The Co-Management Coordinator is responsible for organizing, planning and supporting activities of the co-management groups (HSI and PSI) and works directly with physicians, their office personnel and co-management committees. Interacts with all levels of leadership including the Boards and the Executive Committees in compliance with the medical staff bylaws, rules, regulations, and policies, Woman's Hospital Foundation bylaws, and JCAHO standards and guidelines. Performs various duties assigned by Medical Director, Committee Chairs, general membership and hospital administration.
Requirements:
High school diploma or equivalent required, some college preferred
Three years of previous experience at the executive assistant level
Five years of healthcare experience
Thorough knowledge of bookkeeping/accounting duties to maintain financial data, accounting records, accounts payable, receivable, financial entries and reconciliations
Thorough knowledge of medical terminology procedures for recording and transcribing minutes
Knowledge composing reports and correspondence
Strong computer skills with knowledge of various programs and databases
Responsibilities of the Co-Management Coordinator position include, but are not limited to:
Plans, organizes and supports company board meetings, executive committees, sub-committees, ad-hoc committees, special projects, general membership meetings as assigned. Plans agendas with appropriate parties prior to meeting the meetings. Preparing and organizing and distributing agendas and any supportive materials prior to meetings.
Books meeting rooms, sends notices in advance of meetings, coordinates arrangements for refreshments, media, support personnel, etc. as needed.
Composes minutes, letters and reports within five days after each meeting. Submits minutes for committee approval. Follows up on actions and recommendations generated at meetings by writing/composing communications and securing responses by assigned deadlines.
Maintains accuracy of performance improvement initiative spreadsheet. Requests metric data monthly, with weekly follow-up. Updates metrics spreadsheets with data as received.
Developing and distributing PowerPoint presentations for each quarterly staff meeting.
Confirms accuracy of metrics data each quarter and submits for confirmation and payment processing
Submits for approval and group compensation on a regular basis to Boards, Executive Committees and hospital administration.
Manages banking account, reconciling and reporting monthly. Maintains accuracy of both QuickBooks and QuickBooks Online based on credits and debits to company banking account. Process invoices and payments on a regular schedule and as needed for each group.
Runs financial reports as requested. Reconciles banking accounts and reports monthly to the boards of directors
Organizing and submitting accounting data to companies' accountant each year to ensure timely tax documentation and filing. Distributing tax documentation to each company's membership in a timely manner.
Insuring timely renewal of companies' directors and officers' insurance coverage and general liability insurance coverage each year.
Drafts monthly Medical Director reports, including accomplishments and work plans. Submits to Medical Directors and Hospital Administration for review and approval each month.
Sending invitations to join each company to newly eligible physicians. Processing applications for co-management membership and maintaining up-to-date contact information and membership lists for each company.
Revises Medical Staff Services monthly calendar for HSI and PSI to include call schedule, hospital committees on which members participate and recurrent meetings. Distributes to appropriate parties.
Maintains the co-management groups websites. Notifies appropriate hospital contacts to update data each month. Posts notices, meeting minutes and other appropriate data as needed.
Creates, maintains and updates policies as required.
Checks any correspondence regularly and responds within two business days.
Checks mailbox at least weekly; opens and distributes mail as appropriate.
Provides administrative support to Medical Directors and committee chairs as indicated, including writing letters, memos and articles for physician communication.
Maintains files for correspondence; documents and retains in accordance with retention policies.
Assists with special projects as requested.
Performs other tasks as requested by the co-management group and hospital leadership.
Hours
PRN; this position is not eligible for benefits
Primarily remote; On Campus for required meetings
Pay
$20.82 to $33.31; plus PRN differential
A Work Experience with Purpose
Woman's is one of the largest specialty hospitals in the country dedicated to the care of women and infants. Nationally recognized for exceptional patient care, innovative programs, and a supportive work environment, we consistently exceed state and national benchmarks for patient satisfaction-a reflection of our commitment to those we serve.
We're home to Louisiana's largest delivery service and perform thousands of procedures annually, including over 8,500 surgeries and 35,000 breast procedures. Woman's was the first hospital in the Baton Rouge area to earn Magnet designation for nursing excellence, and we're honored to be named one of Modern Healthcare's Best Places to Work in Healthcare year after year.
We are proud of the care our staff provides to patients-and to one another-every day.
For more information or to contact our recruiting team, email us at *****************.
Woman's Hospital is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
$42k-56k yearly est. Easy Apply 5d ago
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Project Manager - Project Management Office
Woman's Hospital Foundation 3.9
Woman's Hospital Foundation job in Baton Rouge, LA
The Project Manager is responsible for leading and supporting organization-wide process improvement, change adoption, and sustainment efforts. This role partners closely with operational, clinical, and support leaders to improve workflows, reduce variation, and enable measurable performance improvement. This position does not own quality metrics or regulatory compliance, but instead serves as a delivery and improvement partner, ensuring initiatives are executed effectively and improvements are sustained over time.
Requirements:
* Bachelor's degree in business administration, healthcare, engineering, or related field is required.
* Masters Degree in business or hospital administration is preferred.
* Current Lean Six Sigma Green Belt Certification is required.
* Minimum of 1-3 years' project management experience including project experience in a business environment with major measurable deliverables is required.
Responsibilities:
* Continuous Improvement & Lean Methodology - Applies Lean and continuous improvement tools to support workflow analysis, reduce variation, and implement practical process improvements under PMO guidance.
* Change Enablement & Sustainment - Supports change adoption by assisting with stakeholder engagement, communication, and reinforcement activities that help embed improvements into daily operations.
* Process Analysis & Problem Solving - Uses basic process analysis and problem-solving techniques to identify improvement opportunities and support the development of effective solutions.
* Facilitation & Influence - Assists with facilitating meetings, workgroups, and improvement activities, contributing to alignment and progress through collaboration and clear communication.
* Data-Informed Decision Making - Uses available data and performance metrics to support analysis, track progress, and inform improvement efforts.
