Presbyterian Healthcare Services

Call Center Representative-Patient Services

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.99 - $23.76 per hour ⭐ 0-2 yrs exp 💼 Support

Provide high-quality customer service to patients by managing appointment scheduling, referrals, and patient demographics across multiple communication channels. Analyze call patterns and conduct root cause analysis to improve service delivery and patient satisfaction.

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PFS Billing Specialist I-ABQ

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.87 - $23.04 per hour ⭐ 0-2 yrs exp 💼 Finance

Accurately submit insurance claims for all payer types and resolve billing edits or rejections to ensure timely reimbursement. The role involves managing work queues, contacting payers for information, and adhering to CMS and HIPAA regulations.

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Call Center Representative-Health Plan-Work from home

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.99 - $23.76 per hour ⭐ 2-5 yrs exp 💼 Support

Provide high-quality customer service to members and providers across all PHP benefit plans via phone, chat, and written inquiries. Handle claims processing and maintain quality standards while functioning effectively within a team environment.

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IP Facility Coder with CCS - Medical Records

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $23.11 - $35.29 per hour ⭐ 2-5 yrs exp 💼 Software Development

The IP Facility Coder is responsible for assigning appropriate CPT, ICD, and MS-DRG codes to inpatient, outpatient, and specialty records for financial reimbursement. They must also resolve pre-bill edits and denials while ensuring adherence to hospital and federal regulatory policies.

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Remote Pro Fee Auditor/Educator

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $54516.8 - $83262.4 per year ⭐ 2-5 yrs exp 💼 Finance

Perform internal audits and reviews to ensure compliance with enterprise-wide and regulatory coding policies. Develop educational programs and corrective action plans to improve coding quality and resolve billing discrepancies.

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Patient Accounting Collections Specialist

Presbyterian Healthcare Services · Full Time · 3 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.87 - $23.04 per hour ⭐ 0-2 yrs exp 💼 Finance

The specialist is responsible for following up, collecting, and resolving outstanding accounts receivable and claims. This includes contacting insurance companies and patients, providing supporting documentation, and ensuring timely reimbursement.

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Care Coordinator IV-Clovis/Portales

Presbyterian Healthcare Services · Full Time · 4 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $67100.8 - $102K per year ⭐ 10+ yrs exp 💼 Healthcare

The Care Coordinator facilitates an interdisciplinary team approach to ensure cost-effective, quality care delivery across the continuum. They conduct in-depth health risk assessments and implement strategies to improve health outcomes for members with complex conditions.

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Quality Outreach Interventionist

Presbyterian Healthcare Services · Full Time · 9 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $45136 - $68931.2 per year ⭐ 2-5 yrs exp 💼 Others

Manage a panel of Medicare Advantage members to improve Quality, Risk Adjustment, and Medicare STARS performance. Conduct specialized outreach, perform in-home screenings, and provide concierge-level support to help members navigate benefits and community resources.

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Clinical Pharmacy Review Specialist

Presbyterian Healthcare Services · Full Time · 9 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $18.33 - $27.25 per hour ⭐ 2-5 yrs exp 💼 Healthcare

Provides clinical support for pharmacy services by reviewing prior authorization requests and researching clinical data for coverage determinations. Communicates with members and providers regarding benefit coverage, formulary criteria, and pharmacy policies.

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Senior Strategy Manager

Presbyterian Healthcare Services · Full Time · 9 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $103K - $162K per year ⭐ 5-10 yrs exp 💼 Others

The role focuses on providing quantitative rigor and structured thinking to the enterprise strategy function to inform growth initiatives and partnerships. Responsibilities include synthesizing complex data into actionable insights and creating visually compelling deliverables for healthcare leadership.

