Hierarchical Condition Category (HCC) Coding Specialist
Medical records clerk job at Highmark
This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements.
**ESSENTIAL RESPONSIBILITIES**
+ Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD). Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for Coding and Highmark's Policy and Procedures to guide HCC coding decision making. Maintains RPM coding accuracy and productivity requirements.
+ Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work within coding teams and internal partners critical to HCC coding.
+ Participates on ad-hoc projects per the direction of Leadership to address the needs of the department. Provides recommendations for process improvements and efficiencies.
+ Engages in RPM Coding educational meetings and annual coding Summit.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ None
**Substitutions**
+ None
**Preferred**
+ Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
**EXPERIENCE**
**Required**
+ 3 years HCC coding and/or coding and billing
**Preferred**
+ 5 years HCC coding and/or coding and billing
**LICENSES or CERTIFICATIONS**
**Required** (any of the following)
+ Certified Professional Coder (CPC)
+ Certified Risk Coder (CRC)
+ Certified Coding Specialist (CCS)
+ Registered Health Information Technician (RHIT)
**Preferred**
+ None
**SKILLS**
+ Critical Thinking
+ Attention to Detail
+ Written and Oral Presentation Skills
+ Written Communications
+ Communication Skills
+ HCC Coding
+ MS Word, Excel, Outlook, PowerPoint
+ Microsoft Office Suite Proficient/ - MS365 & Teams
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Remote Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$26.49
**Pay Range Maximum:**
$41.03
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J273522
Coder - Inpatient
Medical records clerk job at Highmark
This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES**
+ Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD codes for diagnoses and procedures. (65%)
+ Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%)
+ Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%)
+ Keeps informed of the changes/updates in ICD guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. (5%)
+ Performs other duties as assigned or required. (5%)
**QUALIFICATIONS:**
Minimum
+ High School / GED
+ 1 year in Hospital coding
+ Successful completion of coding courses in anatomy, physiology and medical terminology
+ Certified Coding Specialist (CCS) **OR** Certified In-patient Professional Coder (CIC)
+ Familiarity with medical terminology
+ Strong data entry skills
+ An understanding of computer applications
+ Ability to work with members of the health care team
Preferred
+ Associate's degree in Health Information Management or Related Field
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$23.03
**Pay Range Maximum:**
$35.70
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J272373
Coding Specialist I - MedStar Ambulatory Surgery Centers
Columbia, MD jobs
About this Job:
MedStar Ambulatory Services is currently seeking a CPC Certified Coder with 1 - 2 years of coding experience to join our team! This is a full time, Monday-Friday position, with a hybrid schedule after the successful completion of the 90-day probationary period. Hybrid schedule includes working remotely on Mondays & Fridays and working on-site Tuesday - Thursday. Business office is located in Columbia, Maryland.
General Summary of Position
Job Summary - Codes and abstracts Ambulatory Surgery Center (ASC) services using CPT, ICD-10-CM, HCPCS and other applicable patient classification schemes.
Primary Duties and Responsibilities
Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
Abstracts and ensures accuracy of diagnoses procedure patient demographics and other required data elements.
Adhere to all compliance regulations and maintains annual compliance education.
Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.
Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.
Meets established Quality standards as defined by policies.
Meets established Productivity standards as defined by policies.
Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).
Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic procedural codes and appropriate modifiers using standard guidelines and maintaining departmental accuracy standards.
Exhibits knowledge of other work-related equipment.
Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
Participates in multi-disciplinary quality and service improvement teams.
Minimal Qualifications
Education
High School Diploma or GED required
Associate's degree in coding related studies and/or Bachelor's degree in coding related studies preferred
Courses in Medical Terminology Anatomy & Physiology ICD-CM required and CPT-4 preferred
Experience
1-2 years Coding experience and experience with clinical information systems (3M grouper electronic medical records computer assisted coding) preferred
Licenses and Certifications
Certified Professional Coder (CPC) required
Knowledge Skills and Abilities
Verbal and written communication skills.
Basic computer skills required.
This position has a hiring range of : USD $23.65 - USD $42.03 /Hr.
Auto-ApplyHIM MPI COORDINATOR
Indianapolis, IN jobs
24564 HIM MPI COORDINATOR Apply now » Division:Eskenazi Health Sub-Division: Hospital Schedule: Full Time Shift: Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.
