Bozeman Health Remote jobs - 112 jobs

can be remote. Please review the approved remote states below. Remote Work Approved States: Arizona Florida Georgia Idaho Iowa South Dakota Texas South Carolina Wisconsin North Carolina Michigan *If your state is not listed, you must relocate to Montana or one of the approved states above to be eligible for this position. Position Summary: The Insurance Billing Specialist's main focus is to obtain maximum and appropriate reimbursement for Bozeman Health and all related entities, hospital (HB) and/or professional (PB) claims from third party payers. Supports the timely development and accurate submission of claims to third party payers to include insurance follow-up related to no response, returned claims, denied claims, or claim edits preventing claim submission, submitting corrected or replacement claims, and combining hospital accounts in accordance with payer billing policies. Monitor, resolve or escalate payer denials, returned claims, claim edits, correspondence and report payer claim processing behavior to assist with identifying systemic issues that may require process improvement to strengthen the health of the Revenue Cycle as well escalating identified concerns to the HB or PB Supervisor. Collaborate and coordinate with other Revenue Cycle functions or departments to resolve DNBs, claim edits, denials that are preventing timely claim submission or appropriate reimbursement. Prioritizes and completes accounts routed to billing WQs to reduce accounts receivable days and escalates high-dollar accounts or systemic issues to either the HB or PB Billing supervisor for resolution. Minimum Qualifications: Required High School Diploma or Equivalent One year of office experience Preferred Completion of program in medical billing degree or certification program Two years of healthcare clinic/hospital billing experience Essential Job Functions: Submits timely and accurate claims to primary, secondary, and tertiary insurances for both electronic and paper submission Follows up on applicable No Response WQs and Rejected Claims WQs through phone contact or written correspondence to ensure that no account reaches 180 days old from discharge date and still due by insurance, regardless of dollar amount Reviews accounts by verifying that reimbursement amounts are appropriate, coordination of refunds, if appropriate, and submitting adjustments for approval when necessary, routes claims for appeal, resubmits claims, or moves balances from insurance responsibility to patient responsibility when appropriate Ensures that claims have appropriate information on them for submission to insurance companies or agencies by reviewing claim edit WQs and other prebilling insurance WQs and escalates systemic issues identified to supervisor Assists Customer Service with claim processing questions Identifies and escalates concerns regarding claim processing to Billing Supervisor Knowledge, Skills and Abilities Demonstrates sound judgment, patience, and maintains a professional demeanor at all times Exercises tact, discretion, sensitivity, and maintains confidentiality Performs essential job functions successfully in a busy and stressful environment Learns current and new computer applications and office equipment utilized at Bozeman Health Strong interpersonal, verbal, and written communication skills Analyzes, organizes, and prioritizes work while meeting multiple deadlines Works varied shifts as scheduled and/or needed Schedule Requirements This role requires regular and sustained attendance. The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts. On-call work may be required to respond promptly to organizational, patient, or employee needs. Physical Requirements Lifting (Rarely - 30 pounds): Exerting force occasionally and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people. Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain. Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain. Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination. Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms. Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints. Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability. Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward. Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling. Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials. Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow. Exposures (Rarely): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses. *Frequency Key: Continuously (100% - 67% of the time), Repeatedly (66% - 33% of the time), Occasionally (32% - 4% of the time), Rarely (3% - 1% of the time), Never (0%). The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by individuals so classified. 77211370 Patient Financial Services

Overdose Helpline Operator, General Internal Medicine Schedule: Per Diem, Remote NOTE: Bi-lingual Spanish/English applicants strongly preferred About MOPH: The Massachusetts Overdose Prevention Helpline (MOPH) is a service of the Grayken Center for Addiction at Boston Medical Center and provides critical support, resources, and assistance to individuals at risk of overdose. Our helpline operates 24/7, offering confidential and compassionate assistance to callers seeking help, information, and referrals to local treatment and support services. MOPH aims to reduce overdose deaths and improve access to addiction treatment and support across the state of Massachusetts. Position Overview: The Helpline Operator plays a critical role in the Massachusetts Overdose Prevention Helpline as the frontline point of contact with our callers. They will be responsible for managing incoming calls and talking with callers using a harm reduction framework. Helpline calls are opportunities to engage people who use drugs in meaningful conversation and the ideal candidate would be comfortable talking to people who are actively using drugs and who come from diverse backgrounds and experiences. The ideal candidate should possess excellent communication skills, a calm demeanor in potentially challenging situations, and a strong dedication to saving lives through prompt and compassionate actions. JOB RESPONSIBILITIES Call Center Operations: Manage incoming calls from individuals seeking assistance for themselves or someone else. Offer immediate guidance on overdose recognition and response, instructing callers on how to administer naloxone or other life-saving measures if necessary. Provide information about the helpline to callers and providers. Utilize active listening and effective questioning techniques to assess the severity of each situation and identify potential overdose risks accurately. Collaborate with emergency responders, medical personnel, and 911 dispatchers to ensure swift and appropriate intervention for overdose cases. Utilize de-escalation techniques in emotional situations and maintain composure under high-pressure circumstances. Connect callers with relevant local resources, including substance use treatment centers, support groups, and other community-based services to promote long-term recovery as needed. Data Collection and Management: Document each phone call interaction in REDCap database. Training and Development: Stay updated on best practices related to overdose prevention, crisis management, and substance use treatment through paid ongoing training and professional development. Team Collaboration: Collaborate with other helpline operators, supervisors, and healthcare professionals to share knowledge, improve procedures, and ensure seamless coordination. Qualifications: Education: No requirement Experience: Relevant lived experience with overdose, harm reduction, or substance use preferred. Crisis Management Skills: Demonstrated ability to handle crisis situations with empathy, efficiency, and professionalism. Communication Skills: Excellent verbal communication skills, with the capacity to communicate effectively with diverse populations and individuals in distress. Compassionate and Non-Judgmental Attitude: Strong commitment to treating all callers with empathy, respect, and without judgment. Technological Proficiency: Comfortable using helpline software, databases, and digital communication platforms to manage incoming calls and messages. Must have cell phone to receive calls at operator expense. Confidentiality: Strict adherence to confidentiality policies and regulations concerning caller information and interactions. Demonstrate a commitment to our team's core values: Teamwork: You communicate with and build up your teammates. You are considerate and aware of how what you say and do impacts your colleagues. Mindfulness and Open-Mindedness: You are respectful, kind, and flexible. You avoid making assumptions about people and are mindful of how our work, language, and actions impact our study participants and the communities we serve. High Quality Work: You are reliable and take initiative. You pay attention to the details and ask for help when needed. Professional Growth: You are curious and excited to learn new things. You own up to mistakes, ask questions, and are receptive to feedback. Work/Life Balance: You approach your work with a positive attitude, value self-care, and communicate honestly about your workload. Must adhere to all of BMC's RESPECT behavioral standards. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). Boston Medical Center is an Equal Opportunity/Affirmative Action Employer. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to ************************* or call ************ to let us know the nature of your request. Compensation Range: $15.14- $21.15 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

