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Essex Meadows jobs - 60 jobs

  • **QA Analyst- Financial Clearance/Full Time/Remote

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    Under general supervision, utilizes quality management tools to provide support and directly monitor and assess processes and workflows to ensure staff maintain both quality and production measures. Provides ongoing reporting and feedback to Customer Service management regarding staff performance. Measures and implements efforts to maintain or increase the quality of work performed within Customer Service. Conducts random audits and quality checks to ensure member inquiries are handled professionally and processed in an appropriate manner. Coordinates and facilitates calibration sessions. Facilitates training for new hires and current staff regarding the audit process and departmental quality expectations. monitors contacts and cases as outlined in the department Quality Policy and Procedure Manual. The Quality Assurance Analyst must compile monitored data and participate in the coaching, training, and development of the department's agents. Must have a clear and working understanding of any Service Level Agreement and overall quality standards. The Quality Assurance Analyst must have the skills to interact with various levels of leadership, including strong customer service, conflict resolution, active listening, analytical, writing and computer skills. The Analyst must have the ability to compile reports and effectively communicate the resulting analysis to the management team. EDUCATION/EXPERIENCE REQUIRED: * Associate degree with a major in Business Administration or related field. Related and relevant experience may be considered in lieu of academic requirements. * Related experience is defined as eight (8) years of experience in a call center with a minimum of two (2) years as a lead worker within an insurance, healthcare or government regulated industry. * Two (2) years of experience in call center customer service. * One (1) year of experience conducting quality/performance/evaluation audits. * Experience providing coaching, feedback, and facilitating training. * Experience implementing process change, data analysis, and trend reporting. * Experience in research and quality improvement. * Successfully complete all assigned Epic assigned courses within two (2) months of hire. * Successfully complete all assigned Customer Service Representative New Hire inter-departmental training within two (2) months of hire. * Excellent documentation skills. * Excellent verbal and written communication skills. * Self-directed and self-motivated. * Strong interpersonal skills and discretion. * Organizational and time management skills. * Problem solving and decision-making ability. * Strong understanding of the Henry Ford Health health care delivery system. * Understanding of the functions of support departments requiring frequent interaction with Client Services. Additional Information * Organization: Corporate Services * Department: Insurance Verification * Shift: Day Job * Union Code: Not Applicable
    $66k-95k yearly est. 2d ago
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  • Coordinator-Professional Coding Quality & Education- Remote

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    Directly coordinates, oversees and controls the flow of medical record coded information required of the hospital and ambulatory sites for billing/reimbursement purposes. The Coding Coordinator of Quality & Education is responsible for the completeness, accuracy, quality and timely submission of all medical data and supporting documentation for inpatient discharges and outpatient encounters. Acts as the departmental liaison to the activities in the coding reimbursement process. Assesses, designs and evaluates educational programs and processes that are aimed at improving the quality of documentation practices for Henry Ford Health System. Serves as an educational resource for providers and/or coding staff relating to coding and documentation. EDUCATION/EXPERIENCE REQUIRED: * High School Diploma or G.E.D. equivalent required. Associates Degree in Healthcare related field, Medical Records Sciences, or Business/Healthcare administration or five (5) years coding experience may be considered in lieu of education requirement. * Additional specialty coding certification or two (2) years of specialty coding experience required. * Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. * Five (5) years of specialty coding experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * Certification in at least one of the following: Registered Health Information Technician (RHIT) or RHIT Certification eligibility, CPC-A, CCS, CCP, CCA, COC. Additional Information * Organization: Corporate Services * Department: Inpatient Prof Coding * Shift: Day Job * Union Code: Not Applicable
    $29k-42k yearly est. 43d ago
  • Transaction Flow Specialist/Full Time/Remote - Michigan Residents

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    Under minimal supervision, this position is responsible for the Henry Ford Health System's (HFHS) transaction flow processes, including effective design of the insurance recovery and patient pay workflows, research and identification of root causes resulting in edits and denials, development of error prevention initiatives, and coordination with CBO staff, HFHS business units, and internal customers to drive performance improvement. EDUCATION/EXPERIENCE REQUIRED: * High school degree or equivalent. * Associate's degree or equivalent years of college education, preferred. * Two (2) years of experience within healthcare revenue cycle. * One (1) year of healthcare accounts receivable billing. One (1) year of experience with resolving insurance payer denials. * Experience with both technical (UB) and professional (1500) billing, preferred. * Experience with billing and follow up of variety of insurance payers, preferred. * Experience at a large, complex, integrated healthcare organization, preferred. * Experience with patient billing, patient accounting and other related applications, preferred. Experience with EPIC Patient Accounting System, preferred. * Ability to communicate effectively with colleagues, supervisors, and managers. * Strong organizational and time management skills required to effectively prioritize workflow to meet third party requirements. * Ability to work independently. * Ability to understand and lead change. * Knowledge of Medical terminology, preferred. Ability to analyze data and identify opportunities. Additional Information * Organization: Corporate Services * Department: CBO - Transaction Flow * Shift: Day Job * Union Code: Not Applicable
    $36k-44k yearly est. 27d ago
  • *Release of Info Specialist/Full Time/Hybrid -Troy or Jackson Michigan