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Remote PRN ProFee Multi specialty coder

Presbyterian Healthcare Services · Full Time · 11 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $21.7 - $33.14 per hour ⭐ 2-5 yrs exp 💼 Software Development

Assign appropriate CPT, ICD, and MS-DRG codes to medical records for financial reimbursement and research compliance. Resolve pre-bill edits and denials while maintaining a 95% accuracy rate and meeting productivity standards.

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Nurse Advice Line-Clinical Triage Nurse

Presbyterian Healthcare Services · Full Time · 11 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $27.92 - $42.63 per hour ⭐ 5-10 yrs exp 💼 Healthcare

The Nurse Advice Line performs clinical triage and reviews inbound member and patient calls to ensure appropriate clinical direction and triage. Responsibilities include coordinating care, validating medical information, and consulting with medical directors on non-emergent cases.

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Medical Economics Lead Analyst-Network Strategy

Presbyterian Healthcare Services · Full Time · 12 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $77563.2 - $118K per year ⭐ 5-10 yrs exp 💼 Healthcare

Lead financial modeling and benchmarking to support provider contract renegotiations and network strategy. Translate complex data into actionable insights and executive dashboards to track contract performance and total cost of care.

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Medical Economics Analyst-Payment Integrity

Presbyterian Healthcare Services · Full Time · 12 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $83366.4 - $127K per year ⭐ 2-5 yrs exp 💼 Healthcare

Identify and validate medical cost savings opportunities by analyzing claims data for overpayments and billing anomalies. Partner with Payment Integrity teams and vendors to develop audit strategies and translate operational activities into financial outcomes.

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Revenue Recovery Specialist I-Patient Accounting

Presbyterian Healthcare Services · Full Time · 19 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $17.46 - $25.96 per hour ⭐ 0-2 yrs exp 💼 Sales

The specialist validates claims payments against payer contract terms to ensure compliance and identify recurring payment variance trends. They serve as a resource for hospital follow-up and denial teams regarding complex reimbursement methodologies.

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Patient Accounting Denials Specialist I

Presbyterian Healthcare Services · Full Time · 20 days ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.87 - $23.04 per hour ⭐ 2-5 yrs exp 💼 Finance

Perform root cause analysis and resolution of insurance denials through A/R follow-up and appeals. Manage the submission of corrected claims and medical records to overturn denials while documenting accounts per policy.

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IP Facility Coder

Presbyterian Healthcare Services · Full Time · 24 days ago

Presbyterian Healthcare Services

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

The IP Facility Coder is responsible for assigning appropriate CPT, ICD, and MS-DRG codes to inpatient, outpatient, and specialty records for financial reimbursement. They must resolve pre-bill edits and denials while ensuring adherence to federal regulations and hospital policies.

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Care Coordinator IV-Albuquerque

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States 💵 $67100.8 - $102K per year ⭐ 10+ yrs exp 💼 Healthcare

The Care Coordinator facilitates an interdisciplinary team approach to ensure cost-effective, quality care delivery across the continuum. Key duties include conducting in-depth health risk assessments and monitoring strategies to improve health outcomes for members with complex conditions.

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Care Coordinator IV-Roswell

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States 💵 $67100.8 - $102K per year ⭐ 10+ yrs exp 💼 Healthcare

The Care Coordinator facilitates an interdisciplinary team approach to ensure cost-effective, quality care delivery across the continuum. They conduct in-depth health risk assessments and implement strategies to improve health outcomes for members with complex conditions.

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Remote IP Facility CCS Coder

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States 💵 $21.7 - $33.14 per hour ⭐ 2-5 yrs exp 💼 Software Development

Assign appropriate CPT, ICD, and MS-DRG codes to inpatient and outpatient records for financial reimbursement and research. Maintain high accuracy and productivity standards while resolving pre-bill edits and denials.

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Profee Remote Auditor/Educator

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States 💵 $54516.8 - $83262.4 per year ⭐ 2-5 yrs exp 💼 Finance

The role involves performing internal audits and reviews to ensure compliance with enterprise-wide and regulatory coding policies. It also includes developing educational programs and training for clinical staff to improve documentation and coding accuracy.

