Clinical documentation improvement specialist work from home jobs - 438 jobs

A leading healthcare provider seeks a Clinical Educator NP/PA & Travel Nurse to provide clinical coverage at Skilled Nursing Facilities across the U.S. This role combines patient care and education, requiring travel for approximately 48-50 weeks a year. Candidates must have a certification as a Nurse Practitioner or Physician Assistant, along with 3-5 years of experience in Physiatry. Competitive salary and comprehensive benefits offered, including travel expenses, health insurance, and retirement plans. #J-18808-Ljbffr

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the providers with accurately identifying and documenting the healthcare services provided to the patient. This is accomplished with the recognition of complete and accurate diagnoses, procedures performed, and the treatment provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded post discharge in a timely and accurate manner. A highly successful CDI program is based on a highly interactive process between physicians, CDIS staff and other support services. The program does not challenge the provider's medical judgement, but rather provides a methodology in which to clarify existing documentation. Acts as a liaison between the clinical and coding functions. Provides education to the medical staff and other clinical professional on documentation relevant to the Revenue Management processes and Discharge Not Final Billed reduction. Provides daily interactions with physicians and clinical professionals regarding documentation clarification and optimization. It is expected that the CDIS have previous clinical skills, including an understanding of Anatomy and Physiology in order to appropriately discuss with the physician such issues as the underlying etiology, principal diagnosis, diagnostic studies, treatment modalities, to name a few. The essential focus of this position is to analyze the clinical information, using the documentation as the primary driver for overall System Case Mix Index. Job Duties: Applicants must currently hold the required CDI certification in order to be considered for this position. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP). This is a work from home position. The position is full-time, 40 hours weekly; Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A minimum of 3 years RN work experience is required; BSN is strongly preferred. Benefits at Geisinger: We offer a comprehensive benefits package starting on day one, including: Health, dental, and vision insurance Three medical plan choices, including expanded network options Pre-tax savings plans (FSA & HSA) Company-paid life, short-term, and long-term disability insurance 401(k) with automatic Geisinger contributions Generous PTO that accrues quickly Up to $5,000 in tuition reimbursement per calendar year MyHealth Rewards wellness program with financial incentives Family-friendly support: adoption/fertility assistance, parental leave, military leave, and Care.com membership Employee Assistance Program (EAP): mental health, legal guidance, childcare/eldercare referrals, and more Voluntary benefits: accident, critical illness, hospital indemnity, identity theft protection, pet insurance, and more The Senior CDI Specialist improves the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Assists the providers with accurately identifying and documenting the healthcare services provided to the patient. The position will, through ongoing education, support the improvement and continue to sustain clinical documentation related to relative patient acuity, risk reduction, ad overall improvement and accuracy of Case Mix Index. Acts as documentation liaison to physician staff as a means of finalizing information in the medical record. Job Duties: Reviews inpatient medical records within 24-48 hours of admission for a specified patient population to: evaluate the documentation in order to assign the principal diagnosis, relevant secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, severity of illness Formulates queries when it is determined there is missing documentation, conflicting documentation or unclear documentation. Attends physician rounds on assigned units, as well as interdisciplinary team meetings as appropriate to daily patient assignment. Provides on-going education to physicians and essential healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the patient's record. Collaborates with the nursing staff, clinical nutrition, pharmacist, along with the physicians on documentation in an attempt to resolve queries prior to the patient's discharge. Identifies strategies for sustained work process changes that facilitate complete, accurate clinical documentation. Maintains the confidentiality of all information acquired, pertaining to the patient, physician, associates, and visitors to Geisinger. Promotes a partnership with the Inpatient Coding staff, to provide clinical education, to assure documentation of discharge diagnosis and any secondary diagnoses' to reflect the accuracy of the patient's clinical status and care. Acts as a resource person for the interdisciplinary team in order to promote collaboration and coordination of patient care considering age specific, developmental, cultural, and spiritual needs of the patient. Complies with established hospital and Department Policies, Procedures Assists the Director with daily organization of CDI work flow at all Geisinger facilities. Communicates and partners with the CDI Director regarding issues in need of a coordinated resolution. Position Details: Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Education: Bachelor's Degree-Healthcare Related Degree (Required) Experience: Minimum of 3 years-Nursing (Required) Certification(s) and License(s): Basic Life Support Certification - Default Issuing Body, Certified Clinical Documentation Specialist - Default Issuing Body, Clinical Documentation Improvement Practitioner - Default Issuing Body, Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania Skills: Communication, Computer Literacy, Medical Records Management, Medical Records Systems, Teamwork, Working Independently OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This position will be coding for Pain Management/ Anesthesia. Job Summary Summary: Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations Does this position require Patient Care? No Essential Functions Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information. -Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies. -Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes. -Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials. -Utilize coding software, encoders, and electronic health record systems to facilitate the coding process. -Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives. -Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges. Qualifications Education High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred Experience Medical Coding Experience 3-5 years required Knowledge, Skills and Abilities - In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing. - Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations. - Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes. - Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding. - Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff. - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $21.78 - $31.08/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Support CenterIf you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare seeks to hire an experienced Clinical Documentation Improvement Specialist who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Clinical Documentation Improvement Specialist, you will: • Examine medical records to ensure documentation is accurate, complete, and reflective of the patient's clinical status. • Detect inconsistencies, ambiguities, or missing information in the medical record that may impact coding, compliance, or patient care and request provider clarifications as necessary. • Verify that clinical documentation supports correct ICD-10-CM/PCS and CPT coding for proper reimbursement and collaborates with the coding/revenue cycle team. • Ensure that documentation and provider queries align with regulatory standards, including CMS guidelines and organizational policies. • Communicates and establishes relationships with physicians and clinical staff to share insights, trends and education to improve documentation practices. • Contributes