* Executive & Leader Communication - Prepares and delivers clear project updates and documentation for leaders, with guidance from PMO leadership as needed.
* Collaboration Across Functions - Works collaboratively with clinical, operational, and support teams to support organization-wide improvement initiatives.
Schedule:
* Full-Time; Monday-Friday
* 40 hour work week
Compensation:
* Salaried; Exempt Position
* $69,700 - $115,000
A Work Experience with Purpose
Woman's is one of the largest specialty hospitals in the country dedicated to the care of women and infants. Nationally recognized for exceptional patient care, innovative programs, and a supportive work environment, we consistently exceed state and national benchmarks for patient satisfaction-a reflection of our commitment to those we serve.
We're home to Louisiana's largest delivery service and perform thousands of procedures annually, including over 8,500 surgeries and 35,000 breast procedures. Woman's was the first hospital in the Baton Rouge area to earn Magnet designation for nursing excellence, and we're honored to be named one of Modern Healthcare's Best Places to Work in Healthcare year after year.
We are proud of the care our staff provides to patients-and to one another-every day.
For more information or to contact the recruiter for this position, e-mail *****************
We are an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
$69.7k-115k yearly Easy Apply 11d ago
HIMS Quality Assurance Analyst
Vidant Health 4.2
Remote or Greenville, NC job
The Health Information Services Management (HIMS) Quality Assurance Analyst is responsible for providing HIMS quality audits on scanned documents and ROI requests using daily work queues by supporting the HIMS Team. The incumbent is responsible for assisting with monitoring/tracking imaging and ROI release quality, correcting errors, identifying trends, curriculum development, and providing continuous support for operational leadership. This individual will be knowledgeable in end-user systems and applications relative to HIMS for the purpose of assessing, educating and training staff on systems and applications used.
Responsibilities
* Consistently audit the performance of completed work for all HIMS Imaging and ROI team members, which may also include VMG Physician Practices.
* Adheres to Quality Assurance measures and metrics which report any trends or process improvement opportunities for each project, office, and HIMS division.
* Design/Develop Quality Assurance materials including electronic scorecard, individual quality assessment, and building quality dashboards in the EHR.
* Provide constant communication with senior leadership regarding quality monitoring results, any identified and/or recommended training needs and deficiencies, as well as possible project improvement opportunities.
* Reports all Quality indicators for identification of trends to determine where training deficiencies exist.
* Work with Training & Education (or HIT team) team to develop training modules and assist as needed with training initiative. Provide end user training and support when deemed necessary.
* Maintain the integrity of the current Imaging system with super user knowledge and general understanding of workflows between OnBase and EPIC.
* Responsible for knowing all aspects of the HIMS Operations workflows.
* Abides by the Approved Corporate QA policy.
* Assist HIMS Manager with Concurrent Scanning audits and rounds on units. Provide education and feedback to the units and nurse managers.
* Assist other VH entities as needed to keep WQs timely.
* Responsible for knowing all aspects of the Birth Registration process and workflows.
* Keeps work accurate and current at all times and notifies Manager and/or Supervisor when backlog develops.
* Maintains equipment in good condition.
* Demonstrates an understanding of the medico legal implications and responsibilities as relates to the maintenance of patient records to protect the patient and ECU Health.
* Provides strict control and confidentiality of medical record materials via computer and reception area and assists others in the department in maintaining the same control.
* Follows ECU Health guidelines regarding confidentiality of patient information and any HIPAA laws/regulations.
* Notifies HIMS Manager and/or Supervisor when inaccurate or inappropriate material is contained in medical record.
* Maintains work area in safe and orderly manner. Practices good ergonomic work habits. Confronts all work with a positive attitude.
* Demonstrates effective interpersonal relations and communication skills by maintaining good working relationships with co-workers, management, medical staff and customers.
* Assists in orientation of new HIM employees/volunteers/students. Works with Allied Health students in projects/oversight as assigned.
* Be able to work shift work on rotation, including weekends and holidays, in order to provide departmental coverage if necessary.
* Performs other duties as requested by the HIMS Leadership Team.
Minimum Requirements
* Associates degree or higher in Health Information Technology and 5 or more relevant years of experience is required, or Bachelors degree or higher in Health Information Management and 2 or more relevant years of experience is required.
* Current certification or eligibility for certification by AHIMA as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) is required. If eligible, certification must be obtained within 6 months.
* Notary Public certification required within 6 months of employment (as deemed necessary).
* This role requires the incumbent to be detail-oriented, dependable and to work well with others.
Other Information
* Onsite role based out of Greenville, NC
* This position is predominantly onsite, providing opportunities for direct interaction and collaboration with colleagues. Remote work will be minimal and only required under specific circumstances.
* Monday - Friday day shift:
* 7:00 a.m. - 3:30 p.m.
* Great Benefits
#LI-AH2
ECU Health
About ECU Health
ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.
The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Childrens Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicants qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.
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$64k-84k yearly est. 44d ago
Home Base Patient Services Coordinator II (PSC II)
Brigham and Women's Hospital 4.6
Remote or Boston, MA job
Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research.
The Home Base Patient Service Coordinator (PSC) serves as a key member of the team that provides superior care and exceptional service to its patients. One critical dimension of this service focuses on patient check-in process and improving the human experience upon our patients' arrival to our practice and throughout the duration of their visit. The Home Base PSC will play an important role in redefining and reinvigorating the patient welcome and check-in experience. The PSC will be the crucial "face and attitude" of this patient-centered practice. While also providing medical scheduling services, the PSC will have the unique opportunity to work within a supportive team setting enabled by systems and technologies that will allow the employee to provide patient care and services at their highest levels. In addition, the PSC will be responsible to assist in special projects when skillset and capacity allow, as deemed appropriate by the Practice Manager.
