Johns Hopkins All Children's Hospital jobs - 29 jobs

Inspire health. Serve with compassion. Be the difference. Leads, oversees and ensures the successful delivery and management of projects/systems within scope, quality, schedule, and cost constraints that may be clearly defined or may require dynamic change management to deliver business value. Clinical subject matter expert, and often end user who participates in the selection, planning, and execution of products, services, or outcomes outside of the department scope or regular business duties. May also initiate projects under the direction of pharmacy administration to enhance existing operations. Works with pharmacy executives, directors, functional managers, and clinical pharmacists on a regular basis as well as non-pharmacy clinical, ancillary, informational services, and marketing teams. Collaborates with allocated project team members and evaluates productivity, communication, and teamwork. The job requires project and program management skills to oversee the deliverables for multiple special projects/systems simultaneously so that all projects/systems are integrated across the department. Helps identify project/system strengths, weaknesses, opportunities, and risks. This position allows remote work at the discretion of the reporting operational leader. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference Management of systems/special projects: -Assess feasibility through research and stakeholder engagement -Collect project/system requirements, objectives, and acceptance criteria from sponsors and stakeholders -Ensure that objectives are in line with department and enterprise objectives -Identify, prioritize, and schedule deliverables, milestones, and required activities/tasks -Engage operational leadership to estimate resource requirements, activity durations, and costs -Prepare and update documents such as charter (scope), work breakdown structure, project sign off, and lessons learned -Follow established standards and procedures for reporting and documentation -Work with operational leadership to recruit or assign team members to tasks -Evaluate individual and team performances and provide feedback to operational leadership -Monitor project/system activities, ensuring the accuracy, quality, and integrity of the information -Perform risk assessments and implement mitigation plans -Ensure that the project/system results meet agreed upon business objectives -Facilitate project closure by archiving project documents and conducting project review sessions with stakeholders -Work with operational leadership to smoothly transition deliverables to the functional team(s) Enhancement of operational productivity and performance: -Actively evaluate operational workflow and develop process improvement initiatives where needed -Anticipate, mitigate, and solve workflow problems -Incorporate feedback from patients, clinical staff, ancillary staff, and leaders to improve performance -Standardize yet customize workflow initiatives for individual clinical sites Promotion of a successful project and operational team: -Facilitate effective collaboration and communication among operational, clinical, and ancillary staff -Guide and educate project/system and operational key stakeholders -Unite teammates through conflict resolution and prevention -Recognize individual and team wins -Encourage leadership and professional development opportunities for the team 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 - Bachelor's degree in Pharmacy as a graduate from an ACPE approved College of Pharmacy. PharmD preferred. Experience - Two (2) years of experience with project management, system management, project coordination, and/or general business management. Pharmacy experience preferred. In Lieu Of In lieu of an active SC Pharmacist license, may be a graduate of an ACPE accredited US college of Pharmacy with a SC intern certificate pending initial licensure or have completed requirements for reciprocity pending board of pharmacy interview for licensure. Required Certifications, Registrations, Licenses Licensed to practice as a Pharmacist or eligible to become licensed within 4 months of hire date in the state the team member is working. Knowledge, Skills and Abilities Demonstrated sensitivity to working in a political environment and to interacting with leadership Ability to problem solve. Ability to work in dynamic interdisciplinary team situations; handle urgent, stressful conditions. Ability to exhibit excellent interpersonal skills in dealing with subordinates, peers, supervisors and others outside the department. Knowledge of medical and pharmacy terminology; strong mathematical & computer skills. Understand BOP/DHEC/DEA rules/regulations Work Shift Variable (United States of America) Location Greenville Memorial Med Campus Facility 7001 Corporate Department 70017296 Pharmacy System Support 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.

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.

Inspire health. Serve with compassion. Be the difference. Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in education offerings Participates in monthly meetings 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 - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Five (5) years professional fee coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder (CPC), and Certified Risk Adjustment Coder(CRC) Knowledge, Skills and Abilities Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7002 Value-Based Care and Network Services Department 70028459 HCC Coding Services 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.