The Patient Access Optimization Analyst role is to configure and provide functional and technical support for access optimization initiatives. This position also assists with the analysis, solutioning, documentation, and implementation of Epic-build related functions. * This is a remote position * Working hours Central time zone - 8AM - 5PM * Two positions available The pay range for this position is $31.73/hour (entry level qualifications) - $54.90/hour (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience. ESSENTIAL FUNCTIONS OF THE ROLE * Presentation - able to communicate information professionally and formally to stakeholders through meetings and written presentations. * Independence - proven ability to manage small to medium projects to ensure successful project implementation and engagement. * Excellent verbal and written communication skills, as well as presentation skills. * Strong analytical and advanced research skills. * Solid organizational skills, especially the ability to meet project deadlines with a focus on details. * Ability to successfully multi-task while working independently or within a group environment. * Ability to work in a deadline-driven environment, and handle multiple projects simultaneously. * Ability to interact effectively with people at all organizational levels. * Build and maintain strong relationships. KEY SUCCESS FACTORS * Decision tree design, documentation, and maintenance experience strongly preferred. * Ability to think critically and analyze complex technical solutions. * Epic Cadence Certified strongly preferred. * ServiceNow experience preferred. * Epic Cadence Provider template management and build experience strongly preferred. * Ambulatory and/or Surgery scheduling experience required. * Experienced proficiency in Excel and SQL required. * Able to work through complex business problems and partner with clients using a consultative approach. * Exceptional data/modeling skills with ability to convert raw data into actionable business insights. * Able to apply knowledge of healthcare industry trends and their drivers. * Able to work in a dynamic setting and work well under pressure. * Intermediate to advanced knowledge of statistics (including modeling techniques) preferred. * Lean Six Sigma experience preferred. * 5 years of experience working in Epic strongly preferred. BENEFITS Our competitive benefits package includes the following * Immediate eligibility for health and welfare benefits * 401(k) savings plan with dollar-for-dollar match up to 5% * Tuition Reimbursement * PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level QUALIFICATIONS * EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification * EXPERIENCE - 5 Years of Experience

Work From HomeWork From Home Work From Home, Indiana 46544 The Hospital Outpatient Coding Educator is responsible for coordinating and conducting coding training and developing training content and materials for the Franciscan Alliance Corporate Coding Department, hospital outpatient and professional coding staff. This position ensures training practices are standardized and result in consistent coding outcomes, as well as provides input regarding the content of policies and procedures. This position ensures all new and existing staff members are trained and adhere to current coding policies and procedures. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Develops and maintains all corporate outpatient coding education, training policies and procedures, and coding reference materials. Leads training sessions and assess coder comprehension of covered materials. Makes recommendations for the development of coding resources and policy and procedure development. Assists corporate coding leadership with training and/or development of a performance improvement track for coding coworkers in the corrective action process related to quality or productivity performance. Coordinates with Coding Auditors to prepare education material based on audit results. Develops and maintains a consistent coding operations orientation program, and reports the coders' progress to coding leadership throughout the orientation and training processes Assists Coding Manager and Supervisor with review and response to external coding audits. Acts as a nosologist, analyzing and interpreting disease, procedure classifications, and terminologies for the accurate translation of healthcare data. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Ability to analyze information, make decisions and exercise independent judgement. Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Participates in problem identification, performs root cause analysis and recommends a solution to Coding Management. Assists with development and maintenance of software system workflow for standardization and maximum efficiency. Oversees system testing with regards to any published software updates or software functionality changes Identifies template variation within the EMR that has a negative impact on coding edits/errors. Escalates trends and makes recommendations for template revisions/standardization to FAIS HIM team and Coding Leadership. Coordinates all testing efforts with coding superusers and FAIS teams. Assists with annual verification of coding staff credentials. Orients new physicians with regards to the coding department's role in the revenue cycle, and prepare training material for coding related to physician education. Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines. QUALIFICATIONS High School Diploma/GED With 5 years of Franciscan coding experience - Required or Associate's Degree in Health Information Management - Required Bachelor's Degree in Health Information Management - Preferred Surgery Coding Experience - Required 5 Years Franciscan outpatient coding with CCS, CCS-P, CPC - Required or 3 Years Outpatient Coding Experience with RHIT/RHIA - Required 3 Years Coding Manager or Trainer/Auditor - Preferred CCS, Certified Coding Specialist from American Health Information Management Association (AHIMA) - Required or CPC, Certified Professional Coder from the American Academy of Professional Coders (AAPC) - Required or CCS-P, Certified Coding Specialist - Physician from the American Health Information Management Association (AHIMA) - Required RHIT, Registered Health Information Technician from American Health Information Management Association (AHIMA) - Preferred or RHIA, Registered Health Information Administrator from American Health Information Management Association (AHIMA) - Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Coding Educator - Hospital Outpatient/Professional $51001.60-$75868.00INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Background: The healthcare industry faces many problems - affordability, substandard customer service and inconsistency in care quality, and is not designed around the customer needs, leading to a subpar service experience. Despite encouraging improvements in treatment innovation, the delivery of care is inconsistent, resulting in variations in the quality of care that further compound these problems. We must reimagine a system that is built around the needs of the people we serve with high-value solutions to these pain points. Baylor Scott and White Health (BSWH) is building a customer-focused strategy to solve these problems. We are innovating products and services as a part of Baylor Health Enterprises, an internal startup within the health system. The Customer Solutions team serves as a major growth engine for responsible for developing and launching new digital customer