to organizational quality improvement initiates by ensuring robust and accurate documentation related to MHACs, PPCs, PSIs, SOI/ROM and mortality. • Track and report on metrics related to documentation quality, such as query response rates or documentation accuracy. • Provide guidance and education on documentation best practices and standards to physician and clinical staff to support ongoing improvement. • Assist in internal and external audits by ensuring proper documentation and addressing identified issues. • Maintains and enhances current medical, coding and CDI knowledge via participating in continuing education offerings. Qualifications include: • BSN or Equivalent RN (Registered Nurse) • Minimum of 5 years inpatient clinical experience with 2-5 years clinical documentation improvement experience • Experience with Solventum/3M 360 preferred • Current Maryland license • Relevant certification required, e.g. CDIP or CCDS • Maintains current working knowledge of Coding Clinic Guidelines and federal updates to DRG system (MS, APR, AP etc) • Knowledge of medical terminology, anatomy, physiology, microbiology, and disease processes. Work Schedule: Day Shift Hybrid Position Pay Range: $71,932.12 - $107,889.60 If the salary range is listed as $0 or if the position is Per Diem (with a fixed rate), salary discussions will take place during the screening process. Under the Fair Labor Standards Act (FLSA), this position is classified as: United States of America (Exempt) At Adventist HealthCare our job is to care for you. We do this by offering: Work life balance through nonrotating shifts Recognition and rewards for professional expertise Free Employee parking Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available) Paid Time Off Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance Subsidized childcare at participating childcare centers Tuition Reimbursement Employee Assistance Program (EAP) support As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County. If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference. Join the Adventist HealthCare team today, apply now to be considered! COVID-19 Vaccination Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination. Tobacco and Drug Statement Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use. While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result. Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing. ("Nicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.). Equal Employment Opportunity Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background. AHC does not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law. Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants' religious beliefs. Applicants who wish to request accommodations for disabilities or religious belief should contact the Support Center HR Office.

The Quality Improvement Specialist plans and executes organization-wide improvement projects in order to improve organizational performance and promote efficient use of resources through effective design, measurement and analysis of key clinical and operational processes. Applies statistical techniques, root cause analysis, Lean, Six Sigma, and other process improvement tools and techniques with subject matter experts to drive effective interventions and track the implementation of those interventions. The Quality Improvement Specialist will manage several projects simultaneously. This position is full-time remote. Selected candidate must reside in North Carolina. Occasional travel for onsite meetings at the Home office (Morrisville, NC) may be required. Responsibilities and Duties Manage interdepartmental projects to achieve quality targets- Form a team of experts required for effective completion of the project, documenting the projected resources, dates, and goals Develop and adhere to a timeline and list of tasks and resources should be generated that will describe the project in detail and plot important dates, meetings, and prospective finish Prepare and present project reports on a regular basis to the Project Team, Executives, and the Board of Directors Conduct regular meetings with team members to discuss the status of the project and also to make necessary changes and improvements to achieve the desired results Motivate and influence staff assigned to the project in order to accomplish task(s) successfully Statistics, Sociology, Economics, Public Health, Business Administration, Organizational Development, Psychology or related social science Identify and promptly address any problems that may pose a risk to achieving the desired outcome of the project within the time and budget constraints Create and deliver presentations and trainings to variety of internal and external stakeholders as needed Identify the root causes of quality issues to ensure the problem is well defined and can be addressed Leverage lean concepts to identify nonvalue-added elements and activities, and are able to use quality tools to identify failure points in processes Conduct process mapping exercises, design effective data collection plans, understand sources of performance variation, and communicate these principles effectively to a broad audience Define success targets based on internal and external requirements as well a well thought out business case Effectively measure the key output variables to ensure all performance changes are accurately assessed Conduct statistical analysis of initial and repeat measures to evaluate efficacy of interventions and to improve approach to successfully resolving root cause as needed Design appropriate sampling plans and measurement systems to assess process capability and overall system performance Evaluate validity and accuracy of data sources to draw appropriate conclusions Analyze changes in performance to determine the impacts of interventions Perform any required data analysis to evaluate performance gaps Prepare comprehensive reports to ensuring adequate documentation and methodology to support findings and recommendations Design and lead the implementation of effective interventions to drive improvement Generate and evaluate solution ideas using Lean methodologies to reduce and prevent waste Develop plans for implementing proposed improvements, including conducting pilot tests or simulations, and evaluate results to select the optimum solution Develop a sustainable monitoring process and procedure that will ensure long-term success Verify reduction in failures due to the targeted root cause Ensure that all staff involved in the improvement efforts are trained to sustain the improvements and have a robust monitoring plan to detect future performance issues Knowledge, Skills, & Abilities Advanced Project Management skills Advanced Quality Improvement Methodologies (Lean, Six Sigma, Kaizen, etc.) Advanced Data Collection & Analysis skills Advanced Microsoft Applications (Excel, Word, PowerPoint etc.) skills Advanced Communication Skills Advanced Collaboration Skills (problem-solving, mediation, conflict resolution and teamwork) Knowledge and experience with NCQA and HEDIS measurements Medicaid Experience Financial management skills Minimum Education & Experience Bachelor's degree and five (5) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research; or Master's degree and three (3) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research. Special Requirement Certification as a Lean practitioner and/or Six Sigma Black Belt is required within eighteen (18) months of employment Salary Range $68,227 -$86,990/ Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Quality Improvement Outreach Specialist supports quality improvement initiatives through member-focused outreach and engagement focused on closing quality gaps in care and improving health outcomes. This role conducts proactive outreach to members for all lines of business to encourage completion of recommended preventive screenings and chronic care services. As a key member of the Quality team, this position plays a vital role in improving HEDIS, Stars and other quality measure performance and advancing overall member health through culturally competent education, coordination, and engagement. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Perform outreach calls to members with quality gaps in care · Provide education, motivational support, and scheduling assistance to help close identified care gaps and improve quality outcomes · Follow up with members requiring support in taking steps to close care gaps · Document outreach activities, tracks progress and results and supports reporting for quality campaign and initiatives · Evaluate Health Related Social Needs that may impact the member's ability to access needed services · Collaborate with internal teams to ensure coordinated member support · Meet quality and timeliness standards to achieve individual and departmental performance goals · Maintain current knowledge of quality measures and best practices · Ensure compliance with all state and federal regulations for activities performed · Participate in quality improvement activities and cross-department meetings, supporting discussions and reporting as needed · Develop and maintain policies & standard operating procedures of processes to maintain compliance · Support programs and clinical best practices with the objective of improving health outcomes, preventing hospital readmissions, and promoting health and wellness activities · Other duties as assigned Qualifications: Education Required: · Associate degree in nursing or post high school nursing diploma Education Preferred: · Bachelor's or Master's Degree in healthcare or related field Experience Required: · 2 years of experience as a practicing nurse in a hospital/healthcare setting or performing direct member outreach Experience Preferred/Desirable: · 2+ years of experience in health insurance field · 2+ years of experience in quality improvement Required Licensure, Certification or Conditions of Employment: · Successful completion of pre-employment background check Competencies, Skills, and Attributes: Required : · Strong proficiency in use of office equipment including copier, fax machine, scanner, and telephones · Strong PC proficiency in word processing, spreadsheet, and database software Preferred: · Advanced PC proficiency Professional Competencies: Required: · Effective collaborative and proven process improvement skills · Strong oral and written communication skills; ability to interact within all levels of the organization · Demonstrated commitment to excellent customer service · Knowledge and understanding of current trends in healthcare · Aptitude for aligning process, projects, and people to meet business goals in cross-functional team settings · Health care payer business knowledge including processes and operational data and functions that support the business · Maintain confidentiality and privacy · Capable of investigative and analytical research to make decisions and recommendations based on available information · Independent and sound judgment with good critical thinking skills · Knowledge of managed care, utilization management, and quality management · Establish and maintain working relationships with health care providers, members, and coworkers · Practice interpersonal and active listening skills to achieve customer satisfaction and departmental communication standards · Ability to Interpret policies, programs, and guidelines · Establish and maintain working relationships in a collaborative team environment · Organizational skills with the ability to prioritize tasks and work with multiple priorities · Maintains current knowledge of State, Federal and other applicable regulatory/accrediting agency requirements as they apply to department functions Compensation Range $74,000 - $107,000 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/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Remote - Inpatient Coder II Inpatient Coding Full Time Status Day Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. This position is responsible for assigning ICD-10-CM and ICD-10-PCS codes for inpatient and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic, anatomy and physiology. This position works under the supervision of the Manager and is employed by Mosaic Health System. Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines and organizational compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Completes complex coding assignments for reimbursement, research and compliance with Federal and State regulations. Researches coding guidelines. Reviews and appeals coding denials. Educates/Communicates with providers, querying providers to ensure that optimal clinical documentation is provided to demonstrate the severity and details of the patient's illness in the medical record. Coordinates/Communicates with departments including clinical departments, Quality Improvement, Care Management, Patient Financial Services to ensure accuracy and timeliness of coding. Ensures data accuracy by responding to coding edits received. Cross-trained and able to complete one type of outpatient facility coding in addition to inpatient coding. Example: Emergency Department, Observation, Referral. Mentors and assists with training coders. Completes analysis by utilizing reports, record reviews, etc. Other duties as assigned. Must have coding education. Associate's Degree or higher in Health Information Management / Medical Records required. CCS - Certified Coding Specialist, RHIA - Registered Health Information Administrator, or RHIT - Registered Health Information Technician required. Three years experience in coding in an acute care setting required.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. Comply with comprehensive internal coding policies and procedures that are consistent with requirements. Attends coding meetings and roundtable sessions. Participates in daily huddles and LEAN problem-solving activities. Focused with no distractions while working and participating in meetings. Ensures camera on while attending Teams calls. Assists with organizing the shared drive for the medical coding department. Other duties as assigned by manager. Qualifications High School Diploma/G.E.D. - required Prior experience in hospital medical coding - preferred Prior experience with 3M 360 and EPIC system - preferred Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) Excellent written and verbal communication skills. (High proficiency) Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) Detail-oriented and efficient while maintaining productivity. Coding certification / credential through AHIMA or AAPC and be in good standing. - required Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands Standing - Occasionally Walking - Occasionally Sitting - Constantly Lifting - Rarely Carrying - Rarely Pushing - Rarely Pulling - Rarely Climbing - Rarely Balancing - Rarely Stooping - Rarely Kneeling - Rarely Crouching - Rarely Crawling - Rarely Reaching - Rarely Handling - Occasionally Grasping - Occasionally Feeling - Rarely Talking - Frequently Hearing - Frequently Repetitive Motions - Frequently Eye/Hand/Foot Coordination - Frequently Working Conditions Extreme cold - Rarely Extreme heat - Rarely Humidity - Rarely Wet - Rarely Noise - Occasionally Hazards - Rarely Temperature Change - Rarely Atmospheric Conditions - Rarely Vibration - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Medical Center! Albany Medical is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

PSI is a leading Contract Research Organization with more than 30 years in the industry, offering a perfect balance between stability and innovation to both clients and employees. We focus on delivering quality and on-time services across a variety of therapeutic indications. Job Description We are looking for an Operating Room (OR) Nurse to join PSI as a Clinical Trial Liaison! In this role, a Clinical Trial Liaison: Acts as a specialized liaison to assist sites with a protocol-tailored approach to increase efficiency of the patient identification and recruitment process Assists sites in developing and implementing patient enrollment techniques Coordinates site specific patient recruitment and retention plans observing the planned metrics Provides information specific to the area of expertise to site team members involved in patient recruitment Identifies, tracks, and reports patient enrollment progress throughout the study Analyses the protocol in order to provide the site with the support needed to improve the patient pathway Provides support to the project teams to ensure proper documentation of study-specific assessments related to patient enrollment Assists and advises the site monitor in the area of patient enrollment This role requires travel. Qualifications Registered Nurse (RN) Degree A minimum of 5 years of experience as an OR Nurse Experience in operation and QC procedures related to the equipment used in the specialized area Additional Information All your information will be kept confidential according to EEO guidelines.