Job Summary
Summary
Performs both administrative and clinical functions to support smooth and efficient clinical service or practice operations under general supervision. Performs basic clerical work and tasks that are repetitive and routine. Administrative duties related to patient visits including scheduling, check-in, check-out duties. Actual job duties may vary by Department.
Does this position require Patient Care? No
Essential Functions
* Perform routine administrative and clerical duties relating to a clinical service or physician practice office.
* Make patient appointments and maintain appointment records.
* Greet and assist patients.
* Answer telephones, assist callers with routine inquiries, and schedule appointments.
* File materials in patient folders and print appointment schedules.
* Process patient billing forms and scan documents to patient medical record/LMR.
* Call for patient medical records and laboratory test results.
* Open and distribute unit mail or faxes.
* Type forms, records, schedules, memos, etc., as directed.
* Handles, screens and/or takes messages related to prior authorizations, provider questions, prescription refills, and test results.
* Acts as "Super User" for scheduling, registration and billing systems.
* Provides assistance and training to others in these areas.
* May perform more complex or specialized functions (i.e. schedule changes/blocking) at more advanced competency level.
Qualifications
Education
High School Diploma or Equivalent required
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Certified Medical Administrative Assistant [CMAA] - Data Conversion - Various Issuers preferred
Experience
office experience 2-3 years required
Knowledge, Skills and Abilities
* Proficiency with all Office Suite,
* Knowledge of office operations and standards and understanding of office procedures including filing, copying, scanning, printing and faxing.
* Ability to use phone system and manage more non-routine phone calls and solve routine issues as appropriate.
* Communicating effectively in writing as appropriate for the needs of the audience and talking to others to convey information effectively.
* Understanding written sentences and paragraphs in work related documents, to correspond and communicate with others clearly and effectively (including composing/editing e-mail, memos and letters), and to take complete and accurate messages.
* Managing one's own time and the time of others.
* Well organized and good time management skills to manage multiple tasks effectively, follow established protocols, and work within systems.
Additional Job Details (if applicable)
Physical RequirementsStanding Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%)
Remote Type
Hybrid
Work Location
One Constitution Wharf
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$17.36 - $24.45/Hourly
Grade
3
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$17.4-24.5 hourly Auto-Apply 36d ago
Clinical Review Specialist, Remote
Brigham and Women's Hospital 4.6
Remote or Somerville, MA job
Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
General Summary:
Under the general direction of the Director of Risk Capture, the Pre-Visit Clinical Review Specialist (CRS) facilitates the accurate and appropriate identification of patient medical conditions through comprehensive chart review combined with review of coding output data sources (internal and external claims) that results in improvement in the overall quality, completeness and accuracy of problem lists, visit documentation and disease registry assignments. The CRS utilizes both clinical and coding knowledge of Hierarchical Condition Categories (HCCs) to inform accurate and appropriate diagnosis considerations for suspect condition identification and recapture opportunities. This role serves to educate providers and the clinical care team on all aspects of risk capture and linkages with quality.
Qualifications
Principle Duties:
Drive Clinical Delivery
* Performs accurate and timely pre-visit review of selected ambulatory encounters to identify opportunities to recapture medical conditions that meet criteria as HCC diagnoses and to capture new, suspected HCC conditions.
* Accurately interprets clinical information in the medical record, evaluating clinical indicators to identify potential diagnoses
* Presents clear HCC Consideration Communication to provider and educates providers to obtain greatest possible diagnostic specificity to accurately reflect the patient's condition(s)
Identify Education Opportunities
* Identifies themes through chart review that might present education opportunities for individual or groups of providers
* Gathers feedback from periodic post-visit chart reviews and incorporates these learnings into educational opportunities with providers
* Identifies opportunities for Process Improvement and Quality Improvement, as needed
Foster collaborative relationships across the enterprise
* Communicates appropriately and compliantly with physician or care team through Epic resources to improve medical record documentation
* Participates in ambulatory unit/organizational programs and meetings as needed
* Maintains professional competency by keeping abreast of new coding issues and guidelines. Attends classes and meetings as assigned. Reviews professional CDI and coding literature regularly
* Maintains clinical licensure and/or medical coding credentials (e.g. RN, PA, NP, CRC, CDEO, CCS, CPC) and completes all required Organizational Competencies and trainings (if applicable)
* Meets with providers on an as-needed basis to address concerns or areas of opportunity, and performs chart reviews as needed
* Maintains good rapport and professional relationships, as outlined in MGB Code of Conduct -
* Approaches conflict in a constructive manner, helps identify problems, offers solutions and participates in resolution
* Responsible to perform any other assigned duties as requested
Qualifications:
* Minimum three (3) - five (5) years' experience required in either, case management, outpatient coding, utilization review, CDI or other disciplines with either coding experience however, an equivalent combination of education and experience, which provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements.
* 2 years' experience in Primary Care, medical coding, risk adjustment or CDI preferred
* Current certification in Clinical Documentation Improvement (CDIP, CCDS, CCDS-O or CDEO) preferred
* Certification in medical coding and or risk adjustment (i.e., CRC, CPC, CCS, CDEO, or CCS-P or other pertinent to outpatient) preferred (CRC Required training within 1 year of employment)
* Medical licensure (RN, PA, NP) preferred
* Bachelor's degree healthcare related preferred
* Strong PC skills / Microsoft applications, including Outlook, Teams, Excel, PowerPoint
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$62,400.00 - $90,750.40/Annual
Grade
6
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$62.4k-90.8k yearly Auto-Apply 3d ago
Claims Auditor (Remote - WI or MN)
Sanford Health 4.2
Remote or Marshfield, WI job
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Claims Auditor (Remote - WI or MN) Cost Center:682891379 SHP-ClaimsScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description:
JOB SUMMARY
The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround time, compliance and operational audits as directed by management. The Claims Auditor has working knowledge of the overall aspects of claim processing, both in and outside of Security Health Plan. Audit responsibilities include applying effective, appropriate and efficient audit procedures in collecting, analyzing and reporting concise and relevant findings.
