS 1. Provides guidance on coding and billing, utilizing coding and billing guidelines. Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment Classification (APC) or utilized operational systems. Provides explanatory and reference information to internal and external customers regarding coding assignment based on clinical documentation which may require researching authoritative reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work and trends, and offers suggestions for improvement where opportunities are identified. Reviews accuracy of identified data elements for use in creating data bases or reporting to the state health department. If applicable, applies Uniform Hospital Discharge Data Set (UHDDS) definitions to select the principal diagnosis, principal procedure, complications and co morbid condition, other diagnoses, and significant procedures which require coding. Apply policies and procedures on health documentation and coding that are consistent with official coding guidelines. 3. Assists with maintaining system wide consistency in coding practices and ethical coding compliance. If applicable, initiates and follows through on physician queries to ensure that code assignment accurately reflects the patient's condition, treatment and outcomes. Identifies training needs for coding staff. Serves as a team member for internal coding accuracy audits and documents findings. 4. Acts as a knowledge resource to ancillary clinical departments, patient financial services and revenue integrity analysts regarding charge related issues, processes and programming. Participates in company-wide quality teams' initiatives to improve coding and clinical documentation. Assists with education and training of staff involved in learning coding. Assists in creating a department-wide focus of performance improvement and quality management. Assists and participates with management through committees to properly educate physicians, nursing, coders, CDM's, etc. with proper and accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/review of inpatient and/or outpatient medical records to assure the use of proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials, billing edits/rejections to provide coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple platforms and internal tracking tools. Provides findings for use as a basis for development of coding education and audit plans. 6. Maintains a current knowledge in all coding regulatory updates, and in all software used for coding, coding reviews and health information management for the operational group. Identifies and collects data to allow for monitoring and evaluation of trends in DRG (MS/APR-DRG), APC, HCC, other Heath Risk Adjusted Factors, National Correct Coding Initiative (NCCI) and the effect on Case Mix Index by use of specialized software. 7. May code inpatient and outpatient records as needed. Works as a member of the overall HIMS team to achieve goals in days-to-bill. 8. Works independently under limited supervision. Uses an expert level of knowledge to provide coding and billing guidance and oversight for all Banner facilities and services they provide. Internal customers include but are not limited to medical staff, employees, and management at the local, regional, and corporate levels. External customers include but are not limited to, practicing physicians, vendors, and the community. MINIMUM QUALIFICATIONS Requires a level of education as normally demonstrated by a bachelor's degree in Health Information Management or experience equivalent to same. Demonstrated proficiency in hospital coding as normally obtained through 5 years of current and progressively responsible coding experience required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other qualified coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Demonstrated proficiency in hospital coding as normally obtained through 5 years of current and progressively responsible coding experience required. Must possess a thorough knowledge of ICD Coding and DRG and/or CPT coding principles, as recommended by the American Health Information Management Association coding competencies. Requires an in-depth knowledge of medical terminology, anatomy and physiology, plus a thorough understanding of the content of the clinical record. Extensive knowledge of all coding conventions and reimbursement guidelines across services lines, LCD/NCDs and MAC/FIs. Extensive critical and analytical thinking skills required. Ability to organize workload to meet deadlines and maintain confidentiality. Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts. Must consistently demonstrate the ability to understand the Medicare Prospective Payment System, and the clinical coding data base and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic medical records software. PREFERRED QUALIFICATIONS Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $29.1-48.5 hourly Auto-Apply 12d ago
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  • Hospice Medical Director - Remote Only, Per Diem, Flexible Schedule

    Banner Health 4.4company rating

    Greeley, CO jobs

    **Per Diem Hospice Medical Directorin Beautiful Northern, CO** **Remote Only & Flexible Schedule** **BANNER HEALTH and the Home Care & Hospice Division** , one of the countrys premier, nonprofit health care networks with more than 1,500 physicians and advance practice providers, **has an excellent opportunity for a compassionate, skilled clinician to join our interdisciplinary team!This position serves the growing community in Northern Colorado in partnership with the current care team.** Utilizing a multidisciplinary approach, the qualified candidate will provide remote support to the Home Care & Hospice team of Advanced Practice Providers. **Position Requirements and Information:** + BC/BE in a relevant specialty + Colorado state licensed + Fellowship training in Hospice & Palliative Medicine - NOT REQUIRED + Experience preferred, new graduates also welcome to apply + Flexible schedule primarily providing back-up coverage for the acting Medical Director **Compensation & Benefits:** + **$140/hr** + Malpractice and Tail Coverage **About the area:** With more than 300 days of sunshine, Northern Colorado is one of the best places to live and work offering spectacular views along the Rocky Mountain Front Range, great weather, endless recreational activities, cultural amenities, education, and professional opportunities. + Within one hour of majestic Rocky Mountain National Park & 90 minutes to world-class ski resorts + Numerous outdoor activities including golf, biking, hiking, camping, rock climbing, hunting, and fishing + Thriving cultural and retail sectors + Highly educated workforce & broad-based business sector leading to substantial growth along the front range + Variety of public and private education options for K-12 and easy access to three major universities **PLEASE SUBMIT YOUR CV TODAY FOR IMMEDIATE CONSIDERATION** As an equal opportunity employer, Banner Health values culture and encourages applications from individuals with varied experiences and backgrounds. Banner Health is an EEO Employer. POS15101 Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.
    $140 hourly 39d ago
  • UM Regulatory Nurse Specialist, Health New England

