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- 150 jobs
  • Surgical Coding Associate III

    R1 RCM 4.8company rating

    Remote R1 RCM job

    R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Surgical Coder III you will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). Every day you will accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for coding and reporting, reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner, and Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns. To thrive in this role, you must be able to accurately abstract information from the medial records into the abstract system, according to established guidelines. Here's what you will experience working as our Surgical Coder III: Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD's/NCD's for medical necessity. Reconciling offshore completed claims with feedback Analyzing trends of escalated claims and recommending solutions to decrease future escalations Maintain CFA RETURN spreadsheet with education to the global team Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units) Validate offshore coder escalation of missing medical records and maintaining the MMR file Understand site-specific SOPs and nuances and communicate changes to the team Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines. Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers. Required Skills: High School Diploma or GED required CCS-P, CPC Three (3) years of coding experience in general surgery, orthopedics, neurosurgery and GI Professional coding experience Experience with Athena Must be able to demonstrate proficiency in professional services (95% accuracy). Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie: Documentation Guidelines '95 & '97) For this US-based position, the base pay range is $20.13 - $31.13 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook
    $20.1-31.1 hourly Auto-Apply 10d ago
  • Project Manager, Deployment

    R1 RCM 4.8company rating

    R1 RCM job in Salt Lake City, UT

    R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Project Manager** , you will help deliver seamless client deployments in the healthcare space by managing timelines, resources, and stakeholder communication to ensure operational readiness. Every day you will facilitate client and internal meetings, track project milestones, and identify and escalate risks and issues to ensure successful go-live and post-deployment support. To thrive in this role, you must be highly organized, proactive, and confident in client-facing interactions. You should excel at managing complex projects, asking the right questions, and driving accountability across stakeholders. **Here's what you will experience working as a Project Manager:** + Lead and manage multiple projects simultaneously, including deployments from client discovery through go-live and post-launch support. + Develop comprehensive project plans, including timelines, milestones, and resource allocation. + Monitor project progress and coordinate cross-functional teams to ensure project deliverables are met. + Communicate effectively with stakeholders, providing weekly status reports and monthly readiness presentations to clients. + Identify and mitigate risks and issues that may impact timely project completion and post go-live success. **Required Skills:** + Proven track record of successfully managing multiple projects concurrently from initiation to completion in a designated Project Management position within IT, technology, or healthcare; healthcare Revenue Cycle Management preferred. + Stakeholder management and executive presence, including strong client-facing communication skills and the ability to influence and motivate without authority. + Effective cross-cultural communication skills and experience working with distributed, global teams. + Ability to use Microsoft Office Suite to plan and organize projects, meetings, communicate, report on, and analyze data. For this US-based position, the base pay range is $61,357.00 - $110,424.03 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a target of 10.00% The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. (***************************** R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (*********************************************************************************** To learn more, visit: R1RCM.com Visit us on Facebook (******************************* R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: ********************* .
    $61.4k-110.4k yearly 13d ago
  • Physician Services Coding Specialist II - Multi-Specialty Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The primary purpose of the SPEC, PHYS SVC CODING II is to code physician charges by assigning ICD-10, CPT, HCPCS codes and modifiers from medical record documentation. Must have the ability to utilize multiple resources to support code assignment. Must possess knowledge on how to resolve coding denials and pre-bill coding edits. Productivity and accuracy are measured via internal audits and must be maintained. Level II roles include but are not limited to evaluation and management coding, radiology, and emergency department coding. ESSENTIAL DUTIES AND RESPONSIBILITIES Assign ICD-10, CPT, HCPCS and modifiers codes from documentation Review and appropriately resolve pre-bill edits Review and appropriately resolve coding denials Meet or exceed productivity standards Meet or exceed accuracy rate of 95.5% in monthly internal audits Effectively present coding issues to internal team members, internal clients, or external clients Deliver information in a one-on-one or small group format to peers Meet deadlines and complete assignments before monthly closing dates Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines Other duties as assigned Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Vocational or technical education beyond high school Minimum of 3-5 years coding experience CPC or CCS-P or equivalent certification Multi-specialty Evaluation and Management coding Demonstrate working knowledge of medical terminology, human anatomy, and coding rules and regulations Must possess knowledge of third-party reimbursement regulations and billing practices Ability to examine documents for accuracy and completeness Detail oriented with the ability to identify and resolve problems Must possess knowledge of CCI, LCD, NCD and other applicable coding rules and regulations Detail oriented with the ability to identify and resolve problems Ability to communicate clearly and work effectively with co-workers Ability to work as a team member in all activities Conduct self in an ethical, honest, and professional manner Demonstrate continued willingness to learn and grow Proficient in Microsoft Word, Excel POSITION COMPETENCIES: Builds Team Relationships - Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members. Communicates Effectively - Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker's message without interruption. Tailors writing to audience using correct grammar and spelling. Compliance with Laws, Policies and Procedures - Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines. Develops Self - Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development. Displays Adaptability - Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles. Drives for Results - Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Response appropriately to urgent situations. Focus on the Customer/Client - Ensures that clients have a positive experience. Responds to clients in a timely manner. Demonstrates tact and empathy when responding to clients. Respects Others - Displays sensitivity to the needs and concerns of others. Interacts with others in an open, non-threatening manner. Shows Reliability - Takes personal responsibility for actions and decisions. Consistently works assigned schedule. Acts responsibly and can be counted on to accomplish goals successfully. Compensation and Benefit Information Compensation Pay: $20.51 - $30.77 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $20.5-30.8 hourly Auto-Apply 13d ago
  • Revenue Integrity Director- Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The Director of Revenue Integrity serves in a senior leadership capacity and demonstrates client and unit-specific leadership to Revenue Integrity personnel by designing, directing, and executing key Conifer Revenue Integrity processes. This includes Charge Description Master (“CDM”) and charge practice initiatives and processes; facilitating revenue management and revenue protection for large, national integrated health systems; regulatory review, reporting and implementation; and projects requiring expertise across multiple hospitals and business units. The Director provides clarity for short/long term objectives, initiative prioritization, and feedback to Managers for individual and professional development of Revenue Integrity resources. The Director leverages project management skills, analytical skills, and time management skills to ensure all requirements are accomplished within established timeframes. Interfaces with highest levels of Client Executive personnel. Direct Revenue Integrity personnel in evaluating, reviewing, planning, implementing, and reporting various revenue management strategies to ensure CDM integrity. Maintain subject-matter expertise and capability on all clinical and diagnostic service lines related to Conifer revenue cycle operations, claims generation and compliance. Influence client resources implementing CDM and/or charge practice corrective measures and monitoring tools to safeguard Conifer revenue cycle operations; provide oversight for Revenue Integrity personnel monitoring statistics/key performance indicators to achieve sustainability of changes and compliance with regulatory/non-regulatory directives. Assume lead role and/or provide direction/oversight for special projects and special studies as required for new client integration, system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, hospital mergers, etc. Serve as primary advisor to and collaboratively with Client/Conifer Senior Executives to ensure requirements are met in the most efficient and cost-effective manner; provides direction to clients for implementation of multiple regulatory requirements. Serve as mentor and coach for Revenue Integrity personnel and as a resource for manager-level associates. Maintain a high-level understanding of accounting and general ledger practices as it relates to Revenue Cycle metrics; guide client personnel on establishing charges in appropriate revenue centers to positively affect revenue reporting FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): Adherence to established/approved annual budget SUPERVISORY RESPONSIBILITIES This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Direct Reports (incl. titles) : Revenue Integrity Manager/Supervisor Indirect Reports (incl. titles) : Charge Review Specialist I-II, Revenue Integrity Analyst I-III, Charge Audit Specialist To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to set direction for large analyst team consistent with Conifer senior leadership vision and approach for executing strategic revenue management solutions Demonstrated critical-thinking skills with proven ability to make sound decisions Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely Ability to manage multiple projects/initiatives simultaneously, including resourcing Ability to solve complex issues/inquiries from all levels of personnel independently and in a timely manner Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement Advanced ability to work well with people of vastly differing levels, styles, and preferences, respectful of all positions and all levels Ability to effectively and professionally motivate team members and peers to meet goals Advanced knowledge of external and internal drivers affecting the entire revenue cycle Intermediate level skills in MS Office Applications (Excel, Word, Access, Power Point) Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. Bachelor's degree or higher; seven (7) or more years of related experience may be considered in lieu of degree Minimum of five years healthcare-related experience required Extensive experience as Revenue Integrity manager Extensive knowledge of laws and regulations pertaining to healthcare industry required Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required Consulting experience a plus CERTIFICATES, LICENSES, REGISTRATIONS Applicable clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, CCS highly desirable PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit for long periods of time; use hands and fingers; reaching with hands and arms; talk and hear. Must frequently lift and/or move up to 25 pounds Specific vision abilities required by this job include close vision Some travel required WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Normal corporate office environment TRAVEL Approximately 10 - 25% Compensation and Benefit Information Compensation Pay: $104,624- $156,957 annually. Compensation depends on location, qualifications, and experience. Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level. Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, life, and business travel insurance Management time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $104.6k-157k yearly Auto-Apply 48d ago
  • Inpatient Corporate Coding Coordinator - Remote based in US

