Responsible for resolving patient billing concerns, implementing collection policies, and managing payment arrangements or charity assistance. The role involves posting data, rebilling accounts, and communicating with third-party payers to resolve account balances.
WVU Medicine
44 Remote Job Openings at WVU Medicine
Handle inbound and outbound calls to resolve member inquiries and provide general healthcare information. Collaborate with management and peers to research issues and maintain accurate member documentation.
The Team Lead serves as a primary point of contact and escalation for member and provider service inquiries via chat, calls, and service requests. They are responsible for training new team members, monitoring performance metrics, and collaborating with leadership to align the team with corporate goals.
Manage accounts receivable related to denied claims by investigating denials and writing non-clinical appeals. Ensure financial viability and compliance with federal and state billing regulations while maintaining productivity standards.
Hospital Coding Specialist II - Emergency Department
WVU Medicine
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Full Time
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6 days ago
WVU Medicine
Responsible for assigning accurate ICD-10 and CPT codes for moderately complex patient classes including Emergency Department and observation stays. Ensures compliance with regulatory guidelines and coordinates with physicians to obtain necessary documentation for clean billing.
Responsible for assigning accurate ICD-10 and CPT codes for moderately complex patient classes including ED and observation. Ensures compliance, appropriate reimbursement, and timely abstraction of medical records to facilitate clean billing.
Responsible for obtaining authorizations for elective procedures and services to ensure financial clearance for patients. This role involves reviewing clinical documentation, coordinating with insurance payors, and managing denials to minimize organizational write-offs.
Clinical Denial Specialist - Diagnosis Related Grouping (DRG)
WVU Medicine
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Full Time
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6 days ago
WVU Medicine
Responsible for managing and appealing hospital-based clinical and DRG denials to ensure billing accuracy and revenue recovery. Collaborates with clinical and coding stakeholders to improve documentation quality and organizational compliance.
Responsible for managing utilization review functions, including communicating clinical information to third-party payors to ensure hospitalization approval. The role involves documenting authorizations, processing denials, and liaising between clinical teams and insurance providers.
Responsible for assigning accurate ICD-10 and CPT codes for moderately complex patient classes such as ED and observation. Ensures compliance with regulatory guidelines and coordinates with physicians to obtain necessary documentation for clean billing.
The successful candidate will practice in the area of Radiology. They will provide remote radiology services covering WVU Medicine Community Hospitals.
The successful candidate will practice as a Tele-Radiologist providing services to WVU Medicine Community Hospitals. Responsibilities include interpreting radiological images remotely across West Virginia, Pennsylvania, and Ohio.
Professional Coding Specialist III - Cardiothoracic Surgery
WVU Medicine
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Full Time
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10 days ago
WVU Medicine
Assign accurate ICD-10, CPT, and HCPCS codes for complex surgical procedures, specifically within cardiothoracic surgery. Collaborate with providers to resolve documentation insufficiencies and perform audits to ensure coding accuracy and compliance.
Provide comprehensive medical nutrition therapy to a diverse patient population and document assessments and consults in medical records. Collaborate with medical teams to optimize patient care and supervise nutritional therapy support staff and interns.
Responsible for the accurate coding and abstraction of oncology patient data for clinical trials, research, and national reporting. Duties include case finding, staging, and monitoring patient follow-up activities to maintain accreditation standards.
Supports the design, implementation, and maintenance of clinical software systems through troubleshooting and end-user training. Collaborates with senior analysts to optimize system functionality and coordinates basic project tasks and documentation.
Supports the design, implementation, and maintenance of software systems to enhance operational efficiency and organizational needs. Responsibilities include system troubleshooting, providing end-user training, and coordinating project milestones and documentation.
Facilitates the quality and completeness of clinical documentation to ensure accurate coding, severity of illness, and risk of mortality. Collaborates with providers to identify diagnoses and provides ongoing education on documentation guidelines and compliance.
Manager, Profee Surgical Specialties & Anesthesia Coding Teams
WVU Medicine
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Full Time
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15 days ago
WVU Medicine
Directs the operations of the surgical specialties and anesthesia coding teams to ensure financial viability and optimal reimbursement. Manages staff performance, strategic planning, and the implementation of key performance indicators to maximize cash flow.
The role involves implementing, testing, and maintaining health insurance benefit plans and configurations to ensure regulatory compliance. It also requires analyzing medical billing codes and collaborating with IT to integrate these configurations into technology platforms.
Responsible for resolving credit balances and researching refund requests using Epic work queues and internal reports. The role involves managing guarantor records, transferring payments, and providing customer service to patients and staff.
Oversees day-to-day IT operations and staff development while coordinating the design, implementation, and maintenance of digital experience systems. Leads initiatives focusing on MyChart, EpicCare Link, and Care Everywhere to improve patient and employee digital interactions.