solutions. Customer Solutions generates growth from innovative "white space" opportunities, with a special emphasis on ideas that span digital and traditional in-person channels. The Customer Solutions team enjoys unparalleled access to the executives at BSWH, major investors, and cutting-edge startups across the industry. Entrepreneurial-minded candidates will find a challenging environment, a supportive team and an opportunity to develop a broad skillset while affecting meaningful change in health care. We are looking for people to join this exciting new team who are passionate problem solvers that want to develop a new paradigm to transform how customers are served. Position Summary: The Product Associate will be a critical member of the Muscle and Joint Care product team, responsible for overseeing its development and implementation. They will track key metrics and OKRs and troubleshoot any issues that may arise during the creation and commercialization process, and will be responsible for day-to-day product operations post-launch. This role requires a customer-focused, strategic, and tech-savvy communicator who strives to improve the healthcare experience for customers. The Product Associate will have a high visibility to the Customer Solutions leadership team. This is an exciting opportunity to be part of an innovative team that is changing the status quo in how a healthcare provider goes to market and provides an environment that stimulates professional growth. The products and services built by the Customer Solutions business will have a direct impact on solving the healthcare complexities and easing hardships endured by customers. * Hybrid position, will travel to Dallas, TX one week each month The pay range for this position is $34.58/hour (entry level qualifications) - $53.60/hour (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience. Jobs to Be Done: 1. Execute the product roadmap to deliver solutions that are aligned with product strategy and organizational objectives * Participate in agile team to develop features and user stories, determine downstream operational and technical impacts as well as advocate for product needs * Set and execute sprint goals and communicate with leadership to ensure prioritization aligns with business objectives * Support project management processes including stakeholder training and communication, risk management, status updates and project plans. 2. Support the team in efficient product development * Collaborate with Product Manager to understand and support the development of the product vision, strategic product direction, and product roadmap. * Build detailed workflows based on the product roadmap * Support the Product Manager to work with internal stakeholders (e.g. digital, operations, finance) to understand use cases, assess costs and feasibility * Engage subject matter experts on the agile team to scope and define technical work to support the product roadmap and operational processes * Maintain a deep understanding of the problem space, competitors, and industry * Develop communications and materials to represent the product to stakeholders 3. Monitor and analyze performance to continually improve products * Actively identify and resolve issues and risks, communicating impact and recommended resolutions to leadership * Troubleshoot and resolve issues associated with technology, application, or product feature that impacts customer experience, by coordinating with the digital and in-person teams * Monitor, analyze, and report on product performance Success Factors: * Successful product releases which address a customer problem with a delightful customer experience * Structured approach to troubleshooting and escalating problems as they arise * Effective management of product development * Strong written and verbal communication skills, including developing presentations Preferred Candidate Profile: * Three to four years of professional experience in management consulting, digital product management, product operations, or similar roles in healthcare * Prior experience in a healthcare organization or health-related startup or tech-enabled services environment * Strong program management skills and ability to collaborate with multiple stakeholders to drive a process forward * Excellent organization and time management skills * Exhibits a growth-mindset; can be nimble, is able to continuously test, learn, iterate, and pivot to meet customer needs * Embraces ambiguity and thrives in a startup environment * Ability to travel to Dallas 1 week per month BENEFITS Our competitive benefits package includes the following * Immediate eligibility for health and welfare benefits * 401(k) savings plan with dollar-for-dollar match up to 5% * Tuition Reimbursement * PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level QUALIFICATIONS * EDUCATION - Bachelor's * EXPERIENCE - 1 Year of Experience

Value-Based Care (VBC) Analytics is an independent organization covering the Baylor Scott & White Health Plan (Payer) and Baylor Scott & White Quality Alliance (Accountable Care Organization) analytical and data science needs. We are seeking a customer-facing Healthcare Data Scientist who works closely with key business stakeholders within the value-based care team, to develop use cases related to difficult to solve and complex business challenges. The ideal candidate will work on creating machine learning models using appropriate techniques to derive predictive insights that enable stakeholders to glean insights and enable actions to improve business outcomes. ESSENTIAL FUNCTIONS OF THE ROLE * Communication and Consulting: Summarize and effectively communicate complex data science concepts to inform stakeholders, gain approval, or prompt action from non-technical audience from data-driven recommendations. * Applied Machine Learning: Implement machine learning solutions within production environments at scale. Apply appropriate machine learning techniques that directly impact HEDIS/Stars initiatives * Data Collection and Optimization: Collect and analyze data from a variety of SQL environments (Snowflake, SQL Server) and other data sources, including vendor derived data, electronic health records, and claims data. * Analyze Healthcare Data: Conduct detailed analyses on complex healthcare datasets to identify trends within HEDIS/Stars and utilization, patterns, and insights that support value-based care initiatives, particularly in quality, adherence to standards of care. * Stay Informed: Stay up to date on the latest advancements in data science and healthcare analytics to continuously improve our methodologies and tools. KEY SUCCESS FACTORS The ideal candidate will have some of the following skills and an eagerness to learn the rest. * Healthcare Knowledge: Understanding and prior experience in handling data pertaining to HEDIS, Stars measures and Regulatory specifications. Experience in admin claims data sources such as medical/pharmacy claims, social determinants of health (SDOH) and electronic health records is also required. * Education: Bachelor's or advanced degree in mathematics, statistics, data science, Public Health or another quantitative field. * Effective Communication: Experienced in communicating findings and recommendations directly to Executive-level customers and healthcare professionals. * Analytics Skills: Academic or professional experience conducting analytics and experimentation using algorithms associated with advanced analytics topics, including binary classification algorithms, regression algorithms, Neural Network frameworks, Natural Language Processing, etc. * Technical Skills: Proficiency in common language / tools for AI/ML such as Python, PySpark. Understanding of software engineering topics, including version control, CI/CD, and unit tests. * Problem Solving: A passion for solving puzzles and digging into data. * Technology Stack: Familiarity with deploying data science products at scale in a cloud environment such as Snowflake, Databricks or Azure AI/ML Studio. BENEFITS Our competitive benefits package includes the following * · Immediate eligibility for health and welfare benefits * · 401(k) savings plan with dollar-for-dollar match up to 5% * · Tuition Reimbursement * · PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level QUALIFICATIONS * EDUCATION - Masters' or Bachelors plus 2 years of work experience above the minimum qualification * EXPERIENCE - 3 Years of Experience