JOB QUALIFICATIONS
EDUCATION
For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.
Minimum Required: High school diploma or equivalent. Successful completion of the following courses per departmental procedures, within one year of hire: current procedural terminology (CPT), current international classification of diseases (ICD), health care procedure coding system (HCPCS) and medical terminology.
Preferred/Optional: Associate degree in business, medical or related field. Successful completion of the following courses per departmental procedures at time of hire: current procedural terminology (CPT), current international classification of diseases (ICD), health care procedure coding system (HCPCS) and medical terminology.
EXPERIENCE
Minimum Required: Three years' experience related to health insurance claim processing. Three years' experience related to CPT/HCPCS and current ICD coding. Demonstrated proficiency with analytical problem solving, written and oral communications and the Microsoft Office Suite. Working knowledge of anatomy & physiology.
Preferred/Optional: One year experience in claims auditing.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required: Certified Professional Coder (CPC) or Certified Professional Coder - Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) within three years of hire based on the department position the resides in.
Preferred/Optional: Certified Professional Coder (CPC) or Certified Professional Coder - Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) at time of hire.
QUALIFYING APPLICANTS FROM WI & MN WILL BE CONSIDERED
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$34k-38k yearly est. Auto-Apply 60d+ ago
Home Base SOF Admissions Social Worker
Brigham and Women's Hospital 4.6
Remote or Boston, MA job
Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
LCSW: starting pay rate $68,224
LICSW: starting pay rate $92,227
SIGN ON BONUS AVAILABLE for eligible Non-MGB employees:
$3,000 FOR LCSW, $10,000 FOR LICSW/LMHC, Please ask about the details!
Job Summary
Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research.
The Massachusetts General Hospital seeks a dynamic Licensed Clinical Social Worker (LCSW)/Licensed Independent Clinical Social Worker (LICSW) to serve on the Special Operations Team. In this role, the LCSW/LICSW will provide and oversee the provision of psychiatric, psychosocial, and overall mental health services and referrals for military Special Operators into the Home Base program. They will also be dedicated to supporting the Special Operations Forces (SOF) program and will provide coverage to other clinical operations as needed. The LCSW/LICSW may help cover approximately 2-3 weekend shifts per year.
Summary
This position will collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. They work collaboratively with all healthcare team members to develop and implement treatment plans that support patient-centered plans of care for both individual patients and the medical community.
Does this position require Patient Care? Yes
Essential Functions
* Provides psychosocial assessments of patients and families with social, emotional, interpersonal, and/or environmental issues. Formulates biopsychosocial assessment, disposition, and treatment plans.
* Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team.
* Monitor, evaluate, and record client progress according to measurable goals described in the treatment and care plan.
* Coordinate care for Special Operations Forces (SOF) veterans and military-connected family members seeking care at Home Base with the appropriate internal or external clinicians in a multi-disciplinary team, coordinated care model.
* Serve as a contact point for accepting and triaging SOF referrals from internal clinicians, outside clinicians and self-referred patients.
* Serve as primary case manager for patients in SOF admissions process in collaboration with Admissions Coordinator, including, but not limited to, the following responsibilities: conduct pre-screening to assess treatment and evaluation needs for SOF patients referred; coordinate signing of Release of Information forms, acquire relevant medical records, and coordinate with SOCOM where applicable; serve as point of contact for ongoing questions from the patient as they arise.
* Monitor patient's status in admissions process using appropriate documentation.
* May be asked to collaborate with SOF/ComBHaT team, patients, clinical team, and Resource Specialist to identify clinical and psychosocial needs in patients' home communities and identify appropriate resources.
* May provide direct clinical services to Veterans and/or family members, which may include group or individual therapy.
* May provide psychoeducation regarding PTSD, TBI, and related conditions to Veteran patients and family members as clinically appropriate within the context of the Intake and triage duties.
* Collaborate with an inter-disciplinary team of clinical staff (social workers, psychologists, nurses, psychiatrists, physiatrists, physical therapists, etc.) to coordinate patient care and plan for discharge/aftercare when needed.
* Consult with team to facilitate mandated assessments when abuse is suspected (child, disabled adult, elder), and safety assessment when violence is reported. Collaborates with MGH resources (HAVEN and Child Protection Team).
* May assist with crisis intervention and management.
* Documents timely and relevant information in patient electronic medical record and Home Base database.
* Provide coverage for social work responsibilities in Outpatient Clinic as needed.
* For LICSWs: provide clinical supervision to LC-level and/or MSW students as needed.
* Additional responsibilities as assigned.
Qualifications
Education
Master's Degree Social Work required or Master's Degree Mental Health & Behavioral Medicine required
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Current professional licensure in Massachusetts (LCSW required, LICSW preferred).
Experience
Clinical Social Worker I
Clinical Experience in a medical setting 0-1 years required
Clinical Social Worker II
Clinical Experience in a medical setting 2-3 years required
Knowledge, Skills and Abilities
* Excellent organizational and time management skills.
* Excellent crisis intervention skills.
* Good problem solving and conflict resolution skills.
* Ability to work well collaboratively and independently.
* Strong written and verbal communication skills.
* Knowledge of community resources and the aging process.
* Demonstrates basic foundational skills, showing fundamental knowledge and a commitment to the application of professional values and ethics.
* Demonstrates fundamental skills in formulation, assessment of risks, crisis intervention completion of psychosocial treatment plans, and appropriate documentation.
* May need assistance and guidance in ensuring the patient's needs, safety measures, and concerns are brought forward. Emerging knowledge of internal and external resources.
* Developing and demonstrating interpersonal collaboration in a medical setting- inpatient or outpatient.
* May need coaching/guidance in this area.
* May provide some assistance and support with onboarding for new team members.
* Aware of opportunities in department/service initiatives; participates in initiatives at an entity level. Uses data to measure progress.
