Interviewer jobs at LIFESOURCE BLOOD SERVICES INC - 15 jobs

Introduction Do you want to join an organization that invests in you as an Inpatient Coding Quality Audit Reviewer? At Parallon, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years. Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: * Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. * Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. * Free counseling services and resources for emotional, physical and financial wellbeing * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for child, elder and pet care, home and auto repair, event planning and more * Consumer discounts through Abenity and Consumer Discounts * Retirement readiness, rollover assistance services and preferred banking partnerships * Education assistance (tuition, student loan, certification support, dependent scholarships) * Colleague recognition program * Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Quality Audit Reviewer like you to be a part of our team. Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: * Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and/or outpatient coding across multiple HSCs * Assists in ensuring HSC coding staff adherence with coding guidelines and policy * Demonstrates and applies expert level knowledge of medical coding practices and concepts * Participates on special reviews or projects * Maintains or exceeds 95% productivity standards * Maintains or exceeds 95% accuracy * Meets all educational requirements as stated in current Company policy * Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current What qualifications you will need: * High school diploma and/or GED preferred * Undergraduate degree in HIM/HIT preferred * Minimum of 3 years acute care inpatient/outpatient coding experience preferred * Minimum of 3 years coding auditing/monitoring experience strongly preferred * RHIA, RHIT and/or CCS preferred * Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding Opportunities. CLICK HERE for more information on Parallon HCA Coding Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. " "Good people beget good people."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Inpatient Coding Quality Audit Reviewer opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Department: 85056 Wake Forest University Health Sciences - Academic Clinical and Translational Science Institute (CTSI) Status: Part time Benefits Eligible: No Hours Per Week: 15 Schedule Details/Additional Information: Part-time flexible days/evenings/weekends Fully remote 12-19 hours/week Pay Range $20.80 - $31.20 JOB SUMMARY Under general supervision, interviews and records responses of study/survey participants over the telephone or in person as needed. The Research Interviewer will work on the new PCORI funded project, “Comparing Registry Surveillance and Provider Alerts with and without Patient Outreach, Navigation, and Care Coordination” a multi-center research project designed to study how health systems can help more patients overcome roadblocks to achieve early kidney transplants. This study follows over 1,100 patients with chronic kidney disease receiving care in three health systems (Duke Health, Geisinger Health, University of Mississippi Medical Center) and will study the long-term effect of a new intervention called Patient Centered Early Health System Transplant Outreach. This intervention was designed to (1) identify patients qualifying for kidney transplants as early as possible, (2) support patients and their families with education and behavioral support to help them talk about overcome roadblocks to early transplants, (3) proactively reach out to patients to let them know they are eligible for early transplants and invite them to the transplant center, and (4) navigate patients through the multi-step transplant preparation process. All patients enrolled in the study have completed the intervention and are being followed for an additional 5 years. Research Interviewers will contact patients by telephone for consent to extend their enrollment and to complete telephone surveys every 6 months from April 2026-December 2029. Research Interviewers will use an on-line program (REDCap) to enter participants responses to the survey questions. He/she will contact study participants using a study assigned mobile phone. The Research Interviewer will track contact attempts (e.g., no answer, disconnected phone, message left, successful contact) and outcomes of contacts (e.g., ineligible, refused, completed). Project work will begin as early as April 2026 and will end December 2029. The Research Interviewer will work remotely. All Research Interviewers will be required to complete human subjects training through the CITI program. Research Interviewers are asked to work remotely between 12-19 hrs/wk with a flexible calling schedule Mon-Sat from 8am (EST) - 8pm (EST). EDUCATION/EXPERIENCE High school diploma or GED equivalent. Prior experience in a Call Center, Help Desk or interviewing study participants preferred. Foreign language skills preferred. SKILLS/QUALIFICATIONS Excellent telephone skills Effective oral and written communication skills Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest savings for clients. What you will do: * Perform comprehensive inpatient DRG validation reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc. * Perform readmission reviews, including evaluating prior and current admissions to determine preventability, relatedness, and compliance with readmission policies. * Based on the evidence presented in the medical records, determine, and record the appropriate (revised) Diagnosis Codes, Procedure Codes and