Health information management director jobs near me - 459 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 40hrs/week and 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.

Inspire health. Serve with compassion. Be the difference. Codes medical information into the organization billing/abstracting systems for multiple facilities. Performs moderate to complex Outpatient Surgery, Gastrointestinal (GI) Procedure and Observation coding by assigning International Classification of Diseases (ICD), Current Procedural Terminology (CPT) codes, and HCC codes. Performs Emergency Department, ambulatory clinic, diagnostic, and ancillary coding. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health.Serve with compassion. Be the difference. Codes moderate to complex Outpatient Surgery, and Observation records from clinical documentation as well as Emergency department, ancillary and ambulatory clinic records; assigns modifiers as appropriate. Adheres to department standards for productivity and accuracy. Operates under the general supervision of HIM Coding leadership. Reviews work queues daily to identify charts that need to be coded and prioritizes as per department-specific guidelines and within designated timelines. Follows up on on-hold accounts daily for final coding. Responds to and follows up on priority accounts daily and any accounts assigned by Patient Financial services or Coding leader(s) for final coding.Communicates with leader when trending requests volumes impact productivity. Queries physician or clinical area following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management Association (AHIMA) guidelines and established policy. Applies ICD and CPT codes to the Emergency department, outpatient ambulatory clinic records and ancillary service records based on review of clinical documentation and according to Official coding guidelines; assigns modifiers. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - Certification Program, Associate degree or coding certificate through approved American Academy of Professional Coders (AAPC), American Health Information Management Association (AHIMA) or other approved coding certification program. Experience - Two (2) years of coding experience in an acute care or ambulatory setting. Outpatient coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CCP-H), or Certified Outpatient Coder (COC). Knowledge, Skills and Abilities Demonstrates proficiency in utilizing official coding books as well as the electronic medical record and computer assisted coding/encoding software to facilitate code assignment. Demonstrates continuous learning as evidenced by personally developed reference materials, online publications etc., to stay abreast of new and revised guidelines, practices and terminology, for reference and application. Participates in on site, remote and/or external training workshops and training. Ability to pass internal coding test. Knowledge of electronic medical records and 3M or other Encoder System. Ability to concentrate for extended periods of time; ability to solve problems with close attention to detail and to work and make decisions independently. Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Demonstrated competence in coding and correct extrapolation of official coding and select billing guidelines to specific coding situations. Basic computer skills Work Shift Day (United States of America) Location Blount Memorial Hospital Facility 7001 Corporate Department 70017512 HIM-Coding Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

About Children's Minnesota Children's Minnesota is one of the largest pediatric health systems in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children's Minnesota is one system serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics, multiple specialty clinics and seven rehabilitation sites. As The Kids Experts in our region, Children's Minnesota is regularly ranked by U.S. News & World Report as a top children's hospital. Find us on Facebook @childrensminnesota or on Twitter and Instagram @childrensmn. Please visit childrens MN.org. Children's Minnesota is proud to be recognized by Modern Healthcare as one of 2023's Top Diversity Leaders. The national honor recognizes the top diverse healthcare executives and organizations influencing public policy, care delivery, and promoting diversity, equity and inclusion in their organizations and the industry. Department Overview Health Information Management is responsible for the: * Oversight of the quality, timeliness, and accuracy of the medical record and patient indexes for patient care, legal, revenue, research, and regulatory needs; * Classification of diagnosis and procedures according to approved classification and nomenclatures such as ICD-9, CPT, Snomed, etc. * Maintaining the security and integrity of health information; * Providing documentation tools/services such as dictation, transcription, electronic templates, scribes, and paper forms; * Collection, quality control, and dissemination of data for comparative data bases and statistical reports including specific disease and procedure registries; * Providing access to medical record information through release of information processes. Position Summary Responsible for the accurate assignment of DRG, diagnosis and procedure codes using International Classification of Disease (ICD10 CM/PCS), coding to the highest degree of severity and specificity, including the assignment of present on admission. Uses provider clarification query forms as needed. Collects additional clinical data elements and inputs into hospital database. The HIM Inpatient Coding Specialist assess record completion; assign deficiencies as needed and follow-up on incomplete records to ensure timely billing. Location (e.g. remote or on-site): Remote DHS Background Study Required? No License/Certification/Registration required? Yes * Certifications must be through American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Credentials that meet requirement: Certified Coding Specialist (CCS), Certified Coding Specialist Physician Based (CCS-P), Registered Health Information Administrator (RHIA), Registered health Information Technician (RHIT), Certified Professional Coder (CPC). Education: * As outlined in the above credentials' requirements. Experience: * 4+ years' experience as a coding specialist for inpatient or outpatient services. * Pediatric experience preferred. * Demonstrated experience working with medical providers and allied health professionals preferred. * Must demonstrate knowledge and proficiency in ICD-10-CM/PCS. * Must achieve passing score on Children's Core Coding Competency Assessment. Knowledge/Skills/Abilities: * Requires advanced knowledge of medical terminology, anatomy, physiology and disease processes, and pharmacology. * Requires knowledge of DRG and APC prospective payment systems and reimbursement regulations in an acute care environment. * Ability to work independently and productively with minimal supervision. * Demonstrated excellent verbal and written communication skills. * Demonstrated ability to work well under pressure and maintain attention to detail in order to meet customer expectations. * Demonstrated strong desire to learn. Physical Demands Please click here to view the Physical Demands The posted salary represents a market competitive range based on salary survey benchmark data for similar roles in the local or national market. When determining individual pay rates, we carefully consider a wide range of factors including but not limited to market indicators for the specific role, the skills, education, training, credentials and experience of the candidate, internal equity and organizational needs. In addition to your salary, this position may be eligible for medical, dental, vision, retirement, and other fringe benefits. Positions that require night, weekend or on-call work may be eligible for shift differentials or premium pay. All job offers are contingent upon successful completion of an occupational health assessment, drug screen, background investigation, and compliance with the U.S. Government Form I-9, Employment Eligibility Verification. Children's Minnesota is proud to be an equal opportunity employer whose staff is representative of its community and considers qualified applicants for open positions without regard to race, color, creed, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Defining Systems Requirements: Collaborating to understand and execute the Epic application architecture and integration Project Leadership: Serving as a liaison between end-users' workflow needs and Epic implementation staff Issue Resolution and Project Management: Identifying issues that arise in the application area as well as issues that impact other application teams and working to resolve them. This also involves working closely with the technical support on issues of install choices, master file and category list set up, synonyms and preference lists, etc. Executing Application Build: Facilitating the development of integrated workflows by working closely with the project team, subject matter experts and technical leads to define processes that cross applications and functional areas Personnel Management: Gathering, documenting, and providing performance feedback for team leads/members of assigned team(s) We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements 3+ years of Management/Leadership of an HIM Team Must be certified in Epic Deficiency Tracking, Coding & Release of Information Must be a hands on-leader with experience in operational support and builds Project Management Skills Familiarity with organization's practices of health information management and / or HIM coding Strong communication and interpersonal skills Demonstrated workflow process analysis and design, communication and interpersonal skills, facilitation/training skills, project management capabilities, and leadership orientation Strong assertiveness skills and ability to manage conflict in a variety of situations Superior organizational and people management skills Experience with managing employees, including coaching and performance management Demonstrated ability to align and motivate key process stakeholders, including nurses, physicians, and other clinical/administrative staff Demonstrated ability to interact with multidisciplinary teams Demonstrated application design and implementation skills Demonstrated knowledge and work experience in patient identification management Epic Identity Certification Experience with CDI - ClinDoc Improvement