    Conifer Health Solutions 4.7company rating

    Remote or Dallas, TX job

    Under general supervision and with aid of Official Coding Guidelines, the Corporate Coding Coordinator codes diagnoses and procedures of inpatient accounts according to ICD-10-CM/PCS. The Corporate Coding Coordinator is responsible for assisting the Corporate Coding Manager with second level coding reviews and educates coders on correct coding. Assists the coding department with coding questions, reviews, or inquiries. Required: 3-5 years acute hospital coding experience. Skilled and working knowledge of MS Office suite. Ability to analyze coding related reports and take action. Associates Degree in Health Information Management. RHIT or CCS certification. Preferred: 5 plus years' experience in a large, complex, multi-system acute care hospital organization. Bachelor's Degree in Health Information Management. RHIA and CCS certification. A pre-employment coding proficiency assessment will be administered. Compensation Pay: $30.00-$45.00 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Benefits The following benefits are available, subject to employment status: Medical, dental, vision, disability, AD&D and life insurance Paid time off (vacation & sick leave) Discretionary 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance. For Colorado employees, paid leave in accordance with Colorado's Healthy Families and Workplaces Act is available. #LI-CM7 Performs second level coder reviews on accounts that are sent back from Revint, Iodine, coding audits, and coding/billing editor. Provides coders with education and guidance on correct coding based on second level reviews. Assists coding manager and coding department with coder questions, coding reviews, and coding inquiries. Codes inpatient accounts when coverage is needed. Monitors and assists coding manager with DNFC management to goals. Attends Tenet coding educations and maintains coding credentials.
    $27k-35k yearly est. Auto-Apply 2d ago
  • Patient Advocate Representative - Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    Responsible for screening self-pay patients at hospital bedside for eligibility in various governmental and non-governmental programs. Responsible for identifying all sources of potential payors including auto insurance, Workers' Compensation, commercial insurance, private insurance, TPL, etc. to route account appropriately in the Patient Accounting environment. Also responsible for obtaining and completing the Confidential Financial Statement form and assisting patients in the process of applying for any benefits for which they may be eligible. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Conducts interviews with patients and/or family members. Records and maintains complete documentation of activities performed on account while in-house and during the Patient accounting cycle. Performs financial clearance function including collections. Cancels accounts that have not had any patient cooperation and are not eligible for any programs and prepares accounts for Financial Assistance review. Follows up on EES assigned accounts to ensure follow-through on Government application submitted. Develops a working relationship with patients, based on good communication skills, enabling accounts to be processed quickly with government program eligibility. Conducts field visits to patient homes for skip tracing and or assisting patient with documents. Notifies hospital case management, social services and admissions staff of case screening determinations and outcomes via verbal and written communication. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working familiarity with the rules and regulations pertaining to Federal, State and County programs P/C systems literate including Windows, and Microsoft Outlook, Excel and Word programs Ability to work independently Excellent oral and written communication skills, as well as the clear understanding of the English language Detail oriented, with strengths in dealing with multiple facilities, Supervisors, and Hospital platforms Ability to prioritize and manage multiple tasks with efficiency Bi-lingual preferred (Spanish) Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. High School diploma or equivalent Minimum 2 years work experience with Social Services or Hospital Admitting or related area PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to sit and work at a computer terminal for extended periods of time Must be able to walk through a hospital environment, including across broad campus settings and Emergency Department environments, and visit patients at bedside Ability to travel if required WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Both Hospital and Office facilities, in direct contact with Patients and Staff OTHER Some travel may be required As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation • Pay: $17.20-$25.70 per hour. Compensation depends on location, qualifications, and experience. • Position may be eligible for a signing bonus for qualified new hires, subject to employment status. • Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: • Medical, dental, vision, disability, and life insurance • Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. • 401k with up to 6% employer match • 10 paid holidays per year • Health savings accounts, healthcare & dependent flexible spending accounts • Employee Assistance program, Employee discount program • Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. • For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $17.2-25.7 hourly Auto-Apply 10d ago
  • Coding Quality Auditor - Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Consulting: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards of Ethical Coding (AHIMA).Reviews medical records to determine accurate required abstracting elements (facility/client/payer specific elements) including appropriate discharge disposition IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-9-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition. Coding: Uses discretion and specialized coding training and experience to accurately assign ICD-9, CPT-4 codes to patient medical records. Abstracting: Reviews medical records to determine accurate required abstracting elements (client specific elements) including appropriate discharge disposition. Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by SOW. CDI: Identifies and communicates documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to appropriate personnel for follow-up and resolution. Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to consistently code at 95% accuracy and quality while maintaining client specified production standards Must successfully pass coding test Knowledge of medical terminology, ICD-9-CM and CPT-4 codes Must be detail oriented and have the ability to work independently Computer knowledge of MS Office Must display excellent interpersonal skills The coder should demonstrate initiative and discipline in time management and assignment completion The coder must be able to work in a virtual setting under minimal supervision Intermediate knowledge of disease pathophysiology and drug utilization Intermediate knowledge of MSDRG classification and reimbursement structures Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Associates degree in relevant field preferred or combination of equivalent of education and experience Three years coding experience including hospital and consulting background CERTIFICATES, LICENSES, REGISTRATIONS AHIMA Credentials, and or AAPC PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Duties may require bending, twisting and lifting of materials up to 25 lbs. Duties may require driving an automobile to off- site locations. Duties may require travel via, plane, care, train, bus, and taxi-cab. Ability to sit for extended periods of time. Must be able to efficiently use computer keyboard and mouse to perform coding assignments. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Floats between clients as requested. Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment. OTHER Regular travel may be required As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation Pay: $30.85 - $46.28 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $33k-44k yearly est. Auto-Apply 9d ago
  • Site Lead Process Engineer

