PCH Referral Coordinator - Medical
Coordinates referral requests and manages appointment communications across multiple locations. Obtains necessary pre-authorizations and provides updates on appointment statuses.
Coordinates referral requests and manages appointment communications across multiple locations. Obtains necessary pre-authorizations and provides updates on appointment statuses.
The Clinical Documentation Specialist evaluates physician documentation to ensure accurate representation of patient severity of illness for coding purposes. They also provide guidance to physicians, nursing, and ancillary staff regarding clinical documentation best practices.
Code diagnoses and procedures for outpatient physician charges, including evaluation and management services, office procedures, and surgeries across multiple settings. Thoroughly review medical records to support the collection of patient care information and code diagnoses and CPT for office and surgical services.
The Interim Billing Manager oversees all Medicare, commercial, and Medicaid billing activities within the centralized business office. The role focuses on maximizing reimbursement and minimizing accounts receivable through accurate and timely handling of patient accounts and claims.
The Coding Education Specialist evaluates clinical documentation to ensure coding accuracy and specificity. They provide guidance and education to coders, providers, and staff regarding best practices and correct coding standards.
Perform medical group billing and accounts receivable work, including claim follow-up and edits, credit handling, provider enrollment review, cash posting, and payer underpayment resolution. Support customer service, administrative functions, and other billing-related projects.
The Medicare Billing Supervisor provides leadership and supervision to the department, including performing employee audits and training. They also handle administrative tasks such as phone calls, emails, and attending meetings in the manager's absence.
The IT Project Manager will manage multiple individual IT projects within the Corporate IT Project Portfolio, coordinating with departments and third-party vendors to ensure deliverables meet project schedules. They are responsible for maintaining project data in the ServiceNow system and overseeing project implementation strategies and vendor teams.
The System Grants Director will lead the development and implementation of a system-wide grants strategy to secure revenue and support the organization's mission. This role involves managing pre- and post-award services while ensuring grant compliance across all local markets.
The Provider Onboarding Coordinator manages the end-to-end integration process for new physicians and practices, ensuring operational standards and cultural alignment. They lead cross-functional teams to execute onboarding, offboarding, and practice moves while maintaining compliance and financial oversight.
The specialist serves as the subject matter expert for OPAT/COpAT services, collaborating with interdisciplinary teams to develop and optimize clinical workflows and antimicrobial stewardship programs. They facilitate safe transitions of care for patients on antimicrobial therapy and monitor clinical outcomes to improve patient safety and reduce readmissions.
The Ambulatory CDI Specialist evaluates clinical documentation to ensure coding accuracy and specificity for HCC diagnosis codes. They also provide education and guidance to providers and staff regarding clinical documentation best practices.
The analyst serves as a trusted advisor to pharmacy leadership by translating complex data into actionable insights for strategic decision-making and operational excellence. They are responsible for developing analytics, monitoring performance, and identifying opportunities for growth across pharmacy programs including specialty and 340B initiatives.
The developer will design, implement, and operate BI data analysis systems while collaborating with other developers. They are responsible for creating focused applications that highlight opportunities and provide actionable metrics.
The Application Analyst Lead serves as a liaison between IT and operations to align system design with clinical workflows. They are responsible for system configuration, testing, support, and leading projects with system-wide implications.
The System Clinical Pharmacy Specialist will serve as a subject matter expert for neurology, psychology, and behavioral health, ensuring pharmaceutical care programs are integrated throughout the system. They will collaborate with healthcare teams to develop evidence-based guidelines, conduct clinical research, and oversee quality and regulatory compliance initiatives.
The Clinical Pharmacy Specialist will serve as a subject matter expert in oncology and hematology, collaborating with healthcare teams to implement evidence-based clinical services and pharmacy standards. They are responsible for managing medication-use processes, conducting clinical research, and providing expert pharmacotherapy consultations across the health system.
The coder ensures accurate and complete inpatient coding to support the measurement and reporting of hospital and physician outcomes. They maintain continuous quality improvement and adhere to established clinical coding guidelines.
The Pharmacy Revenue Cycle Analyst ensures optimal revenue capture by monitoring pharmacy charge capture, coding accuracy, and claims processing. They also collaborate with pharmacy leadership to manage payment models, audit denials, and maintain compliance with billing regulations.
The analyst serves as a liaison between IT and operations to align system design with clinical workflows through training, testing, and support. They are responsible for managing stakeholder expectations, resolving technical issues, and ensuring software builds meet organizational and regulatory mandates.
The manager will develop and maintain strategic relationships with pharmaceutical manufacturers and specialty pharmacy networks to optimize medication access. They will also oversee access workflows, including prior authorizations and financial assistance, to ensure timely patient access to specialty therapies.
Responsible for the functional configuration of the ERP system and contract management software, including the transactional exchange of data between ERP and clinical systems. Manages ERP data, inventory control, PAR management, and coordinates system training for employees.
The Oncology Data Specialist is responsible for case finding, abstracting, and follow-up activities for cancer patients. They ensure all reportable cases are identified and documented accurately according to established standards and regulations.
Ensure the overall quality and accuracy of inpatient coding for measuring physician and hospital outcomes. Maintain up-to-date knowledge of clinical coding guidelines in accordance with Coding Clinic and AHA Official Coding Guidelines.
Ensure the overall quality and accuracy of inpatient coding for measuring and reporting physician and hospital outcomes. Maintain up-to-date knowledge of clinical coding guidelines in accordance with Coding Clinic and AHA standards.
The Informatics Pharmacist Specialist manages pharmacy automation and technology systems, ensuring integration and standardization. They provide consultative oversight for pharmacy software systems and lead informatics initiatives to enhance medication use processes.