    Baystate Health 4.7company rating

    Springfield, MA jobs

    Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees. Minimum - Midpoint - Maximum $96,137.00 - $110,510.00 - $130,728.00 UM Regulatory Nurse Specialist - Baystate Health, Health New England This is a full-time remote opportunity. Current States Eligible MA and CT The UM Regulatory Nurse Specialist is responsible for delivering medical or behavioral health utilization management (UM) and coordination of care services to members in compliance with current accreditation requirements and quality standards, and within the scope of the members' benefit package. Supports the HNE mission by developing partnerships with and providing personal and accountable service to members and providers. Impacts positive health outcomes for members and positive financial outcomes. Keeps abreast of professional standards, new technologies and proactively seeks out new learning. Compliance and Coding: The Nurse Specialist will assist the Utilization Management Department with developing, implementing, and maintaining the compliance program and compliance risk management efforts for Health New England (HNE) as they pertain the Utilization Management and Case/Disease Management. This position will also manage all requirements around coding review for the department. This position works to ensure that HNE operates within the policies, procedures, and regulations set forth by HNE and by state and federal laws, including HIPAA, Medicare, and Medicaid. A comprehensive knowledge of policies and procedures related to state and federal regulations is required. This position will work closely with the HNE Compliance Department who providers guidance, conducts reviews or monitor potential issues noted in the annual risk assessment and/or annual work plan. This position will operate as a HS liaison with various departmental stakeholders, including Legal, Government Programs, Complaints & Appeals and Quality. Essential Functions: Pre-authorization review utilizing criteria to determine appropriateness of requested services Admission review utilizing criteria to determine appropriateness of inpatient admission Concurrent review utilizing criteria to determine appropriateness of continued stay and appropriate level of care Retrospective review utilizing criteria to determine appropriateness of requested service/level of care Proactive discharge planning to ensure members' needs are met throughout the continuum of care Performs research to obtain necessary clinical information for decision making Ensures appropriate timeliness, guidelines, and proper notification standards are met Coordination of Care functions Assists members and providers with transition of care, referral management, care coordination, and benefit management Makes appropriate referrals within CSI team as well as to external resources, such as a members PCP to maximize positive member outcomes as per HNE policies and processes Contributes to enhancement of services -existing and new- by participating on workgroups, clinical initiatives, service initiatives, quality initiatives, and others as assigned Assists with creation and revision of departmental Policy & Procedures Processes Member and Provider appeals Effectively utilizes HNE UM/CM/DM policies and processes, and electronic systems Participates with off-site visits to in-plan facilities and providers Compliance Education, Training, and Communication Develops and coordinates general compliance educational activities as directed by the Compliance Department as they relate to Health Services. This includes preparing educational materials for annual compliance training requirements and for smaller informal sessions as directed Monitors and updates SupportPoint as needed Compliance Regulatory Filings and Audits Coordinates compliance and regulatory responses with the HNE Compliance Department when addressing filings for MCO as required by Commonwealth of MA, Division of Insurance, Federal Healthcare Administration, and MassHealth, including but not limited to renewal applications for HMO Accreditation, License, and Mental Health Parity certification for Commercial and MassHealth. In addition, the Health Services Compliance Specialist will be responsible for HS participation in the ODAG annual audit as well as the CMS Mock Audit, coordinating reporting and gathering all pertinent documentation and oversight of any necessary re-training for the HS team Required Education/Experience: Massachusetts RN license required 3-5 years' experience as a UM Clinical Review Nurse for a Health Plan Understanding of the use of medical coding Strong critical thinking skills Innovative thinker Strong analytical and research skills Preferred Experience Certified Professional Coder Certification coding Direct experience in Staff Education Innovative thinker Strong analytical and research skills THE ADVANTAGES OF WORKING WITH BAYSTATE! Excellent Compensation High-quality, low-cost medical, dental and vision insurance Generous PTO Continuing education support and reimbursement Wellbeing programs that include but are not limited to mental, physical, and financial health Pet, home, auto and personal insurance Life insurance Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more! About Health New England Based in Springfield, Massachusetts, part of Baystate Health, Health New England is a regional not-for-profit health plan serving over 160,000 members in central and western Massachusetts and parts of Connecticut. Health New England has been meeting the health care needs of its members for nearly 40 years. Health New England is committed to improving the health and lives of people of our community, both in our workplace and for our members. We are committed to creating opportunities for individuals of all backgrounds to grow and thrive. Education: Bachelors Degree Certifications: Registered Nurse - State of Massachusetts Equal Employment Opportunity Employer Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
    $96.1k-110.5k yearly Auto-Apply 5d ago
  • Oncology Data Specialist (ODS) - $2500 Sign on Bonus!!! FULLY REMOTE!!!!

    Penn Medicine 4.3company rating

    Plainsboro, NJ jobs

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Location: Plainsboro, NJ - FULLY REMOTE!!!! _*_ _** Required to be CERTIFIED - please do not apply if you do not have this certification_ Schedule: Monday - Friday (no weekends) - 7:30 am - 4 pm _Sign-On Bonus of up to $2500 for this position_ _Benefits You'll Receive at Princeton/Penn Medicine:_ _· Generous Paid Time Off benefits, including eight paid holidays that will give you the work-life balance today's world needs_ _· Medical, Dental, Vision, and Prescription coverage plan options that best fit your personal & family needs_ _· Tuition Assistance for both Part-Time (20+ hours) and Full-time (40 hours) employees. ( 0.5 FTE and over)_ _· Flexible Health Savings Accounts (FSA/HAS) to save pre-tax dollars to use towards your personal & family medical costs_ _· 403b Retirement Savings, Penn Home Ownership Services, Commuter Benefits, Pet Insurance and Pension_ _· Access to company paid life insurance, temporary disability. Employee discounts and perks, including but not limited to free secure employee-only parking, Critical Illness Insurance, Accident Insurance, Universal Life Insurance, Disability Income Protection, Group Legal and Pet Insurance are available to eligible employees: paid for through payroll deductions and other. Please click on this_ LINK (**************************************************************************************** _for more information regarding our amazing benefits package._ Implements and monitors procedures to comply with New Jersey State Cancer Registry requirements, American College of Surgeons Commission on Cancer, and the National Accreditation Program for Breast Centers program standards. Along with the Cancer Services Director, and Manager of Cancer Registry & Program Accreditation, ensures that the Penn Medicine Princeton Health Cancer Program maintains ACoS CoC and NABPC Accreditation. Accountabilities: + Identify (case-finding), accessioning, and abstracting new cancer cases in both inpatient and outpatient settings in accordance with the standards set by the New Jersey State Cancer Registry (NJSCR) and Commission on Cancer (CoC) program, while maintaining a high level of accuracy of 95-100 % and meeting productivity quota per institutional and departmental standards. Analyzes data for cases not required by the Federal or State but meeting requirements for special case studies or identified for reportable by agreement cases. - Digests complex clinical information to determine if data entered into the Cancer Registry software is accurate, complete, and valid. Understands clinical pathways to determine treatment types based on site, extent of disease, type of cancer, and associated NCCN guidelines. + - Review data for completeness and accuracy. Pursues missing data necessary for abstract completion by contacting outside physician offices, hospitals, and Cancer Registries. - Manages and maintains lifetime follow-up data on all analytic patients in the Cancer Registry. - Ensures timely and accurate reporting of cancer data to the ACoS CoC and the New Jersey Department of Health (NJSCR). - Ensures compliance with all ACoS CoC and NAPBC program standards. Assists with re-accreditation site visit preparation. - Maintain patient confidentiality and security of patient data in all formats maintained in the Cancer Registry. - Attends and participates in departmental, organizational and/or educational meetings, as requested. Remote employees are expected to travel onsite for meetings/events, as needed. - Cooperates with the State Department of Health (NJSCR) in supplying requested data. - Prepares oncology-related reports for staff, physicians, and outside organizations as requested. - Participates in quality improvement initiatives and assists with department quality assurance and improvement plan as directed by the Manager. - Completes concurrent QA process to ensure ongoing productivity, quality, and professional development goals are achieved. Depending upon the result of the assessment, personalized educational content may be completed. - Maintains knowledge of current trends and developments in the field by reading relevant literature and participating in seminars and conferences to stay up to date with the latest practices and advancements. Applies new insights & new knowledge & techniques to the performance of responsibilities. - Responsible for completing annual education requirements outlined by the National Association of Cancer Registrars (NCRA) to maintain active and good-standing Oncology Data Specialist (ODS) credentials. QUALIFICATIONS + Associate's Degree And 2+ years Experience in the Cancer Registry with a minimum of 1 year of abstraction experience as Oncology Data Specialist in a hospital setting Licenses and Registrations/ Certifications: + Oncology Data Specialist (ODS) - REQUIRED We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. **Salary Range:** $28.08 - $44.77/Hourly As part of their job offer, successful candidates are provided a specific rate, taking into consideration various factors including experience and education. Click here (******************************************** for information on UPHS's Benefits. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 268524
    $28k-44k yearly est. 26d ago
  • NP or PA for Sentara Behavioral Health Specialists-Suffolk

