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Health Alliance Remote jobs - 20 jobs

  • Senior Reimbursement Analyst - Laboratory Billing (Remote)

    The Health Alliance 4.1company rating

    Raleigh, NC jobs

    About the Role We're looking for a Senior Reimbursement Analyst to join our laboratory revenue cycle team, focused entirely on pre-claim accuracy and reimbursement readiness. In this role, you'll act as the final quality gate before claims are submitted - ensuring patient data, eligibility, coding, and medical necessity are correct so claims move cleanly through TELCOR, clearinghouses, and payer systems. This is a hands-on, problem-solving role ideal for someone who enjoys digging into data, identifying root causes, and improving front-end workflows to prevent downstream denials. What You'll Be Responsible For Pre-Claim Review & Accuracy Review lab orders and patient records to identify missing or conflicting demographic, insurance, or clinical data Validate CPT and diagnosis alignment to meet payer medical necessity requirements Ensure ordering provider information (NPI, credentials, facility details) is complete and accurate Proactively resolve coverage and data issues before claims are generated Eligibility & Coverage Analysis Verify insurance eligibility using 270/271 transactions, payer portals, and integrated tools Interpret benefits, exclusions, and coordination of benefits that impact reimbursement Identify and resolve inactive coverage, invalid policy numbers, and payer mismatches Recommend front-end process improvements to reduce eligibility-related errors Clearinghouse & Pre-Adjudication Support Review claim acknowledgments, clearinghouse reports, and payer responses Analyze and resolve pre-submission rejections related to formatting, coding, or payer edits Work with clearinghouse partners to troubleshoot recurring rejection patterns Partner with operations teams to ensure accurate claim creation and routing TELCOR System Support Use TELCOR to review claims, data feeds, file processing issues, and mapping errors Troubleshoot order imports, payer mapping, demographic ingestion, and coverage files Identify systemic TELCOR issues that cause recurring pre-claim errors Collaborate with IT, billing, and analytics teams to resolve interface or data-pipeline issues Data Analysis & Reporting Use SQL to investigate missing data, eligibility mismatches, and payer configuration issues Identify trends in pre-claim errors to support process improvements Contribute to reporting, dashboards, or automated audits that improve claim quality What We're Looking For Required Experience in laboratory billing, reimbursement, or pre-claim operations Hands-on experience working with TELCOR (RCS or QML) Strong understanding of eligibility, benefits, and payer requirements Ability to analyze pre-claim issues and identify root causes Comfort working with data and systems to validate claim accuracy Preferred (Not Required) SQL experience for data validation or reporting Familiarity with EDI / HL7 workflows (270/271, 837, 835) Experience in molecular, toxicology, or high-volume lab environments Experience building audits or automated checks We encourage candidates who meet most - but not all - qualifications to apply. Why Join Us Fully remote role with a specialized, high-impact focus Opportunity to influence front-end revenue quality, not just fix denials Collaborative environment with IT, billing, and analytics teams Work that directly improves reimbursement outcomes and operational efficiency
    $67k-78k yearly est. 26d ago
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  • Access Center Ambassador

    Health Alliance of Hudson Valley 4.1company rating

    Hawthorne, NY jobs

    Job Summary: An Access Center Ambassador acts as the primary point of contact for patients and other callers, handling a high volume of inbound calls to schedule appointments, answer questions, and route calls to the appropriate departments. This position is crucial for maintaining efficient communication across our physician enterprise to ensure a first call resolution and a positive patient experience. Responsibilities: * Answering Phones: Responding to a high volume of calls from patients, insurance companies, and other medical facilities. Must be able to handle 80-100 incoming calls per day. * Verifies and updates current patient demographic, financial, clinical and portal access * Schedules future appointments based on appointment type, time requirements and provider schedule availability. * Respond to patient questions and needs by editing, canceling and rescheduling appointments as necessary and indicated by practice protocols. * Review physician schedules regularly to maximize capacity and verify correct scheduling. * Serves as brand ambassador by upholding the WMCHealth Mission, vision and CARE values and promoting excellence in the patient experience, during every encounter. * Respects patients' needs for confidentiality and empathy during all encounters. * Appointment Scheduling: Scheduling, rescheduling, and canceling appointments, often using CERNER, electronic health record (EHR). * Utilizes technology including specialized software platforms as applicable to maximize productivity. * Call Routing: Directing calls to the correct departments or individuals based on the caller's needs. * Message Taking: Taking accurate messages for staff members who are unavailable. * Customer Service: Providing information, addressing inquiries, and resolving issues related to appointments, billing, and other general concerns. * Maintaining Records: Ensuring accurate and up-to-date patient information in the system. * Communication: Maintaining effective communication within the department and with other departments. * Meet daily productivity targets individually and as a team to achieve WMCHealth mission, vision and CARE values. * Other duties as assigned. * Remote work may be considered for candidates who meet specific requirements after hire and onboarding. Qualifications/Requirements: Experience: Minimum of one (1) year of call center and/or customer service experience preferred. Education: High school diploma or equivalent required. An associate degree from an accredited institution is preferred. Licenses / Certifications: N/A Other: Bilingual (English/Spanish) candidates preferred, but not required. Proficiency in Microsoft Office (Outlook, Word, Excel, and PowerPoint). Special Requirements: * Communication Skills: Excellent verbal and written communication, active listening, and the ability to explain complex information clearly. * Customer Service Skills: Empathy, patience, and a positive attitude when dealing with patients. * Technical Skills: Proficiency in using computer systems, and other relevant tools. * Problem-Solving Skills: Ability to quickly assess situations and find solutions. * Time Management: Ability to manage a high volume of calls and prioritize tasks effectively.
    $35k-59k yearly est. 9d ago
  • Analyst Quality Assurance Performance Improvement - Remote - Physician Services Organization

    Newyork-Presbyterian Hospital 4.5company rating

    Remote

    Quality Assurance Performance Improvement Analyst- Remote NewYork-Presbyterian (NYPMG) are part of the physician enterprise of NewYork-Presbyterian, one of the nation's most comprehensive academic health care delivery systems affiliated with two world-renowned medical schools. Through primary care and multispecialty medical practices, the physicians and other health care professionals of NYPMG, in collaboration with ColumbiaDoctors and Weill Cornell Physicians, provide families with high quality, patient-centered care close to home in the New York metropolitan area. The Quality Assurance and Performance Improvement Analyst will oversee data collection and validation, manage diverse databases, and monitor the quality of information in these databases. This person will be responsible for the conversion of data to an appropriate file format for statistical analysis and periodic production of reports for the program, the Departments and Divisions, and other related and appropriate personnel. Will be able to interface with other databases (e.g., including Information Systems, Departmental/Divisional, and other related and appropriate databases), regarding QAPI data. This is Full-time weekly schedule with varied hours of 7:00AM to 5:00PM (Must be flexible) Preferred Criteria: Master's Degree in related field Intermediate Excel Skills Preferred Required Criteria: Bachelor's degree or related experience. Strong research and analytical skills including collecting, analyzing and summarizing data into identifiable trends in a healthcare setting. Experience supporting PCMH (Patient-Centered Medical Home). Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, belonging, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today. Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP. NYP will not reimburse for travel expenses. __________________ 2024 “Great Place To Work Certified” 2024 “America's Best Large Employers” - Forbes 2024 “Best Places to Work in IT” - Computerworld 2023 “Best Employers for Women” - Forbes 2023 “Workplace Well-being Platinum Winner” - Aetna 2023 “America's Best-In-State Employers” - Forbes “Silver HCM Excellence Award for Learning & Development” - Brandon Hall Group NewYork-Presbyterian Hospital is an equal opportunity employer. Salary Range: $62,000-$84,000/Annual It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works.
    $62k-84k yearly Auto-Apply 43d ago
  • Information Services Summer Intern