Inspire health. Serve with compassion. Be the difference. Ensures all provider services are completely and accurately coded according to approved coding guidelines. Provides coding support to the providers and staff by performing periodic coding reviews, conducting various coding education and training sessions. 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. Educates providers and coding staff within the physician practice setting on proper CPT, ICD-10 and HCPCS coding. Performs random reviews of physician charges to identify opportunities for charge capture, ICD-10 specificity and proper coding of all services rendered. Reviews and responds to coding questions submitted by physicians and coding staff within a timely manner. Communicates billing related issues to assigned supervisor/manager. Shadows provider and coding staff to confirm coding is supported by medical record documentation and identify opportunities to improve upon documentation and coding. Participates in workshops, seminars, webinars, and other educational opportunities to ensure continued learning. Maintain current certification(s) and working knowledge if ICD-10 and CPT coding guidelines. Recommends changes to billing procedures to achieve compliance with applicable laws, rules and regulations. Obtains and maintains instructor status for AAPC PMCC Coding Curriculum, if applicable. Coordinates class schedule and provides instruction for the PMCC Coding Curriculum offered by the AAPC, if applicable. Maintains knowledge if state and federal regulatory guidelines related to proper coding. Participates in meetings with Corporate Compliance in order to identify opportunities for improvement. Schedules education sessions with providers to provide education based on audit findings, if applicable. Participates in A/R Meetings in order to improve overall coding when applicable. 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 - Bachelor's degree in Business or related field of study Experience - Three (3) years billing and/or coding experience In Lieu Of Associate degree with 5 years of coding or coding/billing experience in a professional billing setting. High School Diploma with 7 years coding or coding/billing experience in a professional billing setting. Required Certifications, Registrations, Licenses CPC - CERT PROFESSIONAL CODER Knowledge, Skills and Abilities Data entry skills Work Shift Day (United States of America) Location 1200 Colonial Life Blvd Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services 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.

Thanks for your interest in Children's Mercy! Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years. Children's Mercy is in the heart of Kansas City - a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children's health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital. Overview The Solid Organ Transplant Coordinator performs all activities related to the assigned transplant program, maintaining the resources needed for success. The Coordinator provides direct patient and family care across the continuum from pre-transplant, during transplant and post-transplant, in both ambulatory and inpatient settings. The Coordinator provides education to patients/families, hospital staff, and the community utilizing Organ Procurement and Transplantation Network (OPTN) and United Network For Organ Sharing (UNOS) resources. The Coordinator adheres to clinical practice guidelines, integrates applicable regulatory and practice standards, and participates in quality improvement and research activities. At Children's Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity. Additionally, it's important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children's Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005. If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources. Responsibilities * Provides direct patient care across the continuum from pre-transplant, transplant, and post transplant periods. * Provides education to patients/families, hospital staff, and the community. * Integrates CMS, UNOS and KDIGO standards in practice guidelines and participates in ongoing quality improvement and research activities. Qualifications * Bachelor's Degree and 3-5 years experience Pediatric clinical experience, experience as a transplant coordinator (pediatrics or specialty preferred) * One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire * One of the following: Licensed RN - Kansas, Registered Nurse Multistate License Kansas required upon hire * RN Compact license for all states besides KS and MO * Refer to Nursing and Advanced Practice Provider Licensure and Certification policy for required Life Support Certifications Required Upon Hire * Certified Clinical Transplant Coordinator (CCTC) within 3 years of hire Required Benefits at Children's Mercy The benefits plans at Children's Mercy are one of many reasons we are recognized as one of the best places to work in Kansas City. Our plans are designed to meet the changing needs of our employees and their families. Learn more about Children's Mercy benefits. Starting Pay Our pay ranges are market competitive. The pay range for this job begins at $39.86/hr, but your offer will be determined based on your education and experience. Remote Work/Work from Home This is an intermittent remote position, which means that the person hired will work with his or her manager to determine a schedule that includes both at home and on-site hours at a Children's Mercy location. The incumbent must live in the Kansas City metro area. EEO Employer/Disabled/Vet Children's Mercy hires individuals based on their job skills, expertise and ability to maintain professional relationships with fellow employees, patients, parents and visitors. A personal interview, formal education and training, previous work experience, references and a criminal background investigation are all factors used to select the best candidates. The hospital does not discriminate against prospective or current employees based on the race, color, religion, sex, national origin, age, disability, creed, genetic information, sexual orientation, gender identity or expression, ancestry or veteran status. A drug screen will be performed upon hire. Children's Mercy is smoke and tobacco free. CM is committed to creating a workforce that supports the diverse backgrounds of our patients and families. We know that our greatest strengths come from the people who make up our team, so we hire great people from a wide variety of backgrounds, not just because it's the right thing to do, but because it makes our hospital stronger and our patient care more compassionate. If you share our values and our enthusiasm for service, you will find a home at CM. In recruiting for our team, we welcome the unique contributions that you can bring, including education, ideas, culture, and beliefs.