    Sentara Hospitals 4.9company rating

    Remote

    City/State Carrollton, VA Work Shift First (Days) Provider Specialty Behavioral Health Sentara Medical Group is seeking a dedicated and compassionate provider to join our growing Behavioral Health team. This is an exciting opportunity to help build a new outpatient practice while being connected to a robust network of behavioral health professionals across the region. Position Highlights Outpatient position with potential for remote/telehealth flexibility M-F, 8:00-5:00 p.m. (No Call) Average patient load: 12-14 patients per day Initial team size: 1 provider at a new location, with plans to expand and integrate into a larger brick-and-mortar behavioral health center Collaborative environment as part of a broader outpatient group of 20+ Advanced Practice Providers and 15 therapists Provide support and treatment for a wide range of conditions Benefits Highlights Competitive compensation and comprehensive benefits package Medical, dental, and vision coverage Retirement plans with employer match Paid malpractice with tail coverage Paid time off and CME allowance Supportive administrative and clinical leadership Suffolk, Virginia, offers the perfect blend of small-city charm and modern convenience. Known for its scenic waterfronts, vibrant downtown, and expansive natural beauty, Suffolk provides a welcoming community with excellent schools, diverse dining, and easy access to Hampton Roads' cultural and recreational amenities. With a growing economy and a relaxed pace of life, Suffolk is an ideal place to live and work. . -Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave• Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down - $10,000• Annual CME Allowance• Reimbursement for certifications and free access to complete CEUs and professional development• Pet Insurance• Legal Resources Plan• 100% Malpractice and Tail Coverage• Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met Providers at Sentara are eligible for special benefits such as Annual CME Allowance and 100% malpractice and tail coverage. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs providers in the following states: North Carolina, Nevada, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia and Wisconsin.
    $36k-47k yearly est. Auto-Apply 60d+ ago
  • Cancer Registrar, Certified - FT - Days - Remote

    Sanford Health 4.2company rating

    Fargo, ND jobs

    Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Scheduled Weekly Hours: 40Salary Range: $21.50 - $34.50 Union Position: No Department Details Remote Fargo only Summary The Cancer Registrar, Certified holds the Oncology Data Specialist (ODS) certification and independently abstracts all cancer sites into the Cancer Registry while meeting quality standards. This role efficiently and effectively performs all cancer registry workflows including case finding, abstracting, patient follow-up, and safety net workflows. Job Description Independently analyzes and interprets clinical and demographic data and determine appropriateness of case inclusion in cancer database. Identifies, codes and abstracts records of all eligible cancer patients (analytic and non-analytic), utilizing the cancer registry data system within the guidelines and requirements of the American College of Surgeons CoC, State, Cancer Registry standard setters, and other applicable requirements. Completes abstracting in a multi-facility database structure, analyzes cases for inclusion or exclusion, performs patient follow-up analysis, and is able to complete all safety net workflows. Maintains work performance within production and quality guidelines. Works proficiently in Epic workflows. Completes necessary continuing education to maintain ODS certification, compliance with CoC accreditation standards, and maintains current knowledge of guidance/updates issues by cancer registry standard setters. Possesses knowledge of ICD-10, ICD-0, and morphology coding. Requires extensive knowledge of anatomy, physiology, disease processes, and current standards of care. Adheres to, displays and upholds the Sanford Values. Serves as a role model on professionalism, attitude, knowledge, demeanor and execution of duties. Regularly uses critical thinking skills, problem solving and decision making skills in the course of work. Possesses attributes to include: Skillful and flexible at managing change. Understands a systems approach to problem solving. Possesses excellent written and oral communication skills. Well organized. Willingness and ability to make decisions and be accountable for same. Flexibility, creativity and a willingness to implement new ideas. Knowledgeable in computer hardware and software applications including Microsoft Office, electronic medical records (EMR) and Cancer Registry database. Ability to work with team members in remote locations using a variety of technologies. Works extensively with electronic medical records and protected health information and is required to adhere to Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations and policies related to the same. Qualifications Oncology Data Specialist certified through the National Cancer Registrars Association is required and must meet post-secondary education requirements of NCRA. Minimum of one year Cancer Registry experience is preferred. Oncology Data Specialist certified through the National Cancer Registrars Association is required. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
    $21.5-34.5 hourly Auto-Apply 5d ago
  • Charge Capture Supervisor