    Nationwide Children's Hospital 4.6company rating

    Columbus, OH jobs

    40 hours per week, Remote work Target May 15 2025 - August 11 2025. Strong ability to learn from colleagues, books, documentation, and hands-on exercises. Exposure to source version control tools (e.g. Git, SVN) Exposure to issue tracking and software development best practice (SDLC). Base knowledge of SQL and data design best practices. Basic understanding of all technology hardware and interfaces. Basic working knowledge of development life cycle. Summary: Assists in the development and implementation of programs and projects to support the organization's strategic initiatives. Job Description: Essential Functions: Gathers and analyzes data. Runs pre-defined queries and formats reports as appropriate. Compiles and builds presentation materials to support projects, showcases new initiatives, reports data findings or other related information. Attends weekly group development sessions and actively participates in all NCH intern events. Applies strategic, system-level thinking and operational excellence techniques for problem solving. Performs some clerical office coordination and administrative tasks as needed. Collaborates directly with manager and provides recommendations to improve department or business unit. Education Requirement: Enrollment in High School or an accredited undergraduate, graduate, or doctorate program, preferred. Licensure Requirement: (not specified) Certifications: (not specified) Skills: Proficiencyin MS Office. Effective written and oral communication skills. Ability to work within teams and maintain professional composure in a dynamic work environment that often requires management and completion of multiple tasks. Demonstrates sound judgment and ability to apply logical and critical thought processes when developing solutions. Displays a positive presence and interacts with all levels of staff, outside vendors, consultants, and physicians. Experience: Previous workexperience in the medical field, preferred. Physical Requirements: OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs FREQUENTLY: Bend/twist, Squat/kneel, Standing, Walking CONTINUOUSLY: Audible speech, Computer skills, Decision Making, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting Additional Physical Requirements performed but not listed above: Requires focus and attention to detail while multi-tasking. Able to perform effectively during stressful situations. "The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
    $32k-39k yearly est. Auto-Apply 30d ago
  • Coding Quality Reviewer II - CPC CCS - Surgical Abstract Coding Experience Required - Remote

    Northeast Georgia Health System 4.8company rating

    Remote

    Job Category: Revenue Cycle Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. The Coding Quality Reviewer II is responsible for performing quality analysis of coded medical records, documenting the analysis, summarizing the metrics and reporting quality statistics to management. Responsible for complex multi-specialty coding to include but not limited to: Neurosurgery, UI, Neurology, Critical Care, hospitalists, surgical and others as defined. The Coding Quality Reviewer II is also responsible for communicating identified issues to coding staff and management, as well as reviewing and correcting coding issues from the EMR and PMS systems. In addition, the Coding Quality Reviewer II may be called upon to provide education to staff and clients, prepare coding audits for physician education, and/or coding charts as business needs dictate. The Coding Quality Reviewer II is responsible for providing and ensuring accurate, complete and timely coding of professional services to include all surgical and inpatient services. All coding staff must ensure accuracy and compliance with regulatory standards. Coding Quality Reviewer II is also responsible for performing audits in accordance with NGPG's annual Compliance Work Plan and preparing written and oral communications to the Coding Compliance Manager. Minimum Job Qualifications Licensure or other certifications: CPC and/or CCS-P Coding Certification required Educational Requirements: High School Diploma or GED Minimum Experience: Three (3) years experience coding Multi-Specialty records required. Other: Preferred Job Qualifications Preferred Licensure or other certifications: Preferred Educational Requirements: Preferred Experience: Other: Job Specific and Unique Knowledge, Skills and Abilities Extensive knowledge of ICD-9, CPT, HCPCS coding, medical terminology, federal and state regulatory guidelines and third party payor requirements required Accuracy and attention to detail imperative Ability to interact well with others at all levels with a flexible, energetic, proactive and positive style In-depth knowledge of Optimal coding policy and procedures Highly skilled proficient with Microsoft Office products Ability to communicate (both verbally and written) technical coding information to both technical and non-technical audiences Ability to organize data and provide detailed reporting Ability to prepare presentations and present to large or small audiences Must be highly motivated, detail oriented individual Excellent written and oral communication skills Problem solving and analytical skills Ability to be a self starter/work independently and as a team player Ability to travel to NGHS/NGPG sites as needed Essential Tasks and Responsibilities Perform timely, concurrent quality review of coded medical records. Correct errors identified in the quality process in both EMR and PMS systems. Maintain coding quality statistics and provide detailed reporting to management. Communicate errors to the Posting, Clinicians and AR staff on an individual basis. Communicate to management any problem areas identified in the quality process and steps taken to resolve. Assist with the review and correction of coding errors in the billing process (TM queues). Assist with the review and correction of coding errors in the electronic claims process (clearinghouse on-line errors). Promptly and professionally respond to both verbal and written coding questions from the internal staff and other areas of the company. Review documentation deficiencies for accuracy and communicate identified errors to the coding staff and management. Prepare documentation audits as needed for on-site physician education. Production coding of medical records as per business needs. Adherence to Coding policy and procedures. Review charge slips/cards for completeness (providers are ultimately responsible for codes they assign). Attends Regional and Local sponsored in-services and/or continuing education. Participates in professional development activities and maintains professional affiliations as necessary. Provide and/or validate CPT, ICD-9-CM and HCPCS coding of professional services for outpatient clinics, outreach offices or programs, minor diagnostic procedures, and/or ancillary services. Review charge tickets for missing or inaccurate information. Items reviewed include service and diagnosis codes units of service, modifiers, facility code, place of service, provider billing numbers, etc. Communicate with providers and clinic staff to ensure charge capture of all professional services, supplies, drugs, vaccinations, etc. Monitor reconciliation procedures to ensure all charges are captured and billed in a timely manner. Research and correct claims manager edits in a timely manner by applying coding and carrier specific guidelines while maintaining compliance initiatives. Provide coding coverage to other specialties, departments, divisions, and/or units as required. Attend billing educational sessions to enhance coding knowledge i.e. American Academy of Professional Coders, Professional Medical Coding Curriculum, NGPG Compliance Proficiency training, specialty seminars. Performs other job duties as assigned. Cross trains in other positions as requested. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Frequently 31-65% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Occasionally 0-30% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Frequently 31-65% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
    $51k-78k yearly est. Auto-Apply 42d ago
  • Trauma Registrar - Trauma Services - Full time Days

    Northeast Georgia Health System 4.8company rating

    Remote

    Job Category: Administrative & Clerical Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role: Trauma Registrar - Remote Full-Time | 8:30 AM - 5:00 PM EST (with flexibility based on department needs) Northeast Georgia Health System Are you highly detailed, tech-savvy, and passionate about accurate clinical data? Join our Trauma Services team as a Remote Trauma Registrar, where your expertise supports quality improvement, patient care, and trauma program performance across our organization. Why This Role Matters As a Trauma Registrar, you play a vital role in maintaining the Trauma Registry by ensuring timely, precise abstraction and entry of clinical data. Your contributions directly support compliance, trauma outcomes reporting, and state and national trauma initiatives. What You'll Do Identify trauma patients who meet registry inclusion criteria using state guidelines, ICD-10 codes, and clinical documentation. Abstract complex medical records, including demographics, pre-hospital care, diagnoses, procedures, complications, and inpatient details. Assign AIS, ISS, and ICD-10 codes accurately. Enter and validate patient data in the Trauma Registry and ensure accuracy before submission. Complete 80% of trauma records within 60 days of patient discharge. Generate basic reports, charts, and graphs to support trauma program needs. Participate in trauma-related meetings, staff education, and state registry activities. Support performance improvement initiatives and team communication. What You Bring Required Qualifications High School Diploma or GED. Minimum one (1) year of experience with a clinical registry (Trauma, Cardiac, Stroke, Cancer, etc.). At least two (2) years of healthcare experience with strong knowledge of medical terminology, anatomy/physiology, ICD-10 coding, and chart abstraction. Excellent computer proficiency, including: Microsoft Office Word and strong Excel skills Ability to operate standard office equipment Strong attention to detail, accuracy, communication, and time‑management skills. Ability to work independently with minimal supervision. Preferred Qualifications Certified Specialist in Trauma Registry (CSTR)-or willingness to obtain within two years of eligibility. Previous Trauma Registrar experience (strongly preferred). Experience running or creating trauma registry reports and/or demonstrated ability to build charts and graphs in Excel (preferred). Training & Development AAAM Scaling Course and ATS Registry Course (or equivalent) required within the first 12 months. Maintains at least 8 hours of trauma registry-related continuing education annually. We are committed to continuous improvement, teamwork, empathy, and a culture of learning-core competencies that guide every member of our team. Physical Requirements Occasional lifting/carrying up to 20 lbs Frequent computer and keyboarding work Occasional walking, standing, kneeling, or bending Make an Impact with Us If you are detail-oriented, highly computer proficient, and bring prior Trauma Registrar or registry experience, we'd love to meet you. Your work will help strengthen trauma care for our community every single day. Apply today and help advance trauma outcomes-one accurate record at a time. Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
    $31k-44k yearly est. Auto-Apply 1d ago
  • Environmental Services Technician Associate - Main Environmental Services - Full Time - Days