FLSA Status
Non-Exempt
Job Role Summary
The HIM MPI Coordinator is responsible for reducing and eliminating MPI duplicate records in multiple legacy systems. This position performs merges and unmerges, and provides follow-up information to registration staff and leaders to reduce errors and improve registration process.
Essential Functions and Responsibilities
Supports efforts to migrate to an enterprise-wide MPI, including clean-up of existing identified duplicate records
Develops and maintains systems for identifying individuals with more than one medical record number or medical record numbers applied to more than one patient in multiple legacy systems
Works daily in the EPIC system reports and queues that include but are not limited to: Identity Events Report and G3 Conversion Patient Errors queue
Provides follow-up trend information on duplicates, changes, and trends to leadership
Supports reduction and elimination of duplicate creations through coordination with local system leadership and suggested improved practices
Helps to manage HIM support ticket system
Monitors death updates in the system
Develops and maintains communication systems and processes for notifying other departments of duplicates and surviving numbers to assure synchronization of indices throughout the organization
Assists in developing and maintaining written MPI policies and procedures
Monitors, accesses, and reports the accuracy and integrity of electronic and manual merging of duplicates
Develops MPI-related training materials for HIM and non-HIM based staff that may have MPI back-up responsibilities
Participates in departmental processes to educate the user community of the appropriate protocols to help select a medical record number should a duplicate exist
Strictly adheres to the policies on Confidentiality of Patient Medical Records
Job Requirements
High school diploma or equivalent
Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred
Knowledge, Skills & Abilities
Skills in effective planning and organization
Strong analytic and healthcare-related electronic systems experience preferred
In-depth knowledge of local, state and federal regulatory laws, Eskenazi Health policies and procedures, Indiana State Department of Health regulations and Joint Commission accreditation standards
Working knowledge of document imaging processes, guidelines and protocols
Familiarity with information systems used at Eskenazi Health including but not be limited to: EPIC, Hyland OnBase, Datacap, G3, Cactus is preferred
Proficient in all Microsoft Office suites of products
Excellent oral and written communication skills; excellent customer service skills
Excellent organizational skills
Ability to proficiently use a Microsoft Windows workstation
Ability to work as an effective team member and/or lead MPI-related projects
Ability to define, analyze and measure root causes for data integrity issues
Knowledge of mandated retention periods for medical records
Knowledge of medical terminology
Accredited by The Joint Commission and named as one of Indiana's best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.
Apply now »
Medical Coder
Madera, CA jobs
This position is responsible for accurately assigning ICD-9-CM/ICD-10-CM diagnosis and procedure codes and CPT-4 procedure codes to inpatient and outpatient medical records using the 3M encoding software. The role includes assigning HCFA-DRG and APR-DRG groupers for inpatient records and abstracting clinical, financial, trauma, and quality management data into the organization's health information system. Additionally, this position monitors accounts receivable, abstract and claims rejections, and other related billing reports. Inpatient hospital coding constitutes 70% or more of the total coding workload.
Experience Requirements
Minimum of one (1) year of experience using ICD-10-CM/PCS and CPT-4 coding classification systems
Working knowledge of encoder software, MS-DRG and APR-DRG groupers, and AHA Coding Guidelines
Demonstrated proficiency in data entry and the ability to perform mathematical calculations accurately
Education, Licensure, and Certification
High school diploma or GED accredited by the U.S. Department of Education required
Successful completion of a formal training program in ICD-10-CM/PCS and CPT coding, anatomy and physiology, and medical terminology required
Certified Coding Specialist (CCS) credential required
Position Details
This is a part time (20 hours per week) hybrid position, combining remote work with regular on-site responsibilities and presence required based on departmental needs and organizational priorities.
About Valley Children's Healthcare
Valley Children's Healthcare is an award-winning pediatric healthcare system located in Madera, California, in the heart of the affordable Central Valley. The organization operates one of the nation's largest pediatric healthcare networks, including a 358-bed children's hospital and multiple outpatient clinics. Valley Children's offers access to three national parks and is within driving distance of California's world-renowned coastline, providing an exceptional balance of professional opportunity and quality of life.