    Banner Health 4.4company rating

    Remote

    Department Name: Revenue Integrity-Corp Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $29.11 - $48.51 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. In this Supervisor role, you will provide oversight of a Charge Capture team, as well as working alongside Charge Specialists to ensure timely, accurate revenue resulting from hospital services. In addition to charge capture workflow, you also will be responsible for providing coordination and/or collection of relevant charge capture data as well as maintenance/updates as necessary to ensure the integrity of assigned EMR/AR systems and databases. While this is a supervisor role 50% of the day will be actively performing charge capture functions. Schedule: Monday-Friday, Exempt Location: Remote, Banner will supply equipment Ideal Candidate: Need 3-4 years experience in healthcare revenue integrity, preferably as charge capture and/or coder experience, clearly reflected in uploaded resume; (50% of this role is active charge capture) Bachelors degree or equivalent experience in Billing & Coding (Certifications similar to CPC, CCS a plus); Leadership experience, as this is a Front-Line leader role with 10 direct reports. This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV, WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is responsible for providing coordination and/or collection of relevant financial data to prepare and interpret financial reports for management in an accurate and timely manner. This position provides maintenance/updates as necessary to ensure the integrity of assigned financial systems and databases. This position provides oversight of charge specialists ensuring timely and accurate charge capture and correction of revenue resulting from hospital services. CORE FUNCTIONS 1. Hires, trains, conducts performance evaluations, and supervises the workflow for designated charge staff within department. This includes initiating promotions, transfers, and disciplinary actions. This includes establishing priorities, workloads, controls and work procedures, as well as determines resources needed. Provides oversight and coordination for charge staff who have direct reporting lines to operational leaders. 2. Gathers data from various sources to document and analyze statistics and financial information necessary to complete projects in assigned area. Generates various monthly or bi-weekly financial reports or ad hoc reports that enable management to control and analyze operations. 3. Works with management and staff of various departments to assist with financial data gathering and/or interpretation. Ensures accuracy of financial information systems and maintenance of reporting. Ensures the integrity of statistical files and databases used for financial reporting. 4. Works with other analysts to manage key financial processes within the organization (including operating budgets, forecasts program reporting and analysis, charge management, cost accounting, decision support and reimbursement analysis). 5. Provides financial modeling resources for special projects assigned to the department by management for analysis. 6. Prepares timely and accurate reports and presentations for state and federal agencies, administration and corporate to satisfy mandated reporting requirements policy, law or management. Maintains accurate statistical, contractual or other financial databases, as assigned. 7. May serve as Cost Center/Program CFO (as assigned), which includes the initiation and assistance in identification and implementation of operating improvements and efficiencies by identifying important trends and variances through the review of management reports and financial analysis. Educates users of the assigned financial reporting system on the utilization of reports and the functionality of those reports. 8. Works with management and staff of various departments to assist with data gathering and/or interpretation. Ensures accuracy of information systems and maintenance of reporting. Ensures the integrity of statistical files and databases used for financial and other business reporting purposes. 9. Provides leadership, direction and training for staff reporting to operation leaders; audits and resolves work process problems. Uses specialized knowledge to analyze information and solve business problems. Works independently under general supervision. Provides management with accurate and timely information necessary to effectively manage financial operations for revenues in excess of $300m annually. Consults internally with Department Directors, Administration, Data Operations, Financial Services Department Personnel and Banner Health System personnel. Works with State governmental agencies, colleagues as other healthcare facilities, professional organizations and outside vendors. MINIMUM QUALIFICATIONS Requires a Bachelor's degree in Accounting, Finance or Business Administration or equivalent experience. Requires a proficiency level typically attained with 3 to 4 years of experience in healthcare financial management/analysis work. Must have excellent analytical and organizational skills and the ability to manage multiple priorities with changing needs and deadlines. Requires excellent human relations skills and the ability to effectively interact and communicate both verbally and in writing with all levels staff and outside professionals. Requires strong abilities in statistical analysis, data interpretation, computer software applications, database and spreadsheet programs, plus a proficiency in financial modeling techniques to generate management reports, projections, allocations, and analyses. PREFERRED QUALIFICATIONS Additional related education and/or experience preferred. Anticipated Closing Window (actual close date may be sooner): 2026-05-14 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $29.1-48.5 hourly Auto-Apply 5d ago
  • Senior Grant Administrator - Remote

    Ochsner Health System 4.5company rating

    New Orleans, LA jobs

    We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job resides within Research Financial Operations, which manages research and federal grant applications across the Ochsner Health system. This project management position focuses on grant administration, the “project” being the accurate, consistent, and professional provision of comprehensive pre-award services to a range of Principal Investigators/Project Directors (PI/PDs) across biomedical disciplines and Ochsner sites. These services include the thorough review of budget justifications in terms of Ochsner policy and sponsor requirements; budget preparation; application coordination; and the timely, error-free submission of applications to a variety of portals. The incumbent's duties will include maintaining meticulous records; preparing timely activity, Just in Time, and progress reports; and providing PI/PDs with consulting and problem solving services. The Project Manager will also act as the primary point of contact for the PI/PD, relevant Ochsner units, research support teams, and sponsors to ensure coordination among stakeholders and contributors, all the while upholding high standards and exemplifying best practices. 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 qualified individuals with disabilities to perform the essential duties. This is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion. Education Required - Bachelor's degree. Work Experience Required - 5 years of relevant experience including 3 years of supervisory or project management experience. Knowledge Skills and Abilities (KSAs) Effective verbal and written communication skills and the ability to present information clearly and professionally. Proficiency in various office software packages, including but not limited to Excel, Word, Access, and PowerPoint. Excellent judgment, decision-making, delegating and leadership skills. Analytical skills and ability to demonstrate a logical through process in order to formulate practical solutions to problems. Positive interpersonal skills and ability to effectively and professionally work with people from all backgrounds. Ability to travel throughout and between facilities and work variable schedule, such as nights, evenings, weekends, holidays, extended shifts, etc. Job Duties Manages all facets of assigned project(s). Ensures the project supports organizational and departmental goals. Gathers and analyzes information to prepare status reports. Maintains and enhances professional competency. Performs other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental 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. Normal routine involves no exposure to blood, body fluid or tissue, but exposure or potential for exposure may occur. The incumbent may work around or with patients who have known or suspected communicable diseases and may enter isolation rooms. The incumbent may have an occupational risk for exposure to all communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at ************ (select option 1) or ******************* . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.
    $44k-53k yearly est. Auto-Apply 3d ago
  • Risk Adjustment Coder Professional Billing II, FT, Days, - Remote

    Prisma Health 4.6company rating

    Greenville, SC jobs

    Inspire health. Serve with compassion. Be the difference. Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in education offerings Participates in monthly meetings Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Five (5) years professional fee coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder (CPC), and Certified Risk Adjustment Coder(CRC) Knowledge, Skills and Abilities Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7002 Value-Based Care and Network Services Department 70028459 HCC Coding Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
    $28k-33k yearly est. 1d ago
  • Physician - Remote Emergency Radiologist

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description: Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin. Fellowship training in Body, Neuro, ED or MSK is required. Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT. No CVIR, nuclear medicine or mammography. Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits. If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures. Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers. Coverage needed for afternoons and evenings. No midnight shifts required. Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year Compensation/Benefits: Competitive Salary Flexible shift based model Health, Dental, Life, and Occurrence Based Malpractice insurance Relocation support available if working onsite Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs. MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come. Marshfield Clinic Research Institute: ********************************** Marshfield Clinic Division of Education: ****************************************** Marshfield, Wisconsin Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself. Fun Fact: Marshfield is known as the HEART of Wisconsin! Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care. The Marshfield Promise Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone. The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability. For more information, please contact: Lindsay Becker, Physician and Advanced Practice Clinician Recruiter Phone: ************ *********************************** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $282k-517k yearly est. Auto-Apply 60d+ ago
  • Insurance Representative - Remote ND, SD