    R1 RCM 4.8company rating

    Remote R1 RCM job

    The Site Executive is a strategic and operational leader responsible for overseeing site-level consulting operations. This role ensures alignment with enterprise goals, manages P&L, drives measurable client value, and fosters a high-performing team culture. The Site Executive plays a critical role in use case business case quantification and execution, development and execution of operating metrics, stakeholder engagement and reference ability. Key Responsibilities Leadership & Strategy Lead site-based consulting teams aligned to the managed software delivery model. Translate strategic objectives into operational plans and performance targets. Collaborate with cross-functional leaders to ensure seamless delivery and client satisfaction. Client Delivery & Value Creation Oversee execution of client use cases, ensuring measurable outcomes and ROI. Oversee training and change management plans to drive adoption of best practices Build trusted relationships with customer stakeholders to drive engagement and reference ability. Ensure proactive issue resolution and continuous improvement in service delivery. Ensure steady state client satisfaction through proactive engagement. Financial & Operational Accountability Manage site-level P&L, including budgeting, forecasting, and performance tracking. Monitor key operating metrics to optimize resource allocation and team productivity. Talent Development Coach and develop team leads and foster a culture of accountability and excellence Support recruitment and retention of top consulting talent. Qualifications Minimum of 12 years of experience, including at least 8 years in a management role in consulting, client delivery, or operational leadership roles managing a P&L-preferably within healthcare, BPO, or enterprise software. Proven ability to lead cross-functional teams in a matrixed environment Adept with Ai tools and enthusiastic about the conversion of technology and operations Strong communication, change management and stakeholder management skills. Bachelor's degree - equivalent experience will be considered in lieu or a degree; advanced degree (MBA, MHA) preferred. Up to 50% of travel required depending on area and client location For this US-based position, the base pay range is $243,644.80 - $304,556.00 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 30.00% The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook #LI-TC01
    $31k-50k yearly est. Auto-Apply 60d+ ago
  • RC Precert Clinician - Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The Revenue Cycle Management Clinician for the Pre-Authorization Solution is responsible for: a) All clinical pre-authorization activities associated with patients financially cleared through the Patient Access Support Unit (PASU) and/or the Center for Patient Access Services (CPAS). b) Coordinating with ordering physicians and/or facility staff to secure the necessary prior payment authorization utilizing applicable payer criteria. Include the following. Others may be assigned. ESSENTIAL DUTIES AND RESPONSIBILITIES Performs pre-service authorization reviews to obtain payment authorization for both inpatient and outpatient services. Succinctly abstracts fact based clinical information to support pre-authorization utilizing applicable nationally recognized and payer-specific criteria; communicates timely the clinical information supporting the medical necessity of an ordered test/treatment/procedure/surgery as applicable to the patient's health plan and documents the outcome of the task. Performs the following activities to support the effective operation of the organization's quality management system. A minimum of 2.5 % of time is spent carrying out the following responsibilities: Participation in quality control audit process; participation in department projects and activities to improve overall Conifer and client scorecard metrics. provides feedback regarding improvement opportunities for workflow &/or procedures; and the contributes to successful implementation of all the above. Demonstrates proficiency in the use of multiple electronic tools required by both Conifer and its clients. Collaborate with and engage internal and external customers, such as facility patient access and physician offices, in opportunities for prevention of future disputes; identifies potential process gaps and recommends sound solutions to CAS leadership. Other duties as assigned To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to work independently and self-regulate in compliance with deadlines Proficiency in the application of applicable nationally and payer authorization criteria Possesses excellent customer service skills that include written and verbal communication. Minimum Intermediate Microsoft Office (Excel and Word) skill Ability to critically think, problem solve and make independent decisions Ability to interact intelligently and professionally with other clinical and non-clinical partners Ability to prioritize and manage multiple tasks with efficiency Advanced conflict resolution skills Ability to communicate effectively at all levels Ability to conduct research regarding payer pre-authorization guidelines and applicable regulatory processes related to the pre-authorization process Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. Must possess a valid nursing license (Registered or Practical/Vocational). LPN or RN PREFERRED. Minimum of 3-5 years as a pre-authorization or utilization review nurse in a payer or acute care setting; preferably medical-surgical or critical care/ED CERTIFICATES, LICENSES, REGISTRATIONS Current, valid RN/LPN/LVN licensure Certified Professional in Utilization Review/Utilization Management/Healthcare Management (CPUR , CPUM, or CPHM) or Certified Case Manager (CCM) preferred PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to lift 15-20lbs Ability to travel approximately 10% of the time; either to client &/or Conifer office sites Ability to sit and work at a computer for a prolonged period of time conducting pre-service medical necessity reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Characteristic of typical Call Center environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER May require travel - approximately 10% Interaction with staff at client facilities such as and not limited to Patient Access, Case management, physicians and/or their office staff is a requirement. Compensation and Benefit Information Compensation Pay: $27.30-$40.95 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $27.3-41 hourly Auto-Apply 1d ago
  • Application Support Specialist - Remote based in the US

