The Senior Account Representative manages fiscal functions to ensure accurate and timely payment for hospital services from insurers and patients. They are responsible for resolving payment discrepancies, identifying root causes for denials, and mentoring staff on procedural standards.
The Senior AR Account Specialist is responsible for recovering self-pay balances by reviewing account files and verifying insurance coverage through payer portals. They also identify root cause issues for denials and recommend corrective actions to improve billing accuracy and efficiency.
The Clinical Auditor/Analyst conducts clinical audits and reviews to identify fraud, waste, and abuse within healthcare claims and services. They analyze medical records, coding accuracy, and resource utilization while collaborating with internal departments to resolve identified issues.
The coder will assign accurate ICD and CPT codes for cardiology records while identifying incomplete documentation to query physicians. They are also responsible for maintaining productivity standards, providing staff training, and resolving reimbursement denials.
The Intake Coordinator manages accurate case entry, classification, and data maintenance within the Complaints and Grievances information system. They are responsible for investigating member concerns, ensuring regulatory compliance, and coordinating with various health plan systems to resolve appeals.
The Coder II is responsible for accurately assigning ICD-10-CM and CPT codes to diagnoses and procedures to ensure proper reimbursement. They must also review medical records for completeness, utilize coding guidelines, and communicate with physicians to resolve documentation queries.
Review medical records to determine appropriate coding, acuity levels, and billable supplies to ensure accurate reimbursement. Resolve coding edits and denials while maintaining productivity standards and providing coding education to staff.
The Territory Marketing Manager is responsible for achieving financial goals for the Workers' Compensation business by managing distribution and executing sales strategies. They will develop and maintain effective relationships with independent brokers and monitor territorial market conditions to maximize business opportunities.
The LPN will perform clinical duties such as drawing blood, administering medications, and assisting physicians with examinations and diagnostic procedures. They are also responsible for documenting patient activities in medical records and providing patient education to promote wellness.
The role involves serving as a subject matter expert for Oracle Learning and Talent Management to design, implement, and optimize system solutions. Responsibilities include troubleshooting complex HCM issues, managing Oracle Service Requests, and coordinating quarterly system updates and testing.
The Coder II is responsible for accurately assigning ICD-10-CM and CPT codes for diagnoses and procedures to ensure proper reimbursement. They also manage physician queries for incomplete documentation and maintain coding accuracy and productivity standards.
Manage complex Epic application support, projects, upgrades, integrations, reporting, and process improvements while ensuring documentation, data quality, and confidentiality. Partner with clinical, operational, technical, and vendor stakeholders, provide training, and mentor less experienced analysts.
The Systems Analyst will support transplant clinical workflows, troubleshoot system issues, and partner with operational stakeholders to meet business needs. They are responsible for managing projects, documenting requirements, and mentoring staff on Level 2 and Level 3 support issues.
Responsible for the investigation, evaluation, and disposition of lost time workers' compensation claims across several US jurisdictions. The role involves managing litigation activities, setting reserves, and coordinating with medical experts and legal counsel.