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    Release of Information Specialists are responsible for retrieving and processing medical records requests from government agencies, state agencies, insurance companies, court order subpoenas, attorneys, healthcare providers, disability services, workers' compensation, the Social Security Administration, and other authorized requestors, as well as supporting internal organizational projects as needed. They ensure accuracy and uphold the highest standards of product quality and customer service throughout all interactions. EDUCATION/EXPERIENCE REQUIRED: * High School diploma or equivalent required. * Experience in a Health Information Management/Medical Record Department preferred. * Experience with Microsoft Office products (word, excel). * Experience with computers, electronic medical record, and release of information software preferred. * Knowledge of HIPPA. * Excellent quantitative, analytical, and problem-solving skills. * Strong ability to work independently. * Ability to organize and manage multiple priorities. * Strong work ethic, reliable, resourceful, with a positive attitude. * Knowledge of anatomy, physiology, medical terminology preferred. Additional Information * Organization: Corporate Services * Department: HIM Operations * Shift: Day Job * Union Code: Not Applicable
    $33k-46k yearly est. 49d ago
  • Housekeeper / House Cleaner

    Heath 3.8company rating

    Newark, OH job

    The Cleaning Authority is hiring for FULL TIME positions. WE OFFER THE HIGHEST PAY FOR CLEANING IN THE AREA! Are you tired of retail and fast food hours? Want your nights and weekends back? Would you like to be home during the holidays? You can have them! We clean Monday-Friday first shift and we are closed on the major holidays! No experience? No problem. We have a computer based learning system as well as a thorough training program which includes hands on training with one of our experienced and professional trainers. We offer paid holidays and paid vacations too! Earn PTO (Paid Time Off) as well!!! Requirements: Must be 18 years of age or older Be able to pass a background check Have a great attitude, be a team player, and take pride in your work! A willingness to learn -- everybody can clean, but not everyone cleans like we do! Be able to be on your feet all day with light lifting (less than 15 pounds) -- we won't lie, it's a physically demanding job! Driver's license preferred/ limited non-driver positions available. EOE Are you looking for a career that is both rewarding and fulfilling? Look no further than the housecleaning industry! At The Cleaning Authority, we offer professional housecleaning services backed by more than 25 years of excellence. When you join the team, you'll be trained on our Detail-Clean Rotation System, which has proven effective in more than 20 million cleans across North America. The Cleaning Authority is renowned for providing quality cleans at affordable prices. Founded in Maryland in 1977, The Cleaning Authority was one of the first whole house cleaning services in the region. Our goal is to make our customers' lives better, and we know that starts with our Professional Housecleaners. It's the employees that make The Cleaning Authority great! Each location is committed to hiring only the best and empowering them to become leaders who bring out the best in the people around them. Become a part of a legacy of success and integrity. The Cleaning Authority is looking to hire enthusiastic Professional Housecleaners for full-time and part-time positions. If you enjoy cleaning, giving back to others, and gaining contentment from a job well done, we're waiting for you! This location is independently owned and operated by a franchisee. Your application will go directly to the franchisee, and all hiring decisions will be made by the management of this franchisee. The franchisee will be your only employer. All inquiries about employment at this franchisee should be made directly to the franchise location.
    $23k-28k yearly est. Auto-Apply 60d+ ago
  • Value Based Healthcare Operations Project Mgr. (Hybrid/Detroit & Jackson) - Mosaic CIN

    Henry Ford Hospital 4.6company rating

    Remote or Jackson, MI job

    Mosaic Clinically Integrated Network (CIN) is a Henry Ford Health company and is a leading value based care network, leveraging data and clinical tools to drive performance. To learn more visit: ***************** This position will be hybrid, requiring the ability to work successfully remotely in the Detroit/Jackson areas as well as in person once a week or as warranted in Detroit and Jackson. GENERAL SUMMARY: Under minimal supervision an Executive Leader, performs and/or manages project work of a generally complex nature aimed at improving operating systems and functions within HFHS , with increasing responsibility for project planning. Budgets and allocates analyst resources for projects within scope of responsibility. Prepares reports and recommendations for management and coordinates implementation whenever possible. May act as a consultant on projects outside of specific assignments. Supervises tasks of support staff relative to assigned projects. PRINCIPAL DUTIES AND RESPONSIBILITIES: * Works independently to manage complex projects involving coordination of multiple participants and teams aimed at improving operating systems and functions within HFHS. * Maintains a high level of responsibility for completion of projects within a department, Hospital or Region with strategic implications. * Conducts reviews of Hospital/Medical Group areas on a project basis; acts as a project lead for individual or multi-analyst projects. * Prepares project plans including scheduling, costs, personnel matters and other operational concerns. * Develops and refines project scope, objectives, and work plan. * Recommends and provide input for budget preparation. * Facilitates and/or leads meetings. * Provides periodic project updates to administration. * Prepares project management reports and written/verbal presentations of project findings, conclusions, and recommendations. * Develops and determines priorities and monitors status of projects on an ongoing basis. * Exercises independent judgment and makes difficult decisions. * Works with all levels of the Hospital, Region and System. * Conducts interviews with users and performs various data gathering techniques. * Fosters teamwork with all involved parties to insure efficient project operations. * Documents current systems and operations. * Analyzes client systems, procedures, and operations and identifies opportunities for improvement. * Identifies and tests alternative methods and procedures and identifies associated costs and benefits. * Defines requirements to modify existing procedures or develops new system. * Assists in the implementation of revised or new methods. * Guides support staff in performing operations analysis and decision support activities. * Establishes work schedules and priorities to ensure that work flow is controlled. * Identifies internal staff development needs and opportunities for improvement or enhancement of staff skills. Mosaic/CIN Business Unit focus: * Partners with leaders across the Mosaic CIN, HFPN, and Mosaic ACO-including operations, contracting, finance, and care delivery-to advance value-based care and contracting efforts. Collaborates with key clinical and operational stakeholders to identify strategic opportunities that enhance network alignment and integration. * Assists with the execution of network engagement strategies through programs and projects that support value-based care contracting goals, including achievement of contractual metrics and overall contract success. * Maintains both a broad perspective and focused understanding of value-based care and contracting to inform forward-thinking strategies and recommendations. * Prepares executive-level presentations, dashboards, and reports to enhance understanding among senior leadership, boards, and committees. * Builds and maintains strong working relationships with operational, physician, and communications leaders to ensure accurate and timely messaging across the network and broader organization. EDUCATION/EXPERIENCE REQUIRED: * Requires a Bachelor's Degree in a related field, preferably in Healthcare Administration, Public Health, or business function. Master's Degree is preferred. * Requires a minimum of four (4) years in Operations Analysis, Management Engineering, Operations management, or a related analytical field in health care or management consulting directed toward process improvement. * Previous supervisory and/or consulting experience is preferred. * Previous experience in leading quality improvement initiatives/project management is highly desirable. * Lean training highly preferred. * Significant project management experience and outstanding analytical, communication, and interpersonal skills are required. * Ability to apply innovative solutions to problems and familiarity with TQM process is also required. * Knowledge of value-based contracting and familiarity with risk/reward models (e.g., MSSP, Direct-to-Employer, etc.) preferred. * Proficiency in project management software, Microsoft Office Suite (Excel, PowerPoint, Word), and virtual meeting platforms. * Self-directed, detail-oriented, and results-driven. Additional Information * Organization: Corporate Services * Department: HF CIN * Shift: Day Job * Union Code: Not Applicable
    $46k-62k yearly est. 10d ago
  • *Supervisor- Payment Application/Full Time/Remote-Michigan Residents Only