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The Spec, Application Support is tasked with the optimization and management of specified technology. This position will work closely with various vendors, ensuring the most up-to-date information and changes are evaluated for use and effectiveness in the process. Will work with the process team to determine what technology changes and needs are required to drive process improvements. Will own the development and follow through of any service requests or new implementations. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Stays current and has deep, ingrained knowledge of systems, including end user applications, reporting and enhancements. Can demonstrate full understanding of how the technology supports and is used within specific processes and brings technology driven ideas to the process team. Reviews all ISB's for procedural impact. Edits and works with process leaders and trainers to develop procedural and training documentation. Clarifies system processes and responds to additional requests for information. Works closely with peers to reduce redundancies and ensure there are no conflicts between multiple technologies within processes. Ensures that Software Transfer Implementations are completed accurately and develops test plans. Meets user deadlines for system changes and other requested information. Coordinates with IS to ensure that facility IS departments have the knowledge required to ensure the front-end system is set up appropriately. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Understands workflow and technology needs within the business. Excellent grammar and writing skills Must have good organizational skills Able to work independently with little supervision Able to communicate with all levels of management Must have general computer skills and be proficient in Word, Excel, and PowerPoint Excellent working knowledge of Patient Financial Services operations with specific focus on applicable discipline. Ability to work and coordinate with multiple parties Ability to manage projects Knowledge of AR management technology tools being utilized to deliver on key performance Knowledge of healthcare regulatory rules and how they apply to revenue cycle operations and outsourcing service providers Excellent verbal and written communication skills EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. 4-year college degree in Healthcare Administration, Business or related area or equivalent experience 2 - 6 years of experience in Healthcare Administration or Business Office Lean, Six Sigma or other process improvement certification is a plus PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to work in a sitting position, use computer and answer telephone WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office Work Environment As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation Pay: $21.70 - $34.70 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. #LI-NO3
    $21.7-34.7 hourly Auto-Apply 27d ago
  • Patient Account Supervisor- Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The Supervisor is responsible for the supervision and leadership of the Patient Account Representatives, both on-site and telecommuters. Directly responsible for the interviewing, hiring, training, scheduling, and monitoring of staff as well as all aspects of A/R Management and Performance Management. Attend meetings and respond timely to all requests, including completion of accounts referred to the Supervisory Desk. Identify performance deficiencies and opportunities and implement action plans as appropriate. Effectively maintain a work environment which promotes communication to stimulate the morale, engagement, and growth of subordinates. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned . Responsible for all aspects of the day-to-day supervision and leadership of Patient Account Representatives, including but not limited to the Performance Management metrics of collections, productivity, quality and aging. Interview candidates and make hiring recommendations and decisions. Complete monthly quality evaluations. Monitor staff scheduling and adherence to time and attendance protocol. Responsible for all aspects of A/R Management, including but not limited to maintaining workload balance, ensuring maximum efficiency, eliminating rework, and reducing cost. Promptly identify issues and develop action plans to mitigate or resolve. Train, develop, motivate and assist subordinates in reaching new levels of skills, knowledge and attitude. Effectively maintain a work environment which stimulates and motivates the morale, engagement and growth of subordinates. Identify performance deficiencies and opportunities and implement action plans as needed. Review and respond timely to requests, including emails, telephone calls, issues, account research and resolution as needed by staff, management and clients. Timely completion of accounts referred to the Supervisory Desk by staff or management. Effectively communicate and interact with subordinates, management and clients. Conduct, attend and participate in meetings, conference calls and training sessions, including Management Meetings, Team Meetings, as well as one-on-one monthly meetings with subordinates to provide consistent performance feedback. Complete the mid-year and year end Performance Management review. SUPERVISORY RESPONSIBILITIES If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. No. Direct Reports (incl. titles) Patient Acct Reps, Sr Patient Acct Reps, Lead Patient Acct Reps KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Very good written and verbal communication skills Strong interpersonal skills Strong technical skills, including PC and MS Office Suite knowledge Proficient in building a strong team to meet performance goals Effectively manages multiple tasks Displays sound judgment and reasoning abilities Creative and innovate thinking Achieves results with accuracy and precision Advanced knowledge of healthcare A/R Excellent working knowledge of Patient Financial Services operations with specific focus on Inpatient and Outpatient Managed Care and Commercial payors (i.e., Medicare regulations and compliance; HIPAA) Proficient in Microsoft Office (Word and Excel) Advanced writing skills Ability to provide advanced customer service Ability to train and coach staff Ability to multi-task Strong leadership and organizational skills Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. High School diploma and/or equivalent education 4-7 years experience preferred Advanced knowledge of UB-04, EOB interpretation, CPT and ICD-9 codes. Supervisory experience or demonstrated leadership. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office/Teamwork Environment As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation Pay: $51,626.00 - $77,438.00 annually. Compensation depends on location, qualifications, and experience. Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, life, and business travel insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $51.6k-77.4k yearly Auto-Apply 60d+ ago
  • Regional Corporate IP Coding Manager - Remote based in the US