Inspire health. Serve with compassion. Be the difference. Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions Conducts review and audit of discharged inpatient records (prebill and retrospective reviews) to validate the coding/DRG assignment according to official coding guidelines as supported by the clinical documentation in the record. - 60% Monitor work queues daily to identify, prioritize and assign accounts that need to be coded based on department-specific guidelines and within designated timelines in coordination with leadership. - 10% Mentors and trains coders on application of correct ICD-CD and ICD PCS guidelines. - 10% Coordinates and identifies provider documentation queries for the Clinical Documentation Integrity team to send to clinical providers. Identifies coding and documentation opportunities following established guidelines when existing documentation is unclear or ambiguous following American Health Information (AHIMA) guidelines and established policy. Maintains working knowledge of Centers for Medicare & Medicaid Services (CMS) regulations and applicable carrier local medical review policies. - 10% Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. Collaborates with Coding and CDI to develop and maintain coding curriculum and training materials. - 3% Assists with and develops educational programs for coding staff, clinical documentation staff and medical staff to including yearly coding/DRG updates. - 2% Applies ICD and ICD-PCS codes including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. Codes inpatient records periodically based on review of clinical documentation. - 2% Identifies and assists management with the resolution of coding issues, process improvement and system testing for HIM applications. - 1% Interacts with other departments to resolve coding issues and assists with coding and clinical validation denials. - 1% Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS, Specialty areas and Quality; perform other duties as assigned. - 1% 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 - Associate's degree or Coding Certificate through approved American Health Information Management (AHIMA) or other coding certification program. Experience - 4 years - Four (4) years of experience in in-patient coding and abstracting with healthcare billing process experience in acute care setting. Work experience may NOT substitute for education requirement. Demonstrated high coding accuracy and productivity. In Lieu Of NA Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities Knowledge of electronic medical records and 3M or Encoder System. EPIC health information system experience. Preferred. Strong knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Knowledge of MS DRG prospective payment system and severity systems. Knowledge of Clinical Documentation Improvement principles, quality indicators, formal and informal coding audit process. Ability to work effectively, independently and manage multiple demands consistently. Proficient computer skills (spreadsheets and database). Strong knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Ability to apply broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. - Preferred Work Shift Day (United States of America) Location 1 Medical Park Rd Richland 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.

Inspire health. Serve with compassion. Be the difference. Posts payments and adjustments to invoices resolving any outstanding accounts according to departmental and regulatory guidelines.This is a remote position 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. Analyses and reviews prior account activity and takes necessary actions including calling payer or utilizing payer websites for current status of outstanding accounts receivable (AR). Takes necessary actions to correct claim or obtain any requested information to the payer. Utilizes all appropriate workflows and completes appropriate and detail notes on every account preparing for next steps and/or resolution. Performs daily duties related to collections, variances and/or technical denials in a manner that constantly drives the account towards resolution, while challenging unacceptable responses from payers. Understands, interprets and applies managed care contract terms to accounts for payer resolution. Escalates accounts when appropriate, including but not limited with payer, internally and/or patient when appropriate in accordance with the Prisma Health escalation guidelines in order to minimize aging. Identifies trends and repeated problems and/or charge corrections to management. Contributes to PFS department matrix. Utilizes time and resources, assisting co-workers as time allows. Productivity and quality of work must be met. Identifies areas for improvements. Monitors quality levels, identifies root cause of quality problems and owns/acts on quality problems. 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 - High School diploma or equivalent OR post-high school diploma/highest degree earned Experience - Two (2) years medical billing, customer service, follow up and/or medical office experience. In Lieu Of NA Required Certifications, Registrations, Licenses CRCA preferred. CRCR preferred. Knowledge, Skills and Abilities Communication skills Understands, promotes and adheres to all matters of compliance with laws and regulations. Maintains professional growth and development through seminars, workshops, in-service meetings, current literature and professional affiliations to keep abreast of latest trends in field of expertise. Medical billing, follow up and/or medical office skills Analytical skills Attention to detail Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019122 PBO-Patient Account Services 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.