    Sanford Health 4.2company rating

    Valley City, ND jobs

    Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: 8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 40Salary Range: $16.00 - $25.50 Union Position: No Department Details Summary The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Job Description Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job related duties as requested. Consistently demonstrates accuracy in correcting (identified through pre-edits) and submitting claims to payers. Ensures accounts are billed in timely manner. Consistently reports to a manager any accounts that cannot be finished in a timely manner. When claims are disputed, consistently utilizes the correct resources to ensure the completion of the claim. Accurately and completely follows claim through entire billing process. Ensures all claims consistently meet compliance regulations. Demonstrates accountability by consistently using appropriate resources and channels to problem solve issues. Consistently demonstrates ability to input data accurately into the computer system. Consistently answers the telephone courteously. Maintains and updates computer skills as needed for work assignments. Demonstrates the ability to utilize software applications for maximum efficiency. Consistently ensures verbal communication is courteous, complete, and professional whether using phone or personal contact. Consistently ensures written communication is accurate, complete and professional in presentation whether word processing or using email. Identifies and promptly resolves billing complaints. Directs issues to supervisor when unable to resolve. Documents in computer system all contacts regarding patient accounts. Depending on location, may verify demographics, identify appropriate third-party insurance/payers, set up insurance, initiate patient financial assistance. Contact the insured or financially responsible party to obtain missing information. Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy. Qualifications High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position. Six months' related work experience required. Computer skills essential. When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
    $16-25.5 hourly Auto-Apply 4d ago
  • Risk Adjustment Revenue Manager (Remote)

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process. JOB QUALIFICATIONS EDUCATION Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required. Preferred/Optional: Post graduate degree(s) desirable. EXPERIENCE Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen. Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record. Preferred/Optional: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $72k-94k yearly est. Auto-Apply 14d ago
  • Health Services Assistant Banner Plans and Networks

    Banner Health 4.4company rating

    Phoenix, AZ jobs

    Primary City/State: Tucson, Arizona Department Name: Banner Staffing Services-AZ Work Shift: Day Job Category: Clinical Care Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health. Learn more at **************************** Recognized nationally as an innovative leader in health care, Banner Plans & Networks (BPN) integrates Medicare and private health plans to reduce healthcare costs while keeping our members in optimal health. Known for our innovative, collaborative, and team-oriented approach, BPN offers a variety of career opportunities and innovative employment options by offering remote and hybrid work settings. As a Health Services Assistant you will help support the Clinical Performance Team in a temporary assignment during the annual audit time frame of January 2026 - June 2026. You will be requesting and processing medical records from various provider offices via phone, fax, email, and other modalities. This is a fast-paced and deadline process environment. You will work primarily at the Banner Corporate Offices in Tucson with limited remote work possibilities after training completion. Your work week will be 40 hours per week, working day shifts Monday - Friday. Tucson, Arizona residency is required for this role. As a valued and respected Banner Health team member, you will enjoy: * Competitive wages * Paid orientation * Flexible Schedules (select positions) * Fewer Shifts Cancelled * Weekly pay * 403(b) Pre-tax retirement * Resources for living (Employee Assistance Program) * MyWell-Being (Wellness program) * Discount Entertainment tickets * Restaurant/Shopping discounts Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered. Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes employment, criminal and education) is required. If this Banner Staffing Services role sounds like the right one for you, Apply Today! POSITION SUMMARY This position is responsible for optimizing the experience of patients and families who receive care within the hospital and ambulatory care setting. Effectively interfaces and collaborates with providers and staff to identify solutions to care coordination, involving all team members as needed. This position supports the multidisciplinary team with member navigational services through referral from the team or retrospectively from the payer. CORE FUNCTIONS 1. Researches concerns and provides resolutions to patient's issues and needs, in collaboration with all team members. 2. This position is responsible for on-going client data collection and documentation in the medical record. Engages the appropriate resources within the multidisciplinary team to achieve optimal results for the patient, family, and care givers. 3. Offers assistance with coordinating multiple appointments, utilizing the scheduling systems to ensure thorough communication across the multiple disciplines. 4. Provides a list of care gaps to the multidisciplinary team and works to coordinate to close gaps/issues. Bridges gaps between the member and the clinical team including but not limited to following up with members, asking about needs and obstacles, and addressing health literacy, cultural issues and social-class barriers. 5. Meets and accompanies the patient and family to their initial appointments with providers before and after acute and post-acute transition. 6. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 7. Educates internal members of the health care team on care management and managed care concepts. Facilitates integration of concepts into daily practice. 8. Works independently to provide excellent patient care. Internal customers include patients, staff, and physicians. External customers include patient family and members of the community. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires a knowledge of Medical terminology as normally obtained through the completion of , Medical Assistant Training, Patient Care Technician or Certified Nursing Assistant Training and 2 years of health care experience. Requires excellent time management and problem-solving skills, ability to meet constantly shifting deadlines and timelines and excellent customer service and recovery skills. PREFERRED QUALIFICATIONS Bachelor's degree in Social Work preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $28k-51k yearly est. Auto-Apply 13d ago
  • Cybersecurity Engineer II Firewall