* Demonstrate fundamental skills under supervision. May need assistance in promoting collaboration among healthcare team members, other colleagues, and the organization to support and enhance patient care.
Additional Job Details (if applicable)
Physical Requirements
* Standing Frequently (34-66%)
* Walking Frequently (34-66%)
* Sitting Occasionally (3-33%)
* Lifting Frequently (34-66%) 35lbs+ (w/assisted device)
* Carrying Frequently (34-66%) 20lbs - 35lbs
* Pushing Occasionally (3-33%)
* Pulling Occasionally (3-33%)
* Climbing Rarely (Less than 2%)
* Balancing Frequently (34-66%)
* Stooping Occasionally (3-33%)
* Kneeling Occasionally (3-33%)
* Crouching Occasionally (3-33%)
* Crawling Rarely (Less than 2%)
* Reaching Frequently (34-66%)
* Gross Manipulation (Handling) Frequently (34-66%)
* Fine Manipulation (Fingering) Frequently (34-66%)
* Feeling Constantly (67-100%)
* Foot Use Rarely (Less than 2%)
* Vision - Far Constantly (67-100%)
* Vision - Near Constantly (67-100%)
* Talking Constantly (67-100%)
* Hearing Constantly (67-100%)
Remote Type
Hybrid
Work Location
One Constitution Wharf
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$56,992.00 - $82,992.00/Annual
Grade
6
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$57k-83k yearly Auto-Apply 58d ago
Security Officer - Monroe Regional Hospital
Promedica 4.5
Monroe, LA job
Department: Security Weekly Hours: 0 Status: Per Diem Shift: Variable (United States of America) ProMedica Security Officers ensure the overall safety of our patients, visitors, and employees. While monitoring facilities, the officers also help people who have questions about where they should go.
In this vital safety role, you will regulate and control all traffic, parking enforcement and traffic control when needed. You will investigate and report all accidents, hazards, and incidents. The officer will need to restrain combative patients as needed.
Once in this position, you must successfully complete all required training and remain current in any certifications.
The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive.
REQUIREMENTS
* High School diploma or equivalent.
* Valid driver's license and a clean driving record, as demonstrated by an MVR (motor vehicle record) to be covered under the Company's insurance policy.
* Complete the Basic Security Officer Certification through IAHSS within six (6) months of employment.
PREFERRED REQUIREMENTS
* Associate degree in security or related field.
* Prior security experience.
ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus.
Benefits:
We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It's what makes us one of the best places to work, and helps our employees live and work to their fullest potential.
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact ************************
Equal Opportunity Employer/Drug-Free Workplace
$23k-28k yearly est. 5d ago
Per Diem Health Plan UM Medical Director
Brigham and Women's Hospital 4.6
Remote or Somerville, MA job
Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan UM Medical Director
Qualifications
Education: MD or DO required
Licenses and Credentials:
* Physician - Massachusetts active full license required
Experience:
* 5+ years of Health Plan UM experience
* at least 5 years of clinical practice experience
Knowledge, Skills and Abilities:
* Utilization Management experience
* Excellent written and oral communications skills
* Proficient in basic computer skills, use of EHR's, digital tools
* Multitasking abilities
* Adaptable to change due to business growth
Job Description:
* Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities
* Use CMS, state and internal medical necessity policies to guide MN determinations
* Complete peer to peer case discussions with requesting providers as assigned
* Refer to IRO/external review if specialist match or expertise is needed
* Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
* Monitors performance metrics to identify areas for continuous improvement and ensure compliance
* Establishes and maintains positive relationships with colleagues and customers and gains their trust and respect
* Ensure diversity, equity and inclusion are integrated as a guiding principle
Other duties as assigned with or without accommodation
Additional Job Details (if applicable)
* Primarily remote position
* M-F 830-5pm EST
* Ensures that all assigned work is completed within regulatory timelines
* Checks and addresses assigned work queues, email, Teams messages during assigned work hours
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
0
Employee Type
Regular
Work Shift
Day (United States of America)
EEO Statement:
Balance Sheet Cost Centers is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$179k-266k yearly est. Auto-Apply 9d ago
Aquatics Instructor - Contract Position
Woman's Hospital 3.9
Woman's Hospital job in Baton Rouge, LA
. The candidate will instruct fitness classes in Aquatics.
Job Knowledge:
Specialty certification in Aquatics is required. One year experience preferred. The ability to teach group fitness classes is preferred. Professional liability insurance provided.
Hours:
7:00 AM - 7:00 PM, Days and Evenings
Salary:
$25-$35/hour
1 year contract (Year to Year)
$25-35 hourly 60d+ ago
Line Dancing Group Exercise Instructor - Contract Position
Woman's Hospital 3.9
Woman's Hospital job in Baton Rouge, LA
This is a contract position. The candidate will instruct Line Dancing fitness classes. Candidate will have the opportunity to teach other formats.
Job Knowledge:
Candidate must have group exercise certification, professional liability insurance and CPR/AED certification required. Specialty certification in Line Dancing is required. Yoga, Indoor Cycling, Aqua, REFIT, HIIT, Mat Pilates, Zumba, strength training and/or circuit certification preferred.
Hours:
7:00 AM - 7:00 PM, Days and Evenings
Salary:
$25-$35/hour
1 year contract (Year to Year)
$23k-35k yearly est. 60d+ ago
NICU Director
Woman's Hospital 3.9
Woman's Hospital job in Baton Rouge, LA
Lead with Purpose at Woman's Hospital At Woman's Hospital, leadership is more than a position - it's a commitment to excellence, innovation, compassion, and respect. We are seeking dynamic leaders who live our mission and values, and who are passionate about creating a culture where people feel seen, heard, and valued.