Inspire health. Serve with compassion. Be the difference. The Trauma Registry Analyst supports the Prisma Health Trauma Program and organizational requirements for verification/designation as a Trauma Center by the State Department of Public Health and American College of Surgeons Committee on Trauma (ACSCOT). The Trauma Registry Analyst is responsible for all aspects of the Trauma Registry Data including abstraction, entry, and coding. The Analyst applies comprehensive knowledge of anatomy, physiology and medical terminology to identify and collect complex data on the diagnoses, treatment and quality metrics related to trauma patients receiving care at a Prisma Health Trauma Center. Requires knowledge of State and National Trauma Standards (NTDS) and applies this knowledge in patient identification, data abstraction, co-morbiity and complication recognition to the trauma registry. Performs ICD-10 coding and AIS (Abbreviated Injury Scale) coding of all diagnoses and procedures of trauma patients. Data collected by the Trauma Registry Analyst is utilized by administrators, performance improvement coordinators, researchers, and American College of Surgeons (ACS) surveyors to evaluate the quality of care provided to trauma patients, for statistical analysis, performance improvement initiatives, trauma quality improvement and research. The Trauma Registry Analyst must utilize critical thinking, organization, and time management skills to achieve and maintain high productivity and accuracy.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. Accurately identifies patients for inclusion in the trauma registry as specified by the National Trauma Data Standard (NTDS), State Trauma Registry, and Trauma Center. Accurately abstracts clinical data from Emergency Management System (EMS) Patient Care Record (PCR), in-patient medical record, referring hospital records and autopsy reports including patient demographics, injury event, pre-hospital information, injury diagnoses, operative and other procedures, ED data, co-morbidities, complications, patient outcome and financial data as defined by State Trauma Registry, NTDS, and Trauma Quality Improvement Program (TQIP). Accuracy and completion timeliness rates must meet or exceed established department goals. Accurately codes all diagnoses, procedures and external cause/location of the trauma patient using AIS coding and ICD-10 coding following trauma center, State Trauma Registry, NTDS, and TQIP guidelines. Actively participates in the PI process and supports research by gathering data on hospital specific performance and research metrics. Identifies and reports complications, comorbidities, issues and trends identified to leader. Performs data validation and correction of registry data at the close of each chart using the registry software validation tool. Performs logic validations monthly and makes corrections. Performs data corrections as needed per validation reports and prior to State and Trauma TQIP data submission. Completes assigned inter-rater validations. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that report to a supervisor, manager, director or executive. Minimum Requirements Education - Associate's degree in HIM or related healthcare field preferred. Experience - One (1) year of trauma registry, coding, HIM or relevant healthcare related experience. Requires completion of AAAM course (AIS coding) and Trauma Registry Course within one (1) year of hire. Requires ICD-10 Coding course within one (1) year of hire. In Lieu Of NA Required Certifications, Registrations, Licenses One of the following certifications is preferred: CSTR (Certified Specialist in Trauma Registries) from the American Trauma Society or CAISS (Certified Abbreviated Injury Scale Specialist) from the Assoc. for the Advancement of Automotive Medicine (AAAM). An AHIMA (American Health Information Management Assoc) or AAPC (American Academy of Professional Coders) coding certification preferred. RHIT, RHIA, or CCS preferred. Knowledge, Skills and Abilities Knowledge of anatomy and physiology and medical terminology as well as disease processes. Work Shift Day (United States of America) Location Richland Facility 1510 Richland Hospital Department 15106579 Trauma/Neuro Administration 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.

Thanks for your interest in Children's Mercy! Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years. Children's Mercy is in the heart of Kansas City - a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children's health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital. Overview The Clinical Nutrition Specialist II provides high quality, comprehensive nutrition care to a defined patient population of higher acuity patients in an efficient, timely and caring manner. Staff responsibilities include nutrition assessment of patients at nutritional risk; development, implementation, and ongoing evaluation of the nutrition care plan; nutrition education of patients and families with consideration for individual needs; timely follow-up/communication with the medical provider. The Clinical Nutrition Specialist II is also involved with educating students, hospital staff and community partners as well as participates in continuous quality improvement efforts and research projects. Promotion to the Clinical Nutrition Specialist II is determined by the Nutrition Leadership Team after an RD has achieved 3 years of experience. At Children's Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity. Additionally, it's important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children's Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005. If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources. Responsibilities * Provide nutrition care for all patients in assigned caseload with emphasis on higher risk patients and patients with chronic disease * Provide education and/or in-service training to students, Nutrition staff, other professionals and community partners * Prepare and participate in Quality Improvement and Research (when available) * Participate in Nutrition department activities Qualifications * Master's Degree and 3-5 years experience as a clinical dietitian * Registered Dietitian required upon hire * DIETITIAN LIC KS Licensed Dietitian KS within two weeks of hire Required * DIETITIAN LIC MO Licensed Dietitian MO within two weeks of hire Required * Certification in Specialty Area Preferred * Membership Academy of Nutrition and Dietetics Benefits at Children's Mercy The benefits plans at Children's Mercy are one of many reasons we are recognized as one of the best places to work in Kansas City. Our plans are designed to meet the changing needs of our employees and their families. Learn more about Children's Mercy benefits. Starting Pay Our pay ranges are market competitive. The pay range for this job begins at $28.25/hr, but your offer will be determined based on your education and experience. Remote Work/Work from Home This is an intermittent remote position, which means that the person hired will work with his or her manager to determine a schedule that includes both at home and on-site hours at a Children's Mercy location. The incumbent must live in the Kansas City metro area. EEO Employer/Disabled/Vet Children's Mercy hires individuals based on their job skills, expertise and ability to maintain professional relationships with fellow employees, patients, parents and visitors. A personal interview, formal education and training, previous work experience, references and a criminal background investigation are all factors used to select the best candidates. The hospital does not discriminate against prospective or current employees based on the race, color, religion, sex, national origin, age, disability, creed, genetic information, sexual orientation, gender identity or expression, ancestry or veteran status. A drug screen will be performed upon hire. Children's Mercy is smoke and tobacco free. CM is committed to creating a workforce that supports the diverse backgrounds of our patients and families. We know that our greatest strengths come from the people who make up our team, so we hire great people from a wide variety of backgrounds, not just because it's the right thing to do, but because it makes our hospital stronger and our patient care more compassionate. If you share our values and our enthusiasm for service, you will find a home at CM. In recruiting for our team, we welcome the unique contributions that you can bring, including education, ideas, culture, and beliefs.