Discharge Status Code applicable to the claim. * Using the revised codes, regroup the claim using provided software to determine the 'new DRG' * Where the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review * Document all aspects of audits including uploading all provider communications, clinical rationale, and/or financial research * Identify new DRG coding concepts to expand the DRG product. * Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating Procedures * Meet and/or exceed all internal and department productivity and quality standards * Recommend new methods to improve departmental procedures * Achieve and maintain personal production and savings quota * Maintain awareness of and ensure adherence to Zelis standards regarding privacy What you will bring: * RN or LVN required * Inpatient Coding Certification required (CCS, CIC) within 4 - 6 months of hire date * 1 -3 years reviewing and or auditing ICD-10 CM, MS-DRG and APPR-DRG claims preferred * Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs * Experience performing readmission reviews, including evaluating relatedness, preventability, and compliance with readmission policies * Understanding of hospital coding and billing rules * Clinical skills to evaluate appropriate Medical Record Coding * Experience conducting root cause analysis and identifying solutions * Strong organization skills with attention to detail * Outstanding verbal and written communication skills Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Base Salary Range $79,000.00 - $99,750.00 At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email ***************************. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

Department: 85056 Wake Forest University Health Sciences - Academic Clinical and Translational Science Institute (CTSI) Status: Part time Benefits Eligible: No Hours Per Week: 15 Schedule Details/Additional Information: Part-time flexible days/evenings/weekends Fully remote 12-19 hours/week Pay Range $20.80 - $31.20 JOB SUMMARY Under general supervision, interviews and records responses of study/survey participants over the telephone or in person as needed. The Research Interviewer will work on the new PCORI funded project, "Comparing Registry Surveillance and Provider Alerts with and without Patient Outreach, Navigation, and Care Coordination" a multi-center research project designed to study how health systems can help more patients overcome roadblocks to achieve early kidney transplants. This study follows over 1,100 patients with chronic kidney disease receiving care in three health systems (Duke Health, Geisinger Health, University of Mississippi Medical Center) and will study the long-term effect of a new intervention called Patient Centered Early Health System Transplant Outreach. This intervention was designed to (1) identify patients qualifying for kidney transplants as early as possible, (2) support patients and their families with education and behavioral support to help them talk about overcome roadblocks to early transplants, (3) proactively reach out to patients to let them know they are eligible for early transplants and invite them to the transplant center, and (4) navigate patients through the multi-step transplant preparation process. All patients enrolled in the study have completed the intervention and are being followed for an additional 5 years. Research Interviewers will contact patients by telephone for consent to extend their enrollment and to complete telephone surveys every 6 months from April 2026-December 2029. Research Interviewers will use an on-line program (REDCap) to enter participants responses to the survey questions. He/she will contact study participants using a study assigned mobile phone. The Research Interviewer will track contact attempts (e.g., no answer, disconnected phone, message left, successful contact) and outcomes of contacts (e.g., ineligible, refused, completed). Project work will begin as early as April 2026 and will end December 2029. The Research Interviewer will work remotely. All Research Interviewers will be required to complete human subjects training through the CITI program. Research Interviewers are asked to work remotely between 12-19 hrs/wk with a flexible calling schedule Mon-Sat from 8am (EST) - 8pm (EST). EDUCATION/EXPERIENCE High school diploma or GED equivalent. Prior experience in a Call Center, Help Desk or interviewing study participants preferred. Foreign language skills preferred. SKILLS/QUALIFICATIONS Excellent telephone skills Effective oral and written communication skills Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation * Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training * Premium pay such as shift, on call, and more based on a teammate's job * Incentive pay for select positions * Opportunity for annual increases based on performance Benefits and more * Paid Time Off programs * Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability * Flexible Spending Accounts for eligible health care and dependent care expenses * Family benefits such as adoption assistance and paid parental leave * Defined contribution retirement plans with employer match and other financial wellness programs * Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Various (United States of America) Are you looking to join an organization that promotes growth and values your passion for providing care and services to patients, families, and our community? If so, apply today and join us on Monday, February 2, 2026 at Kennestone Hospital (677 Church Street, Marietta, GA 30060 - Blue Parking Deck) between 12:00PM - 4:00PM. At Wellstar, we appreciate all that you do - for