    The Christ Hospital 4.1company rating

    Remote

    To provide a clean, safe sanitary and appealing environment at The Christ Hospital KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: High School Diploma or GED preferred YEARS OF EXPERIENCE: 1 year of working experience preferred, but not required. REQUIRED SKILLS AND KNOWLEDGE: Basic reading, writing, and math skills required. Prefer basic customer service skills, but not required. LICENSES & CERTIFICATIONS: CHEST certification within 1 year preferred, but not required. EVS Staff Promotes Patient Safety. 1. All patient areas are cleaned daily with approved germicide and cleaning chemicals. 2. Wet floor signs or other caution alerts are used where a slippery or hazardous condition may exist. 3. Infection control procedures are followed. Staff uses proper hand washing and aseptic technique and follows general precautions to include proper PPE in all patient areas. 4. Is aware of and works with other hospital staff to ensure the utmost hospital experience. 5. Follows department policies regarding placement and condition of equipment and cleanliness of closets. Cleaning and Sanitizing. 1. Cleans patient rooms on a daily basis using proper chemicals and department cleaning procedures. 2. Cleans non-patient areas such as nurses' stations, offices, public waiting rooms and restrooms, and other ancillary areas. 3. Terminally cleans patient rooms upon patient discharge to prepare room for new admissions. Customer Service. 1. Interacts daily with patients, visitors and staff promoting a service attitude. 2. Assures that rooms are cleaned daily to the patients' satisfaction. 3. Uses scripting to ask if there is anything else we can do for the patient. 4. Leaves a housekeeper's note daily in each room to include housekeeper's name and department phone number. 5. Leaves tent card with name and a hospital packet in every patient room upon discharge cleaning. Confidentiality. 1. Is aware of and follows hospital policy and federal regulations regarding patient confidentiality. 2. Is tested annually on Safety and Confidentiality. Basic Computer Knowledge. 1. Ability to learn MS Office Outlook for emails. 2. Ability to take and pass required annual Stat Tests. 3. Learn the NaviCare system to log into and out of bed tracking. Other tasks as required
    $52k-104k yearly est. Auto-Apply 15d ago
  • Financial Counselor Associate - CBO Financial Clearance - Full Time - Days (Hybrid)

    Health Alliance 4.1company rating

    Cincinnati, OH jobs

    The oncology patient advocate provides financial counseling services through direct consultation with patients. Responsible for understanding the patient's financial standing, determining a financial course of action based on the standing, and seeking financial assistance programs if necessary. Understands the coordination of insurance benefits, screens and approves state financial assistance programs, and knowledgeable of TCHHN payment options. Possesses the ability to estimate patient liability based on treatment plans/pre-certification, and deliver estimation to the patient or their family. Senses emotionally sensitive financial situations and mitigates family burden; and works continuously with the patient during treatment to adjust financial programs if needed. KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: 2 year / Associate Degree in a related field preferred. YEARS OF EXPERIENCE: 2 - 4 years Healthcare Financial Counseling or Billing required. REQUIRED SKILLS AND KNOWLEDGE: Compassionate, sensitive Communicates well Listens Enjoys interaction with patients Familiar with diagnoses and treatments Knowledgeable about billing and reimbursement processes Aware of how different insurance plans work Persevering Analytical, with independent research ability Organized Patient Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs). Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. LICENSES & CERTIFICATIONS: Candidates must successfully complete the Patient Financial Services training. Obtains accurate patient demographics and insurance information to be used for billing and reimbursement purposes Collects funds for co-insurance, co-pay, and deductible. Responsible for educating patients and designated individuals on their rights and responsibilities as a patient and or guarantor, as well as securing all federal and state mandated forms (i.e., self-pay forms, Joint Commission, HIPAA, Advance Directives, waivers, Advance Beneficiary Notices, Medicare Secondary Payer Questionnaire, etc.). Seek financial assistance necessary This person will also be responsible for keeping a detailed spreadsheet of the patient assistance information. Educate patients about their insurance benefits, including how much of the annual deductible has been paid, the difference between copayments and coinsurance, and any benefit caps in place. Explains the total cost of the planned treatment, the patient's out-of-pocket expense, and the practice's payment policies. Obtains the applications for patients and helps them file them. Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Performs other duties as required and completes all job functions as per departmental policies and procedures.
    $34k-40k yearly est. Auto-Apply 34d ago
  • ETL Architect - Snowflake and SSIS Experience