Join our acclaimed Department of Plastic and Oral Surgery and discover how your talents can change lives. The Department of Plastic and Oral Surgery provides world-renowned plastic and maxillofacial care to 17,000 patients across Massachusetts, New England, and the world each year. At Boston Children's Hospital, success is measured through providing the highest quality customer service, while changing lives by delivering excellent care. The Department has led innovations in many areas including 3-D printing, simulated surgeries, facial reanimation, research and treatment for Vascular Anomalies. As the Department continues to innovate and grow, we are looking for individuals like yourself who are passionate about providing the best pediatric healthcare. The ideal candidate is motivated and hardworking and can multitask in a fast-paced environment. They are flexible and resourceful in high-priority situations to achieve superior care for the patient. Learn more about how you can become part of the team helping deliver life changing care with the Plastic & Oral Surgery Department here. Key Responsibilities: * Physician Support: Working with other team members to monitor the physicians' clinical, operative, meeting, and personal schedule/calendar. * Scheduling: Scheduling and registering patients for office visits and procedures. Obtaining and updating patient demographic, insurance, and primary care/referring doctor information. * Physician and department liaison: Being the primary contact between the physician and patient families. Helping answer and resolving patient issues and concerns. Managing patient call volume; answering appointment requests and routing incoming calls to appropriate destination. * Coordination of care: Acting as the face of the practice and managing every step of the patient's care. Communicating the plan of care to the family. * Clinic management: Preparing charts for physician's clinics and checking patients in for various appointments. Organizing all patient information, including verifying insurance and obtaining required medical records and approved insurance referral authorizations on each patient. Promptly and accurately logging updated information. * Administrative tasks: Patient correspondence, distributing incoming mail, sorting and uploading outside notes and radiographs into the patient's medical record. Processing patient paperwork and requests and assisting in letter writing and various projects and tasks when needed. Minimum Qualifications Education: * High School Diploma/ GED. Experience: * Dental administrative and/or general medical surgical scheduling experience a plus. * Basic customer service and computer skills. * Strong communication skills. * Ability to work with diverse internal and external constituencies. * Demonstrates the ability to pay attention to detail and accuracy. Schedule: M- F, HYBRID, Shifts can be either 7:30am-8:30am- 4pm/5:00 pm. Location can be either Waltham or Boston. This role is eligible for a $2,000 sign on bonus (not eligible for internal candidates and not eligible for former BCH employees who worked here in the past 2 years). Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

Inspire health. Serve with compassion. Be the difference. Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental policies for charge corrections. Participates in coding educational opportunities (webinars, in house training, etc.). Provides feedback to providers in order to clarify and resolve coding concerns. Resolves assigned pre-billing edits. Assists in identifying areas that require additional training. Mentors and assists in training other coders and new team members 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 - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Five (5) years professional fee coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder (CPC) Specialty Certification from AAPC that correlates with assigned specialty Knowledge, Skills and Abilities Maintain knowledge of governmental and commercial payer guidelines. Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Blount Memorial Hospital Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services 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.

Inspire health. Serve with compassion. Be the difference. Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process Provides feedback to providers in order to clarify and resolve coding concerns. Assists in identifying areas that need additional training. 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 - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Two (2) years professional coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder-CPC Knowledge, Skills and Abilities Maintains knowledge of governmental and commercial payer guidelines. Participates in coding educational opportunities (webinars, in house training, etc.). Ability to utilizes appropriate coding software and coding resources in order to determine correct codes. Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Corporate Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services 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.