    Banner Health 4.4company rating

    Remote

    Department Name: IT Network Services Work Shift: Day Job Category: Information Technology Estimated Pay Range: $40.91 - $68.19 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Banner Health was named to Fortune's Most Innovative Companies in America 2025 list for the third consecutive year and named to Newsweek's list of Most Trustworthy Companies in America for the second year in a row. We're proud to be recognized for our commitment to the latest health care advancements and excellent patient care. Our team is Firewall Services within the Banner Infrastructure department and our team supports all perimeter Palo Alto firewalls that protect all hospitals, clinics, MOBs, Cloud, Data Centers, etc. from security breaches such as patient PHI and PII data. As Banner continues to leverage technology to deliver the highest quality of possible care, Cybersecurity is a top priority. Firewalls Services is responsible for planning, implementing, managing, monitoring, and upgrading security measures for the protection of the organization's data, systems, and networks as well as troubleshooting security and network platforms. This position ensures that the organization's data and infrastructure are protected from insider and outsider threats by enabling the appropriate security controls while responding to all system and/or network security breaches. As a Cybersecurity Engineer II, you will be on the front lines and help investigate and remediate cybersecurity incidents, escalate cybersecurity incidents as defined by procedure, and help liaise closely with other teams to ensure the correct response and remediation of cybersecurity incidents. Also in the CSE II role, you will be an innovator and SME within design and architecture as well as helping see Cyber Security projects through to completion within the Banner team. The typical schedule for this role is Monday - Friday 8AM - 5PM AZ time. This can be a remote position if you live in the following states only: AL, AK, AZ, AR, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MD, MI, MO, MN, MS, NH, NM, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WV, WA, & WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position designs, develops, configures, implements, tunes, maintains solutions, resolve technical and business issues related to cybersecurity threat & vulnerability management, identity management, security operations center, forensics, and data protection. Cybersecurity Engineers work with Cybersecurity Architects to execute strategic cyber initiatives, evaluate security components of the network, applications and end-user devices, and provides guidance to ensure new systems meet regulatory and technical standards. Cybersecurity Engineers participate in root-cause analysis efforts to determine improvement opportunities when failures occur. Manage Cyber systems, ensures they are tuned, on the current release and manages appropriate change management across the IT organization and the business. CORE FUNCTIONS 1. Leads in the design and implementation of cybersecurity solutions. 2. Leads in providing technical expertise and support for cybersecurity solutions, including operational aspects of the software, hardware, network/firewall. 3. Leads in the design, implementation, and compliance of secure configurations for applications and infrastructure components. 4. Leads in technical assessments of systems and applications to ensure compliance with policy, standards and regulations. 5. Leads in the ongoing evaluation and development of security policies and procedures. Leads the revision of policies and procedures, as needed. 6. Serves as technical lead of cybersecurity projects, including the development of project scope requirements, cybersecurity product implementation, tuning, operational support model creation. 7. Under general direction, this position is responsible for cybersecurity across multiple departments system-wide and requires interaction at all levels of staff and management. Work closely on cross functional IT Teams. MINIMUM QUALIFICATIONS Must possess strong knowledge of business, information security and/or computer science as normally obtained through the completion of a bachelor's degree in Computer Science, Information Security, Information Systems, or related field. Four to six years of experience of enterprise-scale information security engineering, preferably in healthcare. Must also possess one to three years' experience in a healthcare environment or an equivalent combination of relevant education, technical, business and healthcare experience. Experience, IT operations, automation of cybersecurity processes, coding and scripting languages, ability to document cybersecurity processes as well as use case development. Experience with the assessing cyber products, including vendor selection, define requirements, contractual documentation development. Experienced in planning, designing and implementing cybersecurity solutions. Experienced in operating, maintaining and implementing, upgrading and lifecycle of cybersecurity solutions. Proficient understanding of regulatory and compliance mandates, including but not limited to HIPAA, HITECH, PCI, Sarbanes-Oxley. Advanced knowledge of Security Engineering Principles, including risk management, resilience, vulnerability management, Information Security, NIST, MITRE ATT@CK, etc. Expertise in Cyber products supporting Data Loss Prevention, EDR, AntiVirus, Perimeter services, Threat systems, cyber platform analytics, SIEM, CASB, CLOUD Security, ETC. Requires independent judgment, critical decision making, excellent analytical skills, with excellent verbal and written communications. Ability to think quickly under difficult or complex conditions and clearly communicate to appropriate staff; ability to balance project workloads with customer support and on-call demands. Must demonstrate knowledge of information technology and information security principles and practices. Requires communication and presentation skills to engage technical and non-technical audiences. Requires ability to communicate and interact across facilities and at various levels. Incumbent will have skills to mentor less experienced team members. As is typical in this industry, variable shifts and hours and responding to after-hours notifications may be required. PREFERRED QUALIFICATIONS Certification in two or more of the following areas: Systems Security Certified Practitioner (SSCP), HealthCare Information Security & Privacy Practitioner, (HCISPP), CompTIA Security+, Certified Information Systems Security Professional (CISSP) - Engineering (ISSEP), Certified Ethical Hacker (CEH), SANS GIAC, or Certified Information Systems Auditor (CISA). Three plus years as a System Administrator, Security Operations or in IT Operations. Or three plus years in risk management or GRC experience in the healthcare/medical environment. Must also possess three plus years' experience in a healthcare environment or an equivalent combination of relevant education, technical, business and healthcare experience. Additional related education and/or experience preferred. Anticipated Closing Window (actual close date may be sooner): 2026-05-15 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $40.9-68.2 hourly Auto-Apply 4d ago
  • Service Center Representative Banner Plans and Networks

    Banner Health 4.4company rating

    Remote

    Department Name: Banner Staffing Services-AZ Work Shift: Day Job Category: Administrative Services Estimated Pay Range: $18.02 - $27.03 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Banner Staffing Services (BSS) offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health. Learn more at **************************** Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities. As a Service Center Representative for Banner Plans & Networks you will take inbound calls answering member and provider questions regarding coverage, benefits, claims, and other plan inquiries. You will be working in a fast paced and multitasking environment. You will provide excellent customer service and satisfaction with a goal of first call resolution. As a Service Center Representative, you will be working in a remote setting. Your shifts will be Monday-Friday, working business hours in the Arizona Time Zone. Please note Banner Staffing Services roles do not offer medica benefits or paid time off accrual. These roles are assignment based with no guarantee of hours and assignments can conclude at any time. If this role sounds like the one for you, Apply Today! As a valued and respected Banner Health team member, you will enjoy: Competitive wages Paid orientation Flexible Schedules (select positions) Fewer Shifts Cancelled Weekly pay 403(b) Pre-tax retirement Resources for living (Employee Assistance Program) MyWell-Being (Wellness program) Discount Entertainment tickets Restaurant/Shopping discounts Registry/Per Diem positions do not have guaranteed hours and no medical benefits package is offered. Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes employment, criminal and education) is required. POSITION SUMMARY This position supports the organization's service center by providing daily customer service to physicians and/or staff, employees, health and dental plan members and dependents, payors, hospital staff, and the community at large. Herein referred to as “customer”. CORE FUNCTIONS 1. Receives, documents, researches and responds to customer inquiries following established policies, procedures and standards. (Answer, identify, research, document, and respond to a diverse and high volume of inbound and outbound health insurance related customer calls on a daily basis.) 2. Prepares and/or initiates a variety of correspondence/documents in response to customer inquiries, following departmental procedures and compliance guidelines. (Meet quality, quantity, and timeliness standards to achieve individual department performance goals as defined within the department guidelines and compliance standards.) 3. Facilitates timely research and issue resolution through interaction and communication with the appropriate parties, which includes but is not limited to, department team members, employees within the organization, physician offices, and/or contracted plan representatives. 4. Works cohesively with team members to ensure delivery of outstanding customer service, in a positive work environment, that supports the department's ongoing goals and objectives. 5. Fulfills informational needs of clients for care coordination of members, appropriate access to contracted providers, services of contracted managed care organizations, employee benefits, health and dental plan inquiries, and services of staff such as utilization review, prior authorization, billing and contract management. 6. Services inbound and outbound customer and staff communications for all facilities in the states in which they operate. Works with various departments and staff to provide accurate managed care information. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Demonstrated ability to provide essential customer service and knowledge in a high paced contact center environment as typically demonstrated with up to one year of experience, preferably in a healthcare or managed care. Ability to use technology tools to research and obtain accurate information to respond to customer inquiries via incoming calls, emails and/or instant messaging/chat avenues while maintaining a professional and service oriented demeanor at all times. Demonstrated ability to utilize computer and typing skills. The candidate must possess excellent communication skills to maintain a positive and helpful attitude with customers. Must have the ability to follow oral and written directions as they relate to the functions listed above. Must have the ability to acquire and utilize a sound knowledge of the company's customer information systems, as well as, fundamental knowledge of the organization's benefit programs, as described above. Must possess excellent organizational and time management skills to display the ability to provide timely, accurate information on a variety of benefit-oriented subjects. PREFERRED QUALIFICATIONS Bilingual preferred. Associate's degree with at least one to two years experience in a high call volume service center strongly preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $18-27 hourly Auto-Apply 6d ago
  • Claims Auditor (Remote - WI or MN)