patients, the community and for other team members. Much like our care is tailored to individual needs, so are our careers. By creating a culture that encourages fulfillment for each of our team members, Wellstar supports individuals in pursuing their specific career goals and well-being! We want to help you make the most of all life's moments - both on and off the job. A recruiter will be in touch with you regarding event details. If you are unable to attend the event, we will work with you to schedule an interview based on your availability. Positions Available: Linen Techs Bed Control Liaisons Floor Techs Unit Support Associates Environmental Services Techs Centralized Transporters Supervisor Manager And More! Job Summary: This critical role provides the full range of support necessary for regular, terminal, and isolation cleaning. A key part of this role's accountability is to ensure compliance standards are maintained during the cleaning of hospital specialty areas ( i.e. Operating Room Suites, CATH Labs, GI Labs, VARU, Pharmacy Compounding Lab, Vascular, Labor and Delivery Suites, etc.). More general duties include the following; 1) Proper removal, placement and transporting of waste (i.e. Solid, Chemotherapy, Bio-Hazard, Pharmaceutical, & Hot), recyclables, and other regulated materials; 2) Proper use of Ultra Violet Light devices; and 3) Changing out, removal and replacement of containers (Sharps, Pharmacy Waste, Bio-Hazard, & Chemo Therapy). Since this role is extremely visible to all stakeholders, the incumbent must have good customer service and interpersonal skills to effectively interact with staff members, guests, patients and their families. Individuals will be trained and authorized to handle the proper duties in their assigned areas. Core Responsibilities and Essential Functions: Safety & Infection Prevention * Performs the full range of restroom cleaning and complete patient room cleaning. Always following the cleaning protocol as determined by room, area, location type, i.e. regular room cleaning, terminal cleaning, isolation room cleaning, etc. * Follows infection prevention protocols, knowledgeable of and selects the proper chemicals to accomplish cleaning task(s) * Performs the full range of routine type cleaning tasks such as maintenance of wall, doors, glass/windows, furniture, equipment, floors to include dust mopping, wet mopping, corners, edges, base coves, kick plates, etc. * The proper removal of trash and linen, ensuring that waste streams guidelines and protocol is followed based on waste type, i.e. solid waste, bio-waste, chemotherapy waste, pharmaceutical waste, etc. * Consistently uses correct personal protective equipment (PPE) and donning and doffing techniques to ensure personal safety and that of others. * Consistently uses proper lifting techniques to avoid personal injury. * Comply with all hospital and department rules, policies and procedures. * Follow all protocol for proper and safe us of Ultra Violet Light equipment * Places proper type, size and number of replacement liners in waste containers and complete proper tie off as required. Customer Service * Always exhibit a positive disposition when greeting and supporting staff members, patients, and visitors. * Consistently practices great customer service shills and interpersonal skills when interacting with patients, patient family members, guest and co-workers. * Consistently practices skills and behaviors that support efforts toward World Class Service Teamwork * Work with special project team and/or projects as assigned by supervisor. * Participate in performance improvement projects as required Communication * Documents daily assignments completed. Adjusts to staff shortages and covers other assigned areas. * Uses Epic system to maintain productive flow of beds and patients. Logs in and out as required. Performs other duties as assigned Complies with all WellStar Health System policies, standards of work, and code of conduct. Required Minimum Education: High School Diploma General-Preferred or GED General-Preferred Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated. Additional License(s) and Certification(s): Required Minimum Experience: Some experience Preferred Required Minimum Skills: The ability to speak fluent English must possess the ability to read, write and understand simple instructions in English, The satisfactory completion of the Departmental Training Program must be accomplished during the first thirty (30) days of employment. Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

**Introduction** Do you want to join an organization that invests in you as an Inpatient Coding Quality Audit Reviewer? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. **Benefits** Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (********************************************************************** **_Note: Eligibility for benefits may vary by location._** You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Quality Audit Reviewer like you to be a part of our team. **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. **What you will do in this role:** + Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and/or outpatient coding across multiple HSCs + Assists in ensuring HSC coding staff adherence with coding guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or projects + Maintains or exceeds 95% productivity standards + Maintains or exceeds 95% accuracy + Meets all educational requirements as stated in current Company policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current **What qualifications you will need:** + High school diploma and/or GED preferred + Undergraduate degree in HIM/HIT preferred + Minimum of 3 years acute care inpatient/outpatient coding experience preferred + Minimum of 3 years coding auditing/monitoring experience strongly preferred + RHIA, RHIT and/or CCS preferred + Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding Opportunities. CLICK HERE for more information on Parallon HCA Coding (********************************************************************* **Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. " "Good people beget good people."