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    The Corporate Business Office (CBO) Supervisor works closely with the respective CBO Manager. Responsible for coordinating and leading a designated area within the CBO across a multi-facility integrated healthcare delivery system; which includes all insurance billing and self-pay associated with HFHS hospitals, outpatient clinics and employed physicians. Responsible for oversight and support of the designated area of responsibility to provide timely billing processing and ensure accurate response to customers. Builds and maintains strong working relationships with departments to resolve patient inquiries. Payment Application: Supervisor is responsible for functions related to timely and accurate posting of insurance and patient payments. This includes but is not limited to: * Application of cash and contractual adjustments/discounts * Research and follow up of misapplied or missing payments * Timely balancing and reconciliation of all cash posted * Document storage and retention. * Timely resolution of self-pay credit balances EDUCATION AND EXPERIENCE: * Associates degree in Business Administration, Accounting, or related field preferred. * Two years of experience with healthcare accounts receivable required. * Knowledge of best practices related to revenue cycle operations and day-to-day functionality. * Knowledge of CPT and diagnosis coding and Third Party billing regulations preferred. * Experience at a large, complex, integrated healthcare organization preferred. * Experience with insurance billing, patient accounting systems and other related applications preferred. * Communication skills and the ability to interact effectively with staff. * Ability to manage, coordinates, and leads simultaneously. * Ability to estimate time frames and meet projected deadlines. * Ability to work with a variety of individuals in executive, managerial and staff level positions. * Ability to work independently. * Ability to understand and lead change. * Goal oriented, exceptional interpersonal skills, change management and political skill. Additional Information * Organization: Corporate Services * Department: CBO - Payment Application * Shift: Day Job * Union Code: Not Applicable
    $32k-38k yearly est. 4d ago
  • Medical Transcript - Sendout Lab - 40 hrs - Days

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    does not involve any testing. Using highly specified standard work, accessions anatomic pathology cases by typing clinical history into information systems, and printing cassettes. Triages and tracks a variety of cases and materials. Must be able to transcribe Pathology reports using laboratory information systems with a high degree of accuracy. Requires rapid data entry with good spelling and grammar, proofreading for accuracy and completeness, and follow-up as needed with customers for missing information. Candidates must have the ability to code diagnoses into the Lab and patient information systems. PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Accession surgical cases that arrive in the Pathology laboratory by routine referral, as well as outside surgical pathology consults and occasionally outside autopsy reports. Preparation includes typing demographics from surgical request forms from OR or clinics, typing clinical history, assigning pathologist, entering billing information, making corrections, typing addendums, revising and correcting reports. 2. Collate and transport slides and reports for members of the Pathology staff. 3. Print surgical batch and discard logs. 4. Triage and track specimens. Rehabilitate specimens if necessary and call to obtain any missing information. Participates in process improvements to track and reduce defects. 5. Receive and screen phone calls in a polite and helpful manner and following policies on the proper method for release of information. Additional duties include processing, packaging and shipping specimens to laboratories off-site, working with customers to resolve issues, and monitoring turnaround times. Order and result entry are also tasks associted with this role. Clinical laboratory experience in sample processing is necessary for this role. EDUCATION/EXPERIENCE REQUIRED: 1. Requires a high school diploma or GED. 2. Must demonstrate proficiency in accurate and rapid data entry with good spelling, grammar, and proofreading skills. 3. Competency to learn and use information systems and dictating equipment. Additional Information * Organization: Henry Ford Hospital - Detroit Main Campus * Department: Lab Support Services * Shift: Day Job * Union Code: Not Applicable
    $42k-50k yearly est. 49d ago
  • Outpatient Complex Audit Specialist/Full Time/Remote