The Manager, Lab Cost & Finance will be responsible for creating and maintaining lab costing model(s) and providing financial support to organizational teams. Actively supports FP&A or other lab team members on projects as needed or requested. Work as a contributing member of a highly functioning remote FP&A team. QUALIFICATIONS: Education: Required: Bachelor's Degree in Business Management, Finance, Accounting, or related concentration; MBA or related certification preferred. Experience: Required: Minimum of 5-6 years of experience in a financial analytic or cost accounting role, preferably with a healthcare, insurance, laboratory, or related company. Exceptional analytical skills to process large amounts of financial and statistical information. Proven experience in cost analysis, financial analysis, or a related field, with a strong background in cost management or decision support. Ability to take initiative, engage staff, and create change. Excellent in time management - proven ability to work on and manage multiple projects within tight timelines and in a fast-paced growth environment. Must be a self-starter with strong work ethic, desire to learn, attention to detail, and have a dedication to quality. Experience with Microsoft Excel building spreadsheets and utilizing formulas, pivot tables and graphs. Experience with Microsoft PowerPoint updating and creating presentations that explain financial results. NetSuite experience, preferred. Must possess excellent written, presentation, and oral business communication skills. Adaptable to change in a rapidly growing company. DUTIES AND RESPONSIBILITIES: Develops and maintains standards for COGS and various costing templates. Develops and maintains labor, materials, and overhead cost application rates. Develops pricing solutions for the company's practice groups in conjunction with market trends and profitability goals. Performs detailed financial analysis and creates pricing scenarios in support of the development of pricing alternatives in response to client requests and RFP's. Develops and documents processes related to pricing and COGS, identifies areas for automation and improvement. Challenges assumptions and seek/support cost improvements in lab, be an active contributor to improvement projects and initiatives, validate and review proposed savings. Partners with lab teams to manage costs and review capital proposals. Pro-actively looks at the impact of historic data on future outcomes. Recommends changes to processes and policies to reduce costs and maximize profit. Establishes key performance indicators (KPIs) to measure the success of pricing strategies. Advises management on appropriate use of cost based financial data modeling. Participates in product planning and pricing. Performs modeling as needed. Works with team(s) to develop new product costing in accordance with costing standards. Leads the quarterly client rate review process, including communicating with commercial operations to identify pricing adjustments, working closely with the billing team to ensure all are updated without delays in billing. Ensures the accuracy of client pricing in the company's financial system, including verifying pricing requests and required approvals as well as communicating changes to billing coordinators and others. Supports company decision making with accurate costs and financial information. Must have analytical and problem-solving skills, be detailed, and result oriented. Support other ad hoc analysis, projects, or data request. Adheres to Code of Conduct as outlined in the Baylor Genetics Compliance Program. Performs other job-related duties as assigned. PHYSICAL DEMANDS AND WORK ENVIRONMENT: Remote work role Frequently required to sit Frequently required to stand Frequently required to utilize hand and finger dexterity Frequently required to talk or hear Frequently required to utilize visual acuity to operate equipment, read technical information, and/or use a keyboard EEO Statement: Baylor Genetics is proud to be an equal opportunity employer dedicated to building an inclusive and diverse workforce. We do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, gender identity, veteran status, disability, genetic information, pregnancy, childbirth, or related medical conditions, or any other status protected under applicable federal, state, or local laws. Note to Recruiters: We value building direct relationships with our candidates and prefer to manage our hiring process internally. While we occasionally partner with select recruitment agencies for specialized roles, we do not accept unsolicited resumes from recruiters or agencies without a written agreement executed by the authorized signatory for Baylor Genetics ("Agreement"). Any resumes submitted to Baylor Genetics in the absence of an Agreement executed by Baylor Genetics' authorized signatory, will be considered the property of Baylor Genetics, and Baylor Genetics will not be obligated to pay any associated recruitment fees.

The Clinical Genomic Scientist - WGS Review position has a central role in our groundbreaking whole genome sequencing operation. This position involves clinical documentation review, case analysis, candidate variant selection, and collaboration with other clinical reporting teams. We seek candidates with a strong understanding of gene-disease correlation, molecular mechanism, inheritance, and evaluating the clinical relevance of genetic findings. This position is fully remote and offers daily team huddles, clear objectives, and flexible scheduling. Join our team and contribute to cutting-edge genomics-from the comfort of your home office! Why Baylor Genetics? Work at the forefront of genomic medicine with a team of world-class scientists. Contribute to innovations that shape the future of personalized healthcare. Enjoy a collaborative environment that values expertise, growth, and impact. Duties and Responsibilities on the WGS analysis Team: 80%, possibly up to 100%: Review test requisition forms and clinical notes; perform case analysis using the Emedgene platform; identify and select variants relevant to the proband's phenotype; and request confirmatory testing when necessary. Communicate findings at cross-team huddles Up to 20%: As needed, opportunities for cross-training in WGS variant curations or clinical indication (HPO) may become available Qualifications: For all ranks Degree: Masters in Genetic Counseling, MD, or PhD in clinical medicine, genetics, molecular biology, or equivalent. Familiarity with American College of Medical Genetics (ACMG) variant curation guidelines. Rank: Clinical Genomic Scientist - WGS review I 1 year of prior experience with whole exome or whole genome case review is preferred Rank: Clinical Genomic Scientist - WGS review II 2 years of experience with whole exome or whole genome case review is preferred Rank: Clinical Genomic Scientist - WGS review III 5 years of experience with whole exome or whole genome case review is preferred Rank: Clinical Genomic Scientist - WGS review - Senior 7 years of experience with whole exome or whole genome case review is preferred Demonstration of thorough expertise of gene-disease correlation, case analysis variant selection Rank: Clinical Genomic Scientist - WGS review - Professional 10 years of experience with whole exome or whole genome case review is preferred Demonstration of thorough expertise of gene-disease correlation, case analysis variant selection Track record of high quality, leading projects toward goals, training coworkers, demonstration of workflow process improvement Experience and Competencies: Expertise in concepts of clinical medicine, genetics, genomics, and molecular biology. Knowledge of genomic variation and its correlation with human disease. Familiarity with American College of Medical Genetics (ACMG) variant curation guidelines. Experience in communicating genetic details effectively. Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook). Competencies include Quality Assurance, Analytical and Problem-Solving Skills, Technical Skills, Interpersonal Skills, Oral and Written Communication, Teamwork, Organizational Support, Safety and Security, Dependability, Innovation, Adaptability. Physical Demands and Work Environment: At your Home Office: Frequently required to sit, using screen, keyboard, and mouse. Punctuality attending virtual meetings Occasional weekend rotation may be needed (for example, once a month) EEO Statement: Baylor Genetics is proud to be an equal opportunity employer dedicated to building an inclusive and diverse workforce. We do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, gender identity, veteran status, disability, genetic information, pregnancy, childbirth, or related medical conditions, or any other status protected under applicable federal, state, or local law.

