Provider Customer Advocate - Hybrid
Temple, TX jobs
* To be considered, please ensure you live within a reasonable commuting distance of Temple, TX Interviews are underway and the targeted start date for this class is, January 12, 2026 * If selected, the onsite training hours will be from 8am to 5pm Mon through Fri, for 8 weeks in total
Upon completion of training, you will work a total of 40 hours per week and your 8-hour shifts will be scheduled anytime between 7am and 5pm, Monday through Friday
JOB SUMMARY
The Customer Advocate 1, under general supervision, communicates to Members and Providers policy and procedures and services of the Health Plan (Plan), and handles any complaints concerning the Plan by the membership. This position works on the Members behalf to resolve any issues and concerns by going the extra mile, when needed.
ESSENTIAL FUNCTIONS OF THE ROLE
Under general supervision, communicates to Members and Providers policies, procedures and services of the Plan to ensure complete understanding of the Plan. Assists Members with access to the Plan system, and helps members choose an appropriate physician, and assist with appointments.
Must adhere to call handling goals of 80% of calls answered within 30 seconds. Supports and adheres to call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements. Within 60 days of employment on the floor, must meet monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored. Supports and meets schedule adherence goals based on department policy successful completion of competency testing following initial Advocate training.
Serves as a primary contact for benefits, claims status and simple drug inquires for Individual Plans with working knowledge of other products, based on first contact resolution guidelines. Verifies demographic information on all inquiries and updates the Plan system.
Assists Members with concerns and actively works toward a resolution before the concern escalates to a complaint.
Accesses appropriate sources to obtain benefit information requested by Member and Providers.
Acts as liaison between Members, Providers and billing offices, with follow through to resolve issues.
Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.
KEY SUCCESS FACTORS
Requires successful completion of competency testing following initial Advocate training.
Must successfully complete Customer Service training and successfully pass competency exam to maintain CSA position.
Must successfully complete spelling, grammar and basic computer skills testing during job interview.
Must be proficient in typing and basic computer skills.
Perform well in a fast-paced, stressful routine work environment.
Must possess good phone etiquette and uses effective communication skills (both verbal and written).
Must be familiar with policies, procedures and new products offered by Marketing and completes training as required.
Must be able to multi-task.
Must be knowledgeable in public relations with a diverse customer base.
Must be able to problem solve and act as advocate for the customer.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - H.S. Diploma/GED Equivalent
* EXPERIENCE - 1 Year of Experience
Patient Access Optimization Analyst
Austin, TX jobs
The Patient Access Optimization Analyst role is to configure and provide functional and technical support for access optimization initiatives. This position also assists with the analysis, solutioning, documentation, and implementation of Epic-build related functions.
+ This is a remote position
+ Working hours Central time zone - 8AM - 5PM
+ Two positions available
_The pay range for this position is $31.73/hour (entry level qualifications) - $54.90/hour (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience._
**ESSENTIAL FUNCTIONS OF THE ROLE**
+ Presentation - able to communicate information professionally and formally to stakeholders through meetings and written presentations.
+ Independence - proven ability to manage small to medium projects to ensure successful project implementation and engagement.
+ Excellent verbal and written communication skills, as well as presentation skills.
+ Strong analytical and advanced research skills.
+ Solid organizational skills, especially the ability to meet project deadlines with a focus on details.
+ Ability to successfully multi-task while working independently or within a group environment.
+ Ability to work in a deadline-driven environment, and handle multiple projects simultaneously.
+ Ability to interact effectively with people at all organizational levels.
+ Build and maintain strong relationships.
**KEY SUCCESS FACTORS**
+ Decision tree design, documentation, and maintenance experience strongly preferred.
+ Ability to think critically and analyze complex technical solutions.
+ Epic Cadence Certified strongly preferred.
+ ServiceNow experience preferred.
+ Epic Cadence Provider template management and build experience strongly preferred.
+ Ambulatory and/or Surgery scheduling experience required.
+ Experienced proficiency in Excel and SQL required.
+ Able to work through complex business problems and partner with clients using a consultative approach.
+ Exceptional data/modeling skills with ability to convert raw data into actionable business insights.
+ Able to apply knowledge of healthcare industry trends and their drivers.
+ Able to work in a dynamic setting and work well under pressure.
+ Intermediate to advanced knowledge of statistics (including modeling techniques) preferred.
+ Lean Six Sigma experience preferred.
+ 5 years of experience working in Epic strongly preferred.
**BENEFITS**
Our competitive benefits package includes the following
+ Immediate eligibility for health and welfare benefits
+ 401(k) savings plan with dollar-for-dollar match up to 5%
+ Tuition Reimbursement
+ PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
- EXPERIENCE - 5 Years of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Senior Research & Development Scientist, Algorithm Developer
Houston, TX jobs
We are seeking a highly experienced and innovative Senior NGS Algorithm Developer to lead the design and optimization of computational pipelines for next-generation sequencing (NGS) data. This role focuses on the detection and interpretation of a wide range of genomic features, including small variants (SNVs/Indels), copy number variants (CNVs), short tandem repeats (STRs), methylation patterns, and variants in homologous and homopolymer regions. Expertise in cancer genomics, somatic variant detection, and secondary analysis of NGS data required.