ClearSky Health is seeking a highly qualified Health Information Management (HIM) Manager to lead health information operations in a hybrid role. This position requires strong expertise in inpatient rehabilitation coding and a comprehensive understanding of health information management practices, compliance standards, and documentation integrity. The ideal candidate will hold an AHIMA credential-such as RHIA, RHIT, CCS, CCS-P, CDIP, CHDA, or CHPS-which is preferred but not required. In addition, CCS certification is also preferred. This role combines strategic oversight with hands-on coding responsibilities and collaboration with clinical teams to ensure accurate documentation and audit readiness. Key responsibilities include: Managing HIM operations to ensure medical record accuracy and regulatory compliance Performing or supervising inpatient rehab coding Partnering with clinical staff to support documentation improvement and audit preparation The HIM Manager is responsible for maintaining the security, confidentiality, completeness, and accuracy of medical records in accordance with policies and procedures and within the guidelines of regulatory agencies. The HIM Manager may also act as Privacy Officer for the Hospital. Oversees compliance efforts related to the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) and the Final Rule Audit (FRA). Serves as the primary onsite contact for all RCD/FRA compliance initiatives. This position must integrate company values into daily practice. Essential Functions: Directs, plans, schedules, and participates in day-to-day activities within HIM department, including , indexing, transcription, quantitative analysis, chart completion, the release of medical record information and abstracting of medical information. Oversee daily concurrent medical record completion, collaborating across all disciplines to ensure 100% accuracy and adherence to the Final Rule. Acts as Cerner superuser and source expert in auditing Final Rule elements. Supports providers using Cerner. Directs record assembly and reviews medical records for data elements required for chart completion. Monitors and evaluate physicians and hospital staff to ensure compliance with record keeping requirements. Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization's information privacy practices. Monitors and evaluates physicians and hospital staff to ensure compliance with record keeping requirements. Collaborates with RCD Leadership and hospital staff on process improvement and education regarding documentation and timeliness. Provides development guidance and assists in the identification, implementation, and maintenance of organization information privacy policies and procedures in coordination with Hospital administration, Corporate Compliance Officer, and legal counsel. May perform initial and ongoing credentialing for Hospital medical staff. Safeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required. Provides an environment conducive to safety for patients, visitors, and staff. Assesses the risks for safety and implements appropriate precautions. Complies with appropriate and approved safety and Infection Prevention standards. Performs other duties as assigned to support overall effectiveness of the organization. Once the HIM's hospital is formally under Review Choice Demonstration, the following will be incorporated into day-to-day duties: Follow established protocols to facilitate Medicare affirmations and respond timely to non-affirmations under the Review Choice Demonstration process. Stay informed about changes in RCD/FRA processes, including regional Medicare Administrative Contractor (MAC) approaches and review outcomes. Communicate reasons for admission non-affirmations/denials with hospital leadership and RCD leadership and assist in providing necessary justifications. Assists as directed with denials through the appeal process. Includes synthesizing clinical documentation for each patient's stay into justification for services for all payors. Manage tracking systems to ensure deadlines are met and real-time data on new admissions is available for timely submissions. Minimum Job Requirements Minimum Education & Experience: Two years medical records experience required Two years of medical coding experience preferred. Degree in Health Information Management or related subject required. Prefer program accredited by CAHIIM (Commission on Accreditation for Health Informatics and Information Management). Experience in a management role preferred. Required Licenses, Certifications, and/or Documentation: RHIA or RHIT certification preferred. CCS preferred as additional credential. Required Knowledge, Skills, and Abilities: Demonstrates knowledge in information privacy laws including 45 CFR, Health Insurance Portability and Accountability Act (HIPAA), and state medical records law. Demonstrates a clear working knowledge of general hospital operations. Knowledge of accreditation standards to ensure adherence to all standards set forth by state and accrediting agencies of TJC and CMS. Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency. Working knowledge of medical terminology, abbreviation, and spelling. Ability to maintain exceptional levels of confidentiality. Demonstrates proficiency with general computer skills including data entry, word processing, email, and records management. Demonstrates critical thinking skills. Ability to prioritize, meet deadlines, and complete complex tasks. Ability to maintain quality and safety standards. Ability to work closely and professionally with others at all levels of the organization. Effective organizational and time management skills. Physical Requirements Over the Course of a Shift: A significant amount of sitting, walking, bending, reaching, lifting, and carrying, often for prolonged periods of time. Lifting/exerting of up to 10 lbs. Sufficient manual dexterity to operate equipment and a computer keyboard. Close vision and the ability to adjust focus. Ability to hear overhead pages. #INDLAN