    Conifer Health Solutions 4.7company rating

    Remote or Dallas, TX job

    The Regional Corporate Coding Manager functions under the direction of the Director of Corporate Coding. Provides regional coding management oversight of coding operations for multiple Tenet Hospitals/Markets. Responsible for mentoring Corporate Coding Supervisors or Leads, Coders, DNFC Specialists, and Coding Coordinators in their roles and perform coding education and training orientation in collaboration with the Director of Coding. Performs coding quality reviews and tracks, trends, and manages coding quality performance to Tenet standard. In addition, the Regional Corporate Coding Manager ensures all facilities are properly staffed and productive in order to meet and sustain Tenet DNFC goal. Position will support Tenet corporate located in Texas. ESSENTIAL DUTIES AND RESPONSIBILITIES: Performs coding quality reviews and tracks, trends, and manages coding quality performance to Tenet standard. Responsible for the scheduling of Coders, DNFC Specialists, Leads, and Coding Coordinators to ensure metrics for coder productivity and DNFC are met. Responsible for ensuring coding team meets and maintains the Tenet standard for coding quality. Provides performance management/corrective action for productivity and quality to all direct reports. Responsible for mentoring Corporate Coding Supervisors or Leads, Coders, DNFC Specialists, and Coding Coordinators in their roles and perform coding education and training orientation in collaboration with the Director of Coding. Attends facility DNFC/B meetings and reports on DNFC performance. Accountable for DNFC performance, reporting, and follow-up to leadership. Required: Associates Degree in Health Information Management or associated healthcare field of study. Minimum of four years of inpatient coding experience. One year of coding leadership experience. RHIT and/or CCS credential. Thorough knowledge of ICD- 10-CM and ICD-10-PCS coding principles associated with Official Coding Guidelines and regulatory requirements. Working knowledge of disease processes, anatomy and physiology, pharmacology, and knowledge of DRG classification and reimbursement structure. Effective written and verbal communication skills. Experience with encoders and computerized abstracting systems. Coding proficiency demonstrated by successful completion of Tenet coding exercise. Organizational skills for initiation and maintenance of efficient workflow. Capacity to work independently. Preferred: Bachelor's Degree in Health Information Management or associated healthcare field of study. Five or more years of inpatient coding experience. Five or more years of directly leading large coding teams in a complex health system. RHIA and CCS Compensation Pay: $85,280-$135,000 annually. Compensation depends on location, qualifications, and experience. Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level. Management level positions may be eligible for sign-on and relocation bonuses. Benefits The following benefits are available, subject to employment status: Medical, dental, vision, disability, life, AD&D and business travel insurance Manager Time Off - 20 days per year Discretionary 401k match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance. For Colorado employees, paid leave in accordance with Colorado's Healthy Families and Workplaces Act #LI-CM7
    $85.3k-135k yearly Auto-Apply 29d ago
  • Staff AI Engineer, R37

    R1 RCM 4.8company rating

    R1 RCM job in Salt Lake City, UT

    R1 is thrilled to introduce R37 committed to transforming healthcare financial performance so providers can focus on delivering exceptional care. R37 is pioneering an AI-driven approach to revolutionize revenue cycle management. Today we serve 95 of the top 100 hospital systems in the US and R37 will serve as the AI platform layer delivering results for our customers. Joining R37 offers the dynamic energy of a startup, backed by solid revenue, clear business value, and strong investment support. As a Staff AI Engineer at R37, you will play a pivotal role in shaping and delivering AI-driven technical solutions that drive real business outcomes. You will lead the development of early-phase AI systems to tackle complex unstructured data problems in healthcare, driving results for customers, and developing systems to measure and improve AI performance. **What** **you will** **do as a Staff AI Engineer, R37:** + **Lead AI Development:** Spearhead the creation of initial-phase AI systems for retrieval, ranking, categorization, and generative AI features on unstructured healthcare data + **Outcome-Driven Engineering:** Deliver outcomes through software and models, ensuring projects are aligned with business objectives. Ask questions, disambiguate complexity, document your thinking, and deliver results. + **AI System Design:** Work backwards from extremely complex business problems to design the correct AI abstractions and components in the simplest, most logical, and maintainable way possible. Maintain and operate AI systems at scale, ensuring reliability, performance, and operational excellence in AI production environments. + **Bring Rigor to** **Science Decisions:** Be accountable for scientific decisions to deliver outcomes. Ensure proper evaluation datasets, correct metrics to connect outcomes to models, appropriate model architecture, and effective data flywheels for iterative improvement. + **Mentorship and Best Practices:** Provide mentorship and promote best practices in data and AI while cultivating a collaborative and inclusive team culture. + **Team Growth:** Contribute to team growth by improving hiring and recruiting outstanding AI talent. **We would** **love to hear from you if you have:** + Proven experience building and operating production AI systems such as Search, Ranking, or generative AI products at a significant scale + Comfort in prototyping and pathfinding new opportunities that led to successful 0→1 projects + Proven experience implementing the full lifecycle of an early-phase AI development, from ideating on which models to use through productionizing and maintaining them. + Experience in developing deep product and business knowledge to connect abstract modeling and analysis tasks with business value. + Experience developing models using tools like PyTorch, TensorFlow, experimenting with models from Hugging Faceand deploying to production in with tools like Databricks, AWS Bedrock, Azure ML **While** **it is** **not** **required** **,** **it is** **another advantage** **if you also have:** + A relevant advanced degree (master's or PhD) in Machine Learning, Artificial Intelligence, Statistics, or a related field. **Interview Logistics Notice** As part of our hiring process, selected candidates will participate in an in-person interview. Candidates located near one of our talent hubs-San Francisco, New York, Austin, or Chicago-will be scheduled to meet with team members in those locations. For candidates residing outside these areas, we will arrange travel to a hub for the interview. Travel accommodations will be provided as needed. We are committed to providing equal employment opportunities and ensuring a fair and inclusive experience for all applicants. For this US-based position, the base pay range is $140,000.00-$350,000.00 per year. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan. The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. (***************************** R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (*********************************************************************************** To learn more, visit: R1RCM.com Visit us on Facebook (******************************* R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: ********************* .
    $78k-121k yearly est. 60d+ ago
  • Process Consultant