The ideal candidate will hold a Ph.D. in Bioinformatics, Computational Biology, Genomics, or a related field, and have at least 5 years of hands-on experience in algorithm
development for NGS applications. Experience in pharmacogenomics (PGx) variant calling, including complex loci such as CYP2D6, is strongly preferred.
This role may be performed remotely, hybrid, or onsite, based on candidate preference and business needs.
Key Responsibilities
Design and implement robust, scalable algorithms for: small variants, CNV detection, STR genotyping, methylation analysis, variant resolution in homologous
and homopolymer regions, PGx variant calling, including hybrid alleles and copy number estimation in complex loci (e.g., CYP2D6, TPMT, UGT1A1)
Develop and apply algorithms for somatic SNV/Indel calling, CNV and structural variant detection, as well as methylation, alternative splicing, and fusion analysis in cancer transcriptomes
Integrate phasing and allele-specific analysis for small variants and methylation
Collaborate with assay scientists and software engineers to translate biological requirements into computational solutions
Benchmark algorithm performance using public and internal truth sets
Maintain reproducible workflows using tools like Nextflow, and Docker
Contribute to publications, presentations, and intellectual property development
Required Qualifications
Ph.D. in Bioinformatics, Computational Biology, Genomics, or a related discipline
Minimum 5 years of experience in NGS algorithm development
Proficiency in Python, R, C++, and workflow orchestration tools
Deep understanding of:
Read alignment and variant calling (e.g., BWA-MEM, minimap2, GATK, DeepVariant)
CNV modeling, STR detection tools and methylation callers
Homologous region analysis and control gene normalization
PGx variant interpretation and allele resolution
Experience with long-read technologies (ONT, PacBio) and signal-level data
Strong analytical, problem-solving, and communication skills
Preferred Qualifications
Experience with machine learning models for variant classification
Knowledge of clinical genomics and regulatory standards
Familiarity with pharmacogenomic databases (e.g., PharmGKB, CPIC)
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
Frequently required to sit
Frequently required to stand
Frequently required to utilize hand and finger dexterity
Frequently required to talk or hear
Frequently required to utilize visual acuity to operate equipment, read technical information, and/or use a keyboard
Occasionally exposed to bloodborne and airborne pathogens or infectious materials
EEO Statement:
Baylor Genetics is proud to be an equal opportunity employer dedicated to building an inclusive and diverse workforce. We do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, gender identity, veteran status, disability, genetic information, pregnancy, childbirth, or related medical conditions, or any other status protected under applicable federal, state, or local law.
Clinical Dietitian 2 REMOTE
Austin, TX jobs
**Healthy Weight Coach** **REMOTE - Monday through Friday, no weekends** **Preferred Experience** - Chronic disease (weight loss, diabetes) - Strong behavioral change interest and/or experience - Digital/virtual health coaching experience **Preferred Training**
- Licensed RD
- Experience with MNT for obesity, diabetes, HTN, Lipid disorders
- NBC-HWC
- Mastery of the coaching process, foundational theories/principles of behavior change
- Requires completing an approved training program (minimum 400 hours), documented coaching sessions, and passing a board exam
- Only coaching credential recognized by the National Board of Medical Examiners
* **No Credentialing required***
**JOB SUMMARY**
The Clinical Dietitian 2 provides nutrition therapy and education to patients, families and the community. Performs nutritional assessments of patients and develops care plans. Develops and conducts educational programs and in service training programs. Participates in multi disciplinary patient rounds and patient case conferences.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Conducts patient nutrition assessments on a combination of low and higher acuity patients within scope of practice, which may include both inpatient and outpatient. Utilizes assessment techniques which take into consideration the various needs of age specific populations as well as cultural, religious and ethnic concerns.
Provides appropriate and timely documentation that summarizes the nutrition care plan in the patient's medical record, including nutrition assessment, diagnosis, plan, implementation, and progress toward goals in the course of performing primary duties.
Assesses educational needs and the presence of barriers to learning. Provides nutrition counseling for individuals and groups, taking into consideration any adaptations to teaching methods necessary to meet patient learning needs. Provides education to both low and higher acuity patients within practice scope. Facilitates education to ensure compliance with food safety, sanitation and overall workplace safety standards within the Food and Nutrition Department, if applicable.
Evaluates achievement of learning objectives by the patient and family. Provides appropriate follow-up in accordance with the patient's treatment goals, and refers patient for outpatient counseling, community, or home health services, as appropriate. Conducts ongoing evaluations to lead to a correct nutritional diagnosis of the patient's problems and progress while maintaining safety and professional standards.
Interacts with medical staff as well as food and nutrition staff to ensure conformance with medical nutrition therapy. Interacts effectively with multidisciplinary teams to provide patient care that is integrated and compatible with the patient focused medical and nutritional goals.
Leads team conferences and provide food and nutrition related in services to other medical staff as required.
Assists in developing nutritional care and research protocols. Participates in quality assurance program by assisting in development of patient care criteria and analyzing actual care delivered.