As a Healthcare Revenue Cycle / HIM Manager, your responsibilities will include: 1. Supporting a remote team for daily operations of the healthcare revenue cycle / healthcare coding department. 2. Identifying and implementing strategies to accelerate the revenue cycle by reducing accounts receivable days, improving cash flow, and enhancing profitability. 3. Managing account reconciliation, pre-collection, and post-collection activities to ensure accuracy and timeliness. 4. Identifying and resolving issues that affect revenue cycle performance using analytical and problem-solving skills. 5. Collaborating with cross-functional teams, including billing, coding, and clinical operations, to ensure the effectiveness of the revenue cycle process. 6. Training and mentoring staff on revenue cycle processes and best practices. 7. Staying abreast with the latest trends and regulations in the healthcare industry to ensure compliance and operational efficiency. 8. Developing and implementing policies and procedures to enhance operational efficiency and improve revenue cycle performance. 9. Providing regular reports and updates to senior management about the status and performance of the revenue cycle. 10. This individual will manage routine client meetings to obtain updates on initiatives and address any issues. Qualifications: The ideal candidate for the Healthcare Revenue Cycle / HIM Manager will have the following qualifications: 1. A minimum of 7 years of experience in healthcare revenue cycle management, including account reconciliation, pre-collection, and post-collection. 3. Strong knowledge of healthcare financial management and medical billing processes. 4. Exceptional analytical and problem-solving skills with a strong attention to detail. 5. Proficient in using healthcare billing software and revenue cycle management tools, with a strong background in Oracle Health (Cerner) software. 6. Strong leadership skills with the ability to manage and motivate a team. 7. Excellent communication and interpersonal skills with the ability to interact effectively with all levels of the organization. 8. Strong knowledge of federal, state, and payer-specific regulations and policies. 9. Ability to work in a fast-paced environment and manage multiple priorities. **Responsibilities** Analyzes business needs to help ensure Oracle's solution meets the customer's objectives by combining industry best practices and product knowledge. Effectively applies Oracle's methodologies and policies while adhering to contractual obligations, thereby minimizing Oracle's risk and exposure. Exercises judgment and business acumen in selecting methods and techniques for effective project delivery on small to medium engagements. Provides direction and mentoring to project team. Effectively influences decisions at the management level of customer organizations. Ensures deliverables are acceptable and works closely with the customer to understand and manage project expectations. Supports business development efforts by pursuing new opportunities and extensions. Collaborates with the consulting sales team by providing domain credibility. Manages the scope of medium sized projects including the recovery of remedial projects. Disclaimer: **Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.** **Range and benefit information provided in this posting are specific to the stated locations only** US: Hiring Range in USD from: $87,000 to $178,100 per annum. May be eligible for bonus and equity. Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business. Candidates are typically placed into the range based on the preceding factors as well as internal peer equity. Oracle US offers a comprehensive benefits package which includes the following: 1. Medical, dental, and vision insurance, including expert medical opinion 2. Short term disability and long term disability 3. Life insurance and AD&D 4. Supplemental life insurance (Employee/Spouse/Child) 5. Health care and dependent care Flexible Spending Accounts 6. Pre-tax commuter and parking benefits 7. 401(k) Savings and Investment Plan with company match 8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation. 9. 11 paid holidays 10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours. 11. Paid parental leave 12. Adoption assistance 13. Employee Stock Purchase Plan 14. Financial planning and group legal 15. Voluntary benefits including auto, homeowner and pet insurance The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted. Career Level - IC4 **About Us** As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity. We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all. Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs. We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_************* or by calling *************** in the United States. Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary The Director of Care Management is a key member of the Aetna Better Health of Oklahoma leadership team. This role oversees the implementation and execution of the strategic and operational business plan for clinical operations. The Director ensures compliance with Oklahoma regulatory requirements while delivering holistic, cost-effective, bio-psychosocial care to members through care management and coordination services. The Director Case Management reports to the Senior Principal Clinical Leader. This is a fully remote role but may require onsite meetings. Eligible candidates must live within a one-hour commute to Oklahoma City. Position Responsibilities Lead the clinical team to ensure timely health risk screenings, comprehensive assessments, care plan development, and member interventions in alignment with Aetna Better Health Risk Stratification Framework and Oklahoma contractual requirements. Develop and manage clinical operations to improve clinical and financial outcomes, member engagement, satisfaction, and adherence to best practices and standards. Serve as liaison with regulatory and accrediting agencies and other health business units. Formulate and implement strategies to achieve departmental metrics and provide operational direction. Integrate care coordination and case management with core business functions, including claims, member services, compliance, quality, utilization management, and provider services. Support quality improvement initiatives and oversee successful implementation. Direct enhancements to business processes, policies, and infrastructure to improve clinical operational efficiency. Develop and evaluate policies and procedures to meet business needs. Implement and monitor business plans and oversee transitions impacting clinical operations. Collaborate with internal teams and corporate areas to ensure workflow processes and interdependencies are addressed. Analyze program performance and clinical outcomes to inform decision-making. Promote a clear vision aligned with company values; set challenging objectives and motivate teams to achieve results. Communicate effectively with internal and external stakeholders in both written and oral formats. Evaluate and interpret data to monitor staff performance, ensure regulatory compliance, and develop new programs and processes. Assess team development needs and implement action plans to build high-performing teams. Conduct administrative duties in accordance with established standards for team management. Required Qualifications Active and unrestricted Oklahoma Registered Nurse (RN) license Minimum 10 years of clinical practice experience At least 5 years of management or clinical leadership, including oversight of case management leaders 5 years of case management experience Managed care experience (Medicaid strongly preferred; commercial or Medicare experience acceptable) 3+ years of proficiency with personal computer use, keyboard navigation, and MS Office Suite Nationally recognized case management certification (required or must be obtained within 90 days of employment) Education Master's degree or equivalent experience (BSN preferred) Pay Range The typical pay range for this role is: $99,420.00 - $214,137.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/07/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Department: HIM Revenue Cycle Weekly Hours: 40 Status: Full time Shift: Days (United States of America) As a Coding Specialist, you will conduct audits of physician/provider documentation and coding for office and surgical procedure encounters. You will research and communicate government and private insurance carrier coding/billing policies and provide regularly scheduled education for providers and staff on appropriate coding and billing. In this role, you will review code change requests and conduct review of coding denials or other payer requests. The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive. REQUIREMENTS Associate degree, preferably in a health information management or related field Extensive knowledge of ICD-10, CPT and HCPCS coding. Minimum of 3 years of physician/professional complex surgical and E&M coding experience in a health care system or medical office setting CPC, CCS-P, CPMA, RHIT or RHIA PREFERRED REQUIREMENTS Bachelor's Degree in health information management or related field 3+ years of physician/professional complex surgical and E&M coding experience in a health care system or medical office setting 1-2 years of experience in professional coding auditing and provider education ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus. Benefits: We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It's what makes us one of the best places to work, and helps our employees live and work to their fullest potential. Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact ************************ Equal Opportunity Employer/Drug-Free Workplace

The HIM Coding Specialist is responsible for coding accurately, diagnoses and procedures utilizing the International Classification of Diseases, Clinical Modification (ICD-9/10-CM) and/or the Current Procedural Terminology (CPT) coding systems. Assigns ICD-9/10-CM codes in the proper sequence to reach the appropriate DRG. Minimum Qualifications o Education o Completion of required course work and/or degree for accreditation or registration with the American Health Information Management Association (AHIMA). o Credentials o State Required: None o GPRMC Required/Preferred: Required are accreditation as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Certified Coding Associate (CCA) with the American Health Information Management Association (AHIMA). Also, a recent Health Information Management (HIM) or Health Information Technology (HIT) graduate is preferred if accreditation is successfully completed within 6 months of employment. Membership in Clinical Coding Society (a division of AHIMA) is preferred. Physical Demands 1. Stand and/or walk frequently. 2. Sit frequently. 3. No lift and/or carry. 4. No push and/or pull. 5. Visual acuity and manual dexterity within normal limits. 6. Bend, stoop, and crouch occasionally. 7. Reach floor to overhead occasionally. 8. Computer use frequently.Essential Functions 1. Demonstrates competency in Medical Record Abstract, Medical Record Control, Medical Record Index, and DRG/Case Mix applications in Affinity system. Demonstrates competency in using 3M Encoder. Demonstrates competency using ChartMaxx imaging system. 2. Abstracts and verifies information such as service codes, time of discharge, surgical data, transferring status, observation times, and physician relationship (admitting, attending, primary care, consulting, surgeon, assistant surgeon, etc.) from the medical record. Codes on records of patients under Series Outpatient Service Codes, Parent Accounts prior to the end of the month in which the Parent Account was created, if possible. Checks for uncoded Child accounts on said records on a routine basis. 3. Demonstrates competencies established by Department Director/Coding DRG Coordinator. Demonstrates competency in ICD-9/10-CM and CPT coding by coding pursuant to coding rules of said coding systems. 4. Assigns diagnostic and operative/procedure codes for inpatient and outpatient records, utilizing ICD-9/10-CM. Assigns CPT codes and Revenue Codes on Emergency Department (EDA/EDS service codes), Same Day Services (SDS), and other patients who have undergone outpatient procedures. 5. Reviews each medical record to be coded, ensuring that there is sufficient documentation to support the ICD-9/10-CM or CPT-4 codes assigned. Checks deficiencies and inconsistencies in the medical record. Obtains, either personally or in cooperation with other HIM staff, GPRMC staff, or physicians, any missing medical necessity documentation. 6. Demonstrates ability to reorganize work in order to satisfy fluctuations in volume and staffing adjustments. Codes records as assigned and prioritized by the Coding/DRG Coordinator. 7. Reviews APC edits on outpatient accounts and add modifiers when necessary to produce clean billing claim, 8. Provides coding assistance to Home Health in the absence or direction of the Coding/DRG Coordinator. 9. Participates in audits of medical records for coding accuracy. Actively participates in education opportunities for continuing education and professional growth. 10. Performs other duties as assigned by Coding/DRG Coordinator or HIM Director.Join us. Join great. Join the dynamic team at Great Plains Health and be a part of something truly exceptional. At Great Plains Health, we embody a culture defined by authenticity, integrity, and a genuine commitment to listening to both our patients and each other. As a member of our team, you'll experience a supportive environment where collaboration is key, and every voice is valued. We work together seamlessly, leveraging our collective strengths to provide the highest quality care to our community. Passion drives us forward, propelling us to constantly strive for excellence in everything we do. If you're seeking a rewarding career in healthcare surrounded by like-minded individuals who share your dedication and enthusiasm, Great Plains Health is the place for you. Come join us and be part of a team that's making a real difference every day.