    Northeast Georgia Health System 4.8company rating

    Remote

    Job Category: Administrative & Clerical Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. ETL Architect is a high-level business intelligence professional that is a key part of the Data and Analytics Team and will be generally responsible for the dimensional model design, end to end ETL architecture design, ETL development, and implementation of data models and development of the Data Migration and Data Warehousing solutions. The ETL Architect is also responsible for requirements analysis, source data profiling, identifying data quality issues, designing transformation logic to address data quality issues, experienced with the concepts and/or implementation of metadata data capture, data lineage, master data management and reference data management. The ETL architect designs for data warehouse/data mart solutions should include appropriate staging databases to handle change data capture on the source data, error handling and audit balance control mechanisms. The ETL Architect will have extensive interaction with operational team members and leadership, and will be tasked with analysis of business data and analytics requirements, and the transformation of those requirements into analytics solutions. Working with customers and Management to determine priorities as well mentoring of other team members on ETL concepts and strategies is also an integral role of the position. Working with Infrastructure and DBA team members, ETL Architect is also responsible for keeping the ETL Environments updated periodically to the latest version of the ETL software. Minimum Job Qualifications Licensure or other certifications: Epic Revenue or Clinical Data Model or Cogito Project Manager Certificate required (must be obtained within 6 months of date of hire). Educational Requirements: Bachelors Degree in Computer Science or related field. In lieu of Bachelor's Degree related experience in the field, 11 years progressively responsible, professional job specific work experience and an equivalent combination of education and training that provides the required knowledge, skills and abilities, combined with demonstrated professional growth and achievement. Minimum Experience: A minimum of seven (7) years experience as a various BI and other analytic reporting software applications with strong preference for EPIC, SQL, and Crystal Report Writing. Prior experience providing production level support and/or development in business intelligence (BI)/enterprise data warehouse (EDW) environments. Other: Preferred Job Qualifications Preferred Licensure or other certifications: Preferred Educational Requirements: Preferred Experience: Experience in database development and management tasks such as creating indexes, functions, stored procedures, creating databases, file groups, users, configuring permissions and assigning roles to users. Working knowledge of data warehouse concepts, enterprise data management, modeling techniques and ability to create solutions, participate in strategy discussions and review them with customer as well as project stakeholders. Other: Job Specific and Unique Knowledge, Skills and Abilities Strong analytical and interpersonal skills; demonstrated ability to work with management and customers; proven ability to work independently or as a team member; strong problem solving and troubleshooting skills; initiative in enhancing system productivity, functionality, and performance. Advanced understanding of Data Migration/Data Warehousing/Data Mart delivery life cycle, from requirements definition to creating source to target mapping documents with transformation rules, Error handling design, data quality, design audit Balance control mechanisms to be able to automate jobs, notify proactively failures, write test cases and create templates to document all aspects of the projects throughout the lifecycle. Strong experience with concepts of data profiling, identifying and measuring data quality issues, advanced experience with Master data and reference data management techniques to eliminate hard coding within the ETL processes/jobs. Excellent communication (written, verbal and presentation) and people-facing skills, Proven ability to maintain positive peer, customer relationships, interacting positively and productively with teams across organizational lines. Demonstrates skills in leadership, critical thinking, and consensus and relationship building. Ability to review, re-engineer and/or tune legacy SQL queries and/or ETL jobs/processes to make them run efficiently and within a load window. Must be able to function in dynamic environment subject to changes in schedules and priorities, working on multiple projects/ issues concurrently. Responsibilities may require evening and weekend work in response to needs of the systems supported. Experience in estimation, specification gathering, review code/designs, general planning for execution, monitoring and control. Hands-on with ability to design, re-design (schemas, data models, entity relationships etc.), and probe and guide developers. Possess a solid understanding of data warehousing concepts, including relational and multidimensional modeling. Experience in designing, building, testing, executing and performance tuning of ETL and reporting applications, including automation of ETL jobs for recurring imports; fluent in Microsoft SQL. Experience in designing and developing database objects, tables, stored procedures, views, and triggers. Essential Tasks and Responsibilities Designs end to end ETL architecture for Data Migration, Data Warehousing or Data Mart Solutions using Microsoft SSIS tool. Ensure all ETL Jobs have adequate error handling and audit balance control mechanisms implemented to enable automation. Stands up a DW/ETL Center of Excellence to document and enforce best practices, standards, naming conventions etc. Creates a checklist to review all solutions developed to ensure adherence to the CoE standards. Mentors and trains staff to hold periodic CoE meetings. Implement a reference data management system using tools like Microsoft Master Data Management Services to eliminate hardcoding in ETL jobs. Maintains a service oriented approach with customers, providing follow up and responding to issues/ concerns in a timely manner. Answer staff and client questions in person, via email and via phone. Provide after-hours on-call support on a scheduled basis. Responsible for ensuring service level agreement adherence. Works with staff to adhere to department/organization policies and procedures, compliance and regulatory agency requirements. Works with leaders in IT as well as operations to identify data from other source systems to form richer data sets, including the capture of derived data to address gaps in source system repositories. Promotes and utilizes the data request and development process, including the development of an understanding of a data request, assessment of the appropriate tool to be used to provide the data, creation of a requirements document in partnership with the operational stakeholder and application analyst, development of the data extract and validation of the extract by the operational stakeholder to ensure quality, timeliness and accountability. Participates in and contributes to the data governance program - specifically, validating data lineage, capturing metadata for all existing and any newly developed assets (ETL Jobs), profile various data sources and address data quality issues, work with source system owners to reduce upstream data entry errors. Assists with all upgrade, update or enhancement efforts associated with the ETL tool. In partnership with the Manager of Business Intelligence and Analytics, serves as a mentor and advisor to the BI technical resources and other analysts and provides general project management skills to produce BI views that address customer's needs. Builds and maintains SQL scripts, indexes and complex queries for data analysis and extraction. Troubleshoots problems regarding the databases, applications, and development tools. Assists with the development and implementation of new data sources into the data warehouse or determine ways to be able to utilize data in other systems to support data and analytics for the organization. Conducts or coordinate tests to ensure that intelligence is consistent with defined needs. Responsible for data collection/extraction and developing methods for database design and validation reports. Prepares and maintains key documents and technical specifications for new and existing solutions. Documents specifications for business intelligence or information technology (IT) reports, dashboards, or other outputs. In collaboration with other team members and leadership, supports the evaluation, adoption and implementation of new methods, tools and technologies in order to meet current gaps in the organization-wide data and analytics infrastructure. Works closely with end-users to identify and explain data and reporting discrepancies. Prepares and maintains key documents and technical specifications for new and existing solutions. Provides solution design, perform reviews and participate strategic discussions. Provides application analysis and data modeling design to collect data or to extract data from various disparate systems. Monitors incident management queue. Efficiently troubleshoot, resolve, report and close active issues. Works on additional assignments as delegated by management. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Frequently 31-65% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Frequently 31-65% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Occasionally 0-30% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
    $91k-119k yearly est. Auto-Apply 15d ago
  • Hospice and Home-Based Palliative Care Nursing Supervisor

    Nationwide Children's Hospital 4.6company rating

    Columbus, OH jobs

    Oversees hospice and home-based palliative care nursing responsibilities under the direction of the Hospice Manager. Hospice, palliative care, or home health experience and Pediatric experience strongly preferred. Directly supervises a small team of approximately 6-8 nurses, focusing on mentorship, collaboration, and ensuring high-quality patient care. Provides phone support to on-call nurses as questions arise, offering guidance and consultation in partnership with the Hospice Manager. No formal on-call required. Valid Ohio driver's license and proof of auto insurance required per hospital policy. Must pass motor vehicle background check, meet insurance eligibility, driving qualifications, and complete training per Nationwide Children's Hospital guidelines. Summary: Oversees the Homecare nursing responsibilities for providing safe, effective, patient-family centered care in the home. Performs assigned on call responsibilities to ensure 24- hour availability to meet patient needs. Practices professional nursing and promotes patient advocacy in accordance with the ANA Code of Ethics for Nurses and maintains a current Ohio Nursing License. Plans and coordinates program activities to meet regulatory standards related to but not limited to Medicare and Medicaid Conditions of Participation and Joint Commission Standards. Job Description: Essential Functions: Supervises day to day program operations under the direction of the Home Health Manager. Serves as a clinical expert to assigned Registered Nurses and Licensed Practical Nurses for patient care, policies, staffing, procedures, documentation and skills. Provides auditing and education for safety and quality initiatives. Assists in the training and development of new and existing staff members, including interviews, performance appraisal, event reporting, clinical competency assessment, corrective action/work improvement planning and audits. Makes appropriate staffing decisions with understanding and consideration of workload targets and budget impact in collaboration with the staffing specialists. Engages in the “workplace community” by staying aware of changes, participating in data collection or auditing, understanding Quality Improvement, and representing staff at relevant meetings and then reporting important information and updates back to staff. Assures the acceptance of patient care referrals are appropriate for care in the home/community environment. Education Requirement: BSN, required. Licensure Requirement: Licensed as a Registered Nurse in the State of Ohio. Valid Ohio driver's license and proof of auto insurance as required by hospital policy and position-specific requirements. Must pass motor vehicle background inspection, insurance eligibility, driving qualifications, and training set forth by Nationwide Children's Hospital and maintain qualification of insurance guidelines. Skills: Must have excellent critical thinking skills, good communication and customer service skills, and the ability to organize and manage time well. Ability to work independently, as well as within a multi-disciplinary team. Included skills, but not limited to: pediatric assessment, infusion and central line care, injections, wound care and patient education. Experience: Three years pediatric clinical experience or equivalent combination of education or experience, required. Two years Home Health experience, preferred. One to two years supervisory experience, preferred. Physical Requirements: OCCASIONALLY: Bend/twist, Biohazard waste, Blood and/or Bodily Fluids, Chemicals/Medications, Communicable Diseases and/or Pathogens, Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel FREQUENTLY: Sitting, Standing, Walking CONTINUOUSLY: Audible speech, Computer skills, Decision Making, Depth perception, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near "The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
    $59k-69k yearly est. Auto-Apply 60d+ ago
  • Manager Reimbursement Systems Configuration (Telecommute)