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    Under the direction of the Outpatient Audit, Analytics & Technology Supervisor, in conjunction with OP Audit Analysts and Coordinators will utilize documentation and coding expertise to facilitate audits of the quality and completeness of medical record documentation for outpatient encounters, including but not limited to clinic visits, outpatient surgical procedures, telemedicine, and other ancillary services. Through concurrent, prospective and retrospective evaluation and assimilation of the medical record, the OP Audit - outpatient complex audit specialist will be responsible for utilizing knowledge of Local, State and Federal coding guidelines and regulations, NCCI Edits, ICD-10CM, CPT, Hierarchical Condition Categories (HCC), standards of compliance, and clinical knowledge to accurately abstract information from the electronic health record for compilation of an OP CDI Education database, which supports the Documentation & Coding Provider Education Program, data-driven resourcing, monthly provider performance scorecards, revenue cycle projects, KPI metric dashboards, and administrative decision making related to Revenue Cycle. EDUCATION AND EXPERIENCE: * High school diploma or G.E.D. equivalent required. * Minimum of two (2) years coding experience required. * Additional specialty coding certification or 5-7 years coding experience required. * Prior experience in a healthcare revenue cycle position required. Specialty coding experience preferred. * One to two (1-2) years college or additional course work in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred. * Must have through knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. * Strong organizational and time management skills required to effectively prioritize work. * Ability to communicate effectively with colleagues, supervisor, and manager. * Ability to work independently. * Ability to work remotely. * Proficient in medical terminology. * Proficient in ICD-10 CM, CPT, HCC and HCPCS coding. * Able to recognize patterns and trends and escalate to supervisors to support root cause analysis. * Able to assist other team members. Additional Information * Organization: Corporate Services * Department: CDI - Education Support * Shift: Day Job * Union Code: Not Applicable
    $22k-44k yearly est. 27d ago
  • **Supervisor- Audit, Education, Analytics & Technology/Full Time/Hybrid

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    The Audit, Education, Analytics, & Technology Supervisor, in conjunction with physicians, coders, and clinical staff, will utilize documentation and coding expertise to facilitate the quality and completeness of medical record documentation of outpatient encounters, including but not limited to clinic visits, outpatient surgical procedures, telemedicine, and other ancillary services. Through concurrent, prospective, and retrospective evaluation and assimilation of the medical record along with communication with physicians and other clinicians, the Supervisor will be responsible for achieving improved documentation results for the organization. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The Supervisor utilizes knowledge of national coding guidelines (ICD-10), CPT, Hierarchical Condition Categories (HCC), standards of compliance, and clinical knowledge to identify opportunities and to achieve results. EDUCATION AND EXPERIENCE: * Bachelors degree (Business Administration or Healthcare related field) or 5 years medical billing, coding, auditing, compliance, CDI, revenue integrity, healthcare/business financial or other revenue cycle experience, including at least 1-2 years lead role or supervisory experience may be considered in lieu of education requirement. * Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. * Additional specialty coding certification or 5-7 years coding experience required. * Data analytics experience preferred. * Ability to build relationships, negotiate processes and outcomes, and influence behaviors. * Knowledge of health care fiscal management goals and strategies, including but not limited to trends and issues in health care reimbursement, coding guidelines, and case management. * Knowledge of electronic medical record systems and demonstrated proficiency of Microsoft Office. * Ability to work and lead remote employees. * Ability to withstand pressure of deadlines, multitask, prioritize, adapt to change, and receipt of work with variable requirements. * Ability to work in a highly matrixed environment. * Ability to work independently, be resourceful, and possess strong organizational skills. * Ability to communicate effectively to physicians and other clinical staff; be courteous, tactful, and cooperative. * Ability to use critical thinking and appropriate judgement throughout all phases of work. CERTIFICATIONS & LICENSURES REQUIRED: * At least one of the following certifications is required: CPC, CCS, CCS-P, CCDS, CDIP, RHIT or RHIA. Additional Information * Organization: Corporate Services * Department: CDI - Education Delivery * Shift: Day Job * Union Code: Not Applicable
    $32k-37k yearly est. 27d ago
  • Psychotherapist - Contingent- DAY Shift- - HYBRID position- Dearborn

    Henry Ford Hospital 4.6company rating

    Remote or Dearborn, MI job

    , Remote with 1 day in Dearborn office per week. No Weekends FULLY LICENSED Psychologists, Psychotherapists, Social Workers, Therapists or Professional Counselors, this is a great Hybrid opportunity to join Henry Ford Health! Being a Henry Ford team member gives you a sense of belonging that inspires you to be your best self. Here, you are part of a culture that allows you to invent and reinvent what's possible, with a meaningful purpose that bonds us to our communities. With 10 locations we offer a variety of clinical opportunities for you to support clients in a team-oriented environment. Behavioral Health Services Home (hfhs.org * Psychotherapist provides evidence-based care in the diagnosis and treatment of mental illness and substance use disorders within an interdisciplinary team. * Provides individual, conjoint, group and family psychotherapy; in addition to crisis intervention services, as needed. * Ensures that the quality of care is safe, effective, patient-centered, timely, efficient, and equitable. #LI-NG1 EDUCATION/EXPERIENCE REQUIRED: Master's (or Doctoral) degree in clinical or counseling psychology with one year supervised post masters experience; OR Master's degree in Social Work with two years post Master's experience in mental health/chemical dependency setting. CERTIFICATIONS/LICENSURES REQUIRED: Licensed Psychologist; Licensed Professional Counselor OR Licensed Master's in Social Work Additional Information * Organization: Behavioral Services * Department: Dearborn_Peds_OP BHS * Shift: Day Job * Union Code: Not Applicable
    $40k-67k yearly est. 43d ago
  • **HIM Data Integrity Specialist/Full Time/Remote