Facility Name: Kindred Hospital Bay Area - St. Petersburg Schedule: Full Time Please note: The title 'Clinical Rehabilitation Specialist is functionally equivalent to the Clinical Liaison role. Both titles refer to the same position and may be used interchangeably. Your experience matters Lifepoint Rehabilitation is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Clinical Rehabilitation Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. How you'll contribute A Clinical Rehabilitation Specialist who excels in this role: Educate the community on rehabilitation to develop a census through face-to-face contacts Develop business based on the strategic goals of the rehabilitation program Face-to-face connections within territory to build relationships with referral sources to increase census Identifies barriers to the admission process and creates solutions with the assistance of the program director Ability to review patient medical charts and understand test results, therapy evaluations, pre-existing conditions, and have a general medical knowledge of the patient Ability to clearly and professionally interact with patients, families, and healthcare providers while gathering additional clinical information and past history Conduct thorough patient assessments to identify patients for potential admission into the rehabilitation program Complete detailed Pre-Admission Screens, as applicable, according to facility policies and procedures, Lifepoint policies and procedures, and payer requirements, as applicable. Schedules meetings and arrange in services for medical professionals including potential and existing referral sources, doctors, nurses, social workers and other health care professional. Provide patient updates to physicians, payers, case managers, social workers and other relevant persons. Maintain solid working relationships with new and existing referral sources by providing excellent after-sales service. Other duties as assigned Why join us… We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: Comprehensive Benefits: Multiple levels of medical, dental and vision coverage - with medical plans starting at just $10 per pay period - tailored benefit options for part-time and PRN employees, and more. Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). Professional Development: Ongoing learning and career advancement opportunities. What we're looking for Clinical experience is required At a minimum, should be a graduate of a four-year college program with a bachelor's degree in a health related, business or marketing area of concentration, nursing or therapy preferred Ability to travel in the community to meet clients/customers at hospitals, SNFs, physician offices and other nontraditional referral sources. Valid driver's license and own reliable transportation required Communicate and demonstrate a professional image/attitude for patients, families, clients, co-workers, and others, demonstrating great customer service and listening skills Connect with a Recruiter Not ready to complete an application, or have questions? Please contact Fomeika Ingram by emailing at **********************************. EEOC Statement “Lifepoint Rehabilitation is an Equal Opportunity Employer. Lifepoint Rehabilitation is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.”

Join OBHG: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination! Location: SC Upstate area candidates strongly preferred (Remote). Open to exceptional remote candidates in SC, NC, GA (must be located in these states to be eligible). The Good Stuff We Offer: Hourly Compensation Range: $21.00 - $24.00 per hour + eligibily for RCM bonus A mission based company with an amazing company culture. Paid time off & holidays so you can spend time with the people you love. Medical, dental, and vision insurance for you and your loved ones. Health Savings Account (with employer contribution) or Flexible Spending Account options. Employer Paid Basic Life and AD&D Insurance. Employer Paid Short- and Long-Term Disability. Optional Short Term Disability Buy-up plan. 401(k) Savings Plan, with ROTH option. Legal Plan. Identity Theft Services. Mental health support and resources. Employee Referral program - join our team, bring your friends, and get paid. Medical Coder Position Summary: The Certified Coder is responsible for the data abstraction, evaluation and auditing of Provider assigned CPT, HCPC codes, ICD-10 CM for obstetrics. Essential Medical Coder Responsibilities: Assigns and sequences diagnoses and procedures in accordance ICD-10 CM Official Coding Guidelines, CPT Assistant, Physician at Teaching Hospital Rules and Evaluation and Management Documentation Guidelines Experience with billing, collections from insurance companies and patients, insurance follow up, charge entry Analyze and resolve charge entry coding errors Familiar with revenue cycle management processes Ability to work with eBridge, Putty and Lyra software Report and analyze errors, trends, and findings Compose reports using Microsoft Excel and Word Ability to interpret regulatory and payer rules and directives concerning coding Ability to function in a high volume environment producing quality work Solid interpersonal and telephone communication skills Ability to consistently work independently and problem solve Must be able to multi-task and prioritize job responsibilities Must be dependable, responsible and team oriented Strong attention to detail (such as interpretation of clinical data including medical terminology and disease processes) Demonstrate a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times Strong working knowledge of HIPAA as it relates to the entire revenue cycle management cycle process Perform other duties as assigned. Essential Skills/Credentials/Experience/Education Certified AAPC Coder Associate or Bachelor's Degree, OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE Skill in operating a personal computer; must be proficient in Word, Excel, Power Point. Ability to compose letters, memos, and other correspondence. Effective interpersonal skills required in interactions with Ob Hospitalists and personnel. Ability to work with highly confidential materials. Must possess high ethical standards. Enhances professional growth and development through in-service meetings, education, programs, conferences, etc. Physical Demands (per ADA guidelines) Sitting for long periods of time. Occupation requires this activity more than 66% of the time (5.5+ hrs/day)