Participates in organizing and executing health fairs and other related community events.
Assists in the development, research and revision of facility policies.
**KEY SUCCESS FACTORS**
Accountable for the proper use of patient protected health information.
Ability to deal with complex situations and resolve patient and customer service concerns.
Ability to give clear, concise and complete education and instructions.
Works well in a patient-centered environment as an integral team player.
Ability to adapt communication style to suit different audiences. Empathetic listener, sensitive, upbeat, optimistic, articulate, gracious and tactful. Ability to calm upset patient in a composed and professional demeanor.
Licensed Registered Dietitian preferred.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - Masters'
- EXPERIENCE - 2 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
Registered Dietitians (RD)
* **No Credentialing required***
**Preferred Experience**
- Chronic disease (weight loss, diabetes)
- Strong behavioral change interest and/or experience
- Digital/virtual health experience
**Preferred Training**
- Licensed RD
- Experience with MNT for obesity, diabetes, HTN, Lipid disorders
- NBC-HWC
- Mastery of the coaching process, foundational theories/principles of behavior change
- Requires completing an approved training program (minimum 400 hours), documented coaching sessions, and passing a board exam
- Only coaching credential recognized by the National Board of Medical Examiners
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Insurance Verification Specialist - Hybrid
Dallas, TX jobs
The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.
ESSENTIAL FUNCTIONS OF THE ROLE
Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
Completes appropriate payor forms related to notification and authorization.
Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
Calculates accurate patient financial responsibility.
Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patients account prior to scheduled or unscheduled service during the patient's hospital stay.
Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
KEY SUCCESS FACTORS
1 year of healthcare or customer service experience preferred.
Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
Ability to understand and adhere to payer guidelines by plan and service type.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills. Basic computer skills and Microsoft Office.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - H.S. Diploma/GED Equivalent
* EXPERIENCE - Less than 1 Year of Experience
Project Management Coordinator (Hybrid)
Temple, TX jobs
The Student Affairs Coordinator is responsible for the organization and management of various programs serving the students within the Medical Education Department. ESSENTIAL FUNCTIONS OF THE ROLE Serves as liaison between students, Faculty, College of Medicine and Medical Education Department.
Assists students with academic planning, developing and achieving goals and provide resources for career guidance.
Develops and maintains the Faculty Advisor program.
Serves as primary advisor to campus student organizations, campus activities and community.
Gathers materials. Distributes and coordinates logistics and implements formal orientation program for new students.
Serves as student advocate and informational resource for students seeking academic and personal support services.
Maintains student records including health record, credentialing materials and student permanent files.
Maintains software systems.
Provides information and assists with requests from the Office of Student Affairs.
KEY SUCCESS FACTORS
Strong interpersonal and communication skills.
Ability to plan, prioritize, organize and coordinate work in situations where demands of a diverse nature and conflicting deadlines are involved.
Ability to work well under pressure, remain organized and focused and pay attention to detail, while delivering quality, polite and courteous services.
Ability to work as a team member as well as team leader on respective projects.
Ability to identify problems, recommend solutions, establish priorities and coordinate work activities.
Proficient with Microsoft Office (Word, Excel, PowerPoint, Outlook, Access, Teams, etc). Be willing to learn and become proficient in using other software programs.
Ability to work autonomously, independently and be a self-starter; take initiative.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
* EXPERIENCE - 1 Year of Experience
Financial Analyst/Senior Financial Analyst, Grant Research Administration
Waco, TX jobs
What We Are Looking For
The Baylor University Office of the Vice Provost for Research is seeking a Post-Award Financial Analyst. Strong experience in post award with multiple sponsor exposure (NIH, NSF, DOE, Private, etc.) with strong competencies in budgeting and financial reporting, cost awareness, priority and time management, and analytical thinking skills will be needed to succeed in this position. This position will provide excellent customer service to faculty, research administrators, and sponsors. We are seeking a candidate with strong written and oral communication skills.
This position is eligible for remote work.
An Associate's degree and two years of relevant experience are required. A Bachelor's degree and five years of experience are preferred.
A Master's degree and five years of relevant experience are required for the Senior level opportunity.
Baylor reserves the right to make the final determination on a candidate's qualifications for both level positions.
*All applicants must be currently authorized to work in the United States on a full-time basis.
What You Will Do
Ensure provision of excellent customer service to faculty, local research administrators, and sponsors in the ongoing administration of sponsored research by serving as an expert resource to the Baylor research community
Support all relevant activities in the Post-Award Office, including award set up, award maintenance, transaction review, invoicing, financial reporting, cash management, closeout, and effort reporting
Conduct periodic reviews for assigned sponsored awards (portfolio reviews), including monitoring spending trends, recording of transactions, overdrafts, resolving small balances on awards, reviewing of restricted budgets, tracking cost sharing commitments, and monitoring of subrecipient expenditures
When applicable, ensure accordance with federal and state regulations and guidelines, including federal OMB Uniform Guidance (2 CFR 200), sponsor specific, and institutional policies
Assist in monitoring programmatic (non-financial) reporting to sponsors as needed
Maintain auditable records for sponsored awards, including invoices, reports, and sponsor and internal correspondences by maintaining proficiency in Baylor and sponsor systems
Participate in trainings and professional development opportunities, as determined by the AVP for Research, Post-Award
Performing all other duties as assigned to support Baylor's mission
Ability to comply with University policies
Maintaining regular and punctual attendance
What You Can Expect
As part of the Baylor family, eligible employees receive a comprehensive benefits package that includes medical, dental, and vision insurance, generous time off, tuition remission, and outstanding automatic retirement contributions. Baylor has a comprehensive benefits plan that supports you and your family's wellbeing and allows you to be a part of the life of a vibrant and active college campus. To learn more, go to Baylor Benefits & Advantages.