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    The Health Information Management (HIM) department plays a vital role in maintaining the integrity of patient data, ensuring its accuracy. HIM Data Integrity Specialist professionals are responsible for reconciling health records to uphold quality and precision. Effective management of corrections within the health record is essential for preserving the highest standards of information quality and integrity, which are critical for patient safety. EDUCATION/EXPERIENCE REQUIRED: * Associate degree or two (2) years of experience within healthcare or an HIM department. * Bachelor's degree in Data Science, Statistics, Computer Science, Information Technology, or a related field, preferred. * Experience in data quality management, data analytics, or a related field. * Proficiency in data analysis tools and visualization technologies such as Tableau or Power BI. Must possess strong analytical and problem-solving skills, with the ability to interpret complex data sets and provide actionable insights. * Ability to apply high level of attention to detail and accuracy in data analysis and reporting. * Ability to demonstrate strong communication skills with internal and external customers. * Must have experience with Microsoft applications including but not limited to: Excel, Outlook, OneNote, Teams, Word. * Must be able to work with minimal supervision. * Work independently or in a team setting. CERTIFICATIONS/LICENSURES REQUIRED: * Registered Health Information Technician (RHIT), desired. Additional Information * Organization: Corporate Services * Department: HIM EHR & Quality * Shift: Day Job * Union Code: Not Applicable
    $34k-61k yearly est. 2d ago
  • Supervisor- Call Center Provider Inquiry (Hybrid/Troy) - Health Alliance Plan

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    To supervise, organize and coordinate the Provider Inquiry Call Center. To maximize service levels through scheduling, floor management, coaching and performance management. To maintain and report on all information related to the provider's inquiries received via the telephone/lobby and/or fax. Review, triage, and facilitate all information related to the Provider inquiries, complaints, or grievances received throughout the HAP systems. PRIMARY DUTIES AND RESPONSIBILITIES: * Supervise, develop, coordinate and control all workflow activities in the Provider Inquiry Department (which includes phone monitoring, scheduling staff & adjudicating the phone queue assignment schedule, based on trends to maximize the efficiency of the call center productivity). * Determine training, policies, procedures and benefit needs related to customer servicing. * Maintain quality control within Provider Inquiry based on Provide inquiry--- feedback via letters, phone, e-mail via HAP's website, provider survey cards, and quality audits performed by the department Quality Auditors. * Evaluate employee performance, initiate appropriate coaching and developing and implement disciplinary action within area of responsibility. * Develop the Call Center Statistical Analysis Reports on a daily/monthly/annual basis, including developing all associated written policies and procedures. * Monitor the quality and quantity of the communication between the Client Service Specialists and customers received by telephone and/or in person. * Focus on continuous improvement on customer service and the development of staff in a customer oriented way. * Interface with the Customer Services Correspondence and Grievance sections to be involved in the integral part of resolution for member complaints/grievances received by HAP. * Develop processes/measures that will ensure staff receives continuing education on most current benefits, products, policies, procedures, systems tools, in cooperation with the departmental Training Coordinator. * Assist and/or handle provider complaints received through the President's Office, Board of Directors, Media, Insurance Bureau, or the Department of Public Health ensuring a focus of customer satisfaction in complaint resolution. * Coordinate with internal support departments, i.e., Marketing, Membership & Billing, Claims and Finance Divisions, in the resolutions of enrollment related problems. * Perform other related duties as assigned. EDUCATION/EXPERIENCE REQUIRED: * Bachelor's degree in Health Care, Business or related field or a minimum of four (4) years recent and related work experience in customer service may be considered in lieu of the degree * Minimum of three (3) years of experience in a health care or insurance environment * Minimum of three (3) years of customer service experience in a call center environment and knowledge in claims processing and HMO, PPO and/or Medicare managed products * Minimum of two (2) years of recent supervisory or team lead experience with evidence of driving customer service improvements. * Demonstrate a clear understanding of health care delivery systems * Demonstrate understanding of HMO/AHL health care concepts * Demonstrate human relations management skills * Demonstrate technical understanding of database-oriented computer systems, i.e. FACETS, PEGA * Demonstrated proficient use of Microsoft Office software applications, i.e., Word, Excel, Power Point Additional Information * Organization: HAP (Health Alliance Plan) * Department: CORRESPONDENCE * Shift: Day Job * Union Code: Not Applicable
    $29k-34k yearly est. 4d ago
  • HRIS Consultant | Full Time | Hybrid