What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We're a business unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick of jobs are drawn to IntelliScript's entrepreneurial and collaborative culture of innovation, excellence, exceptional customer service, balance, and transparency. Every single person has a voice in our company and we challenge each other to push the outer limits of our full, diverse potential. We've shown sustained growth that ensures you'll have room to grow your skillset, responsibilities, and career. Our team is smart, down-to-earth, and ready to listen to your best ideas. We reward excellence and offer competitive compensation and benefits. Visit our LinkedIn page for a closer look at our company and learn more about our cultural values here. Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERGs) are employee-led communities that influence policy decisions, develop future leaders, and amplify the voices of their constituents. We encourage our employees to give back to their varied professions, including leadership in professional organizations. Please visit our website to learn more about Milliman's commitments to our people, diversity and inclusion, social impact, and sustainability. What this position entails IntelliScript offers an innovative suite of products that interpret and deliver electronic medical data (such as prescription histories, diagnoses, and treatment data) to help our clients make effective underwriting and risk assessments. The Clinical Informatics Consultant is a vital part of IntelliScript's Clinical Services Team - a team that delivers the clinical intelligence and expertise needed for industry-leading clinical interpretation solutions. Working with various members of teams across the company, you will be instrumental as we continue to innovate, design, and maintain the clinical intelligence behind our decision support software and fulfill the specific needs of each client. Our proven interpretation engines (Irix and Curv) are being adapted to incorporate and interpret electronic health record data in addition to our existing pharmacy and medical claims data. In this role, the Clinical Informatics Consultant will bring professional experience and training from a variety of settings and perspectives, a passion for leveraging health-related data and performing complex analysis to solve business questions, as well as an entrepreneurial spirit. What you will be doing * Clinical condition interpretation: Translate complex clinical data elements into meaningful medical condition identification and severity insights to support our clients' decision-making processes. * Clinical value set creation: Develop and maintain groupings of clinical codes. These building blocks create the foundation of our clinical interpretation insights. You will leverage terminologies such as GPI, RxNorm, ICD-10, CPT, HCPCS, REV, SNOMED, and LOINC codes to facilitate our client's risk assessments. * Clinical terminology management: Oversee the organization, standardization, and maintenance of clinical terminologies to ensure up-to-date, consistent, and accurate results from our interpretation solutions. * UAT and impact testing: Conduct user acceptance testing and impact analysis to validate the functionality and effectiveness of new features and enhancements in our clinical products. * Research and development: Engage in research activities to identify emerging trends in clinical practice and our products, contributing to the development of interpretation solutions. * Model consultation: Consult with data science team to align predictive model features with clinical data concepts and medical knowledge. * Innovation collaboration: Participate in brainstorming and whiteboarding sessions to drive the creation of enhancements for our clinical interpretation solutions and innovative new products. * Clinical data solutions consulting: Provide expert consulting services on clinical data solutions, guiding internal and external clients through the effective design and use of our systems. What we need * Current licensure in good standing as a healthcare professional * Minimum three years of experience in clinical informatics * Experience analyzing electronic health record, medical claims, and pharmacy claims data * Experience enhancing EHR systems and/or clinical decision support software What you bring to the table * Focused on results and able to explain clinical concepts in a way that answers business questions * Adept at ascertaining client needs, conducting an analysis, and presenting solutions * Ability to shift communication styles for clinical, technical, or business audiences * Strong eye toward quality and an acumen for peer review as part of the development process * Capacity to work with and analyze medical data for extended periods of time * Demonstrated "let's find a way to do it" attitude-conviction that no task is too big or too small, quick to approach an issue and find the optimal solution, ready to adapt in any situation * Detail oriented with excellent verbal and written communication skills * Professional when interacting with clients and colleagues * Able to work independently and thrive on a small team * Adaptable and willing to pitch in wherever needed * Skilled in understanding complex systems and thinking abstractly to identify patterns, connections, and opportunities * Proficient in identifying and gathering the information needed to diagnose and solve problems * Capable of generating, developing, and evaluating a wide range of creative ideas, concepts, and solutions * Effective in maintaining performance when faced with uncertain, unclear, or incomplete information Wish list * Continued education and/or advanced degree(s) * Advanced degree or certification in clinical informatics * Experience in software-as-a-service industry * Experience in clinical practice in addition to clinical informatics * Published thought leadership articles, past speaking engagements, etc. * Experience presenting to management-level decision-makers Location The expected application deadline for this job is March 31, 2026. This position is open to remote work. Applicants must be willing to travel to the Milliman office in Brookfield, WI as needed and travel nationwide for meetings, conferences, and team events (up to 10%). Compensation The overall salary range for this role is $93,700 - $199,065 For candidates residing in: * Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia: * $107,755 - $177,675 if overall experience is less than 5 years; and * $120,635 - $199,065 for experience greater than 5 years. * All other states: * $93,700 - $154,500 if overall experience is less than 5 years; and * $104,900 - $173,100 for experience greater than 5 years. A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. Milliman Benefits We offer a comprehensive benefits package designed to support employees' health, financial security, and well-being. Benefits include: * Medical, Dental and Vision - Coverage for employees, dependents, and domestic partners. * Employee Assistance Program (EAP) - Confidential support for personal and work-related challenges. * 401(k) Plan - Includes a company matching program and profit-sharing contributions. * Discretionary Bonus Program - Recognizing employee contributions. * Flexible Spending Accounts (FSA) - Pre-tax savings for dependent care, transportation, and eligible medical expenses. * Paid Time Off (PTO) - Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis. * Holidays - A minimum of 10 paid holidays per year. * Family Building Benefits - Includes adoption and fertility assistance. * Paid Parental Leave - Up to 12 weeks of paid leave for employees who meet eligibility criteria. * Life Insurance & AD&D - 100% of premiums covered by Milliman. * Short-Term and Long-Term Disability - Fully paid by Milliman. Equal Opportunity All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran.