The budgeted salary or hourly range that the University reasonably expects to pay for this position is $60,000 - $80,000.
This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills, knowledge, abilities, education, licensure and certification, analysis of internal equity, and other business and organizational needs.
Explore & Engage
Learn more about Baylor and our strategic vision,
Baylor in Deeds
. Also, explore our great hometown of Waco and the many opportunities to engage locally. If you are new to Central Texas, This is Waco!
Auto-ApplyTrauma Registrar RN (Hybrid)
Temple, TX jobs
The Trauma Registrar Registered Nurse (RN), in collaboration with Trauma program leadership, develops and assures the quality and accuracy of the trauma registry database. Identifies cases, abstracts and maintains the trauma registry database according to existing regulatory requirements.
ESSENTIAL FUNCTIONS OF THE ROLE
Analyzes and abstracts detailed clinical and administrative data from the medical record to meet hospital, accreditation and regulatory agency requirements.
Initiates and performs required follow up activities to assist in improving clinical outcomes.
Conducts and presents trauma registry reports. Responds to request for information utilizing available trauma related database resources.
Collects trauma data for injury research and prevention, as well as quality improvement tracking. Assures accuracy and confidentiality in the handling of all trauma registry related matters.
Runs reports and analyzes data to promote process improvements and optimum patient care. Consults with physicians or other clinical staff as needed for the assistance with acquiring trauma case reporting information.
Reports and transmits hospital data in a timely and complete manner as required to relevant reporting agencies.
Works closely with trauma leadership, hospital staff members, and physicians to maintain trauma designation status.
Participates in Trauma Performance Improvement Program including data analysis, medical record extrapolation, and data entry for the trauma registry.
KEY SUCCESS FACTORS
Knowledge of medical terminology and anatomy.
Knowledge in Trauma Registry methodology, case abstracting, and data entry.
Knowledge of data integrity and analysis.
Knowledge of International Classification of Diseases (ICD 9 and ICD 10) coding, Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) scoring.
General computer skills, including but not limited to: using required software applications, data entry, information security, electronic medical documentation, hand held scanning and email.
Verbal and written communication skills.
Ability to perform statistical analysis.
Ability to analyze data, draw conclusions, and make recommendations.
Ability to work collaboratively in a team environment.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
Hybrid expectation- On-site on Wednesdays (and for new-hire training)
QUALIFICATIONS
* EDUCATION - Bachelor's
* MAJOR - Nursing
* EXPERIENCE - 3 Years of Experience
* Trauma experience preferred
* CERTIFICATION/LICENSE/REGISTRATION -
Registered Nurse (RN)
Abbr. Injury Scale (AAAM AIS): AIS within 12 months.
ICD10 Coding Certificate (ICD): ICD course within 12 months.
Trauma Data Registry Course (TDRC): TDRC withinin 12 months.
Cert Abbrev Injury Scale Spec (CAISS), Certified Trauma Registries (CSTR): CSTR or CAISS within 36 months.
Coder II - OP Physician Coding (Ortho Surgery)
Austin, TX jobs
** **Upper Extremity:** **- Shoulders:** Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair
**- Elbows:** Cubital tunnel release, Bursectomy, Arthroplasty
**- Wrist:** Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment)
**- Hands:** Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, , Dupuytren's (Palmar fascial fibromatosis), Amputations
**Lower Extremity:**
**- Hips:** Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy
**- Pelvis:** Fracture repairs
**- Femur:** ORIF neck fractures, Trochanteric repairs, shaft fracture repairs
**- Knees:** Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs, Arthroscopy
**- Tibia/Fibula:** Plateau repairs, shaft Fracture repairs, Percutaneous repairs, Arthrodesis, Pilon/Plafond repairs, Malleolar repairs, Sprain
**WORK MODEL/SALARY**
Days: Monday - Friday
Hours: 8hrs a day, 80hrs a pay period
100% Remote
The pay range for this position is $26.66 (entry-level qualifications) - $40.00 (highly experienced) The specific rate will depend upon the successful candidate's specific qualifications and prior experience.
**JOB SUMMARY**
+ The Coder 2 is proficient in three or more types of outpatient, Profee, or low acuity inpatient coding.
+ The Coder 2 may code low acuity inpatients, one time ancillary/series, emergency department, observation, day surgery, and/or professional fee to include evaluation and management (E/M) coding or profee surgery.
+ For professional fee coding, team members in this job code will be proficient for inpatient and outpatient, for multi-specialties.