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Inpatient Coding Quality Audit Reviewer opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!** We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview At Zelis, the Itemized Bill and Clinical Chart Dispute Reviewer role is responsible for the resolution of facility and provider disputes as they relate to itemized bill review and clinical claim reviews. They will be responsible for reviewing facility inpatient and outpatient claims for Health Plans and TPA's to ensure adherence to proper coding and billing guidelines as it relates to the Itemized Bill Review (IBR) product and Clinical Chart Review (CCR) product on industry standard coding guidelines and clinical policies, supporting the Office of the Chief Medical Officer in managing disputes related to claim reviews. This position will also be responsible for being a resource for the entire organization regarding IBR and CCR claims. This is a production-based role with production and quality metric goals. What you'll do: * Review provider disputes for Itemized Bill Review (IBR) and Clinical Chart Review (CCR) and submit explanation of dispute rationale back to providers based on dispute findings within the designated timeframe to ensure client turnaround times are met. * Accountable for daily management of claim dispute volume, adhering to client turnaround time, and department Standard Operating Procedures * Serve as subject matter expert for the Expert Claim Review Team on day-to day activities including troubleshooting and review for data accuracy. * Serve as a subject matter expert for content and bill reviews and provide support where needed for inquiries and research requests. * Create and present education to Expert Claim Review Teams and other departments dispute findings. * Research and analysis of content for bill review. * Use of strong coding and industry knowledge to create and maintain bill review content, including but not limited CCR Review Guidelines and Templates, Itemized Bill Review Coding guidelines and Dispute Rationales * Perform regulatory research from multiple sources to keep abreast of compliance enhancements and additional bill review opportunities. * Support for client facing teams as needed relating to client inquiries related to provider disputes. * Utilize the most up-to-date approved Zelis medical coding sources for bill review maintenance. * Communicate and partner with CMO and members of Expert Claim Review Product and Operations teams regarding important issues and trends. * Ensure adherence to quality assurance guidelines. * Monitor, research, and summarize trends, coding practices, and regulatory changes. * Actively contribute new ideas and support ad hoc projects, including time-sensitive requests. * Ensure adherence to quality assurance guidelines. * Maintain awareness of and ensure adherence to ZELIS standards regarding privacy. What you'll bring to Zelis * 5+ years reviewing and/or auditing itemized bill review and clinical chart review claims preferred * Current, active Outpatient Coding Certification required (such as CPC, CCS, or equivalent credentialing). * Registered Nurse licensure preferred * Bachelor's Degree Preferred in business, healthcare, or technology preferred. * Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers * Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs * Understanding of hospital coding and billing rules * Clinical skills to evaluate appropriate Medical Record Coding * Experience performing regulatory research from multiple sources, formulating an opinion, and presenting findings in an organized, concise manner. * Background and/or understanding of the healthcare industry. * Knowledge of National Medicare and Medicaid regulations. * Knowledge of payer reimbursement policies. * Creative problem-solving skills, leveraging insights and input from other parts of an organization. * Consistently demonstrate ability to act and react swiftly to continuous challenges and changes. * Excellent analytical skills with data and analytics related solutions. * Excellent communication skills. * Strong organization and project/process management skills. * Strong initiative, self-directed and self-motivation. * Good negotiation, problem solving, planning and decision-making skills. * Ability to manage projects simultaneously and achieve goals. * Excellent follow through, attention to detail, and time management skills. Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Base Salary Range $79,000.00 - $99,750.00 At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email ***************************. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

**Discover Your Career at Emory University** Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community. **Description** Emory University's School of Nursing is seeking a dedicated and detail-oriented Senior Research Interviewer to join their team. This position will play a key role in participant recruitment, engagement, and data collection for two important longitudinal studies focused on caregivers of individuals with dementia and patients undergoing home dialysis. The ideal candidate will be highly motivated, efficient, and committed to maintaining the highest standards of integrity and work ethic while supporting research that makes a meaningful impact on patient care and caregiver well-being. KEY RESPONSIBILITIES: + Recruits, screens, identifies, contacts, and interviews participants to obtain data for assigned research projects. + Interviews may be conducted in person, in a clinical setting, the subject's residence, or by telephone. + Coordinates the data collection process. + May abstract data from the participant's medical record. + Schedules appointments, obtains consent forms, explains the study to the participant and collects data. + May observe participants and record results of observation through written documentation or video recording. + Edits completed questionnaires for completeness, legibility and accuracy. + Follows up with participants to obtain missing data or clarify existing data. + Designs forms, worksheets and study questionnaires. + May code and enter data into a database. + Compiles data and produces reports to be used for analysis of research findings. + May monitor blood pressure and heart rate and may take vital signs and height/weight measurements. + May collect blood, saliva, or urine samples from participants and prepare them for laboratory testing. + Provides direction to others engaged in the interviewing process. + Maintains required record-keeping. + Performs related responsibilities as required. MINIMUM QUALIFICATIONS: + A high school diploma or equivalent. + Two years of administrative support, customer service or other related experience which includes one year of interviewing experience. + Data entry experience. + Positions that require drawing blood require completion of a phlebotomy training program. NOTE: This role will be granted the opportunity to work from home regularly but must be able to commute to Emory University location as needed. All biweekly employees must reside within the State of Georgia. Emory reserves the right to change this status with notice to employee. **Additional Details** Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory University does not discriminate in admissions, educational programs, or employment, including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training. Students, faculty, and staff are assured of participation in university programs and in the use of facilities without such discrimination. Emory University complies with Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veteran's Readjustment Assistance Act, and applicable executive orders, federal and state regulations regarding nondiscrimination, equal opportunity, and affirmative action (for protected veterans and individuals with disabilities). Inquiries regarding this policy should be directed to the Emory University Department of Equity and Civil Rights Compliance, 201 Dowman Drive, Administration Building, Atlanta, GA 30322. Telephone: ************ (V) | ************ (TDD). Emory University is committed to ensuring equal access and providing reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to seek a reasonable accommodation, please contact the Department of Accessibility Services at accessibility@emory.edu or call ************ (Voice) | ************ (TDD). We kindly ask that requests be made at least seven business days in advance to allow adequate time for coordination. **Connect With Us!** Connect with us for general consideration! **Job Number** _159341_ **Job Type** _Regular Full-Time_ **Division** _School Of Nursing_ **Department** _SON: Academic Advancement_ **Job Category** _Clinical Research_ **Campus Location (For Posting) : Location** _US-GA-Atlanta_ **_Location : Name_** _Emory Campus-Clifton Corridor_ **Remote Work Classification** _Primarily Remote - Biweekly_ **Health and Safety Information** _Not Applicable_

Introduction Do you want to join an organization that invests in you as an Inpatient Coding Quality Audit Reviewer? At Parallon, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years. Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: * Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. * Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. * Free counseling services and resources for emotional, physical and financial wellbeing * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for child, elder and pet care, home and auto repair, event planning and more * Consumer discounts through Abenity and Consumer Discounts * Retirement readiness, rollover assistance services and preferred banking partnerships * Education assistance (tuition, student loan, certification support, dependent scholarships) * Colleague recognition program * Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Quality Audit Reviewer like you to be a part of our team. Job Summary and Qualifications As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. What you will do in this role: * Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and/or outpatient coding across multiple HSCs * Assists in ensuring HSC coding staff adherence with coding guidelines and policy * Demonstrates and applies expert level knowledge of medical coding practices and concepts * Participates on special reviews or projects * Maintains or exceeds 95% productivity standards * Maintains or exceeds 95% accuracy * Meets all educational requirements as stated in current Company policy * Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current What qualifications you will need: * High school diploma and/or GED preferred * Undergraduate degree in HIM/HIT preferred * Minimum of 3 years acute care inpatient/outpatient coding experience preferred * Minimum of 3 years coding auditing/monitoring experience strongly preferred * RHIA, RHIT and/or CCS preferred * Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding Opportunities. CLICK HERE for more information on Parallon HCA Coding Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. " "Good people beget good people."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Inpatient Coding Quality Audit Reviewer opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