We are a nationally recognized healthcare management organization with over 40 years of experience delivering innovative, high-quality clinical solutions. Our mission is to improve member health outcomes by identifying risk, promoting treatment compliance, and delivering personalized care. Position Summary The Director of Utilization Management & Case Management provides strategic and operational leadership for UM and LCM programs. This role is responsible for driving clinical excellence, regulatory compliance, process improvement, and team performance while partnering with senior leadership, clients, and sales to support continued growth. Key Responsibilities Lead and manage UM and LCM teams, fostering high performance and professional development Ensure compliance with URAC standards and applicable state regulations Drive process improvement, efficiency, and automation initiatives Serve as clinical and operational SME for business development and new product launches Collaborate cross-functionally with Sales, Client Services, Clinical, and IT teams Support client relationships, reporting reviews, and strategic planning Participate in sales presentations and client meetings as needed Qualifications Bachelor's degree in healthcare, business, or related field Clinical background with healthcare leadership experience Progressive management experience in healthcare operations Experience working with senior leadership and external clients Experience in utilization management and case management Experience with self-funded groups and InterQual criteria preferred Strong communication, analytical, and leadership skills Ability to travel as needed (approximately 10%) Compensation & Benefits Competitive salary based on experience Comprehensive benefits package including medical, dental, vision, 401(k), PTO, and more Join Our Team If you are a strategic, results-driven healthcare leader ready to make an impact, we invite you to apply.

Who we are Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception. We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out. The Opportunity Access TeleCare is seeking a detail-oriented and experience Health Information Management Specialist to support our growing Neurology Service Line. In this role, you will be responsible for processing medical records reviews, requests, audits, and release of information (ROIs) in a timely manner while ensuring accuracy. This role will safeguard and protect patients' right to privacy, ensure that only authorized individuals have access to the patients' medical information, and all reviews and releases of information are in compliance with the request, authorization, company policy and HIPAA regulations. What you'll work on Receive and process requests for patient health information in accordance with state and federal guidelines Ensure the confidentiality of sensitive patient information by limiting access to the records on an as needed basis Work with clinical teams, facilities, and providers to ensure compliance of healthcare information management documentation Respond to correspondence pertaining to medical records through all designated communication channels Manage and maintain database inquiries Acquire correct patient information from facility EMR's and other sources Prior to releasing documents, verify patient information and date(s) of services Analyze and interpret data to identify areas that need improvement and make necessary recommendations Perform record audits to ensure documentation standards are met Track patient data for quality assessments Identify ways to improve and promote quality and monitor own work to ensure quality standards are met. Perform other duties and responsibilities as required What you'll bring to Access TeleCare Associate's degree in business administration or a related field preferred; bachelor's degree Preferred Minimum of 2 years' experience in healthcare setting Experience with HIPAA regulations Understanding of Auditing, Billing, and Coding initiatives Comfort navigating within major EMR systems Previous experience developing workflows Knowledge of medical terminology, anatomy, and physiology Ability to maintain confidentiality and adhere to HIPAA regulations Understanding of state and federal employment regulations Strong communications skills (written and oral) as well as demonstrated ability to work effectively across departments Demonstrated proficiency with Microsoft office programs, communication, and collaboration tools in various operating systems Ability to work effectively under deadlines and self-manage multiple projects simultaneously Strong analytical, organizational, and time management skills Flexibility and adaptability in a fast-paced environment High growth fast paced organization 100% Remote based environment Must be able to remain in a stationary position 50% of the time Company perks: Remote Work Health Insurance (Medical, Dental, Vision) Health Savings Account Flexible Spending (Medical and Dependent Care) Employer Paid Life and AD&D (Supplemental available) Paid Time Off, Wellness Days, and Paid Holidays About our recruitment process: We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 3 interviews via Zoom. Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.

Who We Are: Since 1946, we've been providing compassionate treatment to support the behavioral, physical and emotional health of children and families, where the needs of each child are individually assessed and dynamic treatment plans are specifically designed to properly transition them from disruptive to permanent, stable environments. Our services include community-based services, residential treatment, and treatment foster care programs throughout our locations in central and northeast Ohio and West Virginia. Working at The Village Network: The Village Network prides itself on a Culture of Care: Come be a part of the mission and a member of a team that has a passion for what they do and the people they serve. Excellent safety record and training program. The Village Network utilizes Collaborative Problem Solving along with The Neurosequential Model of Therapeutics to addresses the individual needs of youth and their families. Tuition and Licensure reimbursement offered for employees looking to advanced their knowledge and skills. Get help earning an advanced degree or get the supervision necessary to earn your independent licensure. Great benefits, competitive salaries, and 272 hours (34 DAYS!) of PTO offered in the first year in addition to 6 paid holidays for fulltime employees with potential for PTO buy back for unused time. EMPLOYEES MATTER AT TVN!! TVN paid out a 6% annual salary bonus and over 80 hours of PTO buyback this past fiscal year and has a 12-year history of providing annual bonus and PTO buybacks! TVN offers a generous retirement contribution and contributed nearly $1.5 million into employee 403(b) accounts this fiscal year! Advancement Opportunities: The village network is a growing organization and we aim to promote from within. Qualifications Job Title: Associate Director of Case Management Reports To: Director of TVN Family Services Direct Reports: Family Engagement Supervisors Summary: As a partner in building brighter futures for youth and their families, your role will be to provide direct supervision and other related technical and clinical support activities that align with The Village Network's Mission, Vision & Values. Essential Tasks, Duties, and Responsibilities: Assures the implementation of all contractional obligations outlined in the Provision of Continuum of Child Welfare Services with Franklin County Children Services (FCCS.) In conjunction with the Program Director and Associate Director of Support Services assures contractual cases remains in compliance with Ohio Department of Job and Family Services (ODJFS), Ohio Administrative Code (OAC), Ohio Revised Code (ORC), FCCS, Council on Accreditation (COA), and TVN requirements. Contributes to the workforce development system including recruiting, interviewing, orienting, training and evaluating staff working in the Family Engagement Department of TVN Family Services. Directly supervises Family Engagement Supervisors Assures program staff are striving to meet the Goals & Objectives from TVN's Strategic Plan. Represents The Village Network interests to agencies at a local, regional, state, and national level through involvement with committees, participation in community provider meetings and acting as a direct liaison with OhioRISE Oversees learning community and implementation of Evidence Based Practices for TVN Family Services Reviews budgetary recommendations and fulfills budget expectations. Performs other duties as required. Knowledge, Skills, and Abilities: Ability to use a computer; familiarity with Word, Outlook, and Electronic Health Record (EHR). Bachelor's Degree in Social Work or related field, Master's preferred; previous relevant management experience required; 5 years previous experience working in child welfare. Excellent verbal and written communication skills; strong teamwork, organizational and time management skills necessary; willingness to be flexible. Valid Ohio Driver's License and maintains a driving record that allows that individual to be insurable with the insurance company providing The Village Network with vehicle insurance. Physical Demands: Ability to comply with The Village Network requirements for using restraints including sufficient strength and completion of extensive training. Ability to handle bending, stooping, lifting, pushing, reaching, and walking for periods of time. Must be able to lift 20 pounds independently. Must be able to remain alert to problems, needs or emergencies that might arise on any shift, maintaining a safe environment for the clients. Ability to communicate (verbal and written) with all levels or personnel, internal and external to the company. Check out our website to learn more about The Village Network ****************************** and visit the Careers page to explore additional opportunities and check out our benefits brochure.