Are you an expert Coding Specialist looking to join an outstanding organization? We at M Health Fairview are looking for a Coder 2 to join our Hospital Based ED coding team! This is a fully remote position that is approved for a 1.0 FTE (80 hours per pay period) on the day shift. The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient visits, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM, CPT-4, and HCPCs Coding Classification systems. Utilizes an electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Coder 2's also resolves clinical documentation and charge capture discrepancies and provides feedback to providers on the quality of their documentation and charging. Responsibilities * Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards. * Actively participates in creating and implementing improvements. * Assigns ICD-10, CPT-4, and HCPCs codes to all diagnoses, treatments, and procedures, according to official coding guidelines. * Knowledge of relationship of disease management, medications and ancillary test results on diagnoses assigned. * Extracts required information from electronic medical record and enters encoder and abstracting system. * Follows-up on unabstracted accounts to assure timely billing and reimbursement. * Resolves any questions concerning diagnosis, procedures, clinical content of the chart or code selection through research and communication. May query physicians on documentation according to established procedures and guidelines. * Meets departmental productivity and quality standards * Complete projects as assigned. * Timely and accurate work * Contributes to the process or enablement of collecting expected payment * Understands and adheres to Revenue Cycle's Escalation Policy. Required Qualifications * Certificate program in Coding or A.A./A.S. in HIM or Certificate with 1-3 years of healthcare experience (MA, HUC, Revenue Cycle) * 1 year of coding experience * Basic knowledge of Windows-based computer software. Epic and Microsoft Teams. * Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary. * Registered Health Info Admin (RHIA) or Registered Health Info Tech (RHIT) or Certified Coding Specialist (CCS) or Professional Coder Cert (CPC) or Certified Coding Specialist - Professional (CCS-P) or Professional Coder- Hospital (CPC-H) or Certified Outpatient Coding (COC) or AAPC specialty certifications Preferred Qualifications * B.S./B.A. in HIM * 2 years of coding experience Benefit Overview Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: ***************************************************** Compensation Disclaimer An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored. EEO Statement EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Job DescriptionDescription: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF) scoring, and physician query briefs. Will participate in Provider education on the importance of diagnosis specificity and documentation guidelines. The Risk Adjustment Coder works to maintain a thorough knowledge of our current automated eClinicalsWork (eCW) enterprise billing system, through which the coding and documentation review are functionalized to provide support to HCCH providers and staffs as necessary. Provides subject matter expertise to others including staff in the Billing department as necessary. This position requires professional maturity, responsibility, integrity, and subject matter expertise to complete the work timely; communicate setbacks to deliverables. and to collaborate with others to meet production and quality standards. Responsibilities include: -Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines -Validate and ensure the completeness, accuracy, and integrity of coded data. -Concurrently, prospectively, and retrospectively review medical records to identify unclear, ambiguous, or inconsistent documentation ensuring full capture of severity, accuracy, and quality. -Query providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes. -Utilizes approved resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS and ensures documentation in the medical record follows official coding guidelines, internal guidelines, and AHIMA physician query brief standards. -Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. -Comply with HIPAA laws and regulations. -Maintain coding quality and productivity standards set forth by HCCH. -Maintain competency in evolving areas of coding, guidelines, and risk adjustment reimbursement reporting requirements. -Assist in internal and external coding audits to ensure the quality and compliance of coding practices. -Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements, including education and support for improvement in HCC coding, and RAF scoring. -Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures relating to clinical documentation compliance related to billing. -Maintains complete confidentiality of patient information. -Assists with developing, implementing, and reviewing policies, procedures, and forms related to areas of responsibility. -Other duties as assigned by your Supervisor. Requirements: Requirements/Skills/Experience -High-speed internet access -Strong clinical knowledge related to chronic illness diagnosis, treatment, and management. -Knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred. -Personal discipline to work remotely without direct supervision -Dental coding skills a plus -Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical chart documentation. Qualifications: -Bachelor's degree in allied health or any related field required. -Minimum 2 years of progressive Professional Risk Adjustment Coding experience required. -Active Certified Risk Adjustment Coder certification (CRC and/or CPC) required -Candidates hired with active CPC, but without Certified Risk Adjustment Coder certification (CRC) must obtain CRC certification within 9 months of hire. Travel Requirements None. Salary Commensurate with experience, education and certifications

Summary Description: Under general direction, this position will be responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Cardiology Coding Specialist works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition, this role monitors and analyzes coding performance at the section and business unit levels. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention. Essential Duties and Responsibilities: Review charts and capture all reportable services. Coordinate with other coding staff to ensure all reportable services are captured and assigned to appropriate physician or ARNP. Assign all appropriate ICD codes, CPT codes, and modifiers per ICD, CPT, and Medicare or commercial carrier published guidelines. Enter charges, review WQs to address edits/denials. Review work queues in EMR and resolve coding issues for professional services for both hospital and clinic places of service. Reconcile charges monthly to ensure capture of all reportable services. Work with business office to resolve hospital billing questions/coding denials or concerns. Assist employees and physicians in providing coding guidance. Ability to communicate effectively both orally and in writing. Pull audit reports and back up documentation for internal audits. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is precise and accurate Assign and/or review the sequence of all CPT and ICD 10 codes for services rendered Collaborate with AR teams to ensure all claims are completed and processed in a timely manner Support the team with applying expertise and knowledge as it relates to claim denials Aid in submitting appeals with various payers about coding errors and disputes Submit statistical data for analysis and research by other departments Ability to identify PSI triggers or have working knowledge of PSI triggers which includes identifying and assigning co-morbidities and complications. Ability to assign the appropriate DRG, discharge disposition code and principal DX codes Serves as the liaison between revenue cycle operations and clients as it relates to charge capture documentation and reconciliation Possesses a clear understanding of the physician revenue cycle Oversees understands and communicates coding and charging processes for each client account based on their existing EHR system as it relates to office and hospital-based services which includes charge captures charge linkages to the CDM and charging processes. Analyzes and communicates denial trends to Clients and operational leaders. CPC or CCS coding credentials required. Cardiology experience preferred. EMR, eCW, Centricity, Epic, Encoder Pro or 3M experience highly desired. Microsoft Office Skills: Excel - Must have the ability to create and manage simple spreadsheets. Word - Must be able to compose business correspondence. License: CPC, CCC or CCS (Required)