As a Leader at Woman's, You Will:
Foster a culture of trust, inclusion, and psychological safety
Inspire, develop, and align teams to achieve organizational goals
Communicate clearly, credibly, and with compassion
Champion service excellence, innovation, and operational improvement
Apply business and financial insights to guide strategic decisions
Drive change and continuous improvement initiatives
About This Leadership Opportunity:
Position Title: Director
Department: NICU
Ideal Candidate Profile: The NICU Director is a dynamic nurse leader who oversees the strategic direction, quality, and operational excellence of the Neonatal Intensive Care Unit. This role upholds the highest standards of patient safety, evidence-based neonatal practice, staff engagement, and family-centered care. Candidates must hold a bachelor's degree in nursing with a related certification (master's degree preferred) and have at least five years of neonatal experience, including prior supervisory or leadership responsibilities.
Key Responsibilities:
Champions creative thinking and innovation to enhance patient care, staff engagement, and unit performance
Develops and executes strategic plans with defined goals, timelines, and performance metrics
Leads teams through change with confidence, adaptability, and clarity in times of uncertainty
Invests in staff development through mentoring, feedback, and opportunities for skill-building
Delegates with clear expectations, context, and follow-up to ensure accountability and success
Applies evidence-based practice and clinical standards to guide care and drive improvements
Facilitate interdisciplinary collaboration to solve complex problems and implement solutions
Fosters open, structured communication and build trust through visibility and transparency
Implements fiscally responsible practices to optimize resources and maintain quality outcomes
Anticipates trends in maternal/fetal nursing and healthcare delivery; prepares teams for future needs
Demonstrates commitment to patient safety and regulatory compliance
Drives performance through data and outcomes
Builds interdisciplinary relationships across the hospital to align goals and improve care delivery
What We Offer:
A mission-driven environment dedicated to women's and infant health
Opportunities for growth, innovation, and career fulfillment
A collaborative culture where your contributions create real impact
Join us in transforming care, empowering teams, and making a lasting difference. Apply now and lead with impact at Woman's Hospital.
If you have any questions or would like to connect with one of our recruiters directly, please e-mail *****************.
Woman's Hospital is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
$80k-113k yearly est. Easy Apply 53d ago
Cancer Registrar, Certified - FT - Days - Remote
Sanford Health 4.2
Remote or Fargo, ND job
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
Scheduled Weekly Hours:
40Salary Range: $21.50 - $34.50
Union Position:
No
Department Details
Remote Fargo only
Summary
The Cancer Registrar, Certified holds the Oncology Data Specialist (ODS) certification and independently abstracts all cancer sites into the Cancer Registry while meeting quality standards. This role efficiently and effectively performs all cancer registry workflows including case finding, abstracting, patient follow-up, and safety net workflows.
Job Description
Independently analyzes and interprets clinical and demographic data and determine appropriateness of case inclusion in cancer database. Identifies, codes and abstracts records of all eligible cancer patients (analytic and non-analytic), utilizing the cancer registry data system within the guidelines and requirements of the American College of Surgeons CoC, State, Cancer Registry standard setters, and other applicable requirements. Completes abstracting in a multi-facility database structure, analyzes cases for inclusion or exclusion, performs patient follow-up analysis, and is able to complete all safety net workflows. Maintains work performance within production and quality guidelines. Works proficiently in Epic workflows. Completes necessary continuing education to maintain ODS certification, compliance with CoC accreditation standards, and maintains current knowledge of guidance/updates issues by cancer registry standard setters. Possesses knowledge of ICD-10, ICD-0, and morphology coding. Requires extensive knowledge of anatomy, physiology, disease processes, and current standards of care. Adheres to, displays and upholds the Sanford Values. Serves as a role model on professionalism, attitude, knowledge, demeanor and execution of duties. Regularly uses critical thinking skills, problem solving and decision making skills in the course of work. Possesses attributes to include: Skillful and flexible at managing change. Understands a systems approach to problem solving. Possesses excellent written and oral communication skills. Well organized. Willingness and ability to make decisions and be accountable for same. Flexibility, creativity and a willingness to implement new ideas. Knowledgeable in computer hardware and software applications including Microsoft Office, electronic medical records (EMR) and Cancer Registry database. Ability to work with team members in remote locations using a variety of technologies. Works extensively with electronic medical records and protected health information and is required to adhere to Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations and policies related to the same.
Qualifications
Oncology Data Specialist certified through the National Cancer Registrars Association is required and must meet post-secondary education requirements of NCRA.
Minimum of one year Cancer Registry experience is preferred.
Oncology Data Specialist certified through the National Cancer Registrars Association is required.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
Woman's Hospital Foundation job in Baton Rouge, LA
The Certified Occupational Therapy Assistant assists in the delivery of pediatric occupational therapy services under supervision in accordance with state, federal, and professional regulations. Requirements: * Graduation from an accredited program with an Associate's degree in occupational therapy
* State licensure with the Louisiana Board of Medical Examiners
* Completed clinicals during the COTA program
* Skills and competency in swimming as appropriate for aquatic therapy treatment
* Previous experience in the treatment of Pediatric patients ages infants - 21 treating patients in the areas of fine motor, sensory processing, developmental delay, and feeding disorders.
Responsibilities:
* Assists the therapist in providing quality service according to state, federal, and professional regulations. Efficiently administers high quality physical therapy care as planned, directed, and supervised by a licensed Occupational Therapist.
* Assists the Occupational Therapist with the patient's testing, evaluation and re-assessment.
* Effectively instructs and progresses patients on the prescribed home exercise program as determined by the Occupational Therapist. Able to recognize the patient's response and adapts treatment plans demonstrating initiative, creativeness and knowledge with the consent of the therapist.
* Prepares all documentation in a clear, accurate, timely, and concise manner according to state, federal, Joint Commission and professional regulations.
* Participates in providing instruction and education to the staff as directed.
* Cleans and records cleaning of toys as it occurs. Ensures delivery of laundry and adequate housekeeping. Wears safety glasses for cleaning and performs procedures per infection control policies of department. Maintains department logs and equipment as assigned.
* Trains and delegates duties to volunteers per needs of the department.