Pay range: $25.18 - $37.77 per hour, based on experience. In addition, this role is eligible to work remotely from an approved state by St. Charles (please refer to the list). If you do not reside in an approved listed state (or do not plan to relocate to an approved listed state) we request, you do not apply for this particular position. Approved states by St. Charles: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin. About St. Charles Health System: St. Charles Health System is a leading healthcare provider in Central Oregon, offering a comprehensive range of services to meet the needs of our community. We are committed to providing high-quality, compassionate care to all patients, regardless of their ability to pay. Our values of compassion, excellence, integrity, teamwork, and stewardship guide our work and shape our culture. What We Offer: Competitive Salary Comprehensive benefits including Medical, Dental, Vision for you and your immediate family 403b with up to 6% match on Retirement Contributions Generous Earned Time Off Growth Opportunities within Healthcare ST. CHARLES HEALTH SYSTEM JOB DESCRIPTION TITLE: PB Coding Specialist II - Advanced Coding REPORTS TO POSITION: HIM Coding Supervisor DEPARTMENT: Health Information Management DATE LAST REVIEWED: May 2024 OUR VISION: Creating America's healthiest community, together OUR MISSION: In the spirit of love and compassion, better health, better care, better value OUR VALUES: Accountability, Caring and Teamwork DEPARTMENTAL SUMMARY: The Health Information Management Departments provide many services to our multi-hospital organization including prepping, scanning and indexing, physician deficiency analysis, release of information, medical record maintenance, facility and profee coding. POSITION OVERVIEW: The Professional Fee Coding Specialist II at St. Charles Health System is responsible for coding and charging SCMG Clinical Services as well as resolving billing edits and denials. This position does not directly manage other caregivers, however, may be asked to review and provide feedback on the work of other caregivers. ESSENTIAL FUNCTIONS AND DUTIES: Advanced skills in reading and interpreting documents contained in the medical record to identify and code all relevant ICD-10-CM diagnoses and CPT-4 procedures for professional fee charges by utilizing an encoder program, and following National and SCHS coding guidelines, Coding Clinic, CPT-4 and other appropriate coding references and tools to ensure proper code assignment and modifiers. Abstracts medical record information in compliance with CMS requirements and SCHS abstracting procedures as appropriate. Use available tools to check entries for accuracy. This may include data for clinical studies and quality management activities. Captures the correct modifiers appropriate for CPT code assignment. Reconciles CCI and Medical Necessity edits. Maintains productivity and quality standards. Works closely with the Patient Financial Services department on medical necessity issues, claim denials, charge master issues, and charge auditor issues. Supports the vision, mission, and values of the organization in all respects. Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change. Provides and maintains a safe environment for caregivers, patients, and guests. Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings. Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate. May perform additional duties of similar complexity within the organization, as required or assigned. EDUCATION: Required: High School diploma or GED required. Graduate of an AHIMA Accredited Health Information Technology program or certification in a self-study course from AHIMA or AAPC required. Preferred: N/A LICENSURE/CERTIFICATION/REGISTRATION: Required: Must possess a valid Registered Health Information Technician (RHIT) certification or one or more of the following: RHIA, CCA, CCS, CCS-P, CPC, COC, CPC-H. This position will require the caregiver to maintain required educational credits (CE) through AHIMA or AAPC. Preferred: Risk Adjustment Coding (micro credential) or AAPCs Certified Adjustment Coder (CRC). Maintains required education credits (CE) through AHIMA and/or AAPC. EXPERIENCE: Required: Minimum of one year of hospital or professional coding experience with a Health Information Management focus. Preferred: Familiarity with 3M encoder. PERSONAL PROTECTIVE EQUIPMENT Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely. ADDITIONAL POSITION INFORMATION: Skills: Position Specific: Knowledge of ICD-10 CM Knowledge of CPT-4 code assignment. Knowledge of CCI and Medical Necessity edits Knowledge of modifiers Maintains professional knowledge by attending educational workshops, reviewing professional publications, participating in educational opportunities. Communication/Interpersonal: Demonstrates SCHS values of Accountability, Caring and Teamwork in every interaction. Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS. Ability to effectively interact and communicate with all levels within SCHS and external customers/clients/potential employees. Strong team working and collaborative skills. Must have a positive attitude, ability to multi-task, pay close attention to details, and be able to act in a professional manner and demonstrate excellent public relations skills. Ability to work in a fast-paced work environment with frequent interruptions, maintaining the highest level of confidentiality at all times. Ability to effectively reach consensus with a diverse population with differing needs. Organizational: Ability to multi-task and work independently. Attention to detail. Excellent organizational skills, Excellent written and oral communication Excellent customer service skills, particularly in dealing with stressful personal interactions. Strong analytical, problem solving and decision-making skills. Language Skills: Read, write, speak, and understand English. Computer Skills: Intermediate ability and experience in computer applications, specifically electronic medical records system, and MS Office. Basic experience in computer applications necessary to record time, obtain work directions, and complete assigned CBL's. PHYSICAL REQUIREMENTS: Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level. Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation. Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing. Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle. Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level. Exposure to Elemental Factors Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface. Blood-Borne Pathogen (BBP) Exposure Category No Risk for Exposure to BBP Schedule Weekly Hours: 40 Caregiver Type: Regular Shift: Is Exempt Position? No Job Family: SPECIALIST HIM Scheduled Days of the Week: Shift Start & End Time:

Job Description TITLE: Director Case Management / Utilization Management / CDI Now is your chance to join a Forbes magazine top 100 hospital where career growth and opportunity await you. They are committed to building healthcare teams whose care exceeds the expectations of their patients and community and are looking for quality talent who share the same values. They're nestled in a beautiful rural setting but close enough to the big city to enjoy that too! If that sounds like the change you are looking for, please read on… What you'll be doing: •Responsible for developing, planning, evaluating, and coordinating comprehensive patient care across the continuum, to enhance quality patient care while simultaneously promoting cost-effective resource utilization. Provides director-level oversight of Inpatient and ED Case Management, Utilization Management and Clinical Documentation Integrity programs, ensuring alignment with organizational goals and regulatory requirements. Monitors patient care, including utilization, quality assurance, discharge planning, continuity of care, and case management activities, and ensures that these functions are integrated into overall hospital operations. Coordinate and monitors activities with appropriate members of the health care team to promote efficient use of hospital resources, facilitate timely discharges, prevent and control infections, promote quality patient care, and reduce risk and liability. Collaborates closely with coders and revenue cycle teams to optimize clinical documentation and support accurate coding, reimbursement, and compliance initiatives. •Responsible for identifying tracking mechanisms in order to evaluate and achieve optimal financial outcomes, to enhance quality patient care, and promote cost-effective resource utilization. •Uses data to drive decisions, plan, and implement performance improvement strategies for case management, utilization management, and clinical documentation integrity •Coordinates daily activities of the Case Management, UM, and CDI Department in order to promote quality patient care, efficient use of hospital resources, facilitate timely and adequate discharges, and reduce risk and liability. •Investigates and initiates follow-up on utilization denials, contract negotiations, and external regulatory agencies' requirements. •Directs operations of our Physician Advisor Program, including analysis of performance through reporting and committee involvement and oversight. •Actively serves on hospital committees and teams and facilitates opportunities for employees to do the same. •Develops, performs, and improves personal and departmental knowledge of computer software and reporting functions. •Organizes and oversees the maintenance of denial and appeal activity. Follows up with physicians and others when indicated. •Prepares or coordinates the preparation of periodic and special reports required by various agencies, insurance contracts, and for hospital committees. •Analyzes and trends data results in order to incorporate efforts and information results with existing systems to optimize the efficiency of operational systems through strategic quality leadership. •Facilitates growth and development of the case management program, utilization management ( including physician advisor program and clinical documentation integrity (CDI), in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities, as needed. •Develop new resources where gaps exist in the system as identified through research and data analysis to meet and enhance the quality/efficiency of comprehensive patient care and/or basic human needs for the community. •Interact with Corporate Consulting and Business office on issues such as contracting, billing, reimbursement, denials, and physician reports cards, and collaboratively initiate improvements related to these areas. •Maintains hospital compliance with the Quality Improvement Organization (QIO) and CMS guidelines. •Maintains professional knowledge by participating in educational seminars and opportunities. •Participates in Population Health work at an organizational level, including active involvement with the System-Wide Care Management Team and Value-Based Care Delivery. Additional info: •Position will report to a Manager that is well respected in the organization. Position is open as the person is retiring. They use EPIC(EMR) and the facility has a lot of technology. Person would be over about 50-60 people between CM/UM/CDI. Great team to work with. •If you're a passionate Pharmacist and seeking a rewarding career in a collaborative healthcare setting, this is the opportunity you've been waiting for. Join us in east central Ohio, and become part of our exceptional team dedicated to delivering high-quality care to our community. Apply now and embark on a fulfilling career journey with us. Requirements What they're looking for: •Master's degree in nursing, Healthcare Administration, or Business Administration required. •Current Ohio RN licensure (or active multi-state licensure). •Certified Case Manager(CSM). •At least three (3) years of management or demonstrated leadership experience required. •Knowledge of prospective payment systems, managed care, infection control surveillance, patient care, disease processes, discharge planning, and continuum of services offered within Genesis and externally. Knowledge of coding, mid-revenue cycle, CDI, physician advisor and payor relations. •Ability to perform data analysis and to utilize computer systems to record and communicate information to other services. •The ability to lead collaboration with other leaders in the organization, especially about the delivery of high-quality, timely, and right site of care. •Excellent leadership, verbal and organizational skills to order to steer the case management process. Benefits Hours and compensation potential: •The position is full time. •The range starts at $62.50hr($130K)-$75hr($156K) depends on years of experience. •Full benefits package being offered.

Records Management Specialist IIEmployment Type: Full-Time, Mid-LevelDepartment: Office Support CGS is seeking an experienced Records Management Specialist to provide administrative support for a large Federal agency initiative. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success:- Customer Service Excellence: Demonstrated ability to interact professionally and effectively with a wide range of individuals, providing high-quality support, resolving issues promptly, and maintaining a positive and empathetic approach to service delivery. - Strong Organizational and Time Management Skills: Proven ability to manage records, files, and data systematically and accurately. Strong attention to detail and the ability to prioritize tasks effectively in a fast-paced environment. - Adaptability with Technology: Comfortable working with electronic records systems and adapting quickly to new software or technological processes. A proactive attitude toward learning and implementing digital tools to enhance productivity. - Training and Development Capabilities: Experience delivering training to colleagues or clients, with the ability to develop and write clear, engaging, and comprehensive training materials or instructional content. - Effective Communication: Excellent written and verbal communication skills, especially in documenting procedures, communicating with team members, and supporting end-users or customers. - Team-Oriented with Independent Drive: A collaborative team player who can also work independently, take initiative, and contribute to continuous improvement efforts. Qualifications:- Previous experience in a customer service role, with a strong focus on client satisfaction and support. - Background in records or data management, including organizing, maintaining, and retrieving information efficiently. - Proficiency in using current versions of Microsoft Windows and related applications (e. g. , Microsoft Office Suite). - Experience with electronic recordkeeping systems or document management platforms. - Prior experience in training roles, including designing, writing, and facilitating training modules or instructional materials. Ideally, you will also have:- College Degree Our Commitment:Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client's specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we've been growing our government-contracting portfolio, and along the way, we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package. - Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board:******************* com/join-our-team/For more information about CGS please visit: ************ cgsfederal. com or contact:Email: info@cgsfederal. com #CJ