A government contract requires that this position be restricted to U.S. citizens or legal permanent residents. You must provide documentation that you are a U.S. citizen or legal permanent resident to qualify. The Psychiatrist provides comprehensive psychiatric care as a Practitioner and Consultant, with emphasis on low- to moderate-acuity patients, primarily using virtual platforms. Responsibilities include evaluating, diagnosing, and treating patients with a variety of mental health conditions, including chronic disorders, psychosis, substance abuse, and other complications. The incumbent develops and implements treatment plans, makes recommendations for major diagnostics, and provides follow-up care. Collaboration with other medical and mental health professionals, military leadership, and case management teams is required to ensure coordinated, high-quality care. Compensation & Benefits: Estimated Starting Salary Range for Psychiatrist: Commensurate with experience. Pay commensurate with experience. Full time benefits include Medical, Dental, Vision, 401K, and other possible benefits as provided. Benefits are subject to change with or without notice. Psychiatrist Responsibilities Include: Conduct psychiatric evaluations, interpret laboratory and clinical findings, and prescribe treatment or refer to specialty services as needed. Provide virtual outpatient care for low- and moderate-acuity patients, maintaining high standards of clinical judgment and patient safety. Participate in Quality Assurance activities, making decisions impacting patient care, including hospitalization recommendations, Medical Evaluation Board (MEB) evaluations, and fitness-for-duty assessments. Prepare and maintain patient records, case summaries, and reports according to regulations and SOPs; update patient charts within 72 business hours or by COB for high-visibility cases. Collaborate with multidisciplinary teams, including physicians, psychologists, nurses, social workers, and military command, to ensure comprehensive care. Attend staff meetings, continuing education sessions, and quality improvement initiatives. Communicate TRICARE and DoD healthcare requirements to patients and ensure safe, effective therapeutic outcomes. Performs other job-related duties as assigned Psychiatrist Experience, Education, Skills, Abilities requested: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Completion of accredited Psychiatry internship, residency, and/or fellowship. Minimum of 2 years providing psychiatric care via virtual platforms; experience within the Military Health System preferred. Current certification from the American Board of Psychiatry and Neurology or the American Osteopathic Board of Psychiatry and Neurology. Current, full, active, unrestricted license to practice Psychiatry. Basic Life Support (BLS) required. Advanced certifications do not replace BLS. Must obtain and maintain appropriate clinical privileges and fulfill credentialing requirements. Must pass pre-employment qualifications of Cherokee Federal Company Information: Cherokee Nation Integrated Health (CNIH) is a part of Cherokee Federal - the division of tribally owned federal contracting companies owned by Cherokee Nation Businesses. As a trusted partner for more than 60 federal clients, Cherokee Federal LLCs are focused on building a brighter future, solving complex challenges, and serving the government's mission with compassion and heart. To learn more about CNIH, visit cherokee-federal.com. #CherokeeFederal #LI #LI-REMOTE Cherokee Federal is a military friendly employer. Veterans and active military transitioning to civilian status are encouraged to apply. Similar searchable job titles: Staff Psychiatrist Clinical Psychiatrist Telepsychiatrist Military Psychiatrist Outpatient Psychiatrist Keywords: Mental health treatment Patient evaluation Virtual care Diagnostic assessment Care coordination Legal Disclaimer: All qualified applicants will receive consideration for employment without regard to protected veteran status, disability or any other status protected under applicable federal, state or local law. Many of our job openings require access to government buildings or military installations. Please Note: This position is pending a contract award. If you are interested in a future with Cherokee Federal, APPLY TODAY! Although this is not an approved position, we are accepting applications for this future and anticipated need.

EBCC Sr Clinical Consultant, EBCC Initiative, FT, 8A-4:30P-155661Description The EBCC (Evidence Based Care Committee) Senior Clinical Consultant role is specifically designed to facilitate the dissemination of the processes and performance improvement activities developed by EBCC, CPSC (Clinical Practice Standardization Council), and S3C( Surgical Services Steering Council), using Lean Six Sigma methodologies. Primarily responsible for traveling across BHSF health system in its entirety to impact practitioner education in any patient-facing care area. Support local EBCC teams throughout the system. Leads the PERC (Practitioner Education Rollout Council) initiative. Serves as an internal consultant for the EBCC clinical consultants, and as an external consultant for clinical and operational leaders on deployment of EBCC products(order sets, pathways, etc.).Extensive knowledge of clinical standards of care and evidence based processes. Serves as a clinical expert in connecting practice, data analysis and the impact of utilization of standardized care on length of stay and variable cost. Ability to expediently lead change, stay attuned to industry trends, and constantly performing impact inventories of current versus future state of newly deployed processes.Qualifications Degrees: Bachelors. Licenses & Certifications: Registered Nurse.Six Sigma Green Belt. Additional Qualifications: Master‘s degree preferred. Certified professional In Healthcare Quality( CPHQ) Preferred. Strong broad clinical nursing background in Critical care, ED, PACU , surgery, oncology and/or progressive care.Continuous performance improvement and /or data analysis, preferably in a healthcare setting. Microsoft Office Suite experience including Excel, Powerpoint, Word, and Visio is highly desirable. Demonstrates desire to learn new skills and drive changes in a positive spirit of cooperation/collaboration. Work experience may substitute for educational attainments and educational attainments may substitute for work experience. High degree of customer sensitivity and attention to detail. Outstanding communication skills, formal/informal leadership and time management skills. Able to facilitate improvement team participation. Strong proven business acumen and ability to translate work to leadership level. Minimum Required Experience: 8 YearsJob Case Management/Home HealthPrimary Location RemoteOrganization CorporateSchedule Full-time Job Posting Jan 8, 2026, 5:00:00 AMUnposting Date Ongoing Pay Grade R24EOE, including disability/vets

