Billing Specialist - Shared Services Insurance Office of AmericaBilling Specialist - Shared ServicesMorgantown, WVRemote$40,000–$60,000 / yearFull timei>Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. Data Validation: Review and verify EPIC data fields, including policy numbers, commissions, ICO/PPE, and related billing details before processing.
Pharmacy Business Coordinator - Home Infusion (Billing and Revenue Cycle) West Virginia University MedicinePharmacy Business Coordinator - Home Infusion (Billing and Revenue Cycle)WVp>MINIMUM QUALIFICATIONS: EDUCATION, EXPERIENCE, CERTIFICATION, AND/OR LICENSURE: Bachelor's Degree in healthcare administration, business, finance, or related field AND one (1) year of business OR healthcare-related experience OR High School Diploma or Equivalent AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND two (2) years of healthcare-related experience OR Associate's Degree AND Nationally Certified Pharmacy Technician (PTCB or EXPT) upon hire AND one (1) year of healthcare-related experience. This position is responsible for conducting payer discussions, in-house financial audits, payer performance compliance, prepayment claims audit, CMS CERT audits, CMS Fraud, Waste, & Abuse audits, and auditing 3rd party payer compliance.
Insurance Claims Specialist HB West Virginia University MedicineInsurance Claims Specialist HBMonongalia County, WVResponsible for managing patient account balances including accurate claim submission, compliance with all federal/state and third-party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 544 SYSTEM Patient Financial Services.
Insurance Claims Specialist PB West Virginia University MedicineInsurance Claims Specialist PBMonongalia County, WVp>Responsible for managing patient account balances including accurate claim submission, compliance will all federal/state and third party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Maintains knowledge of revenue cycle operations, third party reimbursement and medical terminology including all aspects of payer relations, claims adjudication, contractual claims processing, credit balance resolution and general reimbursement procedures.
Patient Access Specialist West Virginia University MedicinePatient Access SpecialistMorgantown, WVp>Rotating Holidays Scheduled Weekly Hours: 20 Shift: Varied (United States of America) Exempt/Non-Exempt: United States of America (Non-Exempt) Company: WVUH West Virginia University Hospitals Cost Center: 545 WVUH Patient Access Address: 1 Medical Center Drive Morgantown West Virginia. Communicates and interacts with clients, families, visitors, physicians, departmental, and hospital staff and the public in general in a manner that demonstrates professionalism and concern for the individuals' need(s).
Clinical Denial Specialist - Diagnosis Related Grouping (DRG) West Virginia University MedicineClinical Denial Specialist - Diagnosis Related Grouping (DRG)Monongalia County, WVp>MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Associate degree in healthcare administration, Nursing, Health Information Management, or related field AND Five (5) years of experience in hospital billing, acute care setting, CDI, inpatient coding, or revenue cycle'. Certification or License in one of the following: Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
Provider Enrollment Specialist West Virginia University MedicineProvider Enrollment SpecialistHarrison County, WVResponsible for the timely, efficient and accurate economic credentialing and provider enrollment of eligible West Virginia United Health System, WVU Health Sciences Eastern Division and WVU Health Sciences Charleston Division medical billing providers and facilities with contracted managed care and governmental plans. Regularly coordinates with IHS Vice Presidents, Administrators, Directors and Managers to obtain information for new facilities, practice locations, providers and services to be added under existing contracts for smooth revenue collection and contract compliance.
HVI Research Regulatory Specialist West Virginia University MedicineHVI Research Regulatory SpecialistMorgantown, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Master's degree OR; Bachelor's degree AND Three years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions OR; Associate's degree AND Five years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions OR; High School Diploma or Equivalent AND Seven years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Obtain certification as a Research Professional through the Society of Clinical Research Associates (SoCRA) OR the Association of Clinical Research Professionals (ACRP) within two years of hire date preferred.
Research Regulatory Specialist West Virginia University MedicineResearch Regulatory SpecialistMorgantown, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Master's degree OR; Bachelor's degree AND Three years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions OR; Associate's degree AND Five years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions OR; High School Diploma or Equivalent AND Seven years of experience in regulatory and research patient billing aspects of industry and government sponsored clinical trials including IRB application submissions. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Obtain certification as a Research Professional through the Society of Clinical Research Associates (SoCRA) OR the Association of Clinical Research Professionals (ACRP) within two years of hire date preferred.
Exercise Specialist West Virginia University MedicineExercise SpecialistMorgantown, WVli>Completes all required feedback and communication to patient and healthcare team including EMR documentation and reports concerning education, exercise progression, exercise treatment, and monitored physiological and vital responses of the patient. Must provide care including the implementation and evaluation of exercise programs for cardiac patients in all phases of cardiac rehabilitation in collaboration with and under the supervision of the Exercise Physiologist, Cardiac Rehab RN and/or Physical Therapist.
Exercise Specialist WVU MedicineExercise SpecialistMorgantown, West Virginia4. Completes all required feedback and communication to patient and healthcare team including EMR documentation and reports concerning education, exercise progression, exercise treatment, and monitored physiological and vital responses of the patient. 1. Must provide care including the implementation and evaluation of exercise programs for cardiac patients in all phases of cardiac rehabilitation in collaboration with and under the supervision of the Exercise Physiologist, Cardiac Rehab RN and/or Physical Therapist.