    Texas Children's Hospital 4.7company rating

    Houston, TX jobs

    We're hunting for a Manager of Reimbursement Systems Configuration (telecommuter/remote), someone who's ready to be part of the best ranked children's hospital in Texas, and among the best in the nation. In this position, you will be responsible the for the day-to-day Operations of a Production driven team(s), maintaining State and Regulatory requirements along with departmental SLAs. Establishes, implements, and monitors quality control measures. Develops, tracks and reports performance, productivity metrics, proactively identifying trends and refocusing the direction of the team(s). Independently accesses workflows and processes for potential improvements and efficiencies. Works collaboratively with leadership and others from various areas across the health plan to evaluate and work cross functionally to implement new ideas and new strategies. Think you've got what it takes? Job Duties & Responsibilities Manages Business Operations Team Manage the work and the direction of the team Direct the Department standards to meet and then exceed any State Requirements Manages cross function work groups to create and implement best practices across multiple Departments Report out to Leadership and Executive Leadership with quantifiable metrics on the quality of the data Define the Department scope and review and sign off on policies and procedures Educate other departments on provider data use in all systems Establishes, implements, and monitors quality control measures related to process and/or system changes impacting reimbursement & benefits Applies regulatory and systems knowledge to ensure regulatory adherence for provider reimbursement Applies reimbursement, regulatory, payment integrity, and systems functional knowledge to ensure regulatory adherence for provider reimbursement Quality Management Coaching and developing Skills & Requirements Bachelor's Degree required Other Medical Coding Certificate preferred 5 years Project management experience required 3 years Management/Leadership experience required 3 years Healthcare industry or MCO environment required Four (4) years configuration, payment integrity, reimbursement experience can substitute a bachelor's degree Required skill - prior hands-on experience with configuration (setting up) of the system for one of the following: Provider contracts, Fee Schedules or benefit engine Required prior management experience
    $52k-96k yearly est. Auto-Apply 11d ago
  • 340B Analyst, Pharmacy Tech

    Phoebe Putney Health System 4.6company rating

    Remote

    Job Number: 33138 Street Address: Remote Address City, State: Remote, Georgia Zip Code: 31701 Department: PPHS PHARMACY 340B PROGRAM Shift: Job Type: PRN/Per Diem The Pharmacy Tech, 340B Analyst is responsible for pharmacy systems and outcomes in the following areas: (1) drug product selection and procurement, (2) 340B program compliance, monthly auditing, reporting, dispensing patterns, and inventory process. (3) Inventory control and billing processes and (4) information support systems/technology development. Description: Essential Functions: Perform business analysis of procurement activities and inventory controls as related to 340B operations and propose effective and user-friendly solutions to business stakeholders. Maintain 340B system databases to reflect changes in the drug formulary, data transmission, and data specifications. Monitor compliance with 340B program requirements and billing guidelines related to qualified patients, drugs and locations. Review and refine executive level and day-to-day 340B program performance reports including, but not limited to, purchasing, dispensation, and cost savings. Build reports, as appropriate, to monitor and improve 340B program compliance and performance. Construct appropriate financial metrics to assess areas of program improvement. Monitor ordering processes, integrating most current pricing from wholesaler. Monitor and analyze purchasing contracts and vendor program offerings to identify opportunities to reduce cost of 340B pharmaceuticals. Periodically review wholesaler and 340B vendor contract(s) for 340B Program compliance. Conduct periodic training and education for Pharmacy Buyers to align and standardize processes across the hospital system. Review 340B program policies and procedures on an ongoing basis and offer contributions and changes related to 340B compliance. Perform routine monitoring activities on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise. Through financial analysis, strive to recognize the value opportunity of the 340B program. Evaluate and provide recommendations related to the implementation of potential cost savings opportunities. Collaborate with Pharmacy, Compliance, and 340B Advisory Committee to develop monthly, quarterly, and yearly audit metrics. Identify trends, discrepancies, and variances to improve the efficiency and effectiveness of operations. Provide recommendations that would improve operations, compliance, and efficiency. Track program performance over time, identify root causes of adverse trends, and make recommendations for improvement. Qualifications: Associate's Degree in Pharmacy Technology or healthcare-related field. (Required). 1 year experience as a Pharmacy Technician. (Required). 1 year of experience or training in pharmaceutical sourcing and/or procurement. (Preferred). 340B hospital (DSH, CAH, SCH, or RRC) program experience. (Preferred). Required Licenses/Certifications: PHAR-C - Certified Pharmacy Tech. PHRMTECH-R - Registered Pharmacy Technician. Completion of Apexus 340B University. Apexus Advanced Operations Certificate within 180 Days.
    $30k-37k yearly est. Auto-Apply 9d ago
  • CT Technologist - Main CT Scanning - Full Time - Nights

    The Christ Hospital 4.1company rating

    Remote

    Eligible candidates may qualify for a hiring bonus up to $30,000 with a 2-year work commitment. To operate CT scanners, obtaining diagnostic images of specified body part as requested. The technologist must be able to produce quality images to present to the radiologist for interpretation and able to function independently with minimal supervision. KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the , credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: Graduation from ARRT accredited Radioloigic Technology school required, and/or has completed on the job experience/training which allows the technologist to obtain certification. YEARS OF EXPERIENCE: Minimum 2 years related experience preferred. REQUIRED SKILLS AND KNOWLEDGE: Knowledge of medical terminology, isolation and sterile techniques/procedures. Patient positioning and equipment operation (x-ray machines and printers). LICENSES & CERTIFICATIONS: Technologists must be board certified by the American Registry of Radiologic Technologists. They must also hold an active, valid Ohio license as Radiographer. CPR certification is also preferred. Communication/Customer Service Responsibility: 1. Greets patient by introducing self and asking patient to verify their name and birthdate. 2. Takes pertinent patient history. Reviews order for procedure and any other documentation, current medications, allergy information and completed questionnaire. 3. Explain procedure to the patient and solicits questions to assure understanding. 4. Is proactive in anticipating needs of the patient, keeps patient and family informed of delays, answers questions and responds appropriately to concerns following up on issues or contacting someone who can. 5. Communicates with all customers, co workers, physicians and their office staff in a professional manner respecting differences. 6. Adheres to all hospital/Imaging Center policies and Excel core values striving to exceed expectations. Clinical Responsibility: 1. Positions patient, scans, and archives procedures according to established protocol producing diagnostic images within quality control parameters. 2. Utilizes proper venipuncture techniques to prepare patient for contrast media administration as necessary. Administers contrast media for the proper completion of CT scans according to established protocol or as directed by a physician. Labels syringes appropriately according to policy. 3. Properly identify, prepare, administer and document various medications used during procedures. 4. Reconcile patient medications to ensure the patients' current medications will not interact with the contrast media used. 5. Completes all work in a timely, efficient, productive manner. 6. Assists co workers in other modalities as appropriate, starting IV's, completing computer functions, preparation of patients. 7. Assist physician with invasive procedures as applicable. 8. Verify physician orders for accuracy and act upon appropriately. Patient Safety Responsibility: Radiation and General Safety 1. Utilizes appropriate radiation reducing techniques that do not compromise high quality images. 2. Protects patients, self and all other personnel from radiation exposure. 3. Wears and stores dosimeter appropriately, switching out monthly and in a timely manner. 4. Uses appropriate devices for moving patients to protect the patient as well as self. 5. Observe patient and assists as necessary to minimize risk of falls or other injury. 6. Adheres to National Patient Safety Goals including but not limited to appropriate hand washing, proper identification of patients, labeling containers, meds administration etc. 7. Complies with all HIPAA requirements, maintaining privacy and confidentiality 8. Understands and could execute policies and procedures in cases of medical emergency, fire, tornado's and other emergency situations. Information Systems Responsibility: 1. Verifies all images are matched and linked in PACS. 2. Verifies completion of all documents, questionnaires, histories pertinent to the CT study being performed. 3. Maintains a working knowledge of all Information Systems, including but not limited to RIS and PACS. Scans documents, enters data correctly, including contrast information when appropriate, charges, tracks data correctly and in a timely manner. 4. Knows process and can perform task of burning images to a CD. General Department Accountability: 1. Maintains knowledge and skills to perform duties and stay current with changes as they occur by attending 75% of all department and technical meetings. Participates in department in-services and reviews memos, emails and bulletins for areas of responsibility. 2. Works to accommodate patients scheduling needs; to best to utilize personnel and equipment while maintaining quality. Works cooperatively with reception staff in all modalities assisting as needed. Works cooperatively with reception staff to assist when needed. Is willing to become multi modality trained. 3. Keeps rooms stocked and equipment cleaned according to department standards. Performs other duties as required or directed. 4. Reports all equipment problems to manager and keeps co workers informed of status. Properly uses and maintains equipment utilizing safety techniques. Is proactive in identifying issues and works to get them resolved in a timely manner. 5. Adheres to time and attendance policy and discuses any variation from the schedule with manager. 6. Maintains appropriate active credentials (ODH and ARRT) and submits within established requirements by Imaging Services. 7. Demonstrates willingness to assist in departmental changes to improve workflow and learn new functions and duties as needed to keep department viable. Job Description additional task/responsibility: Access to patient records in course of normal operations to conduct the business of medical imaging is a responsibility of all designated personnel. Access of records is limited only to records that are pertinent to the patients care or regulatory requirements and only occur when necessary to carry out duties as part of the imaging team. Confidentiality and protection of all records is the responsibility of each individual. This access may occur for the reasons stated below: • Pre procedure in preparation for the scheduled exam • During the procedures in care of the patient • Post procedure to follow up on care • To QA processes to insure data is correct • To conduct retrospective reviews for the purpose of education, research or for compliance to ODH, MQSA, ACR or other regulatory requirements • To respond to daily calls from patients, other departments, physicians or physician offices requesting us to access records to review historical procedure record Documentation of access must occur where appropriate and feasible in log form, comments in EPIC, HIM or McKesson or other available media/format. Performs other duties within scope of practice as assigned.
    $54k-72k yearly est. Auto-Apply 60d+ ago
  • Coding Specialist