Inspire health. Serve with compassion. Be the difference. Leads, oversees and ensures the successful delivery and management of projects/systems within scope, quality, schedule, and cost constraints that may be clearly defined or may require dynamic change management to deliver business value. Clinical subject matter expert, and often end user who participates in the selection, planning, and execution of products, services, or outcomes outside of the department scope or regular business duties. May also initiate projects under the direction of pharmacy administration to enhance existing operations. Works with pharmacy executives, directors, functional managers, and clinical pharmacists on a regular basis as well as non-pharmacy clinical, ancillary, informational services, and marketing teams. Collaborates with allocated project team members and evaluates productivity, communication, and teamwork. The job requires project and program management skills to oversee the deliverables for multiple special projects/systems simultaneously so that all projects/systems are integrated across the department. Helps identify project/system strengths, weaknesses, opportunities, and risks. This position allows remote work at the discretion of the reporting operational leader. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference Management of systems/special projects: -Assess feasibility through research and stakeholder engagement -Collect project/system requirements, objectives, and acceptance criteria from sponsors and stakeholders -Ensure that objectives are in line with department and enterprise objectives -Identify, prioritize, and schedule deliverables, milestones, and required activities/tasks -Engage operational leadership to estimate resource requirements, activity durations, and costs -Prepare and update documents such as charter (scope), work breakdown structure, project sign off, and lessons learned -Follow established standards and procedures for reporting and documentation -Work with operational leadership to recruit or assign team members to tasks -Evaluate individual and team performances and provide feedback to operational leadership -Monitor project/system activities, ensuring the accuracy, quality, and integrity of the information -Perform risk assessments and implement mitigation plans -Ensure that the project/system results meet agreed upon business objectives -Facilitate project closure by archiving project documents and conducting project review sessions with stakeholders -Work with operational leadership to smoothly transition deliverables to the functional team(s) Enhancement of operational productivity and performance: -Actively evaluate operational workflow and develop process improvement initiatives where needed -Anticipate, mitigate, and solve workflow problems -Incorporate feedback from patients, clinical staff, ancillary staff, and leaders to improve performance -Standardize yet customize workflow initiatives for individual clinical sites Promotion of a successful project and operational team: -Facilitate effective collaboration and communication among operational, clinical, and ancillary staff -Guide and educate project/system and operational key stakeholders -Unite teammates through conflict resolution and prevention -Recognize individual and team wins -Encourage leadership and professional development opportunities for the team 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 - Bachelor's degree in Pharmacy as a graduate from an ACPE approved College of Pharmacy. PharmD preferred. Experience - Two (2) years of experience with project management, system management, project coordination, and/or general business management. Pharmacy experience preferred. In Lieu Of In lieu of an active SC Pharmacist license, may be a graduate of an ACPE accredited US college of Pharmacy with a SC intern certificate pending initial licensure or have completed requirements for reciprocity pending board of pharmacy interview for licensure. Required Certifications, Registrations, Licenses Licensed to practice as a Pharmacist or eligible to become licensed within 4 months of hire date in the state the team member is working. Knowledge, Skills and Abilities Demonstrated sensitivity to working in a political environment and to interacting with leadership Ability to problem solve. Ability to work in dynamic interdisciplinary team situations; handle urgent, stressful conditions. Ability to exhibit excellent interpersonal skills in dealing with subordinates, peers, supervisors and others outside the department. Knowledge of medical and pharmacy terminology; strong mathematical & computer skills. Understand BOP/DHEC/DEA rules/regulations Work Shift Variable (United States of America) Location Greenville Memorial Med Campus Facility 7001 Corporate Department 70017296 Pharmacy System Support 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.