AETOS LLC is a Minority Owned CVE Certified Service Disabled Veteran Owned Small Business (SDVOSB) providing information technology solutions focused on building a business that is customer-centered and performance-oriented. At Aetos, we specialize in developing IT solutions to optimize functionality and efficiencies for government and commercial clients to meet their business needs. Job Description Records Management Position Requirements: The candidate will be responsible for maintaining and enhancing an established compliant Records Management System (RMS) in M365 SharePoint environment. The candidate must be knowledgeable of the capabilities inherent to an M365 platform, to include Purview, that apply to creating a compliant records management environment. Candidate must have knowledge of the following : Metadata and how to effectively apply this in SharePoint The creation and management of a taxonomy of Record Series Codes (RSC) Security access controls The organization of Case Files The application of records retention rules and disposition policies. Candidate must be able to design and implement the configuration of the RMS in regard to how records are ingested and how security controls will be applied. Candidate must have a working knowledge of DOD 5015.02 standards as criteria for establishing a compliant records management environment and must also understand the concept of litigation hold requests, FOIA, and audit and business need hold requests. Candidate must also understand the concept of communicating with NARA to align with NARA policies. Candidate will be required to create and respond to communications for and from all types of functional and technical customers through a variety of formats such as conference calls, emails, NARA taskers and directives, Service Hold Requests, File Plans and annual NARA requests regarding records managed by and for the client. An example would be addressing the NARA directive to perform an annual Records Management Program (RMP) assessment survey and submit to NARA's ePortal. Candidate will be responsible for maintaining a Record Maintenance Support process and System Maintenance Support process that provides ongoing RM support to assess problems, seek process improvements and adhere to Federal Regulations. Candidate will work with client to establish internal policy and other governance to ensure the following are addressed in the time and/or manner specified/acceptable by the appropriate authority: Advise in Agency-wide Annual RM Training. Assess and embed RM capabilities in the design of current, or new systems. Create and maintain RM Governance Policy and Guidance. Respond to RM related inquiries (24 hours). Respond and support any requests for information needed because of audit or internal or external analysis. Respond to NARA inquiries and surveys. Implement revisions to records retention schedule. Provide support to incidents or inquiries related to various matters related to the Agency's RM program to include but not limited to records security, records transitioning, incidents-damaged, lost-spillage, RMS, and archiving. Provide administrative support and guidance for creating and maintain current file plans and associated taxonomy to better enable configuration of systems retaining Agency's records. The candidate will work closely with the client's Record Manager and/or Records Owners the following actions will be implemented to maintain system support: Implement steps that include identifying and maintaining a current list of staff responsible completing files, training designated staff how to complete records file plan, tracking designated staff for ongoing reference. Refer to completed Files Plans or like documents to assess how best to configure/automate SharePoint Purview and SharePoint collaboration sites to manage recordkeeping and non-recordkeeping records in a secure manner, and when applicable the routing of permanent records to NARA. Identify and prioritize records for transition to SharePoint such as Finance, Personnel and Audit related supporting documents. Develop an Agency-wide RM awareness training program. Establish forums that enables Records Liaisons, Records Custodians or staff in similar roles to communicate in a practical/efficient manner. For example, FAQ Web Site, and Brown Bag Meetings. Issue taskers or similar requests periodically (at a minimum every 12 month) to Process Owners/Records Liaisons to review if information applicable to them in the Agency's Records Retention Schedule-and Records File Plans is accurate/relevant/current. Hold weekly meetings (at a minimum) with Records Management Office to discuss issuances/changes from NARA or other authorities within DoD Ensure client record support system is on NARA's notification list to be kept informed of any activity that impacts clients RM program to include but not limited to training, updates to NARA tools for submission of SF115s and SF135s. Attend meetings and/or training as required to stay abreast of changes to clients record management system, NARA record management guideline Help implement the findings from NARA Self-Assessments where clients Record Management Program needs to improve such as with implementation of a RM training program; in-out processing protocol to ensure key records especially at the senior level are preserved; embedding RM in the Agency's vital records program; web site RM, email management and when applicable social media. Qualifications Bachelors degree in related field from an accredited institution Must be able to pass DoD Public Trust background check Preference to candidates who have an active CAC or have possessed one in the last few years Must be available to work M-F 800 am to 500 pm EST Must be available for possible travel up to 1 week per year. Minimum five (5) years' experience managing records management programs. Additional Information Applicants must be authorized to work for any employer in the U.S. and reside in the U.S. All your information will be kept confidential according to EEO guidelines.

Primary Location: Work from Home - KYAddress: P.O. Box 909 Louisville, KY 40201-0909 Shift: First Shift (United States of America) Summary: : The job summary for this position is not currently on file electronically. Please see your supervisorr or Human Resources Representative for a hard copy before you complete your acknowledgment.Additional Job Description: Job Summary This position is responsible for reviewing patient medical records to facilitate modifications to clinical documentation through concurrent (pre-bill) interaction with providers and other members of the healthcare team to promote accurate capture of clinical severity of illness and risk of mortality (later translated into coded data) and to support the level of service rendered to relevant patient populations. CDIS exhibits expert knowledge of clinical documentation requirements, MS-DRG Assignment, case mix index (CMI) analysis, clinical disease classifications, major and non-major complications and comorbidities (MCCs or CCs), and quality-driven patient outcome indicators. Interacts as needed with internal customers to include but not limited to hospital staff, physicians, and other revenue cycle team members. Actively participates in department and hospital performance initiatives when needed to ensure ULH success. Responsibilities Completes initial medical record reviews of all inpatient patient accounts (all payers) within 24-48 hours of admission for a specified patient population to: (a) Evaluate and review inpatient medical records daily, concurrent with patient stay, to identify opportunities to clarify missing or incomplete documentation. (b) Assign the principal diagnosis, pertinent secondary diagnoses, procedures for accurate MS-DRG assignment, score risk of mortality and severity of illness and initiate a review worksheet. (c) Conduct follow-up reviews of patients every 2-3 days to support and assign a working or final MS-DRG assignment upon patient discharge, as necessary. Formulate clinically, compliant and credible physician queries regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary. Proactively collaborate with physicians to discuss and clarify documentation inconsistencies to ensure accuracy of the medical record and appropriate capture of the course of treatment provided to the patient. Educate providers about identification of disease processes that reflect SOI, complexity, and acuity to facilitate accurate application of code sets. Gather and analyze information pertinent to documentation findings and outcomes, and use this information to develop action plans for process improvements. Collaborate with case managers, nursing, and other ancillary staff regarding interaction with physicians concerning documentation opportunities and to resolve physician queries prior to discharge. CDIS communicates/completes Clinical Documentation Improvement (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution with appropriate leadership. Remain abreast and current on training of new hires and ongoing CDIS professional staff development as well as participate in CDI-related continuing education activities to maintain certifications and licensures. Collaborate with HIM/coding professionals to review and resolve DRG mismatches for individual problematic cases and ensure accuracy of final coded data in conjunction with CDI managers, coding managers, and/or physician advisors. Identify patterns, trends, variances, and opportunities to improve documentation review processes. Aid in identification and proper classification of complication codes and present on admission (POA) determination (patient safety indicators/hospital-acquired conditions) by acting as an intermediary between coding staff and medical staff. Contribute to a positive working environment and perform other duties as assigned or directed to enhance the overall efforts of the organization. Qualifications CDIS candidate must have and maintain current licensure as a RN, RHIA, RHIT or possess an active CCS (AHIMA) or CPC-H (AAPC) coding credential. CDIS must have 3+ years of acute care experience as a RN or 3+ years inpatient coding experience as a RHIA/RHIT/CCS/CPC-H. Must have advanced clinical expertise and extensive knowledge of complex disease processes with broad clinical experience in an inpatient setting. Certified Clinical Documentation Specialist or Clinical Documentation Improvement Professional (CCDS or CDIP) credential is required within 12 months of employment. KNOWLEDGE, SKILLS, & ABILITIES Working knowledge of medical terminology and Official Coding Guidelines. Ability to work independently, self-motivate, and adapt to the changing healthcare arena Excellent verbal and written communication skills, analytical thinking, and problem solving with strong attention to detail Proficiency in organizational skills and planning, with an ability multitask in a fast-paced environment Proficiency in computer use, including database and spreadsheet analysis, presentation programs, word processing, and Internet research Working knowledge of federal, state, and private payer regulations as well as applicable organizational policies and procedures Working knowledge of quality improvement theory and practice, core measures, safety, and other required reporting programs Ability to formulate clinically, compliant and credible physician queries

