Baptist Health Care Remote jobs - 27 jobs

MEDICAL ASSISTANT: The Medical Assistant assists with patient care management, executes administrative and clinical procedures. The Medical Assistant position provides exceptional medical care that meets each patient's physical, mental, and emotional needs. Provide administrative/clinical assistance to physicians/mid-level practitioners/nurses/patients while adhering to a prescribed treatment plan in accordance with established policies and procedures. 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. The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters. LPN: The Licensed Practical Nurse performs selected nursing acts in the care of the ill, injured, or infirm patient under the direction of the Physician. The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters. MEDICAL ASSISTANT: High School Diploma or Equivalent Required Successful completion of an accredited medical assisting program or Graduation from a formal medical services training program of the United States Armed Forces preferred. Must be certified/registered by day of hire or transfer with one of the following: American Association of Medical Assistants (AAMA) Certified or American Medical Technologist (AMT) Registered with an Active Membership or NCMA National Certified Medical Assistant (NCCT) or National Health Career Association (NHA) or National Association for Health Professionals (NAHP- NRCMA) or AMCA-American Medical Certification Association certification. BLS through American Heart Association is required within 30 days of employment/transfer. Knowledge of anatomy and physiology, medical terminology, medical law, medical ethics, human relations and patient education. Skills and ability in administrative and clinical medical assisting. Must be able to communicate effectively through written and/or verbal communication. Basic Computer skills. Knowledge of and ability to perform EKGs and obtain accurate blood pressure readings. LPN: Graduate of Practical Nursing program is required Current License as a LPN in the State of Florida. BLS through American Heart Association required. Ability to read and understand the English language. Knowledge of patient care charts and patient histories. Knowledge of clinical and/or surgical operations and documentation. Knowledge of patient evaluation and triage procedures. Knowledge of supplies, equipment, and/or services ordering and inventory control. Knowledge of appropriate procedures and standards for the administration of medications and patient care aids. Proficient with Computer skills. Excellent communication skills verbally and written

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Highlights: Named 150 Top Places to Work in Healthcare 2024 - Becker's Healthcare Names One of the Diversity Leaders 2024 - Modern Healthcare Named One of America's Greatest Workplaces for Diversity 2024 - Newsweek Named One of America's Greatest Workplaces for Women 2024 - Newsweek Names One of America's Greatest Workplaces for Job Starters 2024 - Newsweek SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization's 40,000 team members and more than 13,900+ providers are committed to providing exceptional health care services and revealing God's healing presence to everyone they serve. With care delivery sites in Illinois, Missouri, Oklahoma and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 12 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves. To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact: Jon Dirksen Executive Talent Partner ************************* #LI-Remote Job Summary: Under the direction of the System Vice President of Pharmacy, responsible for the strategic executive direction and oversight of pharmacy business and financial management services and programs. The scope of oversight includes managing pharmacy budgets; driving cost savings and revenue optimization; fostering business growth; leading pharmacy supply chain and 340B programs; monitoring pharmacy revenue cycle performance; directing pharmacy business/data analytics services and technology; collaborating on innovative prescription benefit management processes; and directing pharmacy project coordination across these areas. Collaborates with ministry, regional and system-level pharmacy and executive leaders to shape the organization's pharmacy business strategy. Job Responsibilities and Requirements: Primary Responsibilities Provides financial expertise and accountability, identifying and leading initiatives to grow revenue and lower cost across pharmacy service lines. Collaborates with key stakeholders on system planning, business growth & development, and aligning pharmacy initiatives with the organization's strategic plan. Oversees and effectively administers pharmacy operating and capital budgets, including setting annual financial goals. Identifies new pharmacy business opportunities, planning, implementing, and evaluating them as appropriate. Oversees business and vendor relationships and contracts with external entities such as medication wholesalers, distributors, group purchasing organizations, manufacturers, technology vendors, and other pharmacy-related business entities. Ensures pharmacy has a strong revenue cycle process, optimizing billing and charging. Works closely with appropriate stakeholders across the organization to ensure positive performance. Sets strategy for the 340B program including compliance, optimization efforts, and mitigation strategies to maximize savings for the system and patients using advanced knowledge of 340B program. Serve as the 340B subject matter expert for SSM Health, working with Apexus, Health Resources and Services Administration, other governmental authorities, external organizations, and internal stakeholders to ensure the integrity and success of the 340B program. Performs other duties as assigned. Education Master's degree in business related field or Pharmacy degree Experience Ten years pharmacy experience, with seven years in direct people management/leadership Department: ********** 340B_Center_of_Excellence Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

Hours: Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $49.700 - $64.130 - $71.820 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. *This is a remote position* What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in oversight of Sharp HealthCare's (SHC) compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits. Required Qualifications 5 Years experience in acute care inpatient/outpatient coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. Preferred Qualifications Other : Strong background in in ICD-10-CM/PCS coding, DRG coding and CPT coding classification. Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate -PREFERRED Certified Health Care Compliance (CHC) - Compliance Certification Board -PREFERRED Other Qualification Requirements Bachelor's degree in Business, Healthcare Administration, or related field - required. In lieu of Bachelor's degree, Associate's degree and a minimum of 5 years experience in coding, billing and compliance may be considered. One of the following is required: AHIMA's Certified Coding Specialist (CCS), or Certified Documentation Improvement Practitioner (CDIP), or AAPC Certified Inpatient Hospital/Facility (CIC), or Certified Professional Coder (CPC) certification. Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required within 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification within specified timeframe. Essential Functions Coding Compliance Compliance Coding and Billing Audits The Compliance Coding Auditor has the primary responsibility of performing all audits and chart reviews required for inpatient and/or outpatient coding and billing, daily retrospective chart reviews and communication to key stakeholders regarding audit findings and corrective actions, if necessary. Reviews the electronic health record to identify potential coding and billing compliance issues. Prepares written reports of audits, including recommendations to improve compliance. The Auditor will analyze and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. Policy and Procedure maintenance Works in collaboration with the Director and Manager of Compliance and System Management (HIM, CDI, Case Management, Quality, etc.) in developing SHC's standardized documentation, medical necessity, coding and billing policies and guidelines in accordance with state and federal laws, regulations and policies. Professional development Maintain current credentials and knowledge of ICD-10-CM/PCS, MS-DRG, CPT and HCPCs coding classification changes, compliance issues and updates regarding changes in federal and state regulations, policies and procedures pertaining to the Compliance Program. Adheres to a personal plan of professional development and growth through professional affiliations, activities and continuing education. Unit support Key Stakeholder/Business Unit Support Responsible for inpatient and/or outpatient coding and billing investigations and inquiries, as well as answering correspondence from key stake holders regarding inpatient and/or outpatient coding and billing matters and other general Compliance reimbursement inquiries. Will continuously evaluate the quality of clinical documentation and monitor the appropriateness of queries with the overall goal of improving physician documentation and achieve accurate coding. Maintain professional relationship with key stakeholders focusing on high level of client satisfaction. Must demonstrate excellent written and oral communication presentation skills in training SHC workforce and physicians. Professional competency Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required within 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification within specified timeframe. Knowledge, Skills, and Abilities Ability to perform independent research and factual analysis of coding and billing matters and create proposed solutions to root causes. Computer proficiency with Microsoft office applications is required. Ability to function within a fast-paced, dynamic, and growing environment. Excellent time management and problem solving skills. Must demonstrate analytical ability, motivation, initiative, and resourcefulness. Teamwork and flexibility required. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

It's more than a career, it's a calling IL-REMOTE STL PLAN Worker Type: Regular Job Highlights: **Must have prior experience as a Clinical Documentation Specialist** Required Qualifications: 1 year of experience as a Clinical Documentation Specialist Additional Two years' in an acute care setting or relevant experience Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation Improvement Specialist (ACDIS) Preferred Qualifications: CCDS certification Proficiency with MS Office Tool - especially Excel. Prior experience reviewing PSI (patient safety indicator) or experience with Vizient specialized mortality reviews. Eligible Remote States: Candidates are required to reside on one of SSM's approved States: Alabama, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin. Pay Range: $74,484.80 - $111,737.60 Pay Rate Type: SalarySSM Health values the skills and talents that each team member brings to our organization. Compensation for this role is based on a variety of components including relevant experience, labor market, and other qualifications. The posted pay range for this position is what SSM Health reasonably expects, in good faith, to offer based on the circumstances at the time of posting. SSM Health may ultimately pay more or less than the posted range as permitted by law. Job Summary: Performs concurrent analytical reviews of clinical and coding data to improving physician documentation for all conditions and treatments from point of entry to discharge, ensuring an accurate reflection of the patient condition in the associated Diagnosis Related Group (DRG) assignments, case-mix index, severity of illness (SOI), and risk of mortality (ROM) profiling, and reimbursement. Facilitates the resolution of queries and educates members of the patient care team regarding documentation guidelines and the need for accurate and complete documentation in the health record, including attending physicians and allied health practitioners. Collaborates with coding professionals to ensure accuracy of diagnostic and procedural data and completeness of supporting documentation to determine a working and final DRG, SOI, and/or ROM. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Completes initial reviews of patient records and evaluates documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group (DRG) assignment, risk of mortality (ROM), and severity of illness (SOI). Maintains appropriate productivity level. Conducts follow-up reviews of patients every to support and assign a working or final DRG assignment upon patient discharge, as necessary. Queries physicians regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record when needed. Identifies issues with reporting of diagnostic testing proactively. Enhances expertise in query development, presentation, and standards including understanding of published query guidelines and practice expectations for compliance. Educates physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record. Attends department meetings to review documentation related issues. Conducts independent research to promote knowledge of clinical topics, coding guidelines, regulatory policies and trends, and healthcare economics. Collaborates with coding to reconcile the DRG and resolves mismatches utilizing the escalation policy. Troubleshoots documentation or communication problems proactively and appropriately escalates. Reviews and clarifies clinical issues in the health record with the coding professionals that would support an accurate DRG assignment, SOI, and/or ROM. Assists in the mortality review and risk adjustment process utilizing third-party models. Demonstrates an understanding of complications, comorbidities, SOI, ROM, case mix, and the impact of procedures on the billed record. Imparts knowledge to providers and other members of the healthcare team. Maintains a level of expertise by attending continuing education programs. Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's scope of service. Works in a constant state of alertness and safe manner. Performs other duties as assigned. EDUCATION Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation Improvement Specialist (ACDIS) EXPERIENCE Two years' in an acute care setting or relevant experience PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant in Medicine, Licensed - Illinois Department of Financial and Professional Regulation (IDFPR) Or Physician - Regional MSO Credentialing Or Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or Advanced Practice Nurse (APN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or APN Controlled Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN Control Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Missouri Division of Professional Registration Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Missouri Division of Professional Registration Or Nurse Practitioner - Missouri Division of Professional Registration State of Work Location: Oklahoma Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Acknowledgement of Receipt of Application for Physician Assistant - Oklahoma Medical Board Or Physician Assistant - Oklahoma Medical Board Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) Or Advanced Practice Registered Nurse (APRN) - Oklahoma Board of Nursing (OBN) Or Certified Family Nurse Practitioner (FNP-C) - American Academy of Nurse Practitioners (AANP) State of Work Location: Wisconsin Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Wisconsin Department of Safety and Professional Services Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Or Advanced Practice Nurse Prescriber (APNP) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: ********** Sys Clinical Documentation ImprovementScheduled Weekly Hours:40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