Unit Clerk/Care Partner-Acute Rehab-Part Time
Towanda, PA jobs
This is a dual role encompassing both Unit Clerk and Care Partner responsibilities. Responsible for clerical duties, communication and reception duties on assigned nursing units. In addition, employee works with other members of the patient care team to deliver care to specific patient populations. The employee will maintain competency for population specific groups with consideration of physical, communication, safety, nutrition, and psychosocial needs
Education, License & Cert:
High School Grad or Equivalent
Experience:
No Experience Required.
Essential Functions:
Participates in the delivery of patient care for population groups under the direction of an RN/LPN including but not limited to the following:
Lifting, turning, and positioning patients utilizing Safe Patient Handling equipment (> 35 pounds), as appropriate.
Observing confused and difficult patients
AM/PM Hygiene care
Toileting, shaving, washing, brushing hair, dental and mouth care
Feeding
Assisting with range of motion exercises
Mobilizing patients - transfers and ambulation, utilizing Safe Patient Handling equipment (> 35 pounds), as appropriate and following the Mobility protocol
Exercise protocols
Discontinuing foley catheter
Simple dressing changes
Incentive spirometry supervision
Surgical preps
Postmortem care
Administers cleansing enemas
Removal of peripheral IV catheters
Apply external catheter or incontinence device
Sits with confused/disoriented patients or those requiring 1:1 observation for safety/suicide purposes, as assigned
Performs and records accurately:
Temperature, pulse, respirations, blood pressure, heights and weights
I & O
Records bowel movements
ADLs and activities
Performs and records the following specimen collection:
Obtains urine, stool, and sputum specimens for patients; instructs patients in proper specimen collection technique.
Completes EKGs.
Glucose monitoring in Non-Critical Care Areas
Conducts bladder scanning
Basic ostomy care
Transports patients as needed
Serves, sets up and retrieves trays
Distributes water pitchers as appropriate
Orders and distributes nourishment.
Transports equipment
Transports blood products to and from the patient care area.
Participates in patient safety/patient satisfaction.
Answers call bells
Participates in patient rounding
Reports any signs of abuse to the nursing staff
Recognizes, troubleshoots and initiates corrective action needed on equipment.
Maintains neat and tidy environment (empties laundry, delivers equipment, keeps patient rooms clean and safe).
Inventories and assures disposition of patients' belongings when admitted, transferred, and/or discharged.
Assures proper storage of equipment.
Recognizes emergency situations and initiates plan of action
Notifies RN/LPN of any changes seen in patient's condition
Complies with policies and procedures of the hospital/nursing department.
Supports the philosophy of the hospital and department of nursing.
Maintains CPR certification and practice
Demonstrates cost-effective patient care by demonstrating proper use and care of equipment, appropriate and prudent use of supplies, accurate charging of supplies; performing other division-specific tasks, and appropriate utilization of available resources.
Participates in performance improvement activities to improve service and care. Demonstrates strong communication and organizational skills.
Ability to communicate using telephones, computer systems.
Answers telephone promptly and politely, identifying self, title, and department. Receives and sends messages in an accurate and timely fashion.
Communicates with the patients, family, and members of the healthcare team in a concise, tactful, and considerate manner. Must represent the hospital in a professional courteous manner, while being sensitive to how others perceive both verbal and non-verbal communications.
Other Duties:
Assists in the orientation of new personnel and serves as a role model to other employees.
Demonstrates willingness to accept non-routine work assignments as appropriate.
Encouraged to participate in community activities
Attends and participates in unit council (70% attendance).
About Us
Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you'll find staff members who have committed themselves to serving the community.
The Guthrie Clinic is an Equal Opportunity Employer.
The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.
Coder II - Outpatient - Coding & Reimbursement
Lakeland, FL jobs
Details
Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.
Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.
Active - Benefit Eligible and Accrues Time Off
Work Hours per Biweekly Pay Period: 80.00
Shift: Flexible Hours and/or Flexible Schedule
Location: 210 South Florida Avenue Lakeland, FL
Pay Rate: Min $19.37 Mid $24.22
Position Summary
Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.
Position Responsibilities
People At The Heart Of All That We Do
Fosters an inclusive and engaged environment through teamwork and collaboration.
Ensures patients and families have the best possible experiences across the continuum of care.
Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
Safety And Performance Improvement
Behaves in a mindful manner focused on self, patient, visitor, and team safety.
Demonstrates accountability and commitment to quality work.
Participates actively in process improvement and adoption of standard work.