+ Coder 2 utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding.
+ Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.)
+ The Coder 2 will abstract and enter required data.
**ESSENTIAL FUNCTIONS OF THE ROLE**
+ Examines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees.
+ Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing.
+ Communicates with providers for missing documentation elements and offers guidance and education when needed.
+ Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges.
+ Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
+ Reviews and edits charges.
**KEY SUCCESS FACTORS**
+ Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
+ Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
+ Sound knowledge of anatomy, physiology, and medical terminology.
+ Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
+ Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding.
+ Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
+ Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.
Must have one of the following Certifications:
+ Registered Health Information Administrator (RHIA)
+ Registered Health Information Technologist (RHIT)
+ Certified Coding Specialist (CCS)
+ Certified Coding Specialist Physician-based (CCS-P)
+ Certified Professional Coder (CPC)
+ Certified Outpatient Coder (COC)
+ Certified Inpatient Coder (CIC)
+ Certified Interventional Radiology Cardiovascular Coder (CIRCC)
**BENEFITS**
Our competitive benefits package includes the following:
+ Immediate eligibility for health and welfare benefits
+ 401(k) savings plan with dollar-for-dollar match up to 5%
+ Tuition Reimbursement
+ PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**MQUALIFICATIONS**
+ EDUCATION - H.S. Diploma/GED Equivalent
+ EXPERIENCE - 2 Years of Experience
+ CERTIFICATION/LICENSE/REGISTRATION - Must have ONE of the coding certifications as listed:
+ Cert Coding Specialist (CCS)
+ Cert Coding Specialist-Physician (CCS-P)
+ Cert Inpatient Coder (CIC)
+ Cert Interv Rad CV Coder (CIRCC) - Cert Outpatient Coder (COC)
+ Cert Professional Coder (CPC)
+ Reg Health Info Administrator (RHIA)
+ Reg Health Information Technician (RHIT).
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Access Services Scheduling Specialist - HYBRID PRN
College Station, TX jobs
The Scheduling Specialist under general supervision and in accordance with established procedures, schedules outpatient diagnostic procedures including but not limited to radiology and imaging procedures, validates outpatient orders, and captures patient demographic and insurance information.
ESSENTIAL FUNCTIONS OF THE ROLE
Contacts patients or providers for outpatient diagnostic procedures.
Contacts patients to schedule outpatient diagnostic procedures.
Collects patient demographic and insurance information during scheduling phone call with provider or patient.
Validates insurance is in network with the provider.
Compiles patient information such as diagnosis, reason for procedure, medications, allergies and other applicable information prior to scheduled procedure.
Monitors inbound orders process to ensure orders are validated and routed appropriately to ensure patients are contacted timely to schedule procedure.
Contacts department affected by schedule adjustments to ensure patient is prepared and necessary personnel and equipment are available.
Responsible for meeting telephone system metrics and any other productivity standards set by the department to include length of call, length of answer time, and number of calls taken within a specific period.
KEY SUCCESS FACTORS
Must consistently meets performance standards of production, accuracy, completeness and quality.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and suffering patients in addition to life/death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
Basic computer skills and Microsoft Office.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - H.S. Diploma/GED Equivalent
* EXPERIENCE - Less than 1 Year of Experience
Clinical Dietitian 1 HYBRID
Waxahachie, TX jobs
Detailed Shift/Schedule: HYBRID Remote and On site in Waxahachie, TX Detailed Location: BSW Center for Bariatric Surgery- Waxahachie: 2360 N Interstate 35E Suite 310 Waxahachie TX 75165 Specialty: Nutrition/Dietetics Credentialing required prior to start - Our credentialing process takes a minimum of 135 days (about 4 and a half months) from beginning to end
JOB SUMMARY
The Clinical Dietitian 1 provides nutrition therapy and education to patients, families and the community. Performs nutritional assessments of patients and develops care plans. Develops and conducts educational programs and in service training programs.
ESSENTIAL FUNCTIONS OF THE ROLE
Performs nutritional assessment of patients. Analyzes patient medical and nonmedical information through interviewing patients and\or caregivers and reviewing medical records in order to determine appropriate nutrition care. Conducts nutrient intake analysis, and formulates intravenous and enteral nutrition therapy with macro and micronutrient manipulation. Determines total parental nutrition therapy rates and duration of infusion and develops care plans.
Provides individual and/or group nutrition counseling on outpatient and inpatient basis. Provides information on fitness and exercise as related to weight management and diet. Documents pertinent nutritional information in appropriate medical record, and monitors patients to determine need for appropriate modification in nutritional management.
Researches, develops and delivers educational and instructional programs and classes for patients, families, staff, dietetic interns, or community groups. Conducts educational in service training programs for staff, and assists with training, instruction and evaluation of dietetic interns. Develops nutrition education tools, and documents education instruction in patient medical record.
Conducts research and develops proposals to obtain grant funding. Conducts research for projects, writes articles for publications, and delivers presentations on research related topics.
Participate in multi-disciplinary patient rounds and/or case conferences and in discharge planning in order to gather and exchange information, assess patient response to care plan, and maximize efficiency and effectiveness of patient care. Participates in various meetings related to nutrition education, patient care standards, or dietetic internship program in order to gather and exchange information and potentially serve as member of Health Education Task Force.