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Claims Auditor (Remote - WI or MN) Cost Center:682891379 SHP-ClaimsScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: JOB SUMMARY The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround time, compliance and operational audits as directed by management. The Claims Auditor has working knowledge of the overall aspects of claim processing, both in and outside of Security Health Plan. Audit responsibilities include applying effective, appropriate and efficient audit procedures in collecting, analyzing and reporting concise and relevant findings. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: High school diploma or equivalent. Successful completion of the following courses per departmental procedures, within one year of hire: current procedural terminology (CPT), current international classification of diseases (ICD), health care procedure coding system (HCPCS) and medical terminology. Preferred/Optional: Associate degree in business, medical or related field. Successful completion of the following courses per departmental procedures at time of hire: current procedural terminology (CPT), current international classification of diseases (ICD), health care procedure coding system (HCPCS) and medical terminology. EXPERIENCE Minimum Required: Three years' experience related to health insurance claim processing. Three years' experience related to CPT/HCPCS and current ICD coding. Demonstrated proficiency with analytical problem solving, written and oral communications and the Microsoft Office Suite. Working knowledge of anatomy & physiology. Preferred/Optional: One year experience in claims auditing. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Certified Professional Coder (CPC) or Certified Professional Coder - Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) within three years of hire based on the department position the resides in. Preferred/Optional: Certified Professional Coder (CPC) or Certified Professional Coder - Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) at time of hire. QUALIFYING APPLICANTS FROM WI & MN WILL BE CONSIDERED Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $34k-38k yearly est. Auto-Apply 60d+ ago
  • Application Manager

    Penn Medicine 4.3company rating

    Philadelphia, PA jobs

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? + Entity: Corporate + Department: IS-EPIC + Location: Remote based out of 3535 Market Street. Philadelphia, PA + Hours: 8hr Days **Summary** : Responsible for leading and managing multiple cross-functional work teams relating to the development of innovative application solutions that achieve successful performance goals and oversee project plans to ensure milestones and project deliverables are met. Develops working knowledge of application systems and business processes and identifies process improvement initiatives and opportunities for improvement in the application. This role will manage the Willow Ambulatory and Specialty Pharmacy team analysts. **Responsibilities:** + Manages team members through the project management life cycle to ensure that overall progress and management of application project tasks are on track. + Manages cross-functional team members to determine and define specific analytical and technical systems information requirements, objectives and solution sets for the enhancements and configuration of the application. Manages the day to day operations of the assigned application team including but not limited to employee mentoring, timecard retrieval, team meetings and communicating operational requirements of UPHS to all team members. + Manages and coordinates the development of new functionality, testing and implementing scheduled vendor releases and system upgrades and fixing system defects. Develops the change management procedures and protocols for the department creates and maintains all policies and procedures for all assigned applications and develop, plan and execute testing for supported applications. + Defines system requirements and develops logical data models using best practices for build and configuration, maintenance and data integrity. + Communicates all necessary application changes, enhancements and procedures to all necessary internal department teams. + Coordinates, creates and maintains all documentation for assigned applications in order to establish standards for configuration and enhancements within the application. Develops the education and delivery to internal team members, system users and other stakeholders in the utilization of functionality within the application. Delivers customer service to IS clients seamlessly across system boundaries. Ensures safety, confidentiality and security of all data. **Credentials:** + Vendor Certification (Preferred) **Education or Equivalent Experience:** + Bachelor of Arts or Science (Required) + And 5+ years Information Technology experience (Required) We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 296735
    $82k-111k yearly est. 39d ago
  • Technical Analyst (Senior, Mid, Associate Level)

    Penn Medicine 4.3company rating

    Philadelphia, PA jobs

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Entity: Corporate Services Department: IS-Corporate Applications Location: 3535 Market Street Hours: (Remote Eligible), M-F, Daylight **The role involves on-site presence for the first 6 months with the possibility of remote work after the introductory period is complete** **Senior Technical Analyst** The **Senior Technical Analyst** is responsible for creating and delivering technical resolutions to create workflow, process design and programming solutions to business problems. Provides technical expertise to ensure that the design, implementation and end results meet the business requirements. Utilizes strong analytical, programming and communication skills to balance technical and business objectives to improve quality outcomes. **Accountabilities** + Responsible for daily monitoring, maintaining a high degree of performance, coordinating system behaviors, using existing and creating new tools for managing multiple environments. + Maintains, creates, and monitors databases. + Creates and implements project plans and routinely communicate status of work. + Ensures system integrity of the application. + Assists in the education and training of new hires and other team members and be available as a resource for the team. + Identifies problem definitions and make recommendations regarding refinements and decisions throughout the product life cycle. + Participates in disaster recovery planning, testing and be available off hours for production support. + Attends planning and status meetings with key client personnel to understand project requirements and communicate our implementation methodology to the client. + Ensures information system functionality meets all clinical and business requirements of Integration and UPHS organization. + Performs duties in accordance with Penn Medicine and entity values, policies, and procedures + Other duties as assigned to support the unit, department, entity, and health system organization **Minimum Requirements** **Required Education and Experience** + Bachelor's Degree is required + 3+ years of Information Technology experience is required + Healthcare IT experience is preferred **Required Skills and Abilities** + Ability to communicate technical information and ideas + Ability to communicate effectively with all levels of staff + Demonstrated customer service skills + Demonstrated interpersonal/verbal communication skills + Knowledge of basic hardware configurations and database management tools **Technical Analyst** The **Technical Analyst** is responsible for creating and delivering technical resolutions to create workflow, process design and programming solutions to business problems. **Accountabilities** + Responsible for daily monitoring, maintaining a high degree of performance, coordinating system behaviors, using existing and creating new tools for managing multiple environments. + Maintains, creates, and monitors databases. + Utilizes industry standard processes to generate specifications for implementation and for specification review process. + Identifies problem definitions and make recommendations regarding refinements and decisions, throughout the product life cycle. + Attends planning and status meetings with key client personnel to understand project requirements and communicate our implementation methodology to the client. + Ensures information system functionality meets all clinical and business requirements of Integration and UPHS organization. + Participates in disaster recovery planning, testing and be available off hours for production support. + Ensures system integrity of the application is the primary responsibility of the administrator. + Assists in the education and training of new hires and other team members and be available as a resource for the team. + Performs duties in accordance with Penn Medicine and entity values, policies, and procedures + Other duties as assigned to support the unit, department, entity, and health system organization **Minimum Requirements** + Required Education and Experience + Bachelor's Degree is required + 2+ years of Information Technology experience is required + Healthcare IT experience **Required Skills and Abilities** + Demonstrated customer service skills + Demonstrated interpersonal/verbal communication skills + Ability to communicate effectively with all levels of staff + Knowledge of basic hardware configurations and database management tools + Ability to communicate technical information and ideas **Associate Technical Analyst** **The Associate Technical Analyst** is responsible for assisting with the creation and delivery of technical and programming solutions to previously identified needs and business problems under the direction of a senior analyst. Ensures system changes follow change management procedures and protocols. **Accountabilities** + Works with key clients to understand project requirements and communicate implementation methodology. + Consults with senior team members to ensure that system functionality meets clinical and business requirements of Integration and UPHS organization. + Follows established documentation and project status procedures. + Assists in the monitoring of projects and maintains open communication with manager. + Develops new Interfaces according to specification. + Follows established documentation and change control procedures related to user requests, system design and development, modifications, testing, and on-going production support. + Provides on-call and production support as necessary. + Performs duties in accordance with Penn Medicine and entity values, policies, and procedures + Other duties as assigned to support the unit, department, entity, and health system organization **Minimum Requirements** + Bachelor's Degree is required + 1+ years' experience in an Information Technology setting is required + Healthcare IT experience is preferred **Required Skills and Abilities** + Demonstrated customer service skills + Demonstrated interpersonal/verbal communication skills + Ability to communicate effectively with all levels of staff + Ability to troubleshoot, research and solve technically challenging problems + Knowledge of basic hardware configurations and database management tools **Additional Information:** + Experience with Infor CloudSuite modules and tools desired, such as GHR, FSM, LPL, IPA, Columnar, Birst, and Async + Experience with Lawson on-premise system administration preferred + Experience in supporting business systems a plus, such as HR, Payroll, Supply Chain, and Finance + Experience with report development and query tools a plus, such as SSRS, Crystal Reports, and SQL (Oracle/SQL Server) + Experience with system administration of time & attendance tools a plus, such as Kronos **Department: IS-Corporate Applications** **Address: 3600 Civic Center Blvd** **As part of our COVID-19 response, this position may currently be offering partial or full remote work. However, in the near future this position will require full or partial on-site work.** **Be a part of the exciting and ground-breaking upcoming years for the Penn Medicine Information Services department!** **Because growth is essential to continuing to meet the current and future needs of patients, Penn Medicine continues to expand its capabilities.** **Penn Medicine's Information Services (IS) Department** focuses its efforts on the clinical and financial systems that support the day-to-day operations of four hospitals, several satellite practices, and more than 2,000 physicians. Learn more about Information Services We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 139799
    $62k-79k yearly est. 60d+ ago
  • Nurse Case Manager