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    Under the direction of the Director of the department and with high degree of autonomy, the e HR Consultant will work independently or as a Project leader to manage work of a medium to complex nature. The e-HR consultant will plan, organize and coordinate project task completions with individuals and teams of professionals at other levels, as well as to specialized functional resources, and outside contractors while developing solutions for business opportunities/ challenges. Will team up with experts from other disciplines inside and outside HFHS. Focus will be on providing expert technical consultative guidance to HR leadership in the implementation, enhancements and recommending modifications for Human Resources Technology Systems. Work effectively with other members of team and promote a healthy high performing work environment. PRINCIPLE DUTIES AND RESPONSIBILITIES: * Work independently to manage complex projects involving coordination of multiple participants and teams. Maintain a high level of responsibility for completion of HCM projects with strategic implications. * Focus will be on providing expert consultative guidance on HR Data Management to peers and system users. The eHR senior consultant will focus on assuring the integrity of HR System data (employee and system tables) and the effective utilization of the HR System * Make presentations on key initiatives; provide updates on work plans and implementation activities and results. Utilize consulting and project management methodologies in working with business customers and in executing projects. * Analyze and recommend best practice business process/ data models to integrate HR data with self-service applications. * Lead HR technology to next level for web based Self Service applications * Works directly with external customers/Vendors to implement new or enhanced technology (e.g., interfaces, outsourced vendor arrangements, system integration) and manages service and support * Recommend software upgrades for customers' existing programs and systems * Ensure that a program continues to function normally through software maintenance and testing. * Document every aspect of an application or system as a reference for future maintenance and upgrades * Provide exceptional customer service to all customers in anticipating needs of application functionality, resolving problems, and related issues. Perform thorough documentation of programs, businesses process flows and systems. * Assess organizational needs for HR institutional reporting and develop web based data analytics for predictive modeling using HR information. Design, develop and deliver comprehensive workforce analytics, System usage and HR Dashboard solutions. * Work in collaboration with Financial Information System and Supply Chain System counterparts to develop efficient and innovative solutions to deliver managerial reports/information to business unit managers and senior leadership. * Troubleshoot any design failure and determine resolutions for applications that you support. * Run ad hoc reports to support customer's operational needs. Understand and anticipate customer needs to provide data with business insights and variations. * Ability to analyze and recommend solutions for integrations of other ancillary systems like Time entry, Learning, Performance Management and Scheduling systems * Continually strive to be knowledgeable of HFHS HR strategies to anticipate Application functional needs and fully utilize the capabilities of the PeopleSoft HRMS, and related applications. * Use the service request database to manage all assigned cases with adequate and up to date details on progress and status of completion. * Serve as a backup resource to other teammates, as identified on an ongoing basis. * Maintain professional growth and development through seminars, workshops and other learning opportunities. Develop expertise on understanding technical aspects of PeopleSoft to have increased understanding of system design and integration with other facets of PeopleSoft HRMS. * Perform other related duties as assigned or requested. EDUCATION/EXPERIENCE REQUIRED: * Bachelor's degree in human resources, Computer Science, or Qualitative systems. * Degree course with electives in Database Management Systems, Software Engineering, Software Design and Quality, preferred. * Four to six (4-6) years of experience in Information Systems department supporting applications. * Two to three (2-3) years of HRIS/business consulting with experience in Peoplesoft HR, Base Benefits, benefits administration is Required * 4-6 years of experience in SQL is required * Strong interpersonal and analytical skills. * Strong leadership skills to encourage team participation and successful outcomes. * Expertise in designing and utilizing spreadsheets, database applications such as MS Access. * Excellent writing skills as needed for procedural documentation and user communication. CERTIFICATIONS/LICENSURES REQUIRED: * Project Management certification will be an added advantage, preferred. Certified or have specialized training in PeopleSoft HRMS/Information Technology, preferred. #LI-VD1 Additional Information * Organization: Corporate Services * Department: E-HR * Shift: Day Job * Union Code: Not Applicable
    $36k-58k yearly est. 60d+ ago
  • Nurse Practitioner Physician Assistant | Behavioral Health | Troy | Hybrid | Full Time | Days

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    We are seeking a dedicated experienced Nurse Practitioner or Physician Assistant to join our Behavioral Health team at HFHS. This position offers a day shift schedule with no weekends, focusing exclusively on outpatient care. Ideal candidates will have a Nurse Practitioner certification and specialized education or certification in Behavioral Health. Join us in making a difference in the lives of our patients and community. * Provides inpatient and/or outpatient psychiatric care with the supervision, but not necessarily the presence of a qualified member of the medical staff. * Completes a biopsychosocial history, performs a mental status examination, orders and interprets tests, makes diagnoses and institutes and conducts appropriate treatment plans. Works in collaboration with other team members which may include medicine, social work, psychology, physicians in other departments as well as support staff. Performs nursing functions independently. * 1+ year NP outpatient experience and PMHNP certification is required. Must be licensed as a Registered Nurse and certified from MI State Board of Nursing as a Nurse Practitioner (NP) and ANA/ANCC Psychiatric-Mental Health Nurse Practitioner (PMHNP). 1+ year NP outpatient experience and PMHNP certification is required. Requires DEA License and BCLS certification #LI-LB1 Additional Information * Organization: Behavioral Services * Department: Troy_Adult_OP BHS * Shift: Day Job * Union Code: Not Applicable
    $59k-91k yearly est. 49d ago
  • IT Senior Data Warehousing Analyst / Solution Architect- Center for Health Services

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    * Under the general direction of the Project Manager, Manager, or the Director, develops and enhances a data warehouse environment which includes data design, database architecture, metadata and repository creation. * Provides direction and guidance to less experienced team members. * Reviews data loaded into the data warehouse for accuracy. * Responsible for the development, maintenance, and support of an enterprise data warehouse system and corresponding data marts. * Troubleshoots and tunes existing data warehouse applications. * Conducts research into new data warehouse applications and determines viability for adoption. * Assists in establishing development standards. * Evaluates existing subject areas stored in the data warehouse. Incorporates existing subject areas into an enterprise model. * Creates new or enhanced components of the data warehouse. * The responsibilities also include troubleshooting application issues and/or data issues when they arise. * The Senior Data Warehousing Analyst is a leader in an IT team that is accountable for production support (including on-call duties in a 24x7 environment) as well as new projects. * The ideal candidate will have significant experience using analytical skills to seek out, research and evaluate a variety of options to provide clients with high quality solutions that promote efficiency and enterprise-wide standardization. * Must demonstrate the ability to mediate and bridge the relationship between technical and business stakeholders without compromising the needs of the solution users and the strategic goals of the organization. EDUCATION AND EXPERIENCE: * Bachelors degree required; * Advanced degree preferred. * years of applicable work experience required; 5 years applicable experience in a Healthcare setting preferred. * Preferred technical experience includes strong knowledge of state-of-the-art software engineering approaches in design, build, test, debugging problems, and ongoing technical support, and ability to articulate examples of workflows and processes associated with that experience. * Experience with Epic Clarity and Epic Cogito is preferred. * Deep expertise with Microsoft Windows Server, SQL Server, TFS, SharePoint, Net and SSIS technologies. * Experience with Unix operating systems and Oracle database is preferred. * Good understanding of HIPAA data Privacy and Security requirements. * Previous supervisory experience preferred. * Ability to be flexible and work analytically in a problem-solving environment. * Good organizational, multi-tasking, and time-management skills. * Excellent communication (written and oral) and interpersonal skills. * Proven ability to work independently and as a team member. * Experience with the System Development Life Cycle (SDLC). * This position is hybrid - 3 days required in the office at One Ford Place, Detroit and 2 days work from home. * 7 years of applicable work experience required; 5 years applicable experience in a Healthcare setting preferred. Additional Information * Organization: Corporate Services * Department: Ctr for Health Srvcs Research * Shift: Day Job * Union Code: Not Applicable
    $85k-104k yearly est. 18d ago
  • Experienced Patient Services Specialist I - Days - Remote (Michigan Residents)