Maintains current knowledge of nutrition services functions through reading literature, attending workshops, seminars, conferences and by participating in professional organizations.
Assists in developing nutritional care and research protocols. Participates in quality assurance program by assisting in development of patient care criteria and analyzing actual care delivered.
Participates in organizing and executing health fairs and other related community events.
KEY SUCCESS FACTORS
Accountable for the proper use of patient protected health information.
Ability to deal with complex situations and resolve patient and customer service concerns.
Ability to give clear, concise and complete education and instructions.
Works well in a patient-centered environment as an integral team player.
Ability to adapt communication style to suit different audiences. Empathetic listener, sensitive, upbeat, optimistic, articulate, gracious and tactful. Ability to calm upset patient in a composed and professional demeanor.
Licensed Registered Dietitian preferred.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - Bachelor's
* EXPERIENCE - Less than 1 Year of Experience
* CERTIFICATION/LICENSE/REGISTRATION -
Registered Dietitians (RD)
Insurance Verification Specialist - Days - Hybrid
Dallas, TX jobs
The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization?s reimbursement from payers for patient accounts that are scheduled and unscheduled.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
Completes appropriate payor forms related to notification and authorization.
Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
Calculates accurate patient financial responsibility.
Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patient?s account prior to scheduled or unscheduled service during the patient?s hosptial stay.
Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
**KEY SUCCESS FACTORS**
1 year of healthcare or customer service experience preferred.
Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
Ability to understand and adhere to payer guidelines by plan and service type.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
Basic computer skills and Microsoft Office.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - Less than 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Provider Customer Advocate - Hybrid
Temple, TX jobs
* To be considered, please ensure you live within a reasonable commuting distance of Temple, TX ** Interviews are underway and the targeted start date for this class is, **January 12, 2026** *** If selected, the onsite training hours will be from 8am to 5pm Mon through Fri, for 8 weeks in total
**** Upon completion of training, you will work a total of 40 hours per week and your 8-hour shifts will be scheduled anytime between 7am and 5pm, Monday through Friday
**JOB SUMMARY**
The Customer Advocate 1, under general supervision, communicates to Members and Providers policy and procedures and services of the Health Plan (Plan), and handles any complaints concerning the Plan by the membership. This position works on the Members behalf to resolve any issues and concerns by going the extra mile, when needed.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Under general supervision, communicates to Members and Providers policies, procedures and services of the Plan to ensure complete understanding of the Plan. Assists Members with access to the Plan system, and helps members choose an appropriate physician, and assist with appointments.
Must adhere to call handling goals of 80% of calls answered within 30 seconds. Supports and adheres to call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements. Within 60 days of employment on the floor, must meet monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored. Supports and meets schedule adherence goals based on department policy successful completion of competency testing following initial Advocate training.
Serves as a primary contact for benefits, claims status and simple drug inquires for Individual Plans with working knowledge of other products, based on first contact resolution guidelines. Verifies demographic information on all inquiries and updates the Plan system.
Assists Members with concerns and actively works toward a resolution before the concern escalates to a complaint.
Accesses appropriate sources to obtain benefit information requested by Member and Providers.
Acts as liaison between Members, Providers and billing offices, with follow through to resolve issues.
Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.
**KEY SUCCESS FACTORS**
Requires successful completion of competency testing following initial Advocate training.
Must successfully complete Customer Service training and successfully pass competency exam to maintain CSA position.
Must successfully complete spelling, grammar and basic computer skills testing during job interview.
Must be proficient in typing and basic computer skills.
Perform well in a fast-paced, stressful routine work environment.
Must possess good phone etiquette and uses effective communication skills (both verbal and written).
Must be familiar with policies, procedures and new products offered by Marketing and completes training as required.
Must be able to multi-task.
Must be knowledgeable in public relations with a diverse customer base.
Must be able to problem solve and act as advocate for the customer.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Project Management Coordinator (Hybrid)
Temple, TX jobs
The Student Affairs Coordinator is responsible for the organization and management of various programs serving the students within the Medical Education Department. **ESSENTIAL FUNCTIONS OF THE ROLE** Serves as liaison between students, Faculty, College of Medicine and Medical Education Department.
Assists students with academic planning, developing and achieving goals and provide resources for career guidance.
Develops and maintains the Faculty Advisor program.
Serves as primary advisor to campus student organizations, campus activities and community.
Gathers materials. Distributes and coordinates logistics and implements formal orientation program for new students.
Serves as student advocate and informational resource for students seeking academic and personal support services.
Maintains student records including health record, credentialing materials and student permanent files.
Maintains software systems.
Provides information and assists with requests from the Office of Student Affairs.
**KEY SUCCESS FACTORS**
Strong interpersonal and communication skills.
Ability to plan, prioritize, organize and coordinate work in situations where demands of a diverse nature and conflicting deadlines are involved.
Ability to work well under pressure, remain organized and focused and pay attention to detail, while delivering quality, polite and courteous services.