**Facility:** Corporate Offices **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours** **:** **Shift Start Time:** 8 AM **Shift End Time:** 5 PM **AWS Hours Requirement:** 8/40 - 8 Hour Shift **Additional Shift Information:** **Weekend Requirements:** As Needed **On-Call Required:** No **Hourly Pay Range (Minimum - Midpoint - Maximum):** $72.290 - $93.280 - $104.470 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. **What You Will Do** Supervise the effective implementation of the Ambulatory Case Management (ACM) programs that includes the management of patients in the different areas of the care management spectrum. Responsible for operational planning consistent with existing policies and procedures. Responsible for supervision of ACM activities to include tracking, trending, and analyzing data, streamlining and improvement of programs, facilitation of provider education, supporting the Medical Directors, and collaborating on interdepartmental activities. Develop and implement new programs under the direction of the Manager of Integrated Care Management and Director of Health Services. Participates in the development of the annual ACM plans and implementation of corrective action plans related to health plan audits and requirements of National Committee on Quality Assurance (NCQA) and other governing regulatory bodies. Collaborates with the Quality, Compliance, and Training Department to effectively integrate and implement processes consistent with health plan, NCQA, DMHC, and CMS requirements. Participates in the development and implementation of new programs under the direction of the Manager of Integrated Care Management. **Required Qualifications** + Bachelor's Degree nursing or health care related field. + 3 Years experience in the acute patient care setting, including ICU or intermediate care units, Medical-Surgical Nursing, and/or Home Health. + 3 Years in medical management experience, preferably in managed care. + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred Qualifications** + 2 Years leadership experience, preferably in a managed care setting. **Other Qualification Requirements** + Utilization, Case Management, or Quality Management certification preferred. **Essential Functions** + Ambulatory Case Management OperationsSupervise Ambulatory Case Management staff and operational processes in accordance with NCQA, DMHC, CMS and health plan requirements.Oversee the ACM and UM processes of the assigned teams, ensuring staff access to needed information and tools.Ensure that tools utilized by ACM teams are up to date and in alignment with regulatory requirements and internal processes.Establish and maintain appropriate policies and procedures and training plans to include enforcement of standards for all ACM team activities.Coordinate with the Health Services Quality and Compliance department to ensure timely and relevant implementation of training and verify adherence with quality and compliance parameters.Implement and maintain the reporting systems for operational and utilization outcome indicators as it relates to the daily ACM operations. Implement and maintain regular reporting systems for operation and ambulatory care management outcome indicators.Participate in groups in developing and implementing strategic plan to implement organization vision and/or service-culture initiatives.Establish specific quality goals, connecting the vision to the necessary actions and long-term strategies.Recognize physician needs and concerns and act on opportunities for improvement in conjunction with leadership. Collaborate with physicians to address operational issues.Promotes positive outcomes in a managed healthcare setting in support of program initiatives.Lead team members to facilitate and coordinate quality healthcare services and delivery of goods and services to meet a member's specific healthcare needs in a timely, efficient, and cost effective manner utilizing strong communication, problem solving, and critical thinking skills.Direct and collaborate with peers and assists in the case management process as necessary.Assists leadership in promoting team performance goals and in monitoring team progress toward accomplishment of departmental goals and initiatives.Assists in the ongoing education of providers, physicians and their office staff.Implements action plan to improve referral processing under ACM management direction.Enforce policies and procedures for all Case Management activities.Maintains ongoing analysis of program performance and monitors trends and opportunities for enhancement or expansion of the ACM processes and operations Document ACM processes according to SCMG policies and procedures.Collaborate with other disciplines/departments to resolve identified issues with demonstrated improvement in operational flow.Facilitate ACM staff and provider collaboration.Operationalize and establish efficient ambulatory case management and referral management work flows to ensure timely patient care.Bring to attention of the ACM Manager, areas of non-compliance and provide input on actions for improvement.Establish and maintain operational documents such as policies and procedures, desktop procedures as well as all other tools that ACM staff utilize to complete case management activities.Collaborate with vendors to provide in services as appropriate to provide staff with available services. + Human Resource Management All 90 day and annual performance reviews are completed per Sharp guidelines. Provides feedback toward employee performance. Facilitates staff's progress toward agreed upon annual performance goals. Assure employee files are current and complete, including annual TB testing, Safety Testing, Compliance Training, and annual HIPAA test, etc.Manage and assist staff to resolve identified attendance, performance, learning and behavior issues through feedback, counseling, corrective action and goal-setting.Hire staffing for the department per department plan. Orient/mentor staff into new role resulting in achieved competencies. Ensure accuracy with new employee onboarding as it relates to granting systems access, e.g., EPIC, OnBase, health plan websites, EHR, etc.Increases retention rate (or reduces turnover) of select group of staff.Leads initiative that results in improved teamwork and/or building more effective relationships.Decreases occurrences of unsafe work practices and/or worker's injuries.Arranges team coverage for ACM teams in the event of staff absence by demonstrating willingness, flexibility, and competence to assign coverage and/or serve as 'float' as needed with thorough understanding of program differences.Supports ergonomic improvement initiatives, teaching, and assists with enforcing compliance with measures designed to reduce employee injury.Provides training and assistance to staff. Mentors others in developing new skills and assuming new responsibilities.Staffing schedules are coordinated to assure adequate department coverage.Special projects as assigned by Manager, and/or Director. + LeadershipLead groups in developing and implementing strategic plan to implement organization vision and/or service culture initiatives.Establish specific quality goals, connecting the vision to the necessary actions and long-term strategies.Recognize physician needs and concerns and initiate opportunities for improvement.Recognize patient needs and concerns and initiate opportunities for improvement.Collaborate with other disciplines/departments to resolve daily operational issues when supervising unit.Facilitate staff in prioritizing and problem solving daily operational issues.Demonstrate resolution of operational issues with targeted outcomes as negotiated with manager.Utilize team-building skills to provide direction, goal setting, and attainment of goals.Conduct team meetings to include documentation of agendas and minutes on a consistent schedule. + Quality and Productivity PerformanceMonitor and manage staff deviations from team quality and productivity goals.Conduct and report quarterly performance audits and results.Establish and maintain staff meetings quarterly to review progress towards meeting quality and productivity goals. + System Configuration and TestingPlan and develop of operating systems to manage specific SCMG operational and business objectives through the set-up of ACM queues and workflows.Participate in the development and implementation of software functionality, upgrades, and system integration.Coordinate testing efforts of new and current software functionalities and applications.Oversight the process of identifying, reporting, trouble-shooting, and resolving system