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    Are you ready to make a difference in patient lives from the comfort or your own home? In this position you will be providing exceptional customer service to assist patients with their medical bills via phone. We pride ourselves on one call resolution and provide career growth to those who want to excel. The hours are as follows with NO weekends required; * 930am-6pm Monday through Thursday * 830am - 5pm Fridays * Training is 6 weeks with hours from 8am-430pm Monday-Friday The position also offers Health Insurance and paid time off. GENERAL SUMMARY: Responds to patient inquiries regarding healthcare accounts receivables across a multi-facility integrated healthcare delivery system, which includes all hospital and professional billing associated with Henry Ford Health inpatient hospitals, outpatient clinics, laboratory, radiology and employed physicians. Communicates effectively with patients, colleagues, providers, system operational staff, supervisors, and managers. Works independently for maximum efficiency in a high-volume billing Call Center. PRINCIPLE DUTIES AND RESPONSIBILITIES: 1. Handles in-coming telephone activity including answering phones promptly according to system Quality standards, documenting all interactions thoroughly, accurately, and legibly, and takes accountability for inquiries. 2. Ensures timely responses to service center inquiries via phone, fax, email, or mail to assist the customer in understanding their patient responsibility. Strives for first contact resolution in a timely and efficient manner. 3. Ensures timely responses to pre-collection and bad debt collection agency inquiries. 4. Researches and educates patients on outstanding bills and their status, which includes but is not limited to accounts not included in a payment arrangement, recognizing inaccurate information, partnering with legal to review bankruptcies, assisting with Coordination of Benefits, third party liability claims, etc. 5. Initiates and resolves account receivable errors with the hospital and professional billing or coding teams, which includes but is not limited to autopay updates, newborn/patient registration, and adding or removing balances to/from external collection agencies, coding errors, claim filing errors, etc. 6. Effectively discusses the patients' options for resolving outstanding balances including approved discounts and recognizing their eligibility for financial assistance. Connects patients to the Financial Counseling team for charity screening. 7. Ensures accurate and compliant processing and posting of all system payment types to patient hospital and professional claim balances. 8. Assists patients with setting up and navigating the online MyChart system. 9. Obtains, verifies through internal and external resources, adds insurance, and confirms payer filing order. 10. Analyzes and processes refunds as a result of overpayment. 11. Meets system standard quality and productivity expectations. 12. Identifies and escalates potential billing error trends to leadership. 13. Effectively communicates any patient balance issue with internal and external payer, vendors, or contractors. 14. Maintains strict confidentially standards for patient information. Complies with organizational, federal, and state regulations and policies on confidentiality. 15. Supports the standards set forth in the Henry Ford Health Code of Conduct by adhering to legal, ethical, and HIPAA standards. 16. Performs other related duties as assigned EDUCATION/EXPERIENCE REQUIRED: * High school diploma or G.E.D. equivalent. Associate's degree in Business Administration, Accounting, Billing, Coding, or related field preferred. * Three (3) years of Call Center experience. * One (1) year of billing (billing and coding) experience. * Six (6) months of remote work experience. * Internet requirement of 25 Mbps and wired. * Experience in healthcare/medical office customer service strongly preferred. * Ability to interpret insurance billing process (Primary, Secondary, co-insurance, deductibles, and co-pays). * Technical skills (navigation, Microsoft Suite, initial troubleshooting) including guiding patients with online payment methods. * Ability to remain calm and de-escalate callers, as needed. Additional Information * Organization: Corporate Services * Department: CBO - Customer Service * Shift: Day Job * Union Code: Not Applicable
    $27k-30k yearly est. 6d ago
  • Senior Business Intelligence Developer/Full Time/Hybrid Troy or Jackson