Responsible for performing routine sonographic exams in either an inpatient and/or outpatient setting in accordance with established protocols for positioning, image quality, and ALARA principles. Utilizes a variety of specialized equipment to produce sonographic images, as well as computers and various software programs to enter patient related information into hospital databases. Contributes to the overall excellence of the department through commitment to personal excellence in technical and interpersonal skills. Work required the level of knowledge normally acquired through completion of two to three years of occupationally specific education beyond high school or an Associate's degree in Ultrasound technology or closely related field. Experience in maternity care and obstetrics is required. ARDMS required within 12 months of hire in the specific modality or prior to ACR re-accreditation date. Requires the analytical ability to resolve problems that require the use of basic specific, mathematical, or technical principles and in depth experience based knowledge. Requires the ability to explain clinical, technical, and diagnostic procedures to patients and their families.

** **Upper Extremity:** **- Shoulders:** Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair **- Elbows:** Cubital tunnel release, Bursectomy, Arthroplasty **- Wrist:** Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment) **- Hands:** Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, , Dupuytren's (Palmar fascial fibromatosis), Amputations **Lower Extremity:** **- Hips:** Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy **- Pelvis:** Fracture repairs **- Femur:** ORIF neck fractures, Trochanteric repairs, shaft fracture repairs **- Knees:** Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs, Arthroscopy **- Tibia/Fibula:** Plateau repairs, shaft Fracture repairs, Percutaneous repairs, Arthrodesis, Pilon/Plafond repairs, Malleolar repairs, Sprain **WORK MODEL/SALARY** Days: Monday - Friday Hours: 8hrs a day, 80hrs a pay period 100% Remote The pay range for this position is $26.66 (entry-level qualifications) - $40.00 (highly experienced) The specific rate will depend upon the successful candidate's specific qualifications and prior experience. **JOB SUMMARY** + The Coder 2 is proficient in three or more types of outpatient, Profee, or low acuity inpatient coding. + The Coder 2 may code low acuity inpatients, one time ancillary/series, emergency department, observation, day surgery, and/or professional fee to include evaluation and management (E/M) coding or profee surgery. + For professional fee coding, team members in this job code will be proficient for inpatient and outpatient, for multi-specialties. + Coder 2 utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. + Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) + The Coder 2 will abstract and enter required data. **ESSENTIAL FUNCTIONS OF THE ROLE** + Examines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees. + Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing. + Communicates with providers for missing documentation elements and offers guidance and education when needed. + Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges. + Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately. + Reviews and edits charges. **KEY SUCCESS FACTORS** + Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. + Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function. + Sound knowledge of anatomy, physiology, and medical terminology. + Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits. + Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding. + Ability to interpret health record documentation to identify procedures and services for accurate code assignment. + Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables. Must have one of the following Certifications: + Registered Health Information Administrator (RHIA) + Registered Health Information Technologist (RHIT) + Certified Coding Specialist (CCS) + Certified Coding Specialist Physician-based (CCS-P) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Certified Inpatient Coder (CIC) + Certified Interventional Radiology Cardiovascular Coder (CIRCC) **BENEFITS** Our competitive benefits package includes the following: + Immediate eligibility for health and welfare benefits + 401(k) savings plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level **MQUALIFICATIONS** + EDUCATION - H.S. Diploma/GED Equivalent + EXPERIENCE - 2 Years of Experience + CERTIFICATION/LICENSE/REGISTRATION - Must have ONE of the coding certifications as listed: + Cert Coding Specialist (CCS) + Cert Coding Specialist-Physician (CCS-P) + Cert Inpatient Coder (CIC) + Cert Interv Rad CV Coder (CIRCC) - Cert Outpatient Coder (COC) + Cert Professional Coder (CPC) + Reg Health Info Administrator (RHIA) + Reg Health Information Technician (RHIT). As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

As the Manager of Genetic Counseling Clinical Review, you will oversee a team responsible for clinical review of genetic testing orders, ensuring accuracy, consistency, and timely processing. This role provides day-to-day leadership, coaching, and performance management while fostering a collaborative, high-quality work environment. The manager evaluates and improves workflows, conducts routine quality audits, and partners with cross-functional teams to enhance efficiency and customer experience. They also maintain up-to-date SOPs and training materials and ensure effective onboarding and ongoing competency development for all team members. This position plays a key role in supporting operational excellence and the delivery of high-quality genetic testing services. EDUCATION AND EXPERIENCE Master of Science or Master of Arts in Genetic Counseling from an ACGC-accredited program or equivalent. Board certified or board eligible in Genetic Counseling by ABMGG or ABGC. Must be eligible to work in the USA without restrictions. Experience: 3-5+ years of genetic counseling experience, preferably in a clinical genetic testing laboratory, with 3+ years of supervisory experience Training: Onsite training and occasional meetings may be required; remote work may be available depending on experience and operational needs. DUTIES AND RESPONSIBILITIES Essential Functions: Lead, mentor, and manage the clinical order review team, including workload oversight, staffing, coaching, and performance evaluations. Oversee quality assurance by conducting routine QA checks, monitoring accuracy of clinical order reviews, and implementing corrective actions or retraining as needed. Drive process improvement by analyzing workflows, identifying inefficiencies, and partnering with cross-functional teams to implement scalable, data-informed solutions. Maintain and update SOPs, work instructions, and training materials to ensure compliance, clarity, and alignment with evolving workflows and test offerings. Manage onboarding, training, and competency assessments to ensure all GCAs are properly prepared, up-to-date on workflow changes, and consistently delivering high-quality work. Serve as a clinical stakeholder in cross-functional projects, including workflow and system improvements. Assist in managing clinical process improvements to enhance efficiency, reduce error rates, and support scalability. Educate and support trainees, including new clinical team members. Skills: In-depth knowledge of clinical and laboratory genetics. Excellent written and verbal communication skills, with ability to simplify complex scientific concepts. Superior organizational skills and attention to detail for content accuracy and workflow documentation. Ability to work independently and collaboratively across laboratory and clinical teams. Understanding of regulatory and quality standards relevant to genetic testing laboratories (e.g., CLIA, CAP). Proficiency with learning management systems, document management tools, and general computer applications. PHYSICAL DEMANDS AND WORK ENVIRONMENT: Frequently required to sit. Frequently required to talk or hear. Frequently required to use visual acuity for reading technical materials, reviewing documents, and working on a computer. Occasional exposure to laboratory environments or biohazard materials depending on operational needs. EEO Statement: Our organization is an equal opportunity employer committed to fostering an inclusive, diverse, and equitable workplace. We do not discriminate based on race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, veteran status, pregnancy or related conditions, or any other protected status.