**Discover Your Career at Emory University** Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community. **Description** We are seeking a candidate with some prior research experience, either through job experience or during undergraduate degree (recent B.S. in Neuroscience or health-related discipline preferred) is desired. Bonus if research or job experience was human-oriented/healthcare or another setting working with patients (e.g., non-profit, women's shelter, psychology center, etc.).Applicant should be willing to work in a dynamic clinical team research environment, train to lead a clinical research project, and assist with patient assessments, screening and bio-sample collection. KEY RESPONSIBILITIES: + Recruits, screens, identifies, contacts, and interviews participants to obtain data for assigned research projects. + Interviews may be conducted in person, in a clinical setting, the subject's residence, or by telephone. + Coordinates the data collection process. + May abstract data from the participant's medical record. + Schedules appointments, obtains consent forms, explains the study to the participant and collects data. + May observe participants and record results of observation through written documentation or video recording. + Edits completed questionnaires for completeness, legibility and accuracy. + Follows up with participants to obtain missing data or clarify existing data. + Designs forms, worksheets and study questionnaires. + May code and enter data into a database. + Compiles data and produces reports to be used for analysis of research findings. + May monitor blood pressure and heart rate and may take vital signs and height/weight measurements. + May collect blood, saliva, or urine samples from participants and prepare them for laboratory testing. + Provides direction to others engaged in the interviewing process. + Maintains required record-keeping. + Performs related responsibilities as required. MINIMUM QUALIFICATIONS: + A high school diploma or equivalent. + Two years of administrative support, customer service or other related experience which includes one year of interviewing experience. + Data entry experience. + Positions that require drawing blood require completion of a phlebotomy training program. NOTE: Position tasks are generally required to be performed in-person at an Emory University location. Remote work from home day options may be granted at department discretion. Emory reserves the right to change remote work status with notice to employee. **Additional Details** Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory University does not discriminate in admissions, educational programs, or employment, including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training. Students, faculty, and staff are assured of participation in university programs and in the use of facilities without such discrimination. Emory University complies with Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veteran's Readjustment Assistance Act, and applicable executive orders, federal and state regulations regarding nondiscrimination, equal opportunity, and affirmative action (for protected veterans and individuals with disabilities). Inquiries regarding this policy should be directed to the Emory University Department of Equity and Civil Rights Compliance, 201 Dowman Drive, Administration Building, Atlanta, GA 30322. Telephone: ************ (V) | ************ (TDD). Emory University is committed to ensuring equal access and providing reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to seek a reasonable accommodation, please contact the Department of Accessibility Services at accessibility@emory.edu or call ************ (Voice) | ************ (TDD). We kindly ask that requests be made at least seven business days in advance to allow adequate time for coordination. **Connect With Us!** Connect with us for general consideration! **Job Number** _158970_ **Job Type** _Temporary Full-Time_ **Division** _School Of Medicine_ **Department** _SOM: Psych: Admin_ **Job Category** _Clinical Research_ **Campus Location (For Posting) : Location** _US-GA-Atlanta_ **_Location : Name_** _Woodruff_ **Remote Work Classification** _Primarily On Campus_ **Health and Safety Information** _Position involves clinical patient contact, Working with human blood, body fluids, tissues, or other potentially infectious materials_

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based clinical criteria and client specific coverage policies. What you'll do: * Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc. * Implement and conduct quality assurance program to ensure accurate results to our clients * Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating Procedures * Serve as the Subject Matter Expert on DRG validation to team members and other departments within the organization * Prepare and conduct training for new team members * Identify new DRG coding concepts to expand the DRG product * Meet and/or exceed all internal and department productivity and quality standards * Must remain current in all national coding guidelines including Official Coding Guidelines, AHA Coding Clinic and AMA CPT Assistant * Recommend efficiencies and