    Sentara Healthcare 4.9company rating

    Remote

    City/State Virginia Beach, VA Work Shift First (Days) Sentara Health Plans is currently hiring an Integrated Nurse Case Manager in Petersburg, Dinwiddie and Chester the area of Virginia Status: Full Time (40 hrs/wk) Shift: Day (8am-5pm) *Position is remote but does require in person face-to-face assessments multiple times throughout the week. Candidates must be able to travel frequently throughout the week to complete in person assessments. Location of assessments include: Petersburg, Dinwiddie and Chester area of VA Primary responsibilities include: Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures May assist in problem solving with provider, claims or service issues Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home Education Associates or Bachelors Degree in Nursing (Required) Certification/Licensure Virginia or Compact RN License (Required) Experience 3 years experience in Nursing (Required) Experience in Private Duty Nursing or NICU or Experience working with Ventilators (Required) Discharge planning experience (Preferred) Managed Care experience (Preferred) Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave • Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down - $10,000• Reimbursement for certifications and free access to complete CEUs and professional development•Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
    $67k-84k yearly est. Auto-Apply 6d ago
  • Scheduling Specialist

    Banner Health 4.4company rating

    Phoenix, AZ jobs

    Department Name: Clinical Services Admin-Clinic Work Shift: Day Job Category: Administrative Services Estimated Pay Range: $18.38 - $27.57 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. You MUST live in TUCSON or surrounding areas Find your path in health care. Operating a hospital is more than IV bags and trauma rooms. One might be surprised by the number of people who work behind the scenes and play a critical role in ensuring the best care for our patients. Apply today. The Scheduling Specialist will be responsible for coordinates the scheduling of appointments for physicians in the practice or surgical procedures, diagnostic tests, physical therapy, pain management, and other special tests as directed by physicians. This position is also responsible for obtaining necessary authorizations, pre-certifications and/or referrals. Monday - Friday 8:00 am - 5:00 PM This is a Hybrid/Remote position. You MUST live in TUCSON or surrounding areas Banner University Medical Group is our nonprofit faculty practice plan associated with the University of Arizona Colleges of Medicine in Phoenix and Tucson. Our 1,100-plus clinicians provide primary and specialty care to patients at highly ranked Banner - University Medical Centers and dozens of clinics while providing mentorship to more than 1,200 residents and fellows. Our practice values and encourages the three-part mission of academic medicine: research, education and excellent patient care. POSITION SUMMARY This position is located in a medical clinic or physician's practice and coordinates the scheduling of appointments for physicians in the practice or surgical procedures, diagnostic tests, physical therapy, pain management, and other special tests as directed by physicians. This position is also responsible for obtaining necessary authorizations, pre-certifications and/or referrals. CORE FUNCTIONS 1. Provides customer service for patients, families, hospital scheduling departments, and other physician's offices. Acts as a resource to resolve room availability conflicts. 2. Receives physician's orders and completes patient registration. Obtains necessary authorizations, pre-certifications and/or referrals. Works closely with the billing department to ensure accurate coding for all charges. 3. Schedules and re-schedules patients as necessary. Confirms patient's appointments for the following days and informs patients of physician's orders or special instructions prior to appointment or procedure. 4. Answers incoming calls, which may include screening calls, taking messages and providing information to patients, physicians, providers, hospitals and staff. Documents correspondence in the patient's medical record. Updates demographic and insurance information in the practice management system. 5. Assists physicians in examination room when required. Assists front office in answering phones, scheduling appointments, taking messages, prescription refills, locating information and other related duties when necessary. 6. May have supervisory accountability and/or provide direction to support staff. 7. This position has the responsibility of assuring efficient scheduling and workflow of the operation while maintaining outstanding customer relations. Interacts with patients, physicians, third party payers, vendors, registration and central scheduling staff, medical records, billing, and clinical staff. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. The position requires skills normally gained with 2 years of scheduling experience in a physician's office or hospital. Medical terminology may be required for some assignments. Must possess excellent communication, organizational and problem-solving skills. Must be proficient with commonly used office software and have the ability to use software typically used for medical practice management and scheduling. PREFERRED QUALIFICATIONS Knowledge of ICD-9, CPT, and HCPCS coding is strongly preferred. Sound working knowledge of various types of insurance plans and/or worker's compensation preferred. Bi-lingual in Spanish may be preferred for some assignments. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $18.4-27.6 hourly Auto-Apply 1d ago

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