Associate Systems Analyst - MyChart/Digital Experience
WVU Medicine
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Full Time
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20 days ago
WVU Medicine
Supports the design, implementation, and maintenance of software systems, specifically focusing on MyChart and digital experience initiatives. Responsibilities include troubleshooting IT issues, providing end-user training, and coordinating projects to improve patient and operational efficiency.
Partner with leadership to execute HR best practices in change management, talent assessment, and workforce planning. Act as an advisor to business leaders to drive employee engagement and develop succession planning programs.
Manage patient account balances through accurate claim submission and timely follow-up with third-party payers. Resolve claim edits and denials to ensure the financial viability of the healthcare system.
The SNP Lead Care Manager is responsible for onboarding, mentoring, and coaching the SNP care management team to ensure clinical excellence. They oversee compliance with CMS and NCQA standards while managing high-risk member cases and coordinating with interdisciplinary care teams.
Responsible for assigning accurate ICD-10 and CPT codes for various patient classes to ensure proper reimbursement and compliance. The role involves auditing provider documentation, resolving billing issues, and managing split claim processes for critical access hospitals.
Pharmacy Tech - Diversion/Omnicell Analyst/Trainer
WVU Medicine
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Full Time
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25 days ago
WVU Medicine
Responsible for gathering patient clinical and financial data, managing insurance authorizations, and assisting pharmacists with prescription filling and labeling. The role also involves training other technicians and ensuring compliance with pharmaceutical care policies.
Hospital Coding Specialist II- Technology Auditor
WVU Medicine
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Full Time
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25 days ago
WVU Medicine
The Hospital Coding Specialist II is responsible for accurately interpreting medical record documentation and assigning appropriate codes for diagnoses and procedures. They ensure quality and timely coding, charging, and abstraction of accounts for various patient classes.
Responsible for scheduling, cancelling, and registering outpatient visits and procedures for multiple ambulatory clinics. This includes verifying patient information, managing referrals, and coordinating with referring physician offices.
Responsible for managing patient account balances through accurate claim submission, timely follow-up, and denial management. The role involves coordinating with third-party payers and internal teams to ensure the financial viability of the health system.
The representative handles inbound and outbound calls to resolve member inquiries and provide general healthcare information. They collaborate with management to research issues and maintain accurate member documentation and communication channels.
Support the development and validation of data-driven models to improve healthcare operations and patient outcomes. Responsibilities include data preprocessing, feature engineering, and performing exploratory analysis on clinical datasets.
Directs the operations of the enterprise coding department to ensure financial viability and optimal performance. Manages coding supervisors and teams while overseeing strategic planning, compliance, and revenue cycle optimization.
The successful candidate will practice in the area of Radiology as a Tele-Radiologist. Responsibilities include providing diagnostic services to WVU Medicine community hospitals remotely.
The supervisor oversees hospital or professional coding staff, managing day-to-day operations, productivity, and quality assurance. They also facilitate educational activities, ensure regulatory compliance, and act as an expert resource for revenue cycle and clinical departments.
This role leads the enterprise Clinical Denial Management program, overseeing denial and appeal processes across hospital and physician practices to ensure alignment with organizational financial and compliance goals. Key duties include managing clinical appeal processes for various denials, overseeing adjustment work queues in EPIC, and providing education and direction to denial staff.
This role is responsible for educating and training coding staff, overseeing auditing and education plans, performing quality audits, and providing ongoing feedback. The position also acts as an expert coding resource, manages quality improvement audits, and coordinates external audits.
The successful candidate will practice in the area of Diagnostic Radiology for the WVU Medicine Community Hospitals. This role is fully remote and offers additional earning opportunities.
The role involves leading the design, innovation, and implementation of solutions to improve systems and processes by advocating for customer needs and identifying productivity opportunities. Core duties include maintaining a deep understanding of database structures and BI tools to create analytical solutions, serving as the first point of contact for data analytics, and performing data analysis to ensure accuracy and drive strategic business decisions.
This role is responsible for educating and training coding staff, overseeing auditing and education plans, performing quality audits, and providing ongoing feedback. The position also acts as an expert coding resource, manages quality improvement audits, and coordinates external audits.
The Hospital Coding Specialist III is responsible for coding inpatient and interventional radiology cases, ensuring accurate documentation and compliance with coding guidelines. They must also maintain coding knowledge and communicate with physicians to obtain necessary information for accurate coding assignments.
The successful candidate will practice in diagnostic radiology and provide excellent patient care. Additionally, they will be involved in teaching medical students, residents, and fellows.
The Lead Pharmacist will oversee pharmacy operations and ensure compliance with state regulations. They will also provide leadership and management within the pharmacy setting.