problems.Analyze the impact of software changes on accuracy and productivity.Oversee the ACM ambulatory CM and UM process workflows from an application perspective and staff adherence. + Professional Development Maintains competence in all standards of ambulatory case management, referral management and care coordination. Keeps current knowledge and understanding of applicable accreditation and regulatory statutes related to health care, managed care, case management practice.Serves as a resource and mentor to Health Services teams.Attends and actively participates in department/team process/quality improvement activities. + Program Improvement Maintains ongoing analysis of program performance and monitors trends and opportunities for enhancement or expansion of the program.Provides expertise/consultation in developing services/programs, marketing strategies, and business planning.Consults/liaisons with other programs and agencies, and consultants as appropriate Collaborates with other disciplines/departments to resolve identified issues. **Knowledge, Skills, and Abilities** + Effective interpersonal skills: strong verbal, written and presentation skills. + Ability to work well with staff for various educational and professional skills backgrounds to achieve common goals. + Accepts accountability for performance and decisions. + Thorough computer knowledge, including on-line database and personal computer skills. + Knowledge of wide variety of local and national resources for use in Care Management process. + Strong organizational skills with ability to work well under pressure with conflicting priorities. + Ability to read, speak and hear English clearly. + Occasional travel between Sharp HealthCare facilities and provider offices; must provide own transportation. + Demonstrated leadership skills. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

It's more than a career, it's a calling. MO-SSM Health Mission Hill Worker Type: Regular Job Highlights: The SSM Revenue Cycle team is on a fast track to optimization and looking for a strategic thought leader with a proven track record in transformation. This executive role has high visibility within the organization and is a position considered for long term succession planning. Named 150 Top Places to Work in Healthcare 2024 - Becker's Healthcare Named One of the Diversity Leaders 2024 - Modern Healthcare Named One of America's Greatest Workplaces for Diversity 2024 - Newsweek Named One of America's Greatest Workplaces for Women 2024 - Newsweek Named One of America's Greatest Workplaces for Job Starters 2024 - Newsweek SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization's 40,000 team members and more than 13,900+ providers are committed to providing exceptional health care services and revealing God's healing presence to everyone they serve. With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 12 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves. This position IS remote work eligible. SSM Health currently offers remote work within limited states. To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact: Angela Jones Executive Talent Partner *************************** #LI-Remote Job Summary: The Vice President for Revenue Cycle Management Operational Performance is responsible for the strategic leadership, oversight and optimization of hospital and ambulatory revenue cycle operations. Provide visionary leadership while fostering strong partnerships to ensure the accuracy and integrity of revenue processes. Partners with the Chief Revenue Cycle Officer to establish and deliver on the Revenue Cycle strategic vision. Job Responsibilities and Requirements: Job Responsibilities and Requirements: Develop and implement strategic initiatives to enhance revenue cycle operations while ensuring the accuracy and integrity of revenue processes. Oversight and management of coding, coding education, Health Information Management (HIM), Revenue Integrity to include CDM, Accounts Receivable, Cash Management, and Denial Management to ensure compliance with regulatory standards and optimize reimbursement. Develop and implement strategies for denial management to minimize revenue loss. Foster strong partnerships with internal and external stakeholders to drive revenue cycle improvements. Analyze and report on revenue cycle performance, identifying areas for improvement, and implementing corrective actions. Thought partner with Net Revenue, Information Technology, Finance, Clinical Operations and other stakeholders in continuous revenue improvement. Exhibits superior management skills that emphasize team building and strong leadership with the ability to provide clear vision and direction. Leadership development and career pathing to ensure next level leadership readiness. Creates a culture supportive of personnel, fostering individual motivation, teamwork and high levels of performance and accountability utilizing a participative management style to ensure staff retention Develops and manages the operating and capital budgets for operations, analyzes variances, develops plans and takes appropriate actions for productivity and performance improvements. EDUCATION Master's degree in business or healthcare administration OR Bachelor's degree with equivalent experience EXPERIENCE Ten years of experience within the area of revenue management, specifically experience with billing and collections at a multi-entity healthcare organization or large complex revenue cycle services with five year's leadership experience. Department: 8700000033 RCM Leadership Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

Registered Dietitian - Full Time - Clinical Nutrition Services (Remote) Responsibilities: * Provide clinical nutritional services in the form of nutrition assessments, education and medical nutrition therapy for all ages for patients at McLeod Health. May conduct nutrition therapy/nutritional assessments to patients at various McLeod campuses. Provide on-going nutrition therapy by collaborating with other disciplines on the health care team to coordinate medical nutrition therapy needs, participate in multidisciplinary rounds and contribute to hospital quality improvement initiatives. This is a primarily inpatient position; however clinical dietitians may provide medical nutrition therapy and/or nutrition education via outpatient nutrition services and/or community nutrition events as needed. Occasional travel may be necessary as deemed appropriate. Will contribute to dietetic intern precepting. * Must have a clean, neat appearance and friendly attitude. Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values. * This position will require weekend & holiday rotation for full-time employees. * Other duties as assigned. Work Schedule: 80 Hours Biweekly. Full Time. This is a remote dietitian position. Qualifications/Requirements: * 1 year experience required. * Registration with the Commission on Dietetics Registration required. * Registered Dietitian with Bachelor's degree and completion of a dietetic internship program from an ADA/ACEND- approved Dietetic Education Program if registered before January 1, 2024. * Master's degree in nutrition or related area and completion of a dietetic internship program from an ADA/ACEND- approved Dietetic Education Program if registered after January 1, 2024. * Licensure with the South Carolina Panel for Dietetics required. Founded in 1906, McLeod Health is a locally owned and managed, not for profit organization supported by the strength of more than 900 members on its medical staff and more than 2,900 licensed nurses. McLeod Health is also composed of approximately 15,000 team members and more than 90 physician practices throughout its 18-county service area. With seven hospitals, McLeod Health operates three Health and Fitness Centers, a Sports Medicine and Outpatient Rehabilitation Center, Hospice and Home Health Services. The system currently has 988 licensed beds, including Hospice and Behavioral Health. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health. If you would enjoy working in a dynamic environment and are looking for an opportunity to become part of a stellar team of professionals, we invite you to apply online today. We are an equal opportunity employer.