Stewardship
Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
Knows and adheres to organizational and department policies and procedures.
Standard Work Duties: Coder II - Outpatient
Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding
Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment.
Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement.
Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers.
Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily.
Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
Competencies & Skills
Essential:
Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision.
Knowledge of anatomy and physiology, pharmacology, and medical terminology.
Qualifications & Experience
Essential:
High School or Equivalent
Nonessential:
Associate Degree
Essential:
High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.
Other information:
Certifications Essential: CCS
Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Experience Essential:
2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.
Coding Specialist
Durham, NC jobs
Exciting Career Opportunity with Avance Care!
Join our rapidly expanding network of 37 practice locations in the Triangle Area (Raleigh-Durham-Chapel Hill), the Charlotte Region, and Wilmington, NC.
Avance Care is dedicated to elevating the standard of healthcare. As one of North Carolina's largest networks of independent primary care practices, we offer comprehensive services to support the physical, mental, and emotional health of our patients.
As a Coding Specialist, you'll support and maintain coding compliance and patient assessments by applying Certified Professional Coding (CPC) principles to claim documentation process, reducing institutional, legal and financial risk.
This is a full-time role involving 8 hours weekday shifts with no weekends schedule.
We operate in a busy, fast-paced environment, and we seek a candidate who thrives under such conditions.
We offer a comprehensive benefits package available on the first of the month following 30 days of employment.
Selected Responsibilities
Actively abstract and code daily patient encounters through chart documentation, billing for all services, and appropriate assignment of E&M coding related to chart documentation, time, and medical decision making
Thorough understanding of clinic coding (E/M) documentation requirements and HCC concepts impacting population Health Risk Adjustment reimbursement initiatives
Ability to review documentation and abstract all codes with specific emphasis on identifying the most accurate severity of illness according to CMS HCC guidelines
Maintains knowledge regarding policies and procedures with Medicare/Medicaid Carriers and third-party payers, including HCC and RAF guidelines
Effectively work with and support providers through structured communication as it related to chart documentation and coding practices
Understand and apply Correct Coding Initiative (CCI) edits and modifiers, as sometimes specifically required by 3 rd party payers or Medicare
Assign missing procedure CPT, or HCPCS from the Current Procedure Manual and Common Procedure Coding System Manual when necessary
Candidates should preferably have one of the following certifications: Certified Professional Coder (CPC) required, Certified Professional Coder (CPC-A) preferred, or Certified Risk Adjustment Coder (CRC) highly preferred along with at least one year of E&M Coding experience.
Other Priorities
Strong verbal and written communication
Knowledge of insurance practices
Knowledge of CPT, HCPCs, and ICD-10 coding
Time management and workload prioritization skills
If you are excited to join a growing organization focused on changing the way healthcare is delivered to patients in North Carolina, please submit your resume.
All offers of employment are contingent upon the successful completion of a background check and drug screen.
Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identification, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.
Medical Scheduler
Oldsmar, FL jobs
About us:
At Health & Psychiatry, located in the heart of Oldsmar, Florida, with offices across the state, we are looking for a compassionate Medical Assistant to join our team. Our mission is to provide a healthcare experience centered around hope, health, and harmony through personalized behavioral health services.
As a Medical Assistant with us, you will play a key role in delivering outstanding patient care in an environment that values compassion and excellence. Our top priority is the health and well-being of our patients, and we are growing as a company, expanding throughout Florida, the U.S., and internationally. We are proud to offer mental healthcare services globally through our cutting-edge telepsychiatry technology.
If you're passionate about helping others and eager to be part of a growing, dynamic team, we'd love to hear from you!
Please see our website for all that we offer!
***********************************
Key Responsibilities:
Medical Duties: ( included but no limited to:)
Record and update patient medical histories
Measure and record vital signs
Process refill requests
Administer ADHD test (training will be provided)
Assist with Spravato treatments (training will be provided)
Send and obtain medical records
Schedule patient appointments
Answer phone calls and manage patient inquiries regarding any medical issues.
Maintain accurate patient records in compliance with HIPAA guidelines
Key Skills and Competencies:
Strong verbal and written communication skills
Proficient computer skills
EHR system knowledge preferred
A strong desire to learn and expand knowledge
Compassionate and patient-focused attitude
Radiology PRN Clerk
Farmington, NM jobs
Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider-we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community. Radiology Clerk Representatives are professionals that provide structure to the Radiology Department. These individuals are the first stop in radiology for providing patient care and customer service to all who need radiologic services.