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Senior AI Business/Process Analyst

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States 💵 $77563.2 - $118K per year ⭐ 5-10 yrs exp 💼 Software Development

The role focuses on identifying and optimizing business processes for automation using AI and RPA technologies. It involves collaborating with stakeholders to design technical specifications and managing the implementation and continuous improvement of automation projects.

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Certified Cardiothoracic Vascular Surgery Coder

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

The coder is responsible for assigning accurate medical codes to inpatient, outpatient, and specialty records to ensure proper financial reimbursement. They must also resolve pre-bill edits and denials while maintaining up-to-date knowledge of regulatory coding guidelines.

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Patient Accounting Denials Specialist I

Presbyterian Healthcare Services · Full Time · a month ago

Presbyterian Healthcare Services

🌎 United States ⭐ 2-5 yrs exp 💼 Finance

The specialist is responsible for performing root cause analysis and resolving insurance denials through follow-up, appeals, and corrected claims. They must also maintain accurate documentation and ensure compliance with HIPAA and CMS regulations.

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APC- Sleep Medicine - CDS

Presbyterian Healthcare Services · Full Time · 2 months ago

Presbyterian Healthcare Services

🌎 United States ⭐ 5-10 yrs exp 💼 Others

The Advanced Practice Provider will provide direct patient care in a sleep medicine clinic setting. Responsibilities include diagnosing and treating sleep disorders such as apnea, narcolepsy, and insomnia while maintaining documentation according to AASM standards.

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Patient Access Account Specialist I

Presbyterian Healthcare Services · Full Time · 2 months ago

Presbyterian Healthcare Services

🌎 United States 💵 $15.6 - $22.12 per hour ⭐ 2-5 yrs exp 💼 Others

The Patient Access Account Specialist I is responsible for financial clearing of patient accounts, including insurance verification and pre-service collections. They ensure that accounts are cleared prior to the date of service to alleviate patient concerns over financial matters.

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Nurse Practitioner / Physician Assistant - Family Medicine - Santa Fe

Presbyterian Healthcare Services · Full Time · 4 months ago

Presbyterian Healthcare Services

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The provider will deliver comprehensive medical care to patients with both acute and chronic illnesses while collaborating with a healthcare team. Responsibilities include making medical judgments, prescribing treatments, managing patient relationships, and participating in health management initiatives.

assistant medical pharmacist communication behavioral-health counseling literature coaching

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Interventional Cardiologist

Presbyterian Healthcare Services · Full Time · 4 months ago

Presbyterian Healthcare Services

🌎 United States ⭐ 0-2 yrs exp 💼 Healthcare

The Interventional Cardiologist will provide a full spectrum of interventional cardiology services in both inpatient and outpatient settings. They will also participate in a call rotation and manage the physician/patient relationship.

medical literature coaching

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MD-Gastroenterology-Clinic-Virtual-CDS

Presbyterian Healthcare Services · Full Time · 4 months ago

Presbyterian Healthcare Services

🌎 Mexico, United States ⭐ 10+ yrs exp 💼 Healthcare

The physician will deliver clinical care to patients in the GI practice and supervise the care provided by Advanced Practice Clinicians (APCs). They will also lead special clinical programs and work with the leadership team on various operational aspects.

medical risk-management leadership coaching

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Advanced Practice Clinician (NP or PA) - Family Medicine - Santa Fe

Presbyterian Healthcare Services · Full Time · 4 months ago

Presbyterian Healthcare Services

🌎 Mexico, United States ⭐ 2-5 yrs exp 💼 Healthcare

The provider will deliver comprehensive medical care to patients with both acute and chronic illnesses, while managing the provider/patient relationship. Responsibilities also include ordering diagnostic tests, prescribing treatments, and participating in health management initiatives.

assistant medical pharmacist communication behavioral-health counseling literature coaching

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