* Effectively transitions patients to maintenance programs utilizing all programs and meeting the needs of each individual patient.
* Assists and implements treatment protocols for the Pediatric practice Seeks new program development in order to present quality in-services and public programs.
* Any other duties as assigned by Woman's Hospital.
Schedule:
Full-Time
Monday - Friday; schedule will vary
Pay Range:
Hourly/Non-Exempt
$25.20 - $36.54; based on work experience
A Work Experience with Purpose
Woman's is one of the largest specialty hospitals in the country dedicated to the care of women and infants. Nationally recognized for exceptional patient care, innovative programs, and a supportive work environment, we consistently exceed state and national benchmarks for patient satisfaction-a reflection of our commitment to those we serve.
We're home to Louisiana's largest delivery service and perform thousands of procedures annually, including over 8,500 surgeries and 35,000 breast procedures. Woman's was the first hospital in the Baton Rouge area to earn Magnet designation for nursing excellence, and we're honored to be named one of Modern Healthcare's Best Places to Work in Healthcare year after year.
We are proud of the care our staff provides to patients-and to one another-every day.
For more information or to contact our recruiting team, email us at *****************.
Woman's Hospital is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
$25.2-36.5 hourly Easy Apply 60d+ ago
Insurance Representative - Remote ND, SD
Sanford Health 4.2
Remote or Valley City, ND job
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
8 Hours - Day Shifts (United States of America)
Scheduled Weekly Hours:
40Salary Range: $16.00 - $25.50
Union Position:
No
Department Details
Summary
The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement.
Job Description
Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job related duties as requested. Consistently demonstrates accuracy in correcting (identified through pre-edits) and submitting claims to payers. Ensures accounts are billed in timely manner. Consistently reports to a manager any accounts that cannot be finished in a timely manner. When claims are disputed, consistently utilizes the correct resources to ensure the completion of the claim. Accurately and completely follows claim through entire billing process. Ensures all claims consistently meet compliance regulations. Demonstrates accountability by consistently using appropriate resources and channels to problem solve issues. Consistently demonstrates ability to input data accurately into the computer system. Consistently answers the telephone courteously. Maintains and updates computer skills as needed for work assignments. Demonstrates the ability to utilize software applications for maximum efficiency. Consistently ensures verbal communication is courteous, complete, and professional whether using phone or personal contact. Consistently ensures written communication is accurate, complete and professional in presentation whether word processing or using email. Identifies and promptly resolves billing complaints. Directs issues to supervisor when unable to resolve. Documents in computer system all contacts regarding patient accounts. Depending on location, may verify demographics, identify appropriate third-party insurance/payers, set up insurance, initiate patient financial assistance. Contact the insured or financially responsible party to obtain missing information. Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy.
Qualifications
High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position.
Six months' related work experience required. Computer skills essential.
When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
The Non-Government Accounts Supervisor is responsible for overseeing all aspects of billing and Accounts Receivable activities for all non-governmental (commercial and managed care payers). Interacts with and advises department staff regarding billing and accounts receivables policies and procedures and serves as a liaison with other department representatives. Supervises billing, insurance and collection staff to ensure accurate, complete and timing filing and insurance follow-up, collections, variances and denials. Responsible for overseeing the training of all new employees in assigned area. Performs a variety of complete tasks, such as editing and report writing using EHR and clearinghouse software.
Requirements:
Requires graduation from an accredited college or university with a degree in Business Administration, Management or Accounting. Degree may be waived with five years proven practical experience in patient financial services.
Revenue cycle leadership experience preferred.
Knowledge of principles of overseeing a patient accounting office.
Responsibilities:
Monitors billing edits and rejections, and ensures feedback is provided to the original owner so training, process improvement or real- time edits can be initiated.
Analyzes A/R to ensure staff are achieving productivity targets and priorities are changed as needed in order to meet organization or department goals.
Analyzes variances to ensure trends are reported back to the payer or to the Managed Care Department so the contract module can be updated accordingly.
Ensures denial trending is accurately reported and feedback is provided to original owner so that real-time edits can be initiated.
Assists the Director with ensuring the department's operations and business practices are conducted in a manner compliant with regulatory requirements for all applicable jurisdictions.
Ensures all employees follow the time collection process, including the API automated time and attendance systems.
Performs a variety of complex activities involving the auditing, processing and maintenance of daily reports.
Assists in the preparation of reports setting forth progress, adverse trends and appropriate recommendations or conclusions.
Oversees complex activities involving the processing of governmental payer claims.
Reviews various patient accounting transactions such as refunds, discounts and write-offs according to policies and procedures.
Maintains communication with supervisors, managers and department head personnel to coordinate efforts in resolving problems concerning collection of patient accounts receivable and outstanding insurance accounts receivable.
Maintains familiarity and competence of the billing and accounting systems.
Monitors current legislative and regulatory changes impacting billing and collections and communicates changes to the billing and A/R staff.
Acts as a technical resource regarding insurance claims, billing procedures, and collection policies and communicates new work policies and procedures to employees in area as needed.
Responsible for overseeing training all new employees in assigned area.
Any other duties as assigned by Woman's Hospital.
Schedule:
Full-Time; Monday - Friday
8:00 AM - 5:00 PM
Pay Range:
Salary/Exempt
$52,000 - $76,000; based on work experience
A Work Experience with Purpose
Woman's is one of the largest specialty hospitals in the country dedicated to the care of women and infants. Nationally recognized for exceptional patient care, innovative programs, and a supportive work environment, we consistently exceed state and national benchmarks for patient satisfaction-a reflection of our commitment to those we serve.
We're home to Louisiana's largest delivery service and perform thousands of procedures annually, including over 8,500 surgeries and 35,000 breast procedures. Woman's was the first hospital in the Baton Rouge area to earn Magnet designation for nursing excellence, and we're honored to be named one of Modern Healthcare's Best Places to Work in Healthcare year after year.
We are proud of the care our staff provides to patients-and to one another-every day.