Required Behaviors:
As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.
Required Qualifications:
High School diploma or equivalent
Excellent organizational skills
Strong communication - customer service skills
Fluent in English
Physical demands include extended sitting and lifting a minimum of fifty (50) pounds
Preferred Qualifications:
Computer experience in word processing, data base programs and spreadsheets
Strong writing skills
Duties and Responsibilities:
Patient Billing and Accounting Functions:
Obtains insurance authorization for all services; tracking and communication as required
Demonstrates working knowledge of third-party payers' system including Medicare, Medicaid, commercial, PPO and HMO systems and assists with financial counseling of patients
Medical Records Functions:
Patient registration and re-registration into electronic medical record / system:
Includes scanning into e-web system (i.e., all prescriptions, admission face sheet, consents)
Maintains knowledge of current medical record requirements for department and applies knowledge of policies and procedures related to medical record information, confidentiality, release of information and historical data
Patient / Family Front Desk Reception Functions:
Greet and check patient; communicate arrival to clinical staff
Answering phones, take messages, files
Initial intake of referrals
Documentation
Collaborates with appropriate departments, as well as physicians' offices, to get documentation or information to facilitate diagnostic and procedural coding
Compiles all documentation into initial "chart" which includes history forms, insurance information, copies of insurance cards and patient identification, prescriptions, referral forms, etc.
Schedule's Patient Appointments:
Establishes, alters, and communicates appointment schedules to both staff and patients
Arranges transportation as required
Other Duties and Responsibilities
Generates reports / gathers data as instructed
Maintains office supplies / inventory / mail / packages / correspondence
Handles daily routine problems, following proper channels of communication
Demonstrates good organizational skills for prioritizing and delegating
Assumes active role in clinic by participating in staff meetings
Makes recommendations regarding service / process improvements
Understand the basic reporting system for position: Radiology Director, Radiology Manager, Radiology Asst. Manager, Charge Technologist, Lead Clerk
Understand/utilize EMR system in ordering of radiology procedures
Understand/utilize PACS system, CD burning system, Cloud based image sharing system
Transportation of patients as needed
Adheres to hospital dress code
Each employee is responsible for implementing SJRMC's Service Standards into their daily work: Safety, Courtesy, Effectiveness, and Stewardship
Other duties as assigned
Physical Demands and Environmental Work Conditions:
Extended sitting
Lifting a minimum of fifty (50) pounds
Exposure to radiation hazards through radiology procedures
Exposure to body fluids through direct contact, IV procedures, infection, and/or contagious diseases
Requires lifting, moving, pushing, pulling, prolonged standing
Provide multiple and directional guidance during procedures to patients with caring and compassion
Interaction with potential verbally abusive patients
Patient Service Representative
San Antonio, TX jobs
Job Title: Patient Financial Rep Senior
Shift: 9am to 5pm Monday to Friday
Schedule: 5 days a week - 40 hours
Roles and Responsibilities:
Experience working within a multi-facility hospital business office environment. Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms.
Meets expectations of the applicable One Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Performs Revenue Cycle functions in a manner that meets or exceeds key performance metrics. Ensures PFS departmental quality and productivity standards are met. Collects and provides patient and payor information to facilitate account resolution. Responds to all types of account inquiries through written, verbal.
The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of this Job is to ensure account resolution and reconciliation of outstanding balances for patient accounts.
Per Diem Surgical Outcomes Coordinator
Flushing, MI jobs
Precision, Compassion, Results-Join the Team That Delivers
Set your sights on a career with NewYork-Presbyterian Queens and play an integral role in our goal to provide the highest level of complex and innovative surgical care, education for the next generation of surgeons as well as groundbreaking quality enhancements and clinical research. Our Surgical Outcomes Coordinators utilize a uniquely collaborative healthcare model, interfacing with the entire surgical team, including nurses and anesthesia staff to assist with oversight and maintenance of the surgical quality platforms within the Department of Surgery.
Surgical Outcomes Coordinator | Per Diem
Transform your career as a Surgical Outcomes Coordinator and work closely with widely renowned clinical leaders. Utilize your clinical expertise and your keen eye for detail in analyzing, identifying, and recommending opportunities for improvement based upon the noted patterns and trends. Abstract designated surgical cases within the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) to help make tomorrow better for countless individuals.