Ability to work as a team member as well as team leader on respective projects.
Ability to identify problems, recommend solutions, establish priorities and coordinate work activities.
Proficient with Microsoft Office (Word, Excel, PowerPoint, Outlook, Access, Teams, etc). Be willing to learn and become proficient in using other software programs.
Ability to work autonomously, independently and be a self-starter; take initiative.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
- EXPERIENCE - 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Clinical Dietitian 1 HYBRID
Waxahachie, TX jobs
**Detailed Shift/Schedule: HYBRID Remote and On site in Waxahachie, TX** **Detailed Location: BSW Center for Bariatric Surgery- Waxahachie: 2360 N Interstate 35E Suite 310 Waxahachie TX 75165** **Specialty: Nutrition/Dietetics** **Credentialing required prior to start - Our credentialing process takes a minimum of 135 days (about 4 and a half months) from beginning to end**
**JOB SUMMARY**
The Clinical Dietitian 1 provides nutrition therapy and education to patients, families and the community. Performs nutritional assessments of patients and develops care plans. Develops and conducts educational programs and in service training programs.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Performs nutritional assessment of patients. Analyzes patient medical and nonmedical information through interviewing patients and\or caregivers and reviewing medical records in order to determine appropriate nutrition care. Conducts nutrient intake analysis, and formulates intravenous and enteral nutrition therapy with macro and micronutrient manipulation. Determines total parental nutrition therapy rates and duration of infusion and develops care plans.
Provides individual and/or group nutrition counseling on outpatient and inpatient basis. Provides information on fitness and exercise as related to weight management and diet. Documents pertinent nutritional information in appropriate medical record, and monitors patients to determine need for appropriate modification in nutritional management.
Researches, develops and delivers educational and instructional programs and classes for patients, families, staff, dietetic interns, or community groups. Conducts educational in service training programs for staff, and assists with training, instruction and evaluation of dietetic interns. Develops nutrition education tools, and documents education instruction in patient medical record.
Conducts research and develops proposals to obtain grant funding. Conducts research for projects, writes articles for publications, and delivers presentations on research related topics.
Participate in multi-disciplinary patient rounds and/or case conferences and in discharge planning in order to gather and exchange information, assess patient response to care plan, and maximize efficiency and effectiveness of patient care. Participates in various meetings related to nutrition education, patient care standards, or dietetic internship program in order to gather and exchange information and potentially serve as member of Health Education Task Force.
Maintains current knowledge of nutrition services functions through reading literature, attending workshops, seminars, conferences and by participating in professional organizations.
Assists in developing nutritional care and research protocols. Participates in quality assurance program by assisting in development of patient care criteria and analyzing actual care delivered.
Participates in organizing and executing health fairs and other related community events.
**KEY SUCCESS FACTORS**
Accountable for the proper use of patient protected health information.
Ability to deal with complex situations and resolve patient and customer service concerns.
Ability to give clear, concise and complete education and instructions.
Works well in a patient-centered environment as an integral team player.
Ability to adapt communication style to suit different audiences. Empathetic listener, sensitive, upbeat, optimistic, articulate, gracious and tactful. Ability to calm upset patient in a composed and professional demeanor.
Licensed Registered Dietitian preferred.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - Bachelor's
- EXPERIENCE - Less than 1 Year of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
Registered Dietitians (RD)
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Access Services Insurance Verification Specialist - Days - Hybrid
Dallas, TX jobs
The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization?s reimbursement from payers for patient accounts that are scheduled and unscheduled.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
Completes appropriate payor forms related to notification and authorization.
Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
Calculates accurate patient financial responsibility.
Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patient?s account prior to scheduled or unscheduled service during the patient?s hosptial stay.
Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
**KEY SUCCESS FACTORS**
1 year of healthcare or customer service experience preferred.
Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
Ability to understand and adhere to payer guidelines by plan and service type.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
Basic computer skills and Microsoft Office.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - Less than 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Contact Center Specialist - Hybrid
Frisco, TX jobs
The Contact Center Specialist 1, working under close supervision, responds to routine inbound phone calls, emails and electronic requests to assist as front line support for product and/or service requests. This may include, but not limited to, technical support, answering questions, registering new patients, scheduling healthcare appointments, providing financial clearance, handling complaints, troubleshooting problems and providing information on behalf of the institution.
ESSENTIAL FUNCTIONS OF THE ROLE
Responds to, and resolves routine inquiries, complaints and concerns through inbound phone calls, emails and electronic requests. Ensures a positive and exemplary experience with all customers by focusing on customer satisfaction and resolution.
Provides accurate, valid and complete information to customers by using the right methods and tools. Identifies emergent health situations based on caller information and coordinates immediate triage.
Works collaboratively with providers, clinical staff and other departments to ensure patients? needs are met.
Responsible for calming upset customers by providing a composed and professional demeanor. Identifies and escalates priority issues for resolution.
Documents all customer contacts and accurately processes various documents to ensure optimal service.
Accurately schedules, prepares and communicates appointment details and necessary financial information to facilitate timely arrival, appointment preparedness, preparation testing, and optimal reimbursement, in accordance with system and operating guidelines. May be required to ensure accurate creation of new accounts in the electronic medical record system, avoiding the creation of duplicate accounts, and verifying insurance coverage.