The Clinical Consultant II is responsible for acting as the clinical expert while leading the implementation of WellSky solutions for clients. The scope of this job includes bridging the gap between clinical workflows and solution functionality to ensure successful deployment, customization, and adoption of the solution. This opening is with our Blood Management Professional Services team. If the details below sound like you, we invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities: Collaborate with project teams to complete implementation tasks, including gathering requirements, analyzing clinical workflows, and identification of workflow challenges. Engage with providers to review requests and offer recommendations based on proficient knowledge of clinical workflows that will ultimately enhance patient care, treatment plans, and health outcomes. Provide hands-on training to designated clients while guiding them through the solution's functionalities and features to increase proficiency in utilization. Use industry compliance knowledge and follow established practices and guidelines to ensure the implementation of clinical solutions complies with regulations and standards. Review a variety of factors for solution configurations, understand solution functionalities, and troubleshoot technical issues to offer consultation and support. Perform other job duties as assigned. Required Qualifications: Bachelor's Degree or equivalent work experience At least 2-4 years relevant work experience in a blood bank setting Preferred Qualifications: Proven experience implementing FDA 510(k)-cleared software solutions in clinical settings Demonstrated ability to design workflows, develop staff training programs, and author standard operating procedures (SOPs) In-depth knowledge of blood and cellular therapy regulations and compliance standards Job Expectations: Willing to travel up to 50% based on business needs Willing to work additional or irregular hours as needed Must work in accordance with applicable security policies and procedures to safeguard company and client information Must be able to sit and view a computer screen for extended periods of time WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year

Pharmacy Clinical Consulting Advisor Internal Job Title - Clinical Account Manager (CAM) Area of Operation - Colorado, Utah, Pacific Northwest As part of Cigna Pharmacy Management, the Pharmacy Sales Advisor is a licensed clinician who serves as the primary pharmacy benefits subject matter expert supporting Cigna Integrated Pharmacy clients within an assigned geographical market(s) and client size band. The Pharmacy Sales Advisor position will be responsible for developing and maintaining relationships with internal stakeholders including the medical sales teams and pharmacy underwriting organization as well as external brokers and consultants. The primary objective of this position is supporting long-term client retention and growth, while achieving Cigna's corporate strategic goals. The Pharmacy Clinical Consulting Advisor also provides pharmacy product and clinical expertise in support of the Medical Sales teams as well as the Pharmacy Implementation organization. This position is responsible for working with the Cigna Medical teams to support the Pharmacy component of an integrated benefit, which typically includes Medical, Pharmacy, and Behavioral. This includes service support, reporting, pricing, and/or other performance guarantees - while working with multiple internal stakeholders at Cigna and Evernorth, as well as external influencers (e.g. consultants, producers and decision makers in the benefits organization or financial and/or C-Suite of our clients). The primary roles of the Pharmacy Clinical Consulting Advisor are: Retain the assigned book of business through proactive portfolio management, including an understanding of available performance guarantees and pricing strategies in order to renew clients and preserve earnings. Participate in client meetings and presentations to review client performance and sell in the suite of pharmacy management programs and solutions that align to Cigna's overall value proposition of lowering total healthcare costs. Act as Pharmacy Sales support for renewals involving consultants. Cultivate meaningful, productive, mutually beneficial relationships internally and externally by gaining the confidence and trust of key stakeholders through honesty, integrity and reliability. Educate and consistently advance the knowledge of pharmacy within the Cigna Medical sales organization. This includes deep dives on our products and services, as well as championing an understanding of the clinical integration points across benefits. Communicate effectively, delivering multi-modal messages that convey a clear understanding of the unique needs of the different audiences requiring interaction. Proactively anticipates communication needs in order to remove ambiguity. Actively participate in finalist meetings for existing business where necessary. Gather and share relevant competitive intelligence in support of retention and new sales efforts. Acts as the clinical subject matter expert supporting medical sales team or the pharmacy Implementation team with escalated pharmacy benefit issues, when necessary. Manages complexity, by analyzing and making sense of a considerable volume of sometimes contradictory information to effectively solve problems. Asks the right questions and attentively listens to others. Stays abreast of clinical pharmacy practice guidelines, including the new drug pipeline, biosimilars, gene therapies, upcoming patent expirations, etc. Additional Responsibilities: Facilitate meetings with clients and brokers to resolve service concerns; act as the escalated issue contact for pharmacy issues when contacted by the medical sales teams. Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive consultation, as well as manage follow-up questions that may arise. Provide executive support for pricing, audit, and contract questions, as requested by internal partners managing these efforts. Translate pharmacy coverage rules and formulary decisions based on Cigna policies with support from Clinical program development partners. Any other tasks as defined by management and/or client needs not named above, as required to support our internal and external stakeholders, clients, and partners. Qualifications: Clinical pharmacy background required; R.Ph. or Pharm.D. 5 years or more of Pharmacy Benefit Management (PBM) experience supporting client expectations Mid to Large Employer account management experience preferred Experience with consultative client management methodologies Proven ability to manage thru a renewal independently with minimal supervision Ability to work through the organizational processes needed to support clients (especially those that are clinical in nature, considering exceptions, etc.) A self-motivated individual displaying ownership, accountability and responsibility Operational understanding and competence with PBM business model Understanding the financial and pricing strategy of PBM Technical skills using all Microsoft programs Ability to travel up to 50% of the time depending on candidate's location with little or no advance notice Competencies: Clinical understanding of PBM space Customer Focus Organizational Agility Network Building Verbal & Written Communication Skills Presentation Skills Financial Acumen Negotiation skills Executive presence If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 107,000 - 178,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.