process improvements to improve departmental procedures * Maintain awareness of and ensure adherence to Zelis standards regarding privacy What you'll bring to Zelis: * Registered Nurse licensure preferred * Inpatient Coding Certification required (i.e., CCS, CIC, RHIA, RHIT) * 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred * Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers * Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs * Strong understanding of hospital coding and billing rules * Clinical and critical thinking skills to evaluate appropriate coding * Strong organization skills with attention to detail * Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships. * Demonstrated thought leadership and motivation skills, a self-starter with an ability to research and resolve issues Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Base Salary Range $95,000.00 - $120,650.00 At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email ***************************. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

**Discover Your Career at Emory University** Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community. **Description** We are seeking a candidate with some prior research experience, either through job experience or during undergraduate degree (recent B.S. in Neuroscience or health-related discipline preferred) is desired. Bonus if research or job experience was human-oriented/healthcare or another setting working with patients (e.g., non-profit, women's shelter, psychology center, etc.).Applicant should be willing to work in a dynamic clinical team research environment, train to lead a clinical research project, and assist with patient assessments, screening and bio-sample collection. KEY RESPONSIBILITIES: + Recruits, screens, identifies, contacts, and interviews participants to obtain data for assigned research projects. + Interviews may be conducted in person, in a clinical setting, the subject's residence, or by telephone. + Coordinates the data collection process. + May abstract data from the participant's medical record. + Schedules appointments, obtains consent forms, explains the study to the participant and collects data. + May observe participants and record results of observation through written documentation or video recording. + Edits completed questionnaires for completeness, legibility and accuracy. + Follows up with participants to obtain missing data or clarify existing data. + Designs forms, worksheets and study questionnaires. + May code and enter data into a database. + Compiles data and produces reports to be used for analysis of research findings. + May monitor blood pressure and heart rate and may take vital signs and height/weight measurements. + May collect blood, saliva, or urine samples from participants and prepare them for laboratory testing. + Provides direction to others engaged in the interviewing process. + Maintains required record-keeping. + Performs related responsibilities as required. MINIMUM QUALIFICATIONS: + A high school diploma or equivalent. + Two years of administrative support, customer service or other related experience which includes one year of interviewing experience. + Data entry experience. + Positions that require drawing blood require completion of a phlebotomy training program. NOTE: Position tasks are generally required to be performed in-person at an Emory University location. Remote work from home day options may be granted at department discretion. Emory reserves the right to change remote work status with notice to employee. **Additional Details** Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory University does not discriminate in admissions, educational programs, or employment, including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training. Students, faculty, and staff are assured of participation in university programs and in the use of facilities without such discrimination. Emory University complies with Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veteran's Readjustment Assistance Act, and applicable executive orders, federal and state regulations regarding nondiscrimination, equal opportunity, and affirmative action (for protected veterans and individuals with disabilities). Inquiries regarding this policy should be directed to the Emory University Department of Equity and Civil Rights Compliance, 201 Dowman Drive, Administration Building, Atlanta, GA 30322. Telephone: ************ (V) | ************ (TDD). Emory University is committed to ensuring equal access and providing reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to seek a reasonable accommodation, please contact the Department of Accessibility Services at accessibility@emory.edu or call ************ (Voice) | ************ (TDD). We kindly ask that requests be made at least seven business days in advance to allow adequate time for coordination. **Connect With Us!