Writes messages on behalf of patients, caregivers and healthcare professionals to clinic administrative and provider staff.
KEY SUCCESS FACTORS
Experience in a call center, customer service and/or healthcare setting preferred. Should possess a moderate understanding of general aspects of the job.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Excellent data entry, numeric, typing and computer navigational skills.
Knowledge of patient portal preferred.
Knowledge of customer service principles and practices preferred.
Knowledge of call center telephony and technology preferred.
Ability to promptly assess requests by using electronic and paper resource materials and correctly respond to customer inquiries.
Comfortable working in a fast paced, constantly changing, and stressful environment.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - H.S. Diploma/GED Equivalent
* EXPERIENCE - Less than 1 Year of Experience
Access Services Scheduling Specialist - Hybrid
Round Rock, TX jobs
Must live within a 30 mile radius to location The Scheduling Specialist under general supervision and in accordance with established procedures, schedules outpatient diagnostic procedures including but not limited to radiology and imaging procedures, validates outpatient orders, and captures patient demographic and insurance information.
ESSENTIAL FUNCTIONS OF THE ROLE
Contacts patients or providers for outpatient diagnostic procedures.
Contacts patients to schedule outpatient diagnostic procedures.
Collects patient demographic and insurance information during scheduling phone call with provider or patient.
Validates insurance is in network with the provider.
Compiles patient information such as diagnosis, reason for procedure, medications, allergies and other applicable information prior to scheduled procedure.
Monitors inbound orders process to ensure orders are validated and routed appropriately to ensure patients are contacted timely to schedule procedure.
Contacts department affected by schedule adjustments to ensure patient is prepared and necessary personnel and equipment are available.
Responsible for meeting telephone system metrics and any other productivity standards set by the department to include length of call, length of answer time, and number of calls taken within a specific period.
KEY SUCCESS FACTORS
Must consistently meets performance standards of production, accuracy, completeness and quality.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and suffering patients in addition to life/death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills.
Basic computer skills and Microsoft Office.
BENEFITS
Our competitive benefits package includes the following
* Immediate eligibility for health and welfare benefits
* 401(k) savings plan with dollar-for-dollar match up to 5%
* Tuition Reimbursement
* PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
* EDUCATION - H.S. Diploma/GED Equivalent
* EXPERIENCE - Less than 1 Year of Experience
Insurance Verification Specialist - Hybrid
Dallas, TX jobs
The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
Completes appropriate payor forms related to notification and authorization.
Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
Calculates accurate patient financial responsibility.
Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patients account prior to scheduled or unscheduled service during the patient's hospital stay.
Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
**KEY SUCCESS FACTORS**
1 year of healthcare or customer service experience preferred.
Must have the ability to consistently meet performance standards of production, accuracy, completeness and quality.
Ability to understand and adhere to payer guidelines by plan and service type.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, behavioral health and/or suffering patients in addition to life or death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills. Basic computer skills and Microsoft Office.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - Less than 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Contact Center Specialist - Hybrid
Frisco, TX jobs
The Contact Center Specialist 1, working under close supervision, responds to routine inbound phone calls, emails and electronic requests to assist as front line support for product and/or service requests. This may include, but not limited to, technical support, answering questions, registering new patients, scheduling healthcare appointments, providing financial clearance, handling complaints, troubleshooting problems and providing information on behalf of the institution.
**ESSENTIAL FUNCTIONS OF THE ROLE**
Responds to, and resolves routine inquiries, complaints and concerns through inbound phone calls, emails and electronic requests. Ensures a positive and exemplary experience with all customers by focusing on customer satisfaction and resolution.
Provides accurate, valid and complete information to customers by using the right methods and tools. Identifies emergent health situations based on caller information and coordinates immediate triage.
Works collaboratively with providers, clinical staff and other departments to ensure patients? needs are met.
Responsible for calming upset customers by providing a composed and professional demeanor. Identifies and escalates priority issues for resolution.
Documents all customer contacts and accurately processes various documents to ensure optimal service.
Accurately schedules, prepares and communicates appointment details and necessary financial information to facilitate timely arrival, appointment preparedness, preparation testing, and optimal reimbursement, in accordance with system and operating guidelines. May be required to ensure accurate creation of new accounts in the electronic medical record system, avoiding the creation of duplicate accounts, and verifying insurance coverage.
Writes messages on behalf of patients, caregivers and healthcare professionals to clinic administrative and provider staff.
**KEY SUCCESS FACTORS**
Experience in a call center, customer service and/or healthcare setting preferred. Should possess a moderate understanding of general aspects of the job.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Excellent data entry, numeric, typing and computer navigational skills.
Knowledge of patient portal preferred.
Knowledge of customer service principles and practices preferred.
Knowledge of call center telephony and technology preferred.
Ability to promptly assess requests by using electronic and paper resource materials and correctly respond to customer inquiries.
Comfortable working in a fast paced, constantly changing, and stressful environment.
**BENEFITS**
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - Less than 1 Year of Experience
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.