Registration Specialist West Virginia University MedicineRegistration SpecialistBridgeport, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Registration Specialist -PRN West Virginia University MedicineRegistration Specialist -PRNClarksburg, WVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Registration Specialist- Patient Access West Virginia University MedicineRegistration Specialist- Patient AccessThomas Imaging Center, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Registration Specialist - Pediatrics - Full-Time West Virginia University MedicineRegistration Specialist - Pediatrics - Full-TimeWVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Registration Specialist - Colorectal Department West Virginia University MedicineRegistration Specialist - Colorectal DepartmentWVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Clinical Denials Specialist West Virginia University MedicineClinical Denials SpecialistMonongalia County, WVThis includes but is not limited to, denial investigation, follow-up with insurance companies, billing, auditors and clinics/hospital departments, non-clinical appeal writing, accurate and timely account adjustments all while ensuring compliance with all federal, state, third-party billing regulations and contract agreements. Manages and distributes incoming mail in an accurate and timely manner; includes Epic documentation, logging incoming correspondence, uploading to document warehouse and routing mis-directed mail; processes outgoing certified mail.
Ambulatory Charge Capture Analyst West Virginia University MedicineAmbulatory Charge Capture AnalystMorgantown, WVHigh school diploma AND six (6) years of experience in business analysis OR bachelor's degree in finance, business management, information technology/computer science, healthcare administration, nursing or related field AND two (2) years of experience in business analysis or similar role.\n \nEXPERIENCE: \n \n1. \n \nThe Ambulatory Charge Capture Analyst serves as an embedded revenue cycle specialist within assigned clinical department(s), ensuring accurate and complete charge capture for all billable services, procedures, and supplies.
Insurance Claim Spec West Virginia University MedicineInsurance Claim SpecMonongalia County, WVResponsible for managing patient account balances including accurate claim submission, compliance will all federal/state and third party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Maintains knowledge of revenue cycle operations, third party reimbursement and medical terminology including all aspects of payer relations, claims adjudication, contractual claims processing, credit balance resolution and general reimbursement procedures.
Hospital Coding Specialist II- Claim Edits Team West Virginia University MedicineHospital Coding Specialist II- Claim Edits TeamMonongalia County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Patient Financial Resolution Advocate West Virginia University MedicinePatient Financial Resolution AdvocateMorgantown, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides the patient a receipt, and documents payment in the registration/billing systems. Communicates and interacts with clients, families, visitors, physicians, departmental, and hospital staff, and the public in general in a manner that demonstrates professionalism and concern for the individuals' needs.
Customer Support Associate Teknogin SLPCustomer Support AssociateMorgantown, WVNATURE OF WORK: The Customer Support Associate supports the provision of direct services by providing daily services as needed, including but not limited to daily coverage of the front office, admissions, phone service, and medical records in order to serve our clients timely and properly. Employee will ensure the clients are in compliance for their appointments either prior to being scheduled or prior to receiving services by checking the client address, phone, and insurance information are correct and in the computer system.
Cash Management Specialist West Virginia University MedicineCash Management SpecialistClarksburg, WVli>Analyzes and reconciles posting amounts from patient payment and other sources of payment (non-accounts receivable (AR) cash) to the patient accounting system and accounting department. Identifies any unidentified payment transactions that route to the clearing account, following facility processes to move non-patient money to correct general ledger account.
Regional Oncology Specialist - West Virginia Exact Sciences CorpRegional Oncology Specialist - West VirginiaMorgantown, WV$127,000–$191,000 / yearDevelop and implement a highly strategic and actionable tactical plan to maximize the utilization of our products in the most productive accounts while staying within budget; support corporate objectives and highlight the delivery of key selling messages and provide a high-level of customer service toward being the best-in-class provider. Working on the Oncology Sales team, the Lead Regional Oncology Specialist (Lead ROS) will develop and implement a plan to maximize the utilization of Exact Sciences' products in targeted accounts, while staying within budget, and support the corporate objectives and highlight the delivery of key selling messages.
Patient Registrar Oncology West Virginia University MedicinePatient Registrar OncologyBridgeport, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar (Spine) West Virginia University MedicinePatient Registrar (Spine)Bridgeport, WVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar - PC West Virginia University MedicinePatient Registrar - PCBridgeport, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar -ENT West Virginia University MedicinePatient Registrar -ENTBridgeport, WVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar (PRN) West Virginia University MedicinePatient Registrar (PRN)Bridgeport, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar PRN West Virginia University MedicinePatient Registrar PRNElkins, WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar (Grafton) West Virginia University MedicinePatient Registrar (Grafton)WVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Patient Registrar West Virginia University MedicinePatient RegistrarWVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Customer Service Representative PFS West Virginia University MedicineCustomer Service Representative PFSMonongalia County, WVFrequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in preforming duties throughout the work shift. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Customer Service Representative West Virginia University MedicineCustomer Service RepresentativeMonongalia County, WVAdditional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 656 SYSTEM Customer Service. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in preforming duties throughout the work shift.
NewHealth Pro - US Virtual Alight IncHealth Pro - US VirtualWVp>Your primary responsibility is to be an advocate for members requiring guidance across the health benefits environment by helping them navigate questions about their benefits, identify the highest quality and cost-effective providers, understand benefit claims, and be an advocate for the employee across the health ecosystem. Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate's experience, education, certification/credentials, market data, internal equity, and geography.
Referral Specialist West Virginia University MedicineReferral SpecialistSaint Francis Hospital, WVCollects comprehensive detailed patient medical information, determining the need for nursing intervention and expediting care for those deemed urgent, interpreting and applying polices and procedures, providing financial education to customers regarding benefits to assist in their understanding of personal financial liability, and obtaining insurance verification and pre-certification. Demonstrates flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs (i.e. weather or disaster).
Legal Support Specialist West Virginia University MedicineLegal Support SpecialistWVFrequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in performing duties throughout the work shift. Responsible for answering telephone calls from patients to resolve patient liability by adhering to all applicable laws and the collection policies and procedures of WVUHS.
Credit Balance Specialist