Move into the next phase of your career with this dynamic opportunity. Participate in the peer review process, resident education and research. Be a part of an all-embracing culture of teamwork , collaboration and innovation . Enjoy flexible scheduling, strong nurse-physician partnership, and opportunities for professional advancement, ours is a destination workplace for talented Quality Improvement Specialists.
Preferred Criteria
Prior NSQIP and/or CDI experience
Required Criteria
Bachelor's degree
NYS licensed Nurse Practitioner, Registered Nurse, or Physician Assistant
Certification/recertification as SCR through ACS NSQIP.
Certification/recertification as SCR through MBSAQIP
5 years of recent hospital experience and/or verifiable Documentation Improvement experience
#LI-MM1
Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, belonging, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today.
Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP.
NYP will not reimburse for travel expenses .
2024 “Great Place To Work Certified”
2024 “America's Best Large Employers” -
Forbes
2024 “Best Places to Work in IT” -
Computerworld
2023 “Best Employers for Women” -
Forbes
2023 “Workplace Well-being Platinum Winner” -
Aetna
2023 “America's Best-In-State Employers” -
Forbes
“Silver HCM Excellence Award for Learning & Development” -
Brandon Hall Group
NewYork-Presbyterian Hospital is an equal opportunity employer.
Salary Range:
$81.00/Hourly
It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works.
Receptionist Medical $16/HR - $20/HR
Gretna, LA jobs
Private Family Practice Full Time Position We Are Open: Monday - Friday 8 am - 6 pm, Sat 8 am - 12 Noon Plus Paid Overtime MUST Be Close By/ Local Person To Gretna, LA 70057 Medical Receptionist/Front Desk Full Time Position Benefit Package: Paid Health Insurance, Paid Holidays and Paid Vacation, Bonuses
Plus Paid Over Time
Sorry Must Be a Medical Receptionist
NO New Grads
Please Apply By CV or Resume
Remote Release of Information Specialist
Remote
Release of Information Specialist I (ROIS I) The Release of Information Specialist I (ROIS I) initiates the medical record release process by inputting data into Verisma Software. The ROIS I works quickly and carefully to ensure documentation is processed accurately and efficiently. This position may be done remotely. The primary supervisor is Manager of Operations, Release of Information.
Duties & Responsibilities:
Process medical ROI requests in a timely and efficient manner
Process requests utilizing Verisma software applications
Support the resolution of HIPAA-related release issues
Organize records and documents to complete the ROI process
Read and interpret medical records, forms, and authorizations
Provide exemplary customer service in person, on the phone and via email, depending on location requirements
Interact with customers and co-workers in a professional and friendly manner
Utilize reference material provided by Verisma to ensure compliance and confidentiality is always maintained
Attend training sessions, as required
Live by and promote Verisma company values
Perform other related duties, as assigned, to ensure effective operation of the department and the Company
Minimum Qualifications:
HS Diploma or equivalent, some college preferred
RHIT certification, preferred
2+ years of medical record experience
2+ years of experience completing clerical or office work
Experience using general office equipment including desktop computer, scanner, Microsoft Office Suite to complete tasks
Experience in a healthcare setting, preferred
Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
Must be able to work independently
Must be detail oriented
Phlebotomist/Laboratory Clerk (FT)
Cleveland, OH jobs
Please Note!!! Although you are submitting an employment application and resume for this job on Indeed or Zip Recruiter, you will still need to put in an employment application and resume at NEON. Please visit our website at ****************************************************
Duties:
Under the direct supervision of the Laboratory Supervisor, the Phlebotomist/Clerk performs a variety of tasks related to phlebotomy, communications, patient flow, information processing and record keeping in the laboratory. The Phlebotomist/Clerk must be able to communicate intelligently by telephone, file reports, retrieve reports from file, relate information to others, direct patients to the proper place for assistance and perform limited waived testing. The Phlebotomist/Clerk must follow instructions exactly, write legibly, spell correctly and perform venipuncture, capillary puncture and waived tests in accordance with established quality laboratory standards. The Phlebotomist/Clerk must maintain the highest standards of professional performance in the delivery of comprehensive health care for patients.