    Henry Ford Hospital 4.6company rating

    Remote or Detroit, MI job

    Under the direction of a Manager, Director or Lead/Experienced developer, implements a comprehensive program to extract data using a computer programming language or collect data, then analyze it and effectively report information from this data to a variety of customers in a user-friendly and actionable way. This position generates reports, develops tools and provides consultative support as needed. Our customers include physicians, physician groups, physician leaders, hospital leaders, the Board of Trustees, system leadership, transformation consulting, clinical/non-clinical services, Markets, Community, Service Lines, Revenue Cycle, Finance, external oversight/regulatory bodies, or any other user needing information. The Senior Business Intelligence Developer should be able to enhance the data driven culture within the Henry Ford health System, must be able to work in cross-collaboration to gather data, generate reports, develop automated tools, and provides actionable interpretation of information to all the customers. The candidate must be able to present information to customers at all levels, including but not limited to executives, physicians, clinical staff, peers, and external oversight/regulatory bodies. Independently develop comprehensive data assets, ad-hoc reports and implement new or improved reporting processes to support strategic goals, clinical efforts, and any business initiative. Must be able to work with least amount of direction, manage deadlines, maintain timeliness, delivery, and high quality of the products. Anticipate and quickly adapt to evolving needs of the customer. Consistently demonstrate excellent analytical and problem-solving skills while maintaining keen attention to detail. Candidate must be able to handle complex and ambiguous requests, maintain timeliness of delivery, data quality and manage changing deadlines. EDUCATION/EXPERIENCE REQUIRED: * Bachelor's Degree with a Healthcare, Computer Science, Engineering, Mathematics/Statistics, Business, OR an Applied Science major. * Three to four (3-4) years of experience in a Healthcare OR Business setting. * Expert in the use of advance Excel, SQL, report building, tool development, requirements gathering and technical documentation. Experience in the use and design of Relational Databases, Data Models, Data Visualizations, curated datasets, data cubes OR experience in Electronic Medical Record(EMR) report development, functionality of any EMR(Epic, Cerner, McKesson or other widely used EMRs). * Maintain code repositories on SCM system, familiar with merging, pushing, pulling, branching, staging and code commenting OR MS TFS. * Good understanding of fundamental Computer Programming concepts OR Electronic Medical Record systems. * Basic understanding of Statistical and Machine Learning concepts. * Basic understanding of dimensional models and Data Warehouse OR Electronic Medical Record system. * Experience in any Business Intelligence tools such as Tableau, Cognos, Looker, Toad, Minitab, Power BI, Qlik, SSRS OR any other. * Develop multidimensional semantic layer and analytics query objects for end-users. * Proven customer service experience with strong active listening skills. * Able to present complex information to diverse audiences. * Excellent written and verbal communication skills. Additional Information * Organization: Corporate Services * Department: Revenue Cycle Administration * Shift: Day Job * Union Code: Not Applicable
    $97k-119k yearly est. 2d ago
  • *CBO Payment Applications Specialist/Full Time/Hybrid

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    The Payment Applications Specialist is responsible for accurately posting payments received from patients and third-party payers to healthcare accounts receivables across a multi-facility integrated healthcare delivery system. This includes managing billing associated with Henry Ford Health System hospitals, outpatient clinics, and employed physicians. PRINCIPLE DUTIES AND RESPONSIBILITIES: 1. Post and balance patient payments received through various methods such as check, EFT, and credit card. 2. Post and balance payments received from third-party payers, applying related contractual adjustments and determining patient responsibility. 3. Post and balance payments received from collection agencies via electronic payment files. 4. Utilize automation processes to balance and post EFTs. 5. Balance and reconcile 835 Remittance files following proper work queue procedures to address remittance file errors and PLBs. 6. Resolve aged deposits to ensure proper application of payments or return of funds to the appropriate party. 7. Understand and apply HFH third-party insurance contract terms to appropriately apply contractual adjustments. 8. Analyze payer denial reasons to appropriately determine insurance responses based on adjudication using standard ANSI remittance codes. 9. Retrieve remittance files from payer websites and upload to document retention software. 10.Research and process misapplied or missing payments following proper work queue procedures. 11.Review and analyze unposted 835 remittance file activity and make recommendations on proper resolution. 12.Process refunds resulting from payments received in error. 13.Handle credit card chargebacks and items returned for nonsufficient funds. 14.Meet established quality and productivity expectations. 15.Identify and report any potential issues to leadership. 16.Adhere to legal and ethical standards as set forth in the HFH Code of Conduct. 17.Perform other related duties as assigned EDUCATION/EXPERIENCE REQUIRED: * High school diploma or equivalent required. * One year of experience in finance, accounting, or healthcare revenue cycle related position preferred. * Experience with general ledgers or other accounting functions preferred. Additional Information * Organization: Corporate Services * Department: CBO - Payment Application * Shift: Day Job * Union Code: Not Applicable
    $38k-70k yearly est. 2d ago
  • *Supervisor-Inpatient Coding/Full Time/Hybrid-Michigan Residents

    Henry Ford Hospital 4.6company rating

    Remote or Troy, MI job

    GENERAL SUMMARY: The Inpatient Coding Supervisor is responsible for daily oversight and coordination of the inpatient coding processes across the multi-facility integrated healthcare delivery system. Provides supervision and oversight to inpatient coding team while maintaining complete and accurate coding and acceptable DNFB levels. Complies and has working knowledge of coding rules and regulations, HIPPA, case mix index (CMI) analysis, and reimbursement requirements. Builds and maintains strong working relationships between data quality coordinators, documentation specialists, audit team, quality, and medical staff. EDUCATION/EXPERIENCE REQUIRED: * Associate degree and two (2) years' experience in related field or in lieu of degree two (2) years of management or supervisor experience in a position that demonstrates leadership ability, initiative, and assertiveness. * Five (5) years of working experience with ICD10 Coding, MSDRG assignment and reimbursement methodology. * Proficiency with database, spreadsheet, and related software programs. * Demonstrated ability to multi-task in a high-level multidisciplinary environment. * Communication skills and the ability to interact effectively with staff. * Analytical ability necessary to conduct basic research analyzes and interprets data, evaluate processes, and propose improvements. * Ability to supervisor, coordinates, and leads simultaneously. * Ability to estimate time frames and meet projected deadlines. Interpersonal skills necessary to provide effective leadership to departmental personnel and to develop and maintain a wide variety of internal and external cooperative working relationships. * Ability to work independently. Goal oriented, interpersonal skills, change management and political skill. CERTIFICATIONS/LICENSURES REQUIRED: * RHIA, RHIT, or CCS certification Additional Information * Organization: Corporate Services * Department: Inpatient Coding * Shift: Day Job * Union Code: Not Applicable
    $32k-38k yearly est. 49d ago

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