The Nurse Coordinator reviews pre- and post-service denials, secures escalated insurance authorizations, and coordinates with revenue cycle teams to optimize revenue and prevent future denials. They also collaborate with physicians to ensure clinical documentation supports the intensity of service and level of care determinations.
The consultant is responsible for implementing performance improvement and standardization initiatives within the Revenue Excellence department. They collaborate with leadership to drive transformational change and ensure the long-term sustainability of revenue cycle processes.
The specialist is responsible for pre-service financial clearance, including insurance verification, benefit validation, and obtaining authorizations. They also initiate the billing process and support organizational strategic objectives through data analysis and project leadership.
The Grants Specialist manages the operational lifecycle of regional grants, including research, writing, and proposal coordination. They ensure compliance with federal regulations and maintain accurate financial documentation across all regional programs.
Sorts, date-stamps, organizes, scans, indexes, and distributes patient and insurance correspondence, while researching returned mail and updating patient account addresses. Supports billing and follow-up operations through mail production, certified mailing of medical records, supply management, reporting, and cross-training.
Reviews patient records to improve the clarity, completeness, accuracy, and integrity of clinical documentation, supporting appropriate coding, medical necessity, severity of illness, and risk of mortality. Clarifies documentation with physicians and care teams, provides education, tracks reviews and queries, and participates in quality improvement and professional development activities.
The specialist verifies insurance eligibility, secures prior authorizations, and confirms referral requirements for clinic appointments. They also collaborate with clinic staff to resolve coverage issues and ensure accurate patient information is documented.
The Member Service Specialist responds to consumer inquiries regarding Medicare Advantage plan benefits, services, and complaints while ensuring compliance with federal and state regulations. They also implement retention strategies and conduct outreach to members and providers to close gaps in care.
The specialist analyzes health records for documentation compliance and assists with medical record elements for coding and hospital operations. They also perform document imaging, validate patient data, and provide support to providers regarding record completion.
The Home Care Coordinator serves as a liaison between acute care settings and home care services to facilitate smooth patient transitions. Responsibilities include managing referrals, educating families and staff, and maintaining clinical documentation in compliance with organizational policies.
The Registered Nurse will assess and triage patient needs while providing clinical guidance and care coordination. They will also manage medication refills, test results, and support patients through transitions of care.
The Virtual Care Coordinator RN conducts remote patient assessments and develops individualized care plans in collaboration with an interdisciplinary team. They provide virtual support to families and caregivers while coordinating care with field staff and physicians.
The Virtual Care Coordinator RN conducts remote patient assessments and develops individualized care plans in collaboration with an interdisciplinary team. They provide virtual education and support to patients and families while coordinating care with field staff and physicians.
Performs daily billing and follow-up activities for government and non-government accounts to ensure accurate revenue cycle operations. Investigates payment discrepancies, manages claim rejections, and provides training and guidance to junior team members.
Performs daily billing and follow-up activities for government and non-government accounts to ensure accurate revenue cycle operations. Researches claim rejections, manages payment delays, and communicates with departments to resolve billing discrepancies.
The manager provides leadership for hospital revenue integrity functions, including managing the Charge Description Master, denial prevention, and root cause analysis. They are responsible for optimizing revenue performance through process redesign, staff development, and interdisciplinary collaboration.
The Area Claims Manager is responsible for strategizing and implementing processes to manage hospital professional, general, and employment practices liability claims and litigation. They direct claim investigations, determine resolution strategies, and supervise outside defense counsel while ensuring compliance with internal policies and reporting requirements.
The coordinator is responsible for analyzing clinical and billing data to identify root causes of denials and implementing effective prevention strategies. They collaborate with inter-departmental teams to ensure documentation accuracy, regulatory compliance, and revenue cycle optimization.
The Virtual Care Coordinator RN will conduct remote patient assessments and coordinate individualized care plans using telehealth technology. They will provide virtual support to families and collaborate with the interdisciplinary team to ensure comprehensive care delivery.
The role is responsible for ensuring accurate CPT/HCPCS documentation and charge capture within assigned revenue integrity areas. It involves educating clinical staff on documentation standards and performing coding functions to ensure alignment with AMA and Medicare guidelines.
The analyst is responsible for data capture, analysis, and reporting to ensure operational efficiency and accurate patient billing. They perform regular audits, manage charge reconciliation processes, and educate staff on documentation and coding standards.
The Virtual Care Coordinator RN conducts remote patient assessments and develops individualized care plans in collaboration with an interdisciplinary team. They provide virtual education and support to patients and families while liaising with field staff to ensure comprehensive care delivery.
The specialist is responsible for ensuring accurate CPT/HCPCS documentation and charge capture to support the patient billing process. They also analyze data, educate clinical staff on documentation requirements, and perform audits to ensure compliance with coding guidelines.
The accountant is responsible for developing and maintaining accurate financial information for the general ledger and financial statements. They will prepare monthly journal entries, reconcile accounts, and assist with the preparation of annual budgets and financial reports.
The Registered Nurse will perform telephone triage, assist with office procedures, and provide direct patient care including phlebotomy and medication administration. They are also responsible for medical record documentation, patient education, and coordinating specialty referrals.
The Community Liaison develops relationships with community referral sources, agencies, and healthcare professionals to promote the PACE program and secure referrals. They also collaborate with operations staff to align sales strategies and ensure the effective delivery of services to the elderly community.
Direct regional Clinical Documentation Integrity programs, ensuring compliance with organizational standards while monitoring performance, accuracy, productivity, and documentation quality. Lead and develop CDI staff, educate providers and clinical teams, analyze performance data, and collaborate with coding, physician, and executive stakeholders to support accurate clinical records and appropriate DRG assignment.
The coordinator manages patient placement, bed assignments, and transfer center operations to ensure efficient patient flow across the organization. They collaborate with clinical and operational teams to monitor capacity and remove barriers to timely access to care.
The Nurse Auditor is responsible for coordinating revenue integrity and charge-related denials while ensuring compliant clinical documentation. They perform routine chart reviews, provide education to clinical staff, and identify trends to optimize revenue.
The analyst is responsible for auditing department information, ensuring accurate CPT and ICD-10 documentation, and performing charge capture functions to support operational efficiency. They also synthesize data to identify trends, resolve charge discrepancies, and provide educational support to clinical departments.