About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description The Credentialing Data Coordinator will support the Medical Staff Services Credentialing team. This role involves collecting, verifying, and maintaining accurate records within the Credentialing system. Strong attention to detail, organizational skills, and the ability to handle confidential information are essential. Perform other administrative duties as assigned. Experience Required 2-3 years of Medical Staff Office, or related health care experience, preferred. Education Requirements High School/GED required. Associates preferred. Salary Min ($) USD $17.50 Salary Max ($) USD $27.00

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Highlights: SSM Health IHT is seeking a certified analyst and technically skilled team member with strong Epic Environment build experience to join our IT Revenue Cycle Growth Team. Candidate must be Epic Certified in Resolute Hospital Billing (HB) and/or Hospital Claims and Remits with relevant work experience and background in hospital billing. In addition to technical expertise in design, build and testing, the individual will serve as an IT liaison for Epic end-users, business partners and other epic analysts in both clinical and revenue cycle roles. Our team projects include onboarding new acquisitions and building new Epic Departments across the 4 states we serve. Applicants should have a passion to research and implement healthcare revenue cycle solutions leveraging known best practices for build and testing along with project implementation strategies delivering exceptional patient financial experience outcomes. Job Summary: Configures, implements, supports and maintains applications and technical integrations, specifically Epic applications, to meet the needs of the organization. Serves as a coordinator and collaborates with business operations, information technology, leadership, system users and vendors. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Builds requirements and translates into configuration and business process changes, using knowledge of standard workflows. Provides routine maintenance and standard build for Epic applications and systems using existing internal processes, policies and procedures. Provides technical knowledge analyzing Epic vendor software updates and the impact to the business for Epic applications. Troubleshoots and resolves basic to moderately complex application issues and provides end-user support for Epic applications. Codes complex functions including building application tables and reports for Epic applications. Updates testing scripts to incorporate ongoing system development and implementations. Acts as a resource for Epic colleagues with less experience. May lead small projects with manageable risk and resource requirements. Analyzes, prioritizes, and organizes technical requirement specifications, using data, diagrams, and flowcharts to inform decision making. Solves complex problems, takes a new perspective on existing solutions and exercises judgment based on the analysis of multiple sources of information. Performs other duties as assigned. EDUCATION Bachelor's degree in computer science or related field, or equivalent years of experience and education EXPERIENCE Three years' relevant experience Experience in Epic builds CERTIFICATION Epic certified in one or more modules PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. Department: ********** Growth -Revenue Cycle Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: The selected candidate must reside in our four state footprint. Missouri, Illinois, Oklahoma or Wisconsin only. Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Discusses with payor regarding criteria and payor decision. Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration. Documents outcome in electronic medical record. Participates with other members of team regarding opportunities for improvement in standard work. Performs review of pre-admission, perioperative, and post operative surgical cases. Performs other utilization management tasks as assigned. Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's scope of service. Performs other duties as assigned. EDUCATION Graduate of accredited school of nursing or education equivalency for licensing EXPERIENCE Two years' registered nurse experience REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Missouri Division of Professional Registration State of Work Location: Oklahoma Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) State of Work Location: Wisconsin Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: ********** Sys Utilization ManagementScheduled Weekly Hours:40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Highlights: Exciting opportunity for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus. Join our mission-driven team as a Corporate Responsibility Auditor Senior, where your expertise in compliance and healthcare coding and billing helps safeguard integrity, elevate patient care, and drive financial performance. In this pivotal role, you'll lead investigations, champion process improvements, and collaborate across departments to ensure our commitment to ethical excellence. If you're passionate about making healthcare better from the inside out-this is your opportunity to shine. Enhances overall financial performance by reviewing all assigned government audit denials and determining appropriate follow-up actions. Appeals denials which are found to be unsubstantiated through review of the medical record and/or billing information. Tracks assigned cases and enters data of audit related information into web-based audit tracking tool. Supports staff education, quality improvement, policy development, and overall improvement of financial performance. Supports and guides in the development and enhancement of an organized system to monitor, evaluate, and improve the quality and best practice methodology related to the corporate compliance program. Ensures that commitment to the compliance program is communicated and ensures the program's effectiveness. Assists in meeting appropriate regulatory standards related to billing, reimbursement and third-party contractual arrangements. Ensures that employees (including physicians) comply with policies, third party requirements and federal regulations. Provides leadership in process improvement and collaborative strategies with others as well as creative approaches to complex situations. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Initiates development and maintenance of compliance program, including compliance awareness education, implementation and maintenance of compliance policies and procedures, and monitoring of policy adherence and enforcement. Identifies, researches, summarizes, presents, educates and implements traditional and non-traditional approaches to multi-faceted issues to provide best practice. Performs or conducts compliance investigations and presents recommendations to physicians and committees. Implements process improvements and supports system wide implementation of new initiatives. Provides leadership and facilitates change in application of solutions requiring organized processes and outcomes. Documents and discusses detected deficiencies in billing and reimbursement with personnel of departments and provides recommendations to prevent future deficiencies. Develops and maintains processes to monitor program effectiveness through audits, analysis of employee hot-line reports, post office box inquires and other feedback mechanisms. Remains current with government and third party billing regulations, government initiatives on fraud and abuse, and other related legislation. Researches and performs analysis of compliance