Education:
High School Graduate or GED equivalent .
Certified phlebotomist , certification eligible or equivalent in training and/or experience.
Proof of certification from approved national certifying agency e.g. ASCP, NHA or IAPS required within six months of hire.
Minimum Qualifications:
Certified or certification eligible in accordance with an approved certifying agency e.g. ASCP, NHA, IAPS or equivalent required in training and/or experience.
Knowledge of medical terminology.
Ability to work without close and constant supervision.
Clerical ability required to accurately record, transcribe and calculate test reports and results.
Manual and finger dexterity required to collect blood specimens and perform laboratory test.
Apply Here
Auto-ApplyRelease of Information Specialist- Onsite Jacksonville, FL
Jacksonville, FL jobs
Release of Information Specialist I (ROIS I) The Release of Information Specialist I (ROIS I) initiates the medical record release process by inputting data into Verisma Software. The ROIS I works quickly and carefully to ensure documentation is processed accurately and efficiently. This position is located at a client site. The primary supervisor is Manager of Operations, Release of Information.
Duties & Responsibilities:
Process medical ROI requests in a timely and efficient manner
Process requests utilizing Verisma software applications
Support the resolution of HIPAA-related release issues
Organize records and documents to complete the ROI process
Read and interpret medical records, forms, and authorizations
Provide exemplary customer service in person, on the phone and via email, depending on location requirements
Interact with customers and co-workers in a professional and friendly manner
Utilize reference material provided by Verisma to ensure compliance and confidentiality is always maintained
Attend training sessions, as required
Live by and promote Verisma company values
Perform other related duties, as assigned, to ensure effective operation of the department and the Company
Minimum Qualifications:
HS Diploma or equivalent, some college preferred
RHIT certification, preferred
2+ years of medical record experience
2+ years of experience completing clerical or office work
Experience using general office equipment including desktop computer, scanner, Microsoft Office Suite to complete tasks
Experience in a healthcare setting, preferred
Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
Must be able to work independently
Must be detail oriented
Release of Information Specialist
Ruston, LA jobs
Perform or assist in performing all release of information functions and any medical record clerical functions required to maintain accurate, timely, and easily retrieved medical records to aid in continuing care and providing the patient satisfaction and accurate and timely release of information to external requestors.
Release of Information Specialist
Ruston, LA jobs
Job Description
Perform or assist in performing all release of information functions and any medical record clerical functions required to maintain accurate, timely, and easily retrieved medical records to aid in continuing care and providing the patient satisfaction and accurate and timely release of information to external requestors.
Job Posted by ApplicantPro
Onsite Release of Information Specialist I
Phoenix, AZ jobs
Onsite Release of Information Specialist I (ROIS I) The Release of Information Specialist I (ROIS I) initiates the medical record release process by inputting data into Verisma Software. The ROIS I works quickly and carefully to ensure documentation is processed accurately and efficiently. This position is based out of a client site, in PHX, AZ. The primary supervisor is Manager of Operations, Release of Information.
Duties & Responsibilities:
Process medical ROI requests in a timely and efficient manner
Process requests utilizing Verisma software applications
Support the resolution of HIPAA-related release issues
Organize records and documents to complete the ROI process
Read and interpret medical records, forms, and authorizations
Provide exemplary customer service in person, on the phone and via email, depending on location requirements
Interact with customers and co-workers in a professional and friendly manner
Utilize reference material provided by Verisma to ensure compliance and confidentiality is always maintained
Attend training sessions, as required
Live by and promote Verisma company values
Perform other related duties, as assigned, to ensure effective operation of the department and the Company
Minimum Qualifications:
HS Diploma or equivalent, some college preferred
RHIT certification, preferred
2+ years of medical record experience
2+ years of experience completing clerical or office work
Experience using general office equipment including desktop computer, scanner, Microsoft Office Suite to complete tasks
Experience in a healthcare setting, preferred
Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
Must be able to work independently
Must be detail oriented
Release of Information Specialist
Billings, MT jobs
You'll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet Recognition consecutively since 2006.
And you'll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine!
You can make a difference here.
About Us
Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality.
Your Benefits
We provide a comprehensive and competitive benefits package to all full- and part-time employees (minimum of 20 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more. Click here for more information or download the Employee Benefits Guide.