    R1 RCM 4.8company rating

    Remote R1 RCM job

    The Process Consultant designs and delivers scalable, secure, and high-impact technology solutions that align with client-specific use case and the managed software delivery model. This role bridges business needs and technical execution, ensuring seamless integration of platforms and processes. Key Responsibilities Translate business requirements into technical architecture and implementation plans by conducting a current state assessment including standard operating procedures and process mapping Partner with Process Engineers and consulting teams to deliver end-to-end solutions by creating a product vision document, product roadmap and future state process flow. Provide technical and operational guidance throughout the engagement Design implementation and stakeholder communication plan for client-specific use cases Design end user technology training and change management plan to drive adoption and create feedback loop for ongoing support Develop sustainable mechanisms to monitor KPIs and SLAs that provide measurable value creation and performance tracking for steady state operations. Preferred Qualifications 5+ years of experience in enterprise architecture or solution design. Experience in consulting, client delivery, or operational environment desired Bachelor's degree - equivalent experience will be considered in lieu of a degree in Computer Science, Information Systems, or related field Experience with healthcare platforms (e.g., EHR, RCM, ERP) is a plus. Strong communication and stakeholder engagement skills. Must be willing and available for a minimum 50% travel, based on location of employee and clients. For this US-based position, the base pay range is $145,000.00 - $194,785.02 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00% The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook #LI-TC01
    $56k-85k yearly est. Auto-Apply 60d+ ago
  • CDI RN Specialist - PRN Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians' clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements, MS-DRG Assignment, and clinical conditions and/or procedures. Educates members of the patient care team regarding documentation guidelines, including the following: attending physicians, allied health practitioners, nursing, and case management. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. 1. Record Review: •Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population to: (a) evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) record in business partner designated CDI tool and/or host medical record system. •Conducts follow-up reviews of patients every 24-48 hours or as needed up through discharge to support assigned working MS-DRG assignment upon patient discharge, as necessary. •Formulate physician queries regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary. •Collaborates with providers, case managers, nursing staff and other ancillary staff regarding documentation and to resolve physician queries prior to discharge. 2.CDI •Communicates/Completes Clinical Documentation Integrity (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up, provider education and DRG Miss-Match reconciliation. •Assists with Provider education, rounding and communication regarding open queries for resolution. 3. Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD10-CM and PCS coding. Attends CDI Boot camp, CDI/coding trainings annually and quarterly for inpatient coding. Attends monthly education lecture series (MELS) and all CDI/coding assigned learn share modules as well as any additional required CDI education. 4. Assist in training department staff new to CDI 5. Performs other duties as assigned KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. CDI Specialist must display teamwork and commitment while performing daily duties Must demonstrate initiative and discipline in time management and medical record review. Travel may be required to meet the needs of the facilities. Proficient knowledge of disease pathophysiology and drug utilization Intermediate knowledge of MS-DRG classification and reimbursement structures Critical thinking, problem solving and deductive reasoning skills. Effective written and verbal communication skills Excellent computer skills including MS Word/Excel Knowledge of coding compliance and regulatory standards Excellent organizational skills for initiation and maintenance of efficient workflow Regular and reliable attendance Capacity to work independently in facility on-site setting. Capacity to work independently in a virtual office setting if required for specific assignment. Exhibit flexibility as needed to meet program needs. Understand and communicate documentation strategies. Recognize opportunities for documentation improvement. Formulate clinically, compliant credible queries. Ability to successfully comply to robust auditing and CDI program monitoring Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. Preferred: Acute Care nursing and/or Provider relevant experience Zero (0) to two (2) years CDI experience Two (2) plus years' nursing experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review Two (2) plus years' Provider experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review Graduate from a Nursing program, BSN, or graduate program; OR Graduate from Medical Doctor and/or Foreign Medical Doctor Program CERTIFICATES, LICENSES, REGISTRATIONS Active state Registered Nurse license; OR Graduate MD and/or FMD license Preferred: CDIP or CCDS PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to sit for extended periods of time. Ability to stand for extended periods of time. Must be able to efficiently use computer keyboard and mouse. Good visual acuity WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. OTHER Must be able to travel as needed, not to exceed 10%. Compensation and Benefit Information Compensation • Pay: $34.86-$52.29 per hour. Compensation depends on location, qualifications, and experience. • Position may be eligible for a signing bonus for qualified new hires, subject to employment status. • Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: • Medical, dental, vision, disability, and life insurance • Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. • 401k with up to 6% employer match • 10 paid holidays per year • Health savings accounts, healthcare & dependent flexible spending accounts • Employee Assistance program, Employee discount program • Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. • For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $34.9-52.3 hourly Auto-Apply 3d ago
  • Senior Solutions Engineer