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? + Entity: Corporate + Department: Corp HIM CDI + Location: Remote: Based out of Penn Presbyterian Medical Center- 51 N 39th St + Hours: PART TIME (Anytime between 7am-7pm Monday-Friday) **Summary:** The Clinical Documentation Specialist will be responsible for supporting an organization-wide system for improving clinical documentation in the medical record by prompting physicians and other clinicians for complete and accurate documentation. The CD Specialist will utilize presentation, general instruction, and a compliant query discussion to instruct the clinical teams in appropriate documentation as suggested by CMS coding guidelines and to ensure that the clinical chart is the true and reflective document of the patient, their related prioritized diagnostic portrait, severity of illness, and treatment related. Working under the leadership and moderate supervision of the Corporate Manager of Clinical Documentation and in close concert with both the clinical care teams and the Corporate HIM teams, the Clinical Documentation Specialist will educate and utilize compliant questions and tools toward a complete, reflective record. They will also analyze trends and offer direction to primary care staff w regard to changes in coding practices and noted trends noted in team documentation requiring clarity and/or specification to reflect truth in diagnostic reflection. **Responsibilities:** + Direct review of patient charts to audit clarity and full reflection of severity in care team documentation w consideration of CMS coding guidelines + Provide clinical care teams with ongoing education and training on current trends in documentation and coding + Provide clinical care teams with ongoing education and training on current trends in documentation and coding + Enter clinical review data and related anticipated follow-up in EPIC PENN Chart to truthfully demonstrate current state discovered via chart review, discovery of qualities needing further provider clarification, abstraction of clinical indicators, and the assignment of Initial DRG and Working DRG + Generate compliant queries and non-leading clinical conversation w regard to requesting further specification and/or diagnostic clarity and/or clinical diagnostic significance and severity + Ensure that the concurrent inpatient clinical documentation accurately reflects severity of illness and intensity of service using the above noted compliant query system + Ensure the present on admission (POA) status of clinical conditions/diagnoses are charted appropriately within defined regulatory timeframes + Assign a working MS-DRG upon initial admission review, and communicate with Physician or designee requesting appropriate documentation + Ongoing concurrent chart review, identification of complications and co-morbidities, collaboration with team regarding improving documentation + Maintain strict HIPPA compliance and confidentiality in reference to all information reviewed and/or discussed + Maintains responsibility for professional development by participating in workshops, conferences, and/or in-services and maintains appropriate records of participation + Proficient in negotiating complex systems to effect positive change + Ability to interpret, adapt, and apply guidelines and procedures + Ability to analyze complex clinical scenarios and apply critical thinking. Extensive knowledge of reimbursement systems + Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation and coding + Extensive knowledge of treatment methodology, patient care assessment, data collection techniques and coding classification systems is necessary + Serve as a resource on DRG issues **Credentials:** + RHIA or RN (Preferred) + CCDS or CDIP or RN (Preferred) Education or Equivalent Experience: + Bachelor of Arts or Science (Required) + And 3+ years healthcare experience + Master of Arts or Science (Preferred) + Clinical experience with knowledge of Medicare reimbursement system & coding structures (Preferred) We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 292857

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. Pay Range: $62,108.80 - $91,765.75 Scheduled Weekly Hours: 40 Position Overview HIM Coding Rev Spec Inpatient *Remote* CANDIDATES MUST RESIDE IN THE NEW JERSEY/PENNSYLVANIA AREA SUMMARY (Basic Purpose of the Job) Provides expertise in development and maintenance of rules, policies and procedures to ensure organizational compliance with industry standard coding rules and guidelines. Interprets and applies National Uniform Billing Compliance rules, guidelines, laws and industry trends to support claims payment, provider reimbursement and system configuration to proactively address cost efficiencies and compliance requirements. Recommends clinical classification and reimbursement guidelines and standards. Reviews coding in provider contracts and participates in development of coding standards for provider contracts. Performs health data analytics related to reimbursement business and policy decisions.MINIMUM REQUIREMENTS Education: High School diploma or equivalent. Associate's degree preferred. CCS required. Experience: 5 Years of inpatient coding experience necessary Other Credentials: CCS Knowledge and Skills: Prior experience with an encoder and EMR computer systems. Possesses excellent organizational, interpersonal, verbal, and written communication skills. Knowledge of denials management preferred. Special Training: Mental, Behavioral and Emotional Abilities: Ability to effectively manage multiple projects simultaneously and ability to respond quickly in a fast paced environment. Usual Work Day:8 Hours ESSENTIAL FUNCTIONS Verifies accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations. Acts as the primary department expert on DRGs while consistently monitoring regulatory updates and their implementation. Conducts regular audits and reviews of medical records at a senior level and assists with external and internal reviews for coding accuracy. Reviews claim denials and rejections pertaining to coding and medical necessity issues and exercises discretion and judgement when recommending corrective action plans such as educational programs to prevent similar denials and rejections from occurring in the future. Assists in implementation of policy and procedural changes within the department regarding coding and quality issues required by third party payers and according to recommendations by coding consultants and agencies. Develops and coordinates educational and training programs on coding and documentation for department staff, providers, billing staff, and ancillary departments. Provides management with various statistical reports, data, and audits information on health information management compliance issues, internal and external quality assurance results and activities, performance improvement activities and other statistical information as required or requested. Adapts to changing department demands required for higher department efficiency. Liaises with Quality and other departments for validation of HACs, PSIs, and complications, etc... to ensure accurate external reporting. Assists other departments with ICD-10-CM / ICD-10-PCS. Performs other duties as assigned. PHYSICAL DEMANDS AND WORK ENVIRONMENT Frequent physical demands include: Occasional physical demands include: Standing , Walking , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Talk or Hear Continuous physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 15 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing Anticipated Occupational Exposure Risks Include the following: N/A IND123 This position is eligible for the following benefits: Medical Plan Prescription drug coverage & In-House Employee Pharmacy Dental Plan Vision Plan Flexible Spending Account (FSA) - Healthcare FSA - Dependent Care FSA Retirement Savings and Investment Plan Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance Supplemental Group Term Life & Accidental Death & Dismemberment Insurance Disability Benefits - Long Term Disability (LTD) Disability Benefits - Short Term Disability (STD) Employee Assistance Program Commuter Transit Commuter Parking Supplemental Life Insurance - Voluntary Life Spouse - Voluntary Life Employee - Voluntary Life Child Voluntary Legal Services Voluntary Accident, Critical Illness and Hospital Indemnity Insurance Voluntary Identity Theft Insurance Voluntary Pet Insurance Paid Time-Off Program The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.