This role supports the Utilization Management Nurse and RN Appeals Writer by preventing clinical denials and ensuring timely peer-to-peer reviews. Responsibilities include investigating the root causes of denials and documenting outcomes within the Epic system.
The HIM Associate manages fetal birth and death certificates while performing chart maintenance and analysis to ensure regulatory compliance. They also handle the release of medical information and investigate accounts missing documentation for coding and billing purposes.
The Senior Informatics Specialist improves revenue cycle efficiency and automation by optimizing Epic functionality and supporting technical system implementations. This role also monitors internal controls, manages interface issues, and provides training and support to end-users.
The Financial Counselor assists patients with Medicaid and charity care applications while educating them on financial liabilities. They are responsible for developing payment arrangements for patients within a facility-based setting.
The Ancillary Coder is responsible for reviewing, analyzing, and assigning accurate ICD-10-CM and CPT-4 HCPCS codes for outpatient medical records. Primary duties include coding for diagnostic, clinical, emergency room, and specimen patient types.
The RN Appeals Writer is responsible for analyzing clinical information from medical records to draft effective narratives for Medicare and Medicaid appeals. They also assist in research for Administrative Law Judge hearings and collaborate with legal resources to ensure optimal outcomes.
The RN Appeals Writer is responsible for reviewing and analyzing clinical medical records to draft effective narratives for Medicare and Medicaid appeals. They also assist in research for beneficiary hearings and collaborate with legal resources to ensure optimal outcomes for denied cases.
The role involves operationalizing and delivering training programs for staff in Patient Financial Care units, both in online classrooms and through collaboration with leadership. Additionally, the educator will monitor performance metrics and use data to identify and develop targeted staff development opportunities.
The Application Coordinator is responsible for the design, build, testing, and ongoing support of clinical and revenue cycle applications. They also provide tier III support and collaborate with interdisciplinary teams to implement system configuration changes.
Directs the development and implementation of revenue cycle reporting and analytics programs to improve operational and financial performance. Translates complex business data into actionable insights for leadership to support strategic decision-making and process improvement.
The manager will provide system-level oversight of utilization management activities. This includes ensuring effective review processes and managing professional staff.
Lead the enterprise strategy and operations for payer denials and recovery across hospital and physician revenue cycle functions, including appeals, underpayment recovery, contract compliance, recoupment defense, and payer disputes. Preserve and recover revenue through denial prevention, recovery programs, payer contract enforcement, and accountability, while representing the organization to payers, regulators, auditors, legal counsel, and other partners.
The Virtual CT Technologist performs and controls advanced CT imaging procedures remotely while providing guidance to on-site support teams. They are responsible for ensuring image quality, adhering to radiation safety protocols, and maintaining accurate documentation of all scan details.
The Application Coordinator is responsible for the design, build, testing, and ongoing support of Epic clinical or revenue cycle applications. They work with interdisciplinary teams to design future-state workflows and provide tier III support for the system.
Responsible for triaging Tier 2 clinical calls and resolving application issues for healthcare staff. Documents all troubleshooting steps and resolutions within the ticketing system while providing just-in-time training for clinical users.
Review, analyze, and assign accurate ICD-10-CM and CPT-4 HCPCS codes for outpatient medical records. Focus primarily on hospital outpatient surgery, wound care, and observation documentation.
Assess physician educational needs regarding coding and documentation to develop and lead training programs. Ensure all coding activities comply with clinical billing standards and government regulations for inpatient and specialty services.