    R1 RCM 4.8company rating

    Remote R1 RCM job

    R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. R1 is thrilled to introduce R37 committed to transforming healthcare financial performance so providers can focus on delivering exceptional care. R37 is pioneering an AI-driven approach to revolutionize revenue cycle management. Today we serve 95 of the top 100 hospital systems in the US and R37 will serve as the AI platform layer delivering results for our customers. Joining R37 offers the dynamic energy of a startup, backed by solid revenue, clear business value, and strong investment support. As our Senior Solutions Engineer, you will be the technical expert and product champion who bridges the gap between our AI-driven revenue cycle technology and healthcare organizations. Drawing on your real-world experience in healthcare billing, AR management, or coding, you'll demonstrate how our solutions solve actual RCM challenges. You will work closely with sales teams, prospects, and clients to showcase our applications while serving as the trusted advisor who truly understands the day-to-day realities of revenue cycle operations. To thrive in this role, you must combine deep RCM domain expertise with excellent presentation skills and technical acumen. Here's what you will experience working as Senior Solutions Engineer: Own the technical win: Lead product demonstrations for prospects and clients, translating complex AI and automation capabilities into tangible business value that resonates with RCM professionals. Leverage your RCM expertise: Apply your hands-on experience in billing, AR management, or coding to build credibility and speak the language of revenue cycle leaders, managers, and operators. Drive proof of concepts: Design and execute POCs that prove our platform's value, working closely with client teams to ensure successful technical evaluations. Partner with sales: Collaborate with account executives throughout the sales cycle, from discovery through close, serving as the technical and domain expert. Shape the product: Provide feedback to product and engineering teams based on client needs and your RCM expertise, influencing our roadmap and solution development. Master demo delivery: Own and optimize demo environments to showcase our platform's capabilities and ROI for different RCM use cases, independently handling configuration changes and basic customizations while collaborating with technical teams for advanced modifications as needed. To be successful in this role, the candidate will have: 5+ years of hands-on experience in healthcare revenue cycle operations (billing, AR management, coding, denials management, or related areas) OR healthcare consulting focused on middle or back-end revenue cycle 3+ years of solutions engineering or pre-sales experience in SaaS environments Proven ability to deliver compelling technical demonstrations and presentations to diverse audiences from C-suite to end users Strong understanding of healthcare IT systems, EHRs, and revenue cycle workflows Experience supporting enterprise sales cycles and complex technical evaluations Excellent communication skills with ability to translate technical concepts into business value It's a plus if you bring: Solutions engineering experience specifically in healthcare technology Experience with healthcare data standards (HL7, FHIR, X12) Knowledge of AI/ML applications in healthcare Track record of supporting $1M+ enterprise deals Certifications in revenue cycle (CRCR) or health information (RHIA, RHIT, CCS) Interview Logistics Notice As part of our hiring process, selected candidates will participate in an in-person interview. Candidates located near one of our talent hubs-Atlanta, San Francisco, New York, Austin, or Chicago-will be scheduled to meet with team members in those locations. For candidates residing outside these areas, we will arrange travel to a hub for the interview. Travel accommodations will be provided as needed. We are committed to providing equal employment opportunities and ensuring a fair and inclusive experience for all applicants. #LI-R37PRODUCT For this US-based position, the base pay range is $112,718.72 - $187,269.24 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 20.00% The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook
    $112.7k-187.3k yearly Auto-Apply 21d ago
  • Patient Account Representative - Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance. Representative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account. Team member should possess the following: Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions Access payer websites and discern pertinent data to resolve accounts Utilize all available job aids provided for appropriateness in Patient Accounting processes Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities Provide support for team members that may be absent or backlogged ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards. Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results. Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor. Participate and attend meetings, training seminars and in-services to develop job knowledge. Respond timely to emails and telephone messages as appropriate. Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office (Word, Excel) Ability to learn hospital systems - ACE, VI Web, IMaCS, OnDemand quickly and fluently Ability to communicate in a clear and professional manner Must have good oral and written skills Strong interpersonal skills Above average analytical and critical thinking skills Ability to make sound decisions Has a full understanding of the Commercial, Managed Care, Medicare and Medicaid collections, Intermediate knowledge of Managed Care contracts, Contract Language and Federal and State requirements for government payors Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims. Intermediate understanding of EOB. Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. Ability to problem solve, prioritize duties and follow-through completely with assigned tasks. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. High School diploma or equivalent. Some college coursework in business administration or accounting preferred 1-4 years medical claims and/or hospital collections experience Minimum typing requirement of 45 wpm PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office/Team Work Environment Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation Pay: $17.62 - $24.68 per hour. Compensation depends on location, qualifications, and experience. Position may be eligible for a signing bonus for qualified new hires, subject to employment status. Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, and life insurance Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $17.6-24.7 hourly Auto-Apply 60d+ ago
  • Revenue Integrity Manager- Remote