Inspire health. Serve with compassion. Be the difference. All employees are expected to be knowledgeable and compliant with Prisma Health's values of compassion, dignity, excellence, integrity and teamwork. This job is responsible for the identification of trauma patients meeting registry inclusion criteria, abstracting clinical and outcomes data from the medical record, coding diagnoses, procedures, and injuries utilizing ICD-10 coding, AIS coding, E-Codes, and entering data into the Trauma Registry per National Standards and State Standards/State Trauma Regulations published by the American College of Surgeons (ACS), National Trauma Data Bank (NTDB) and SC Department of Health and Environmental Control (DHEC). Performs data analysis on Trauma Registry data for monitoring data quality and performs data analysis and writes reports to support the activities of the Trauma Program such as performance improvement, research, administrative and medical staff meetings, injury prevention, and Trauma Center Designation/Verification process. Essential Functions * All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. * Maintains professional development and current in coding principles. Maintains current knowledge of and complies with National standards published by the ACS, State Standards published by DHEC and State Trauma Regulations. Maintains registry within the standards and dataset of NTDB, State Trauma Registry Data Dictionary, and PHR Trauma Program. * Accurately identifies patients meeting Trauma Registry inclusion criteria per SC Trauma Registry Data Dictionary, NTDB and ACS standards for inclusion into the Trauma Registry. * Accurately abstracts clinical data from pre-hospital EMS database and the in-patient medical record including demographics, co-morbidities, diagnoses, injuries, ED data, operations, procedures, complications, outcomes, performance improvement, and financial data per SC Trauma Registry Data Dictionary, NTDB and ACS standards, and PHR Trauma Program. * Accurately codes procedures, diagnoses, and injuries using ICD-10 coding, AIS injury coding, E-codes and other appropriate coding schemes, and accurately enters into Trauma Database within departmental guidelines. * Participates in performance improvement monitoring by gathering data on performance metrics, identifying and reporting complications, and performing analysis of registry data in support of clinical process improvement initiatives. Prepares reports pertinent to Trauma performance improvement and reports issues and trends identified to PI Coordinator and TPM. * Prepares, processes and submits Trauma Registry records to State Trauma Registry quarterly per State Trauma Regulations and annually to the National Trauma Data Bank within established timeframe. Ensures compliance of registry with Palmetto Health HIPPA regulations. * Responsible for report writing from the Trauma Registry Database for information requests by trauma administration, physicians, other PHR departments, and outside entities to support coding, billing, trauma research, injury prevention, performance improvement, Trauma Center Designation/Verification process, and other activities of the Trauma Program. Ensures compliance with Palmetto Health HIPPA and IRB research policies. * Performs data analysis and data validation on Trauma Registry Data on a routine basis for data quality and errors and omissions to maintain registry integrity. * Attends and participates in Multi-disciplinary Trauma Patient Care Conference, Multi-disciplinary Trauma Committee, and Trauma Association of South Carolina. Participates at the State level in all activities involving Trauma Registry. * Independently works with Trauma Registry software vendor and PHR information technology on NTDB and State data submissions, upgrades, data imports, and all enhancements involving Trauma Registry. * Performs other duties as assigned. Supervisory/Management Responsibilities * This is a non-management job that report to a supervisor, manager, director or executive. Minimum Requirements * Education - Associate Degree in Health Information Management or related field of study. * Experience - Two (2) years in medical record coding or relevant clinical experience. In Lieu Of * In Lieu of the education and experience requirements noted above, the following combination of education, training and/or experience will be considered an equivalent substitution: An AHIMA, AAPC coding certification, CSTR and/or CAISS, or other healthcare related licensure. Required Certifications, Registrations, Licenses * RHIT, RHIA, CCS, or CSTR (Certified Specialist in Trauma Registry) preferred or eligible. Requires AAAM course certification (AIS coding) and Trauma Registry Course within one (1) year. Knowledge, Skills and Abilities * Extensive knowledge of ICD-10 coding, AIS coding, E-codes, anatomy, physiology, medical terminology and disease processes. * Computer literate and be proficient in keyboarding, spreadsheets, word processing, and databases. * Ability to analyze and report registry data to support the activities of the Trauma Program. * Ability to work independently and have a strong aptitude for detail. Work Shift Day (United States of America) Location Richland Facility 1510 Richland Hospital Department 15106579 Trauma/Neuro Administration 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.

Inspire health. Serve with compassion. Be the difference. Performs tasks of moderate to difficult complexity relating to both hospital and physician accounts. Handles a large volume of inbound calls. Responsible for also making outbound calls related to self-pay follow up on accounts. Assists patients with requests for information, complaints, and resolving issues. Responsible for data analysis and interpretation throughout all functions of revenue cycle, to determine reasons for denials, non-payment and overpayment, post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances and analysis/movement of unapplied, unidentified, undistributed balances. Moderate to difficult levels of evaluation, analysis, decision making required in these roles. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Resolves billing concerns, addresses inquiries related to insurance concerns/matters, assist patients with MyChart while simultaneously establishing a rapport with our diverse field of patients. Reviews accounts to determine insurance coverage; obtains and corrects any missing or inaccurate information. Discusses patient responsibility, which includes educating patients on claim processing, deductible, coinsurance, and co-pays. Interacts with patients by making patients aware of payment options such as payment plans and financial assistance as well as how to apply for financial assistance if circumstance warrant. Ability to set up payment plans in MyChart based on patient's personal needs. Greets patients in a professional and courteous manner. Communicates clearly and professionally in both oral and written communication. Be clear and concise in all communication to ensure patients understand the information that is being communicated to them by the Customer Service Specialist. Maintains a high level of poise and professionalism in dealing with patients. Knows when to escalate a patient service issue real time. Research customer requests or issues, determines if further action is needed, forwards to appropriate party for resolution, and exercises good judgement to determine urgency of patient's need. Contacts payer and makes hard inquiries on account status if needed. Escalates problem accounts to the appropriate area(s). Documents billing activity on a patient's accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders. Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for any potential further analysis if needed. Ensures all work is compliant with privacy, HIPAA, and regulatory requirements. Participates in general or special assignments and attends all required training. Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance. Answers all incoming calls from Prisma Health patients 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 - High School diploma or equivalent OR post-high school diploma / highest degree earned Experience - Two (2) years billing, bookkeeping, and/or accounting experience In Lieu Of NA Required Certifications, Registrations, Licenses NA Knowledge, Skills and Abilities Knowledgeable of the job functions required for a A/R Follow-up Representative, Cash Posting Representative, Claims Clearinghouse Representative, Correspondence Representative, Credit Processing Specialist, Denial/Appeals Specialist, Payment Research Specialist and a Quality Assurance Specialist. Knowledgeable of the entire Revenue Cycle and Epic. Work Shift Day (United States of America) Location Patewood Outpt Ctr/Med Offices Facility 7001 Corporate Department 70019935 System Billing Office 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.

Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. 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 values: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Incumbent(s) operate under the general supervision of HIM Coding leadership. Applies ICD and ICD-PCS codes to inpatient records, including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/CCs, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the optimal principal diagnoses with appropriate POA indicator assignment and sequencing of risk adjustment diagnoses following established guidelines. Reviews work queues 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. Identifies and requests physician queries following established guidelines when existing documentation is unclear or ambiguous following American Health Information Management (AHIMA) guidelines and established organization policies. Ensures all open queries initiated by Clinical Documentation Specialists have been addressed prior to final coding. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Adheres to department standards for productivity and accuracy. Identifies and trends coding issues escalating identified concerns Consults, provides professional expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. 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 or Associate degree or Coding Certificate through American Health Information Management (AHIMA) or other approved coding certification program. Experience - Three (3) years coding experience in an acute care or ambulatory setting. Inpatient coding experience. EPIC health information system experiences preferred. In Lieu Of In lieu of education and experience requirements noted above, successful completion of the IP Coder Associate program or coder associate may be considered. Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. Knowledge, Skills and Abilities Participates in on site, remote and/or external training workshops and training. Attends and participates in CDI-Coding Task Force and other collaborative training and education with CDI, PFS and Quality. Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate coding assignment. Knowledge of electronic medical records and 3M or Encoder System. Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. Knowledge of MS DRG prospective payment system and severity systems. Ability to concentrate for extended periods of time. Ability to work and make decisions independently. Work Shift Day (United States of America) Location 5 Medical Park Rd Richland 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.

Inspire health. Serve with compassion. Be the difference. Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues.Job Description Essential Functions Validate/Review codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. 40% Responsible for resolving all assigned pre-billing edits.15% Utilizes appropriate coding software and coding resources in order to determine correct codes. 15% Communicates billing related issues to assigned supervisor/manager and participates in Denial meetings in order to improve overall billing when applicable. 10% Participates in coding educational opportunities (webinars, in house training, etc.). 5% Provides timely feedback to providers in order to clarify and resolve coding concerns. 5% Maintain knowledge of governmental and commercial payer guidelines. 5% Assists with the Coding Education team to identify areas that need additional training. 5% 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 - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree - Preferred Experience - 2 years - Professional coding only In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder-CPC Knowledge, Skills and Abilities Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database and data entry Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services 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.

Inspire health. Serve with compassion. Be the difference. The Professional Billing Quality Coding Auditor will support the Medical Group Coding and Education department by performing routine reviews of coders to ensure accurate coding. This position will also perform specialty reviews as identified by Coding and Education leadership. Prepares a summary of findings and presents reports to leadership on a monthly basis. Will assist with training coders on identified opportunities for improvement. Will also assist in preventing coding denials when applicable. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers and HCPCS codes using official coding guidelines and CMS guidelines and prepares a summary of findings. Performs review of all coders within the department and prepares a summary of findings. Provides training to coders on identified issues found during reviews. Codes charges for professional billing based on review of clinical documentation. Identifies and assists with the resolution of coding issues and process improvement. Assists in creating edits to prevent denials. Assists in creating a standardized process for front end coding including the development of training materials. Mentors and trains coders on correct coding guidelines. Interacts with other departments to assist in resolving coding. 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 - Bachelor's degree in Business or related field of study Experience - Three (3) years multi-specialty coding experience in professional billing In Lieu Of NA Required Certifications, Registrations, Licenses CPC Certified Professional Coder (AAPC) and CPMA Certified Professional Medical Auditor (AAPC) Knowledge, Skills and Abilities Knowledge of medical terminology and basic anatomy and physiology with the ability to apply coding concepts to ensure correct coding. Analytical skills. Working knowledge of Epic, Encoder Pro, 3M Ability to work independently and manage multiple projects consistently Proficient computer skills (word processing, spreadsheets, database) Data entry skills Work Shift Day (United States of America) Location Independence Pointe Facility 7001 Corporate Department 70019178 Medical Group Coding & Education Services 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.

Inspire health. Serve with compassion. Be the difference. Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in education offerings Participates in monthly meetings 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 - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred Experience - Five (5) years professional fee coding experience In Lieu Of NA Required Certifications, Registrations, Licenses Certified Professional Coder (CPC), and Certified Risk Adjustment Coder (CRC) Knowledge, Skills and Abilities Knowledge of office equipment (fax/copier) Proficient computer skills including word processing, spreadsheets, database Data entry skills Mathematical skills Work Shift Day (United States of America) Location Independence Pointe Facility 7002 Value-Based Care and Network Services Department 70028459 HCC Coding Services 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.