    Nationwide Children's Hospital 4.6company rating

    Columbus, OH jobs

    Performs coding related appeals based on specialty assignment(s) for all payers. Access all payer portals and pull payer policies. Works closely with AR staff to resolve denials. Employee must be on-site for the first 90 days or so for training and probation before becoming fully remote. One day in office per month required afterwards. Employee must reside within Ohio. Schedule: M-F (Day Shift) Summary: Analyzes and reviews medical records and assigns appropriate codes for billing and statistical purposes. Ensures accuracy and compliance with coding guidelines and regulations. Job Description: Essential Functions: Analyzes medical records and utilizes coding books to accurately assign codes for diagnoses, procedures, and other medical services or charges. Reviews claims denials and appeals to identify coding errors. Performs coding and billing corrections and charge reconciliations. Researches newly identified diagnoses and procedures for code assignments. Maintains compliance with current coding guidelines and regulations. Communicates with physicians, parents, and third-party payors to ensure billing and reimbursement accuracy. Assists customers and staff with billing and coding questions. Conducts billing and coding audits to ensure accuracy and identify missed opportunities. Reports the results and recommends quality improvements. Education Requirement: As required by listed licensure and/or certification requirement. Licensure Requirement: (not specified) Certifications: RHIT, RHIA, CPC, CCS, CCS-P, or COC, required. Skills: (not specified) Experience: Two years ofcoding experience, required. Three years computer experience in a data processing capacity, required. Physical Requirements: OCCASIONALLY: Bend/twist, Climb stairs/ladder, Lifting / Carrying: 0-10 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking FREQUENTLY: (none specified) CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting Additional Physical Requirements performed but not listed above: Ability to multi-task within a demanding environment. "The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
    $37k-44k yearly est. Auto-Apply 16d ago
  • Financial Counselor Associate - CBO Financial Clearance - Full Time - Days (Hybrid)

    The Christ Hospital 4.1company rating

    Ohio jobs

    The oncology patient advocate provides financial counseling services through direct consultation with patients. Responsible for understanding the patient's financial standing, determining a financial course of action based on the standing, and seeking financial assistance programs if necessary. Understands the coordination of insurance benefits, screens and approves state financial assistance programs, and knowledgeable of TCHHN payment options. Possesses the ability to estimate patient liability based on treatment plans/pre-certification, and deliver estimation to the patient or their family. Senses emotionally sensitive financial situations and mitigates family burden; and works continuously with the patient during treatment to adjust financial programs if needed. KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: 2 year / Associate Degree in a related field preferred. YEARS OF EXPERIENCE: 2 - 4 years Healthcare Financial Counseling or Billing required. REQUIRED SKILLS AND KNOWLEDGE: Compassionate, sensitive Communicates well Listens Enjoys interaction with patients Familiar with diagnoses and treatments Knowledgeable about billing and reimbursement processes Aware of how different insurance plans work Persevering Analytical, with independent research ability Organized Patient Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs). Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. LICENSES & CERTIFICATIONS: Candidates must successfully complete the Patient Financial Services training. Obtains accurate patient demographics and insurance information to be used for billing and reimbursement purposes Collects funds for co-insurance, co-pay, and deductible. Responsible for educating patients and designated individuals on their rights and responsibilities as a patient and or guarantor, as well as securing all federal and state mandated forms (i.e., self-pay forms, Joint Commission, HIPAA, Advance Directives, waivers, Advance Beneficiary Notices, Medicare Secondary Payer Questionnaire, etc.). Seek financial assistance necessary This person will also be responsible for keeping a detailed spreadsheet of the patient assistance information. Educate patients about their insurance benefits, including how much of the annual deductible has been paid, the difference between copayments and coinsurance, and any benefit caps in place. Explains the total cost of the planned treatment, the patient's out-of-pocket expense, and the practice's payment policies. Obtains the applications for patients and helps them file them. Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Performs other duties as required and completes all job functions as per departmental policies and procedures.
    $34k-40k yearly est. Auto-Apply 34d ago
  • Pathology Accessioner