    Conifer Health Solutions 4.7company rating

    Remote or Frisco, TX job

    Oversees professional staff responsible for managing, coordinating, and implementing Charge Description Master (“CDM”) and charge capture initiatives and processes to ensure revenue management and revenue protection. Serving in a senior leadership capacity, has direct interaction and interface with internal and external executive level staff. Facilitates CDM and charge capture education; ensures adherence to government/non-government regulatory directives; ensures appropriate levels of control are established to satisfy audit/review requirements; and facilitates revenue management communications and information flow. Oversees maintenance of accurate and timely patient accounting system(s) changes/updates to sustain data integrity and to facilitate claims processing; ensures quality reviews occur to identify and minimize system errors. Plans revenue management strategies as identified in data/report analyses to ensure consistency/standardization, to identify improvement opportunities, and to facilitate appropriate knowledge transfer. Plans, prepares, and administers annual budget; develops and maintains budgetary controls; balances department needs with Conifer annual budget goals. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Serves as a resource and in a consultative role to various levels of customers; works closely and collaboratively with other internal departments. Manages a professional team to evaluate, review, plan, implement, and report various revenue management strategies to ensure CDM integrity; to identify charge capture improvement opportunities; resolve billing edits and to facilitate appropriate education. Evaluates and maintains workflow processes to ensure efficiencies; works with all personnel involved in the revenue cycle to optimize CDM interfaces, billing edit resolution and charge capture processes. Researches, evaluates, and interprets guidance from a variety of sources to determine department and/or facility impact and to ensure optimal revenue management; continually reviews and monitors billing and coding changes affecting CDM and charge capture processes to ensure accurate claims production, appropriate distribution of information, and to identify target areas for education. Provides incident management and problem resolution; views incidents and problems from a systemic perspective to determine enterprise-wide solutions; oversees implementation of recommendations and monitors results to prevent recurrence; investigates complex issues as required. Manages/oversees special projects and special studies as required for new clients, system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, or other projects including, but not limited to: Oversees pricing initiatives such as strategic pricing, across-the-board increases, tiered pricing, pricing transparency; conducts interim pricing reviews and performs financial analyses for strategic initiatives. Manages implementation of CDM and/or charge capture corrective measures and monitoring tools to ensure sustainability of changes; reviews and monitors statistics and key performance indicators to identify improvement opportunities and ensure compliance with regulatory/non-regulatory directives. FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): This position may be required to monitor and explain expense variances to budget on a regular basis SUPERVISORY RESPONSIBILITIES This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. No. Direct Reports (incl. titles) Charge Review Specialist I-II, Revenue Integrity Analyst I-III, Charge Audit Specialist KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely Ability to respond in a professional manner to complex inquiries from various levels of personnel Accepts personal responsibility for the quality and timeliness of his/her work; establishes due dates for projects and assignments and meets those dates; efficiently organizes activities Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement Adapts easily to changing conditions and work responsibilities; works well with people of vastly differing levels, styles, and preferences Understands external and internal drivers affecting revenue management Ability to read, review, analyze, and interpret a variety of state/federal regulatory information and managed care contracts and the affect on appropriate claims production including multiple patient accounting systems, clinical/order entry systems, ancillary systems, and CDM Ability to utilize and research various published resources, appropriate reference materials, Internet resources, seminars, and other associated information sources to continually stay abreast of changes in regulatory information Working knowledge in MS Office Applications (Excel, Word, Access, Power Point) Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. Bachelor's degree or higher; related experience may be considered in lieu of degree Prior supervisory experience required Minimum of five years healthcare-related experience required Working knowledge of laws and regulations pertaining to healthcare industry required Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required Prior CDM or charge capture experience required Consulting experience a plus CERTIFICATES, LICENSES, REGISTRATIONS Applicable clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, CCS highly desirable PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit for long periods of time; use hands and fingers; reaching with hands and arms; talk and hear. Must frequently lift and/or move up to 25 pounds Specific vision abilities required by this job include close vision Some travel required WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Normal corporate office environment As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation Pay: $81,952.00 - $122,907.00 annually. Compensation depends on location, qualifications, and experience. Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level. Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: Medical, dental, vision, disability, life, and business travel insurance Management time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. 401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.
    $82k-122.9k yearly Auto-Apply 45d ago
  • Financial Counseling Rep I

    R1 RCM 4.8company rating

    R1 RCM job in Riverton, UT

    R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration The Financial Counselor will be responsible for counseling patients or parties responsible for payment. The Patient Financial Counselor will educate patients on their responsibilities and potential options. The PFC is responsible for accurately and compassionately explaining to the patient their financial obligations during the financial counseling session. In addition, the counselor must obtain any necessary pre-certifications or authorizations and assist with any financing or third-party applications. In this role, the successful candidate must display a strong sense of patient care and attention to detail. Responsibilities: Explain financial responsibilities for services received, payment options and collection procedures to patients or parties responsible for payment. Counsel patients regarding insurance benefits and recommend alternative sources of payment and financial assistance when appropriate. Contact insurance carriers or other sources and act as an advocate for the patient. Initiate process for collecting prepays due and perform follow up activity to insure maximum collection is achieved. Identify hospital, public and private financial assistance programs for patients unable to meet their financial obligations. Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in completing assistance program applications and determine eligibility and coverage. Notify manager, physician and servicing department of possible delay of service for any elective, urgent admissions, procedures and scheduled diagnostic testing which have not been approved prior to the date of service. Maintain accurate documentation of pre-processing information. Provide assistance to uninsured patients and families in completing and filing Medicaid or assistance program applications with the appropriate agency. Perform all other duties and projects as assigned. Required Qualifications: High school diploma is required At least one year of call center experience Attention to detail Strong customer service experience Ability to multi-task and navigate between multiple systems simultaneously Ability to handle a large volume of incoming calls Desired Qualifications: Spanish Bi-Lingual Previous experience as a financial counselor with background in medical terminology preferred Understanding of State and Federal assistance Physical Requirements: See, read, and/or operate computers, telephones, office equipment, documents, labels, including manipulating paper requiring the ability to move fingers and hands. Remain sitting, standing, or walking for long periods of time to perform work on a computer, telephone, or other equipment. Frequent interactions with associates, patient care providers, patients, and visitors that require associate to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information banding patients, etc. Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items (over 5 lbs.). For this US-based position, the base pay range is $17.80 - $24.73 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. (***************************** R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (*********************************************************************************** To learn more, visit: R1RCM.com Visit us on Facebook (******************************* R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: ********************* .
    $17.8-24.7 hourly 37d ago
  • Project Manager, Deployment

    R1 RCM 4.8company rating

    Remote R1 RCM job

    R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Project Manager, you will help deliver seamless client deployments in the healthcare space by managing timelines, resources, and stakeholder communication to ensure operational readiness. Every day you will facilitate client and internal meetings, track project milestones, and identify and escalate risks and issues to ensure successful go-live and post-deployment support. To thrive in this role, you must be highly organized, proactive, and confident in client-facing interactions. You should excel at managing complex projects, asking the right questions, and driving accountability across stakeholders. Here's what you will experience working as a Project Manager: Lead and manage multiple projects simultaneously, including deployments from client discovery through go-live and post-launch support. Develop comprehensive project plans, including timelines, milestones, and resource allocation. Monitor project progress and coordinate cross-functional teams to ensure project deliverables are met. Communicate effectively with stakeholders, providing weekly status reports and monthly readiness presentations to clients. Identify and mitigate risks and issues that may impact timely project completion and post go-live success. Required Skills: Proven track record of successfully managing multiple projects concurrently from initiation to completion in a designated Project Management position within IT, technology, or healthcare; healthcare Revenue Cycle Management preferred. Stakeholder management and executive presence, including strong client-facing communication skills and the ability to influence and motivate without authority. Effective cross-cultural communication skills and experience working with distributed, global teams. Ability to use Microsoft Office Suite to plan and organize projects, meetings, communicate, report on, and analyze data. For this US-based position, the base pay range is $61,357.00 - $110,424.03 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00% The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at ************ for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook
    $61.4k-110.4k yearly Auto-Apply 15d ago

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