work plan. Coordinates audits/record reviews and provides education to departments when necessary. Implements corrective actions in cooperation with both clinic and business office management. Serves as resource to all internal and external customers, answering questions, researching topics and providing information regarding coding, documentation and compliance issues. Partners with other individuals/departments to foster best practice methodology and compliance. Performs other duties as assigned. EDUCATION Bachelor's degree, or equivalent combination of experience and education Registered Nurse preferred EXPERIENCE Three years' experience PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS None Department: 8821000033 Corp Responsibility Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Highlights: Exciting Opportunity for an Epic Systems Analyst at SSM Health! Required certifications are EpicCare Ambulatory, Inpatient Clinical Documentation, or Procedure Orders. Preferred certifications are Beacon Oncology and/or Bugsy Infection Control. Job Summary: Acts as a broad subject matter expert for service line Epic functionality and integrated third-party applications. Identifies best practices for the business and works closely with stakeholders to define the technical systems and enhancements needed to deliver business results. Conducts research on possible solutions and makes recommendations based on findings. Develops detailed analysis for proposals that outline feasibility, scalability and costs. Suggests, designs, tests, implements, and evaluates solutions. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Contributes to service line research for business needs and translates into the technical enhancements necessary for configuration and business process changes. Develops proposals that outline feasibility and costs. Codes complex functions including building application tables and reports for multiple Epic applications. Tests build to ensure quality delivery to business partners. Implements and stabilizes core business applications, researching application infrastructure needs, associated hardware, endpoints, and databases. Proactively identifies and solves complex problems; uses ground-breaking and innovative methods to think beyond existing solutions which impact business direction and drive business performance. Researches and recommends best practices for scalability, supportability, ease of maintenance, and system performance. Analyzes, prioritizes, and organizes technical requirement specifications using data, diagrams, and flowcharts to inform decision making. Leads functional teams or projects in a project management role with moderate resource requirements, risk, and/or complexity. Plans and coordinates with internal and external stakeholders to establish project scope, system goals, and requirements. Troubleshoots and resolves complex integrated issues crossing applications and works with vendors to solve issues. Performs other duties as assigned. EDUCATION Bachelor's degree in computer science or related field, or equivalent years of experience and education EXPERIENCE Three years' relevant experience with Epic functionality, design, configuration, and technical environment concepts/functions. Experience in Epic builds required. CERTIFICATION Epic certified or accredited in one or more modules PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois, Missouri, Oklahoma, Wisconsin N/A Department: ********** BH ID Onc Ped Women Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Ideal candidate has experience with E/M and Interventional Radiology or Vascular Surgery coding Come join us as a remote Coder II Professional at SSM Health! You will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. You will be responsible for reviewing patient information, assigning appropriate codes, and ensuring compliance with coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of SSM Health. Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. *Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Primarily focuses on coding of high complexity, such as surgical, specialty service, higher than average cost services, evaluation and management services. Responsible for resolving coding related denials. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies all billable services through review of all applicable data sources, including but not limited to: electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs, nursing home visit documentation, procedure reports generated from non-the electronic health record systems, etc. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer-specific guidelines. Consults with physicians/ providers as needed to clarify any documentation in the record that is inadequate, ambiguous, or unclear for coding purposes. Provides education around documentation improvement for maximum patient care. Assists physicians/providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding physician/provider documentation. Identifies opportunities for education and communicates trends to lead Reviews and resolves charge sessions that fail charge review edits, claim edits, and follow up denials. Works to improve billing based on findings/resolution of errors. Trains and mentors coding staff to effectively perform their job responsibilities following current coding policies and procedures. Assists coders with medical terminology, disease processes and complex surgical techniques. Manages assigned charge review, claim edit, and coding follow up work ques. Performs other duties as assigned. EDUCATION High school diploma or equivalent EXPERIENCE Two years' experience PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois, Missouri, Oklahoma, Wisconsin Certified Coding Associate (CCA) - American Health Information Management Assoc (AHIMA) Or Certified Coding Specialist - Physician-based (CCS-P) - American Health Information Management Assoc (AHIMA) Or Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) Or Certified Professional Coder (CPC ) - American Academy of Professional Coders (AAPC) Or Registered Health Information Administrator (RHIA) - American Health Information Management Assoc (AHIMA) Or Registered Health Information Technician (RHIT) - American Health Information Management Assoc (AHIMA) Or Certified Professional Coder Apprentice (CPC-A) - American Academy of Professional Coders (AAPC) Or Certified Coding Specialist (CCS) - American Health Information Management Assoc (AHIMA) Work Shift: Day Shift (United States of America) Job Type: Employee Department: Scheduled Weekly Hours:40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Performs as a vital member of the interdisciplinary care team member, an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved documentation results and risk adjusted scores for the organization, along with documentation and electronic health record charts that accurately capture the clinical picture. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Reviews clinical records of both clinical documentation integrity and mortality scoring. Collaborates with others regarding clinical documentation improvement (CDI) and risk adjustment (mortality) findings. Maintains knowledge of Centers for Medicare and Medicaid Services (CMS) requirements related to clinical documentation and provides feedback to clinical staff regarding these requirements during the concurrent record review process. Maintains knowledge of mortality models, observed rate/expected rate (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency. Serves as a liaison between coding staff and physicians as appropriate. Identifies and initiates opportunities for new program development or program extensions, as well as opportunities based on outcomes analysis for program process improvements. Works with other team members regarding opportunities for improvement in standard work. Maintains documentation, logs adjusted risk and CDI opportunities. Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's scope of service. Works in a constant state of alertness and safe manner. Performs other duties as assigned. EDUCATION Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation Improvement Specialist (ACDIS) EXPERIENCE Two years in an acute care setting with two years experience in clinical documentation or 4 years experience in clinical documentation with a Certified Clinical Documentation Specialist (CCDS) certification PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant in Medicine, Licensed - Illinois Department of Financial and Professional Regulation (IDFPR) Or Physician - Regional MSO Credentialing Or Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or Advanced Practice Nurse (APN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or APN Controlled Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN Control Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Missouri Division of Professional Registration Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Missouri Division of Professional Registration Or Nurse Practitioner - Missouri Division of Professional Registration State of Work Location: Oklahoma Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Acknowledgement of Receipt of Application for Physician Assistant - Oklahoma Medical Board Or Physician Assistant - Oklahoma Medical Board Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) Or Advanced Practice Registered Nurse (APRN) - Oklahoma Board of Nursing (OBN) Or Certified Family Nurse Practitioner (FNP-C) - American Academy of Nurse Practitioners (AANP) State of Work Location: Wisconsin Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Wisconsin Department of Safety and Professional Services Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Or Advanced Practice Nurse Prescriber (APNP) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: ********** Sys Clinical Documentation Improvement Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

Registered Dietitian - Full Time - Clinical Nutrition Services (Remote) Responsibilities: Provide clinical nutritional services in the form of nutrition assessments, education and medical nutrition therapy for all ages for patients at McLeod Health. May conduct nutrition therapy/nutritional assessments to patients at various McLeod campuses. Provide on-going nutrition therapy by collaborating with other disciplines on the health care team to coordinate medical nutrition therapy needs, participate in multidisciplinary rounds and contribute to hospital quality improvement initiatives. This is a primarily inpatient position; however clinical dietitians may provide medical nutrition therapy and/or nutrition education via outpatient nutrition services and/or community nutrition events as needed. Occasional travel may be necessary as deemed appropriate. Will contribute to dietetic intern precepting. Must have a clean, neat appearance and friendly attitude. Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values. This position will require weekend & holiday rotation for full-time employees. Other duties as assigned. Work Schedule: 80 Hours Biweekly. Full Time. This is a remote dietitian position. Qualifications/Requirements: 1 year experience required. Registration with the Commission on Dietetics Registration required. Registered Dietitian with Bachelor's degree and completion of a dietetic internship program from an ADA/ACEND- approved Dietetic Education Program if registered before January 1, 2024. Master's degree in nutrition or related area and completion of a dietetic internship program from an ADA/ACEND- approved Dietetic Education Program if registered after January 1, 2024. Licensure with the South Carolina Panel for Dietetics required.

About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description The auditor reviews professional fee billing, coding and documentation. Reviews to be performed are identified based on the then-current OIG Workplan and compliance risk analyses. Customers include employed providers, senior leadership, clinical and non-clinical staff of Cooper University Health Care. Under the supervision of the Chief Compliance Officer, auditors are responsible for supporting the corporate compliance program, responsibilities include: Performance of timely and effective compliance and operational reviews to assess coding, documentation and billing accuracy, identify compliance related risks, internal control weaknesses, revenue capture opportunities and assist in determining the root cause of any identified non-compliance with government rules and regulations, state laws and Cooper policies and procedures Preparatory work for reviews/audits including developing a scope of work. Reviewing available documentation. Analyze/review audit data and prepare reports for review and presentation to management, providers and departments, making recommendations for improvement Determine charge corrections and refunds resulting from compliance reviews and ensure they have been completed. Post-review/audit education/training when applicable. Performing follow-up reviews when necessary. Ensuring appropriate work papers, either paper or electronic, are maintained in accordance with regulations/policy Assist in the development of policies and procedures that establish standards for compliance, as well as preparation of other guidance documents and tools to assist Coper providers and staff in appropriate billing, coding and documentation. Serve as liaison for questions, concerns, incidents and complaints regarding compliance matters, responding directly to the inquiry and/or consulting or interacting with other team members or departments. Inform Chief Compliance Officer of major findings; based on types of questions/concerns received, recommend remedial correction and prevention actions; identify education/awareness opportunities and guidance topics Work with all levels within the organization to ensure that internal controls throughout the system provide for accurate, complete and compliance program and processes Experience Required 3+ years' experience in an academic medical center preferred, with emphasis on provider compliance activities, including but not limited to: auditing, monitoring, investigation and training Demonstrated knowledge and understanding of provider professional fee billing, coding and documentation practices in inpatient and outpatient settings. Demonstrated expertise in medical terminology. Demonstrated expertise in healthcare coding (CPT, ICD-9, ICD-10, APC, HCPCS). Demonstrated knowledge and understanding of HIPAA rules and regulations affecting the management of confidential protected health information (PHI). Demonstrated knowledge and understanding of federal and state statutes, laws, rules and regulations affecting billing, coding and documentation practices in support of healthcare services provided to beneficiaries of federally-funded healthcare programs and other third party payers. Demonstrated knowledge and understanding of the essential elements of an effective compliance program Working knowledge and understanding of: - provider professional fee revenue cycle and reimbursement. - electronic billing and medical record systems - sampling technologies and statistical analyses .Experience using personal computers required. Experience using the following applications is desirable: Word, Excel, e-mail, and healthcare related billing systems. Experience using MDAudit audit software and/or EPIC EMR desirable Education Requirements Current certification as a CPC or COC License/Certification Requirements Current CPC or COC Valid driver's license and automobile insurance per company policy Salary Min ($) USD $36.00 Salary Max ($) USD $59.00