    The Christ Hospital 4.1company rating

    Remote

    The Pathology Accessioner plays a vital role in supporting the operations of our laboratory environment by assisting in the preparation and processing of specimens for analysis, ensuring adherence to aseptic techniques, maintaining accurate records of specimen collection and processing activities, collaborating with laboratory staff to ensure timely and accurate results for patient care, and utilizing knowledge of anatomy and physiology to support laboratory procedures and recognizing potential issues. This position is responsible for ensuring that all gross room and associated activities are conducted efficiently and in compliance with established protocols. EDUCATION: High school diploma or GED required. Anatomical Pathology and Medical Terminology knowledge or classes preferred. YEARS OF EXPERIENCE: Minimum of one year experience as a phlebotomist or health care-oriented background. REQUIRED SKILLS AND KNOWLEDGE: Superior knowledge of anatomic pathology. Excellent multi-tasking skills required. Excellent attention to detail. Ability to read and comprehend written information required; ability to effectively and efficiently perform a variety of job duties in a stressful, fast paced environment is required. Keyboarding skills preferred. Customer Focus Builds a positive relationship with customers through phone interactions. Assists clients and coordinates respectfully with technical departments to ensure quality service delivery for anatomic pathology results. Uses proper telephone etiquette when receiving and transferring calls. When taking messages, gathers all necessary details such as the caller's name, date, time, and phone number to ensure the accuracy of the situation. Asks clarifying questions to identify the underlying problems and offer solutions. Advocates for customers by engaging with them positively. Refers to other resources when necessary. Uses appropriate laboratory terminology when engaging with the customers. Accurately provides test results to the appropriate personnel. Utilizes established protocols and independent judgment to assess the credibility and accuracy of test results. Evaluates and identifies the necessary specifications for specimen collection, ensuring clarity on the type, quantity, and handling procedures to support accurate and reliable testing outcomes. Technical Efficiently secures and processes written orders, ensuring all documentation is thorough and accurate. Prioritizes stat add-ons with a sense of urgency, recognizing their critical role in prompt decision-making. Verifies any orders that present uncertainties, ensuring clarity and adherence to established protocols. Maintains the integrity of specimens meant for testing, conducting a detailed assessment before accepting requests to guarantee the highest quality of results. Department Support Receives and sorts clinical lab specimens. Prepares specimens for testing and analysis. Scans and/or enters specimen and patient information data. Ensures all lab equipment is working properly and performs minor instrumentation maintenance. Troubleshoots any specimen related issues. Replenishes test bench supplies as needed. Maintains a clean and safe work environment. Completes record logs and other administrative duties as requested. Follows all Standard Operating Procedures to ensure safety and quality standards. Packages and sends out all Send-out Specialty Testing. Processes samples, records tracking number, and prepares kits for shipment. Contacts specialty labs and arranges for supplies and shipment of samples. Handles all POC disposal and sends out to funeral homes, coordinates with wings department, and attends quarterly meetings for troubleshooting. Works with pastoral services to coordinate footprints being sent to patients. Assists with autopsies when staffing is below minimum levels. Conducts weekly disposal of tissue. Reconciles the daily outstanding logs to assure delivery of incoming testing. Collects and records all information needed to investigate issues, such as patient details, dates, and tests ordered. Lets customers know when they can expect a follow-up call. Takes all necessary steps to fix technical issues and ensure timely solutions. Shows strong knowledge of instruments, quality control, and patient testing. Provides on-site technical assistance to data entry staff to assist with handling of Outreach samples. Process Improvements Brings to the attention of the management team any recurring challenges and concerns. Suggests solutions to issues and aids as needed to implement those solutions within the department. Collaborates with lab managers to implement technical changes needed to resolve the issue. Utilizes additional communication methods as necessary. Anticipates and actively identifies areas for process and system improvement. Professional Development Maintains currency in the field, including maintenance of any necessary licensure/certification, through continuing education, conferences, meetings, in-services, networking, literature, and/or seminars. Performs other duties assigned.
    $28k-42k yearly est. Auto-Apply 7d ago
  • Assistant Manager, Nursing Services-RN - Main PTSS/PAT/Chart Room - Full Time - Days

    The Christ Hospital 4.1company rating

    Remote

    Clinical Assistant Managers advocate for and allocate available resources to promote efficient, effective, safe and compassionate nursing care based on current standards of practice while promoting shared decision-making and professional autonomy. This role encompasses assisting with the management of personnel, budget, strategic planning and regulatory standards as well as the overall care delivery system on the unit. KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: Graduate from an accredited School of Nursing. BSN is strongly preferred. Commensurate combination of RN experience and Nursing education (ADN, Diploma in Nursing) and commitment to complete BSN may be considered in lieu of BSN upon hire. YEARS OF EXPERIENCE: Minimum of two (2) years in clinical nursing practice. One (1) year experience in leadership or charge role preferred. REQUIRED SKILLS AND KNOWLEDGE: Demonstrated knowledge of nursing, healthcare, and organizational systems, and strategies. Demonstrated knowledge and experience in performance improvement theory and application. Knowledge of JCAHO standards and other external organizations related to healthcare evaluation and accreditation. Experience with the methodologies and processes related to organizational financial viability. Well-developed communication, facilitation, and interpersonal skills. LICENSES & CERTIFICATIONS: List any certifications and licenses required to perform this position. Graduate of an approved School of Nursing and Current RN licensure in the state of employment. Membership in professional organizations is desirable. Certification in area of specialty is required within 6 months of eligibility. BLS certification is required prior to patient contact. Administrative Leadership in Collaboration with Clinical Manager: Assists in development of PI Plan initiatives in collaboration with Clinical Manager to improve outcomes. Demonstrates knowledge of job standards and key requirements for each staff position in assigned areas of responsibility, holding subordinates accountable for the responsibilities inherent to their positions. Provides feedback/counseling, and assists with discipline to assigned staff as appropriate. Provides assigned staff with performance evaluations as defined by HR. Supports peer review systems, and implements as feasible with mechanisms in place for staff input into their own evaluations. Provides structure and opportunity for staff nurses to establish and accomplish their goals. Participates in regular leadership and staff meetings. Creates an atmosphere that encourages staff participation in nursing and hospital based activities. Ensures staff maintains/achieves necessary competencies for their job functions along with unit educator. Supports professionalism through ethical conduct, appearance, positive communication, attendance and holding self accountable for same standards set for staff. Participates in councils, task forces, and special projects as assigned or requested and provides opportunities for staff. Collaborates with Clinical Manager to ensure that patient satisfaction targets are achieved and maintained. Operations in Collaboration with Clinical Manager: Ensures personnel work hours best meet the needs of the unit. Participates in the development and implementation of models of patient care delivery which maximize resources and productivity with respect for individual rights, preferences, ethnicity, culture and diversity. Ensures safe and therapeutic environment is maintained for patients, personnel, physicians, and visitors. Assists in interviewing for staff vacancies in a timely manner. Serves as advocate for patients and families. Ensures the nursing process is utilized in care delivery. Ensures new hires, float, and agency personnel receive appropriate and timely orientation, with processes documented per policy along with the unit educator. Evaluates and provides input to Manager on the effectiveness of unit operations, quality and appropriateness of care. Participates in performance improvement activities for assigned areas of responsibility. Assists staff and physicians in obtaining data; collaborates in using data to meet expectations, correct variances, and simplify work processes. Disseminates and discusses data outcomes with staff and physicians. Informs Manager, Director and/or risk manager of serious or potentially serious patient/visitor problems and issues as soon as they are identified. Coordinates nursing care with other healthcare disciplines, and assists in integrating services across the continuum of health care. Works collaboratively with physicians, clinical manager, charge nurses and other staff to facilitate the smooth and efficient patient throughput on a daily basis. Collaborates with Clinical Manager in ensuring compliance with regulatory standards. Maintains a high level of visibility on the unit. Finance in Collaboration with Clinical Manager: Identifies and quantifies resources needed to support patient care activities in areas of assigned responsibility. Acts in a cost conscious manner taking into account the limitations of resources in order to maintain productivity standards. Balances patient needs, quality, and cost effectiveness. Manages and organizes work through objectives leading to goal attainment. Professional Maintains and seeks responsibility for self development. Participates in hospital Leadership programs. Networks with colleagues to share ideas, trends, and innovations in areas of responsibility. Maintains membership and association in professional nursing organizations, incorporates standards into operations to keep current with community and national practice trends. Shares knowledge and information with peers, other nursing leaders, and encourages changes in practice based on research and scientific principles. Appropriately represents nursing and/or the hospital in the community. Assists staff in developing professionally through pursuit of additional education, clinical ladder and certifications. Seeks out opportunities for and supports community service activities.
    $81k-109k yearly est. Auto-Apply 49d ago
  • Registered Nurse - Main PACU - PRN