The Contract Specialist is responsible for the lifecycle management of low to moderate risk vendor goods and services agreements, maintains applicable contract records, correspondence, and files, and monitors contracts for expiration taking action to amend, extend, or close-out as appropriate. Position: Contracts Specialist Department: Supply Chair Corp Procurement Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Handles routine or standard form contract agreements and related documentation in accordance with established contract policies and procedures; executes low to moderate risk contracts. Able to negotiate basic business terms in accordance with prescribed templates and guidelines. Reviews solicitations and prepares routine response for proposals, bids, and contract modifications. May prepare basic requests for proposal, information or quotation as directed. Prepares and administers routine correspondence, negotiation memoranda, and contract documentation to ensure timely and coordinated submittal. Prepares, organizes and maintains contract records and files to ensure business continuity and optimization of the contract lifecycle management and ERP systems. Documents contract performance and compliance where required, escalates non-conformance to leadership for follow up. Communicates contract policy and practice to internal business teams; ensures contract review, approval and execution in accordance with guidelines and policies. Assists internal or external business teams on issues and developments relative to assigned contracts. Coordinates with Supply Chain and Accounts Payable teams to rectify pricing discrepancies; ensures accurate and timely processing of vendor payments utilizing purchase orders. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Bachelor's degree or equivalent education and experience preferred CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Certification from National Contract Management Association (NCMA) or International Association for Contract and Commercial Management (IACCM) or similar credential preferred. EXPERIENCE: 1-3 years related business or contract experience KNOWLEDGE, SKILLS & ABILITIES (KSA): Strong written and verbal communication skills; detail oriented in all notes and documentation. Intermediate to advanced skill in use of Microsoft products including Word, Excel, PowerPoint, Forms, etc. Proficient using contract lifecycle management and ERP systems. Basic analytical skills necessary to make sound recommendations based on data. Able to develop accurate and precise summary information. Compensation Range: $50,500.00- $73,000.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

The Sr. Data Governance Analyst plays a key role in advancing BSWH data governance initiatives and driving data-informed decision-making across the organization. The Data Governance Analyst provides data analytics, data management, data architecture support and alignment. This role is responsible for designing, implementing, and optimizing metadata management, data catalogs, lineage documentation, and governance workflows and platforms. This position leverages advanced analytical tools to uncover meaningful insights that support strategic initiatives and performance improvements. Partnering with stakeholders across the organization to translate complex data into actionable intelligence. Functions as a bridge between IT, business, legal, and compliance teams to ensure data is accurate, compliant. Working closely with data product managers, business SMEs, and technology teams, the analyst enhances data discoverability, quality, and compliance across the enterprise; supporting BSWH Data Strategy and enabling timely, data-driven decisions built on trusted information. The Senior Data Governance Analyst is a key contributor to the data governance program by conducting regular assessments of data assets establishing standards, creating necessary policy documentations, identifying areas for improvement and ensuring alignment with business objectives. By fostering a culture of data stewardship, this role helps maximize the value of data as a strategic asset and promotes consistent, high-quality analytics across the enterprise. 100% remote position **_The pay range for this position is $40.35/hour (entry level qualifications) - $62.52/hour (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience._** **ESSENTIAL FUNCTIONS OF THE ROLE** + Study and research features of new database versions and tools to prepare for future growth. + Establishes technical standards and guidelines for the effective use of databases. + Train, educate and assist in the development of personnel including data governance tools, principles and practices. + Develop, implement, and manage practices/policies for data quality, security, access, and usage. + Provide data literacy oversight and support to ensure data integrity and quality. + Ensure data privacy, security, and compliance. Support PHI classification, data quality checks, and lineage validation. + Act as liaison between data stewards and analytics team, promoting adoption of best practices. + Monitor and assess data quality for key metrics, identify issues and provide pragmatic recommendations. + Catalog and manage data assets, ensuring they are properly classified and accessible to authorized users. + Prepare and present reports and presentations on data governance activities, metrics, and outcomes. + Ensure Data Governance key assets (Glossaries, Data Dictionary, Reference Data List, Lineage and Business Process Maps, technical assets) are maintained and used effectively. + Develop and deliver data management technology and Data Steward training, keeping training materials up-to-date. + Liaising closely with Data Stewards to understand their data needs and requirements, and chairing data meetings. + Leading the design and build of data catalogue content, metadata models, and workflows. + Design, implement, and maintain governance processes, and workflows (e.g., stewardship approvals, data access protocols) and supporting their use by Data Governance members. + Implement and monitor data quality standards to maintain high levels of accuracy, completeness, and reliability. + Handle data lifecycle management, support governance tools, monitor KPIs, and operationalize data standards across systems. + Stay updated on industry trends and best practices in data governance, applying new insights to enhance organizational practices. **KEY SUCCESS FACTORS** + Deep understanding of healthcare data and operations. + Knowledge of Data Warehousing, ODS, or other reporting environment in a work environment. + Knowledge of healthcare and health insurance claims processing domains. + Ability to write complex SQL queries against relational databases. + Must possess excellent documentation and communication skills. + The ability to understand, model, and interpret data. + Accuracy and attention to detail. + Must possess good social skills. + Excellent written and verbal communication and collaboration skills. + Experience working across business and technical teams. + Strong analytical and problem-solving skills to identify and solve complex business problems. + Knowledge of data management, data governance frameworks/platforms, data cataloging/lineage concepts, data architecture, data analytics best practices and techniques. + Knowledge of metadata management concepts, modeling, tools. standards and best practices. **BENEFITS** Our competitive benefits package includes the following + Immediate eligibility for health and welfare benefits + 401(k) savings plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level **QUALIFICATIONS** EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification EXPERIENCE - 5 Years of Experience As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Work From HomeWork From Home Work From Home, Indiana 46544 The Clinical Denial Specialist II functions as a hospital liaison to appeal denied claims for Medicare, Medicaid, Managed and Commercial insurance. This position entails detailed retrospective review via EPIC of patient medical records to analyze and compile data for additional documentation request and claim denials, using trends and patterns identified to support process improvement. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Schedule: Monday - Friday, 8am - 5pm Develop reports Review governmental contractor's response Identify underlying root causes for potential denials and works closely with departments and Clinical Documentation Integrity to reduce denials Write and ensure all appeals are filed in a prompt and timely manner for Medicare, Medicaid, Managed, and Commercials Payor Audit medical documentation for adherence to insurance and CMS guidelines relating to inpatient/observation services, or other denial issues Knowledge of inpatient criteria to establish medical necessity letters QUALIFICATIONS Active Indiana RN license required BSN or Associate's with 5 years of nursing experience required 3 years of denial experience required 5 years of nursing or case management experience preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Clinical Denial Specialist II $52395.20-$77948.00INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Corporate Coding Manager develops and implements coding strategies and provides operational leadership to manage and maintain efficient coding processes. This position supervises staff, prepares and forecasts budgets and strategic plans oversees quality assurance programs, and ensures regulatory compliance. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Provides oversight and leadership to the Coding Supervisors within the department, and manages the performance of coworkers through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team. Oversees the auditing and education program to ensure accurate and compliant coding and billing practices. Makes decisions regarding changes to coding staff day-to-day functions; aligns all aspects of coding operations to align acute and ambulatory corporate initiatives, including standardized corporate coding policy and procedure development and enforcement. Participates in problem identification, performs root cause analysis, and develops a solution that produces expected outcomes and intended results. Assists with the development of the organizational wide standardization and implementation of a corporate coding compliance plan to include compliance with external regulatory and accreditation requirements. Creates an environment that coworkers want to work in and maintain a high level of coworker satisfaction. Serves as department liaison for regional meetings and projects and to other teams that interact with the coding team; assists with items specific to coding needs for planning of new department builds and department revisions. Assists the Coding Manager with inquiries/audits and denials from third party agencies related to coding. Function Purpose Orientation to coding fundamental support role in business operations in supporting the revenue cycle and how coding influences. (ex. Physicians, Clinical Operations teams, BPCI, quality measures Acts as a nosologist, analyzing and interpreting disease and procedure classifications and terminologies for the accurate translation of healthcare data; applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Maintains expert knowledge of Franciscan Alliance coding software tools; assists with development and maintenance of software system workflow for standardization and maximum efficiency. Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines. Director with development and manages departmental budgets, including making budget allocations, approving expenditures and ensuring expenses are within budget. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders, and adheres to official coding guidelines. QUALIFICATIONS Associate's Degree Health Information Management - Required Bachelor's Degree Health Information Management - Preferred 4 years Coding Manager - Required 4 years Franciscan Coding Supervisor - Required 3 years Coding Experience - Required Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Required - OR - Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Required TRAVEL IS REQUIRED: Up to 20%JOB RANGE:Coding Manager $77,750.40 - $121,492.80INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Supervisor of Denial Management oversees the daily operations of a team responsible for medical claim denial follow-up and underpayments, and all support activities associated with managing claim denials. This position assists management in maintaining the denial management system, workflows and analysis reporting including the collection and interpretation of patterns to quantify denial causes and their financial impact. The Supervisor of Denial Management collaborates with other system departments to apprise them of trends and process improvement opportunities, with a focus on preventing future claim denials. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Supervise the work of others and manage the performance of individuals through feedback and recommendations. Implement process innovations and works closely with Insurance Payers, Revenue Cycle leadership and Department Managers in revenue-producing departments to reduce denials and to improve upon the Revenue Cycle KPIs. Participate in people management activities for direct team members such as conducting performance evaluations, disciplinary actions, and interviews. Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data. Coordinate department efforts with other departments to align interdepartmental functioning, strategic goals, and expectations. Develop and monitor a structured, organized workflow to ensure actions carried out consistently and accurately. Act as the first point of escalation within the team by acting as a coach and mentor. Prepare operational progress or status reports on a regular basis. Independently develop effective relationships with patients, hospital departments, and other external parties. Coordinate meetings and in-service training with Payor representatives and vendors. Develop reports, policies, procedures and training materials for employee training and business improvements. Ensure compliance with state and federal billing regulations. Review the final documentation for write-offs and adds avoidable write off language. QUALIFICATIONS Preferred Associate's Degree Required High School Diploma/GED 5 years Patient Accounting required 1 year Supervisory or leadership experience Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Supervisor Denial Management $48,838.40-$72,675.20INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Designs, develops, supports, and maintains the organization's systems infrastructure, including the implementation and design of hardware and software. Makes updates to system related installation documentation. Performs end-user support. Proactively researches and locates necessary tools and processes to identify troublesome trends as they develop. Ensures a stable performance environment for the enterprise systems. Participates and leads various moderate to complex IT projects