Magnet: Commitment to Nursing Excellence
Billings Clinic is proud to be recognized for nursing excellence as a Magnet-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years. Click here to learn more!
Pre-Employment Requirements
All new employees must complete several pre-employment requirements prior to starting. Click here to learn more!
Release of Information Specialist
HEALTH INFO MGMT (HIM) - HOSP (BILLINGS CLINIC HOSPITAL)
req10455
Shift: Day
Employment Status: Full-Time (.75 or greater)
Hours per Pay Period: 1.00 = 80 hours every two weeks (Non-Exempt)
Starting Wage DOE: $19.68 - $24.60
Under minimal supervision, the HIM ROI Specialist will be responsible for coordinating centralized requests for release of information for all areas within Billings Clinic where records are maintained (i.e., hospital and clinic records, radiology, lab systems, etc.). Responsibilities include review of all written and verbal requests for release of information to ensure the validity of the request and the authorization to release the requested information comply and adhere with all regulatory requirements and guidelines and Billings Clinic policies and procedures.
Essential Job Functions
* Supports and models behaviors consistent with Billings Clinic's mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
* Acts as the centralized review point for receipt of all requests for release of information from both the hospital and clinic medical records. Evaluates authorizations to ensure they meet all eight (8) criteria required by HIPAA and the state of Montana. Evaluates requests that do not require an authorization to ensure Billings Clinic can disclose the information without an authorization through review of HIPAA, Montana law, and Billings Clinic policies.
* Accepts and signs for subpoenas and/or court orders; performs initial review to determine if all criteria (HIPAA and Montana law) are met and confers with Manager, Director or General Counsel for final approval to process.
* Responds to questions of patients and/or staff regarding appropriate disclosures, researches legal and regulatory guidelines in questionable situations, facilitates request and receipt of protected health information (PHI) from other facilities for Billings Clinic.
* Identifies presence and/or location of medical records by reviewing CIS, Medic, AS400 or documentation of other medical record locations (includes branch clinics, inactive records in storage, shadow chart locations, PHI that Billings Clinic maintains previously belonging to other practitioners, and microfilm). Coordinates with and/or forwards request for release of information to the appropriate areas for copying of the appropriate records to provide integrated response to request. Ensures that complete medical record is obtained and copied when such is requested or in response to subpoena or court order.
* Log requests in ROI (Release of Information) software identifying requestor, patient, information requested, date needed, ensuring compliance with regulatory and legal requirements.
* Reviews all copies of health care information prior to disclosure of records to the requestor to ensure:
only the requested materials have been released
authorization matches healthcare information copied
records have been obtained from Radiology, Patient Accounts, and any other site housing PHI that has been authorized to be disclosed
information is delivered to the appropriate individual or requestor based upon the authorization, subpoena or court order
* Acts as a resource and provides support to HIM Specialists and release of information staff by handling customer complaints, resolving issues, identifying request priorities and assigning requests to be processed. Responsible to train HIM Specialists to read authorizations and obtain appropriate information from the medical record.
* Receives copies from various areas and compares each page to the original medical record to ensure complete information requested is provided prior to certifying affidavit or records are delivered for subpoenas or court orders.
* Invoices each request to ensure appropriate charges are made for copies; processes checks received in department by crediting invoice in software; and documenting monies received and forwarding to HIM Administrative Assistant.
* Maintains or exceeds 95% accuracy based on audit findings. Maintains or exceeds 90% department productivity standards for assigned tasks
* Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.
* Maintains competency in all organizational, departmental and outside agency safety standards relevant to job performance.
* Performs other duties as assigned or needed to meet the needs of the department/organization.
Minimum Qualifications
Education
* High School or GED
Experience
* Six months of medical records release of information experience in a healthcare setting, preferred
Certifications and Licenses
* Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) desirable
Billings Clinic is Montana's largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital and trauma center, based in Billings, Montana. Learn more at ******************************
Billings Clinic is committed to being an inclusive and welcoming employer, that strives to be kind, safe, and courageous in all we do. As an equal opportunity employer, our policies and processes are designed to achieve fair and equitable treatment of all employees and job applicants. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, religion, sex, gender identity, sexual orientation, pregnancy, marital status, national origin, age, genetic information, military status, and/or disability. To ensure we provide an accessible candidate experience for prospective employees, please let us know if you need any accommodations during the recruitment process.