    The Christ Hospital 4.1company rating

    Remote

    Ready to help shape the future of Cincinnati's #1 Hospital? Your passion to make a difference is something we share. As a registered nurse at the Christ Hospital Health Network, you'll join an inclusive team committed to your success. You'll be respected as an individual and celebrated for your achievements. You'll discover a range of powerful opportunities to grow-and experience the support of your leaders every step of the way. Your voice and experience will be valued as you mentor others, participate in unit-based and system-wide councils and share your vital feedback. Because when you continue to thrive, we continue to improve the health of our community and create exceptional outcomes. Here's how you'll thrive: Work alongside the best at Cincinnati's #1 Hospital, 10 years and counting Magnet designated hospital with the region's best nurse-patient ratio allowing you to deliver exceptional patient care in a nurturing work environment Flexible self-scheduling empowers your work-life balance Endless opportunities to grow with a renowned clinical advancement program, plus continued education and mentorship opportunities across units Direct access to executive leaders through semi-monthly roundtable events Team member resource groups ready for your voice Here's what makes us the best and separates us from the rest: New Virtual Nursing system on designated units Hercules Mattresses for easy repositioning of patients Shared Leadership Council structure Clinical Advancement Program Smartphones for easy EMR Documentation and enhanced communication Paid Parental Leave program Tuition Assistance and support of initial certifications Dedicated Professional Development Specialists provide in-person, consistent, individualized residency support and guidance through the first year of nursing practice Here are your additional requirements: Documentation - You'll accurately and concisely document the nursing process in the patient's electronic medical record, reflecting the implemented plan of care by the patient, family, and healthcare team. You'll also ensure timely documentation of care, updates, education, and the patient's and family's responses, in line with hospital policy. Team Member Responsibilities - As a healthcare team member, your responsibilities will include adhering to all organizational and department policies, completing required training, meeting all educational requirements while demonstrating your commitment to continuous learning and providing the legendary patient care The Christ Hospital Health Network is known for over the last 130 years. Licenses & Certifications Current RN licensure in the state of employment. BLS required before patient contact. ACLS required within 6 months of hire in step-down and ICU areas. Unit specific certifications may be required. More about our PACU unit: The Post Anesthesia Care Unit (PACU) is a 28-bed unit serving general surgery, GU, spine, orthopedics, neurosurgery, kidney transplants as well as a 10-bed unit serving the women's center (GYN procedures). Staff on this unit care for a variety of post-surgical patients in a fast- paced, high acuity environment which requires ICU skills, time management, and flexibility with hours worked in order to meet our patient needs. Here's how you'll deliver best-in-class care: The Christ Hospital Health Network Nursing Process Assessment - You'll deliver comprehensive care by assessing the patient's physical, emotional, spiritual, and educational needs utilizing The Christ Hospital Health Network Professional Practice Model - all while continuing to collaborate with your healthcare team Diagnosis & Planning - Working closely with the patient and family, you'll create personalized care plans that prioritize patient needs and goals. Implementation - You'll be providing evidence-based, best-in-class care by educating patients and families, executing well-planned interventions and utilizing hospital policies and procedures. Evaluation - You'll monitor and adjust care based on patient outcomes and evidence-based practices. Leadership & Professional Development - Working closely with your Clinical Manager, you will take an active role in driving improvement and achieving better outcomes through the development and evaluation of Performance Improvement (PI) initiatives. You'll be an advocate for High Reliability principles to enhance patient care and operational efficiency while using data to fuel progress. You'll also demonstrate your leadership skills by motivating, educating, delegating, and mentoring peers and team members, while managing patient care effectively.
    $60k-79k yearly est. Auto-Apply 13d ago
  • Medical Coding Auditor

    St. Luke's Hospital of Chesterfield Mo 4.6company rating

    Chesterfield, MO jobs

    Job Posting We are dedicated to providing exceptional care to every patient, every time. St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for "Outstanding Patient Experience" by HealthGrades. Position Summary: Performs data quality reviews on patient records to validate coding appropriateness, missed secondary diagnoses and procedures, and ensures compliance with all coding related regulatory mandates and reporting requirements. Monitors Medicare and other payer bulletins and manuals and reviews the current OIG Work Plans for coding risk areas. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values. This position is 100% remote. Education, Experience, & Licensing Requirements: Education: Associate degree in Health Services Experience: 5 years of production coding experience or 5 years coding auditing experience. ICD-10-CM (including coding conventions and guidelines), CPT-4 (including coding conventions and guidelines), HCPCS, NCCI edits, and APC experience. Cerner and 3M/Solventum experience. Licensure: RHIA, RHIT, or CCS certification Benefits for a Better You: * Day one benefits package * Pension Plan & 401K * Competitive compensation * FSA & HSA options * PTO programs available * Education Assistance Why You Belong Here: You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.
    $44k-65k yearly est. Auto-Apply 60d+ ago
  • Certified Pharmacy Technician I - Main Med Surg Pharmacy - Rotating

    The Christ Hospital 4.1company rating

    Remote

    Under the direct supervision of the Director of Pharmacy, Assistant Directors, Technician Supervisor, Pharmacists, and according to the standard procedures, a Technician I assist in the preparation and distribution of medications. As a representative of both The Christ Hospital Health Network and Department of Pharmacy Services, promotes a positive image in all dealings with all other hospital employees and hospital guests. KNOWLEDGE AND SKILLS: Responsible for handling cash as it pertains to selling prescriptions or other pharmacy items. EDUCATION: High school diploma or GED YEARS OF EXPERIENCE: Pharmacy technician experience preferred. REQUIRED SKILLS AND KNOWLEDGE: LICENSES & CERTIFICATIONS : The person has passed an examination approved by the Ohio State Board of Pharmacy, PTCB/ CPhT. Person must register as Technician in Training with Ohio State Board of Pharmacy, if not currently registered with the Ohio State Board of Pharmacy. ;Upon completion of training period the person must complete registration as Certified Technician with the Ohio State Board of Pharmacy. The person must keep active certification with the Ohio State Board of Pharmacy. Under the direct supervision of a registered pharmacist, prepares medications according to physician order. Includes the following activities: 1. Unit Dose:-Includes filling, packaging, distributing, labeling and scanning medications. Weighs, measures and mixes ingredients, emulsions, liquids, powders, and ointments using proper equipment and technique. Ability to sign in, load and refill automated dispensing machines. Basic inventory of CII safe. 2. IV room-Using aseptic technique prepares and labels intravenous admixtures and other sterile products. Fills syringes and reconstitutes small volume injectable pharmaceuticals for subsequent check and dispensing by a pharmacist. Maintains equipment according to procedure. ;(i.e., cleans the laminar air flow hood). 3 *limited to staff that are trained in Outpatient RX area- Selects prescription items for customers. Rings the register and completes the Ohio State Board requirements with each sale. Uses technology in the department. This includes the following: 1. Patient information lookup in Epic 2. In-Basket RX messages in Epic for unit dose medications 3. Compounding repackaging in Epic 4. Printing of labels in Epic and wasplabeler DP tracker Delivery-Includes the transportation of medications from the pharmacy to areas outside the pharmacy. This includes medication cart delivery, IV run and unit dose run. Runs delivered at the correct “run time”, and delivered to the correct area, refrigerator vs cart. Assists the Pharmacist in daily activities. Answers telephone, receiving and relaying messages as needed. Re-orders drugs and supplies when stock is low or predetermined stock level indicated. Rotates stock, checks expiration dates and cleans assigned area. Performs as a receptionist at the RX window. Distributing medications and orders for the correct department and patient. Fills out appropriate paperwork for distribution of medications, and RX computer paper. ;Answers and directs phone calls and assists with any issues. Maintains a safe environment according to policy and procedure. Maintains the department in a neat, clean and orderly manner. Follows departmental and hospital safety policies and procedures. Performs other duties as deemed necessary by the Director of Pharmacy, Assistant Director, Operations Coordinator, Technician Supervisor and Pharmacists.
    $37k-45k yearly est. Auto-Apply 60d+ ago

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