intended to continually improve/upgrade the enterprise servers. Experience working in EPIC systems required. Position: Systems Engineer II - Epic Department: Information Technology Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Experience in mission-critical enterprise server environments performing network engineering (hardware and software), and designing, planning, and implementing servers and infrastructure using the latest technology. Thorough understanding of distributed systems architecture and comprehensive knowledge of multiple technical disciplines. Excellent technical knowledge and aptitude in the areas of networks, network topologies, network file servers, applicable software, and troubleshooting techniques. Ability to solve enterprise server issues and to manage the performance and capacity of a LAN/WAN environment. Ability to effectively adapt to rapidly changing technology and apply it to business needs. Understanding of the enterprise business and business processes; knowledge of business unit functions and cross-group dependencies/relationships. Ability to anticipate user requirements and identify and resolve complex problems with minimal supervision; Ability to assess internal and external communication practices, anticipate future network requirements, and research and analyze emerging technologies. Build and configure Windows-based servers. Support digital transformation efforts Configure backup and monitoring on all servers as needed. Understanding the Microsoft security patch cycle and apply patches to servers as needed. Support Microsoft Office 365 Must be able to work independently with little to no daily supervision, is a team player and open to ideas and learning. Be able to modify storage, memory and network settings as appropriate. Server performance monitoring. Work with users to troubleshoot issues with performance, access and other administrative tasks. Able to communicate effectively across the organization. Take part in Change Control process. Take part in regular on-call rotation. Create and Post Documentation. 3rd Level end-user support. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Bachelor's degree in Computer Science, Engineering, or related discipline; equivalent experience acceptable. CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Current Epic ECSA certification required Microsoft Certifications: MCSE highly desirable AWS Certifications: Cloud Practitioner, Associate or Professional level Architect highly desirable EXPERIENCE: Minimum of 4-7 years of related experience KNOWLEDGE AND SKILLS: Technical Skills: Hyperspace Web • Networking • Interconnect • System Pulse • Business Continuity Access • EPS • System Performance Analytics • My Chart • Care Everywhere • EpicCare Link • Hyperspace Client • Capacity Management • Scripting/Programming • VMware • Windows Server Management Demonstrated knowledge of the following technical knowledge/skills are preferred, including from among the following: Hardware: Dell Servers* OS: Windows 2016/2019/2022 * Microsoft AD/Azure AD * Microsoft O365 * Microsoft Exchange * Microsoft Defender * Microsoft ADFS * Mimecast * PowerShell Scripting * Microsoft Certificate Authority * Microsoft DHCP/DNS * Microsoft System Center * Automation Support * VMware Environment Experience * AWS * Strong customer service and communications skills Good judgment and analytical skills Strong follow-up and organizational skills Compensation Range: $83,000.00- $120,500.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

Join TriHealth as an Anatomic Pathology Assistant TriHealth is seeking a reliable and detail-oriented individual to support our pathology team at Bethesda North Hospital Laboratory. In this essential role, you will assist pathologists, pathologist assistants, and histotechnologists with a variety of tasks that ensure the accuracy, efficiency, and quality of patient testing and specimen handling. Location: Bethesda North Hospital at 10500 Montgomery Road, Cincinnati, OH 45242 Work Hours: Full Time, 80 hours bi-weekly Day Shift No weekend commitment Job Overview: The responsibilities of this position may include but are not limited to: supports pathologists, pathologist assistants, and histotechnologists in all related duties in surgical pathology; handle ordering and packaging of send-out testing; gathering information for service and billing; slide distribution within the department; handling messages from pathologists regarding patient testing; answering phones; acting as a liaison for courier services; reconciling pending logs; pulling slides and blocks as needed/requested; managing temperature logs; limited instrument maintenance; other duties as assigned by Supervisor. Job Requirements: High School Degree or GED Job Responsibilities: Ability to Prioritize/Organize/Handle Quantity of Work Accuracy/Quality/Completeness of Work Complex Assignments Received/Delegated/Completed Judgement Skills/Problem Solving Skills Overall Procedure Knowledge/Quality Assurance Knowledge - including documentation as needed Working Conditions: Climbing - Rarely Hearing: Conversation - Consistently Hearing: Other Sounds - Frequently Kneeling - Occasionally Lifting 50+ Lbs. - Rarely Lifting Pulling - Rarely Pushing - Occasionally Reaching - Rarely Sitting - Consistently Standing - Rarely Stooping - Occasionally Talking - Consistently Use of Hands - Consistently Color Vision - Occasionally Visual Acuity: Far - Frequently Visual Acuity: Near - Consistently Walking - Frequently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone's opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community

The Collector II under general supervision and according to established procedures, performs collection activities for assigned accounts. Contacts insurance company representatives by telephone or through correspondence to collect inaccurate insurance payments and penalties according to BSWH Managed Care contracts. Maintains collection files on the accounts receivable system. **ESSENTIAL FUNCTIONS OF THE ROLE** Performs collection activities for assigned accounts. Contacts insurance companies to resolve payment difficulties and penalties owed to BSWH in accordance with Managed Care contracts. Contacts insurance company representatives by telephone or through correspondence to check the status of claims, appeal or dispute payments and penalties. Has knowledge of CPT codes, Contracting, per diems, and other pertinent payment methods in the medical industry. Maintains collection files on the accounts receivable system. Enters detailed records consisting of any pertinent information needed for collection follow-up. Processes accounts for write-off and for legal. Conducts thorough research and manual calculation from Managed Care Rate Grids and Contracts to determine accurate amounts due to BSWH per each individual Insurance Contract. Enters data in Patient Accounting systems and Access database to track and monitor payments and penalties. Prepares legal documents to refer accounts to the Managed Care legal group for accounts deemed uncollectable. Through thorough review ensures that balances on accounts are true and accurate as well as correct any contractual or payment entries. Verify insurance coding to ensure accurate payments. Receives, reviews, and responds to correspondence related to accounts. Takes action as required. **BENEFITS** Our competitive benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level **QUALIFICATIONS** - EDUCATION - H.S. Diploma/GED Equivalent - EXPERIENCE - 2 Years of Experience As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.