** Connect with us for general consideration! **Job Number** _158982_ **Job Type** _Temporary Full-Time_ **Division** _School Of Medicine_ **Department** _SOM: Psych: Admin_ **Job Category** _Clinical Research_ **Campus Location (For Posting) : Location** _US-GA-Atlanta_ **_Location : Name_** _Woodruff_ **Remote Work Classification** _Primarily On Campus_ **Health and Safety Information** _Position involves clinical patient contact, Working with human blood, body fluids, tissues, or other potentially infectious materials_

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview At Zelis, the DRG Clinical Dispute Reviewer role is responsible for the resolution of facility and provider disputes as they relate to DRG validation. They will be responsible for reviewing facility inpatient and outpatient claims for Health Plans and TPA's to ensure adherence to proper coding and billing, analyzing inpatient DRG claims based on industry standard inpatient coding guidelines, and supporting the Office of the Chief Medical Officer in managing disputes related to clinical claim reviews. This position is a production-based role with production and quality metric goals. What you'll do: * Review provider disputes for DRG Coding and Clinical Validation (MS and APR) * Review and submit explanation of dispute rationale back to providers based on dispute findings within the designated timeframe to ensure client turnaround times are met. * Accountable for daily management of claim dispute volume, adhering to client turnaround time, and department Standard Operating Procedures * Serve as subject matter expert for the Expert Claim Review Team on day-to-day activities including troubleshooting and review for data accuracy. * Serve as a subject matter expert for content and bill reviews and provide support where needed for inquiries and research requests. * Create and present education to Expert Claim Review Teams and other departments dispute findings. * Research and analysis of content for DRG reviews. * Use of strong coding and industry knowledge to create and maintain claim review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales * Perform regulatory research from multiple sources to keep abreast of compliance enhancements and additional bill review opportunities. * Support for client facing teams as needed relating to client inquiries related to provider disputes. * Utilize the most up-to-date approved Zelis medical coding sources for claim review maintenance. * Communicate and partner with CMO and members of Expert Claim Review Product and Operations teams regarding important issues and trends. * Ensure adherence to quality assurance guidelines. * Monitor, research, and summarize trends, coding practices, and regulatory changes. * Actively contribute new ideas and support ad hoc projects, including time-sensitive requests. * Ensure adherence to quality assurance guidelines. * Maintain awareness of and ensure adherence to ZELIS standards regarding privacy. What you'll bring to Zelis: * 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred * Current, active Inpatient Coding Certification required (ie. CCS, CIC,RHIA, RHIT, CPC or equivalent credentialing). * Registered Nurse licensure preferred * Bachelor's Degree Preferred in business, healthcare, or technology preferred. * Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers * Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs * Understanding of hospital coding and billing rules * Clinical skills to evaluate appropriate Medical Record Coding * Experience performing regulatory research from multiple sources, formulating an opinion, and presenting findings in an organized, concise manner. * Background and/or understanding of the healthcare industry. * Knowledge of National Medicare and Medicaid regulations. * Knowledge of payer reimbursement policies. * Creative problem-solving skills, leveraging insights and input from other parts of an organization. * Consistently demonstrate ability to act and react swiftly to continuous challenges and changes. * Excellent analytical skills with data and analytics related solutions. * Excellent communication skills. * Strong organization and project/process management skills. * Strong initiative, self-directed and self-motivation. * Good negotiation, problem solving, planning and decision-making skills. * Ability to manage projects simultaneously and achieve goals. * Excellent follow through, attention to detail, and time management skills. Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Base Salary Range $95,000.00 - $127,000.00 At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email ***************************. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

At Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based clinical criteria and client specific coverage policies. What you'll do: Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc. Implement and conduct quality assurance program to ensure accurate results to our clients Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating Procedures Serve as the Subject Matter Expert on DRG validation to team members and other departments within the organization Prepare and conduct training for new team members Identify new DRG coding concepts to expand the DRG product Meet and/or exceed all internal and department productivity and quality standards Must remain current in all national coding guidelines including Official Coding Guidelines, AHA Coding Clinic and AMA CPT Assistant Recommend efficiencies and process improvements to improve departmental procedures Maintain awareness of and ensure adherence to Zelis standards regarding privacy What you'll bring to Zelis: Registered Nurse licensure preferred Inpatient Coding Certification required (i.e., CCS, CIC, RHIA, RHIT) 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs Strong understanding of hospital coding and billing rules Clinical and critical thinking skills to evaluate appropriate coding Strong organization skills with attention to detail Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships. Demonstrated thought leadership and motivation skills, a self-starter with an ability to research and resolve issues Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Base Salary Range $95,000.00 - $127,000.00 At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email ***************************. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.