For more information or to contact our recruiting team, email us at *****************.
Woman's Hospital is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law.
$52k-76k yearly Easy Apply 60d+ ago
Senior Cyber Security Engineer - Network Security
Sanford Health 4.2
Remote job
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
Scheduled Weekly Hours:
40Salary Range: $40.00 - $66.00Pay starts at $40 and increases according to years of applicable experience.
Union Position:
No
Department Details
***Working remotely is an option if you currently live in SD, ND, MN, IA, NE or WI.
Required Skills and Qualifications:
Strong communication skills to explain complex concepts to various stakeholders
Excellent documentation skills for development of diagram, requirements, process mapping and overall design solutions
Strong team player with curious and flexible nature.
Strong understanding of network protocols (TCP/IP, OSI model) and network security concepts
Expertise in network switch, routing, and security technologies (firewalls, VPNs, IDS/IPS, etc.)
Experience with security frameworks and standards (NIST, CIS, ISO 27001)
Proficiency in scripting languages (Python, Perl, PowerShell)
Strong problem-solving and analytical skills
Excellent communication and interpersonal skills
Summary
Responsible for the technical and operational delivery of enterprise cybersecurity solutions. Focuses on the development and implementation of processes and tools for identifying, evaluating, implementing, troubleshooting, and maintaining technical security controls for the organization. These controls are designed to prevent, detect, and contain security threats; enabling Sanford to be productive while maintaining a secure environment that optimizes Sanford's return on investment.
Job Description
Lead the building, configuring, and maintaining of cybersecurity systems to ensure our operational environments stay compliant and secure. Implements security controls using industry best practices across numerous technologies including, but not limited to SIEM, email filtering, web and content filtering, firewall, IPS/IDS systems, identity and access management, SSO/MFA, vulnerability management, and data protection. Skillfully maintains the existing security systems, including implementing new features, performing upgrades, and managing technical configurations/policies across a variety of business-critical systems. Proficiently monitors and responds to security system health alerts. Respond to day-to-day operational work such as managing security tools while simultaneously multitasking with strategic project initiatives.
Provide security consulting services to other Sanford health groups. Provide assistance to a 24x7 team of dedicated security engineers focused on maintaining operational stability while reducing risk. Build and maintain key vendor and supplier relationships. Lead strategic project initiatives ensuring the processes and procedures are well defined and documented. Recognize both internal and external threats and understand/communicate risks to Sanford Assets. Make strategic recommendations to enhance and improve overall security posture. Advise on methods to increase efficiency of current toolsets (such as script automation or process improvement recommendations). Mentor others within the team as well as receive instruction and guidance from others within the team. Write documentation that can be used by all team members and other employees. Identify gaps in established/documented process and update as needed.
Works under limited guidance due to previous experience/breadth of knowledge of processes and organizational knowledge. Acts independently to determine methods and procedures on new assignments. Regularly presented with new assignments and projects that require the application of independent judgement/interpretation of policies/practices. Checks own work and the work of other team members.
Qualifications
Bachelor's degree in cyber security or an information technology related field.
Minimum of 4 years experience working in Cyber Security field.
Security Certifications (CISSP, CISA, CISM, Security+, CEH, etc.) are highly desired
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
$40-66 hourly Auto-Apply 60d ago
Physician - Remote Emergency Radiologist
Sanford Health 4.2
Remote or Marshfield, WI job
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description:
Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin.
Fellowship training in Body, Neuro, ED or MSK is required.
Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT.
No CVIR, nuclear medicine or mammography.
Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits.
If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures.
Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers.
Coverage needed for afternoons and evenings. No midnight shifts required.
Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year
Compensation/Benefits:
Competitive Salary
Flexible shift based model
Health, Dental, Life, and Occurrence Based Malpractice insurance
Relocation support available if working onsite
Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs.
MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come.
Marshfield Clinic Research Institute: **********************************
Marshfield Clinic Division of Education: ******************************************
Marshfield, Wisconsin
Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself.
Fun Fact: Marshfield is known as the HEART of Wisconsin!
Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care.
The Marshfield Promise
Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone.
The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability.
For more information, please contact:
Lindsay Becker, Physician and Advanced Practice Clinician Recruiter
Phone: ************
***********************************
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$282k-517k yearly est. Auto-Apply 60d+ ago
Risk Adjustment Revenue Manager (Remote)
Sanford Health 4.2
Remote or Marshfield, WI job
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description:
The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process.
JOB QUALIFICATIONS
EDUCATION
Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required.
Preferred/Optional: Post graduate degree(s) desirable.
EXPERIENCE
Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen.
Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record.
Preferred/Optional: None
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$72k-94k yearly est. Auto-Apply 14d ago
Medical Assistant - Neurosurgery
Promedica Central Physicians 4.5
Monroe, LA job
Department:
Neurosurgery
Weekly Hours:
40
Status:
Full time
Shift:
Days (United States of America)
A ProMedica Medical Assistant is a key member of our patient centric care delivery model. In the office setting, the Medical Assistant communicates with patients and co-workers and collaborates with leadership to recommend changes to improve patient care.
This person in this position provides a safe patient experience from the moment they walk into a ProMedica facility. From fathering data from the patient to documenting the reasons for the visit and obtaining vitals, the medial assistant strives for clinical excellence.
Communication is key in this role. You will communicate with patients, peers and all members of the health care team. You will show your clinical knowledge outside patient rooms as well when answering patient phone calls and relaying messages for providers or nurses.
The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive.
REQUIREMENTS
High school graduate or equivalent.
BLS (CPR), must present a current BLS course card from the AHA at time of employment or obtain certification within 90 days of hire.
PREFERRED REQUIREMENTS
Previous experience in medical office preferred.
Certified or Registered Medical Assistant.
ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus.
Benefits:
We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It's what makes us one of the best places to work, and helps our employees live and work to their fullest potential.
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact ************************
Equal Opportunity Employer/Drug-Free Workplace
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