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Highlights: Join our Epic team and put your technical expertise to work optimizing key clinical and financial workflows. As an Epic Systems Analyst, you'll configure, support, and enhance Epic applications-solving complex issues, improving Hospital Billing/Claims performance, and partnering with teams and Community Connect sites to reduce defects and streamline processes. If you excel at problem‑solving, collaboration, and delivering a clean, reliable Epic build, this role offers the opportunity to make a meaningful systemwide impact. Job Summary: Configures, implements, supports and maintains applications and technical integrations, specifically Epic applications, to meet the needs of the organization. Serves as a coordinator and collaborates with business operations, information technology, leadership, system users and vendors. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Builds requirements and translates into configuration and business process changes, using knowledge of standard workflows. Provides routine maintenance and standard build for Epic applications and systems using existing internal processes, policies and procedures. Provides technical knowledge analyzing Epic vendor software updates and the impact to the business for Epic applications. Troubleshoots and resolves basic to moderately complex application issues and provides end-user support for Epic applications. Codes complex functions including building application tables and reports for Epic applications. Updates testing scripts to incorporate ongoing system development and implementations. Acts as a resource for Epic colleagues with less experience. May lead small projects with manageable risk and resource requirements. Analyzes, prioritizes, and organizes technical requirement specifications, using data, diagrams, and flowcharts to inform decision making. Solves complex problems, takes a new perspective on existing solutions and exercises judgment based on the analysis of multiple sources of information. Performs other duties as assigned. EDUCATION Bachelor's degree in computer science or related field, or equivalent years of experience and education EXPERIENCE Three years' relevant experience Experience in Epic builds CERTIFICATION Epic certified in HB Claims PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. Department: ********** Release Management Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

The Certified Coder is responsible for ensuring that charges are assessed and entered in compliance with applicable coding regulations, standards, policies and guidelines as established by CMS and the various third party payers. This requires a thorough understanding of CCI edits and payer rules regarding medical necessity and bundling of services. The Coder is also responsible for assisting with provider inquiries regarding documentation standards as well as providing pertinent feedback to providers regarding the quality of clinical documentation. Coders may work remotely from home, which requires appropriate internet connectivity and physical space to complete work while maintaining HIPAA standards. Qualifications Education required: High School graduate or GED. Education preferred: Formal coder training strongly preferred. License, certification and/or registration: Certified Professional Coder or similar certifications (CCA, CPC, CCS, etc...) Experience: Minimum of three years of medical coding experience required. Previous experience with electronic medical records and billing systems required. Previous experience in procedure coding preferred. Advanced education may be substituted for some experience. Additional skills/abilities: Skill in using computer and calculator. Basic skills with excel spreadsheets. Knowledge of medical billing and patient accounting services. Knowledge of medical coding and clinic operating policies and procedures. Throrough knowledge of regulations, policies and procedures established by CMS and various third party payer related to coverage, medical necessity and bundling of services. Knowledge of the organization's policies and procedures. Ability to examine clinical documentation for accuracy and completeness. Ability to prepare records in accordance with detailed instructions. Ability to work effectively with co-workers and supervisors as a team member. Ability to communicate clearly. Upholds effective work habits including, but not limited to, regular attendance, teamwork, initiative, dependability and promptness. Thorough understanding of ICD-10 and CPT coding required. About Us Highlights of our hospitals Huntsville Hospital was recently named Best Regional Hospital and #2 in Alabama by U.S. News & World Report. With 971 beds, a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU, and the largest Emergency Department and Level 1 Trauma Center in the state with our own specialized Red Shirt Trauma Program, there are many opportunities to apply your knowledge and skills. We are a certified Primary Stroke Center and named "One of the Top 100 Hospitals in the Nation with Great Heart Programs." From six cath labs and four EP labs to multiple medical and step-down units, you can continually grow your skillset! We offer a training center on campus for continuing education, Shared Governance Program, Clinical Ladder for professional development, The Daisy Award, and if you are a new grad, a Nurse Residency Program to help you transition from student to professional nurse. We care about you and your well-being by offering an excellent benefits package, childcare, health and wellness programs, an onsite employee pharmacy, a free health clinic, tuition assistance, and much more. We are committed to creating a diverse environment and proud to be an equal opportunity employer. We are a partner to the U.S. Army's Partnership for Your Success (PaYS) program. Ask us about incentives and additional opportunities. Huntsville Hospital Benefits: We are committed to providing competitive benefits. Our benefits package for eligible employees includes medical, dental, vision, life insurance, flexible spending; short term and long term disability; several retirement account options with 401K organization match; nurse residency program; tuition assistance; student loan reimbursement; On-site training and education opportunities; Employee Discounts to phone providers, local restaurants, tickets to shows, apartment application and much more! Learn more about Huntsville Hospital Health System: * Careers: ************************************** * Benefits: **************************************** * Education & Professional Development: ******************************************** * Life In Huntsville: ******************************************************

About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description Coder III demonstrates proficiency in coding high acuity inpatient accounts and/or coding of technical outpatient accounts including, but not limited to Observation, Radiation Oncology, Chemotherapy Infusion, Cardiac Cath/Electrophysiology or Interventional Radiology and Surgery to support Revenue Cycle goals for timely billing. Experience Required 3-5 years required Inpatient coding preferred Education Requirements High School Diploma/GED License/Certification Requirements One or more of the following required: RHIA, RHIT, CCS, CIC, COC, CPC, CCA, CCC, CIRCC, CCVTC and/or any of the Core Credentials or specialty credential of AAPC or AHIMA Salary Min ($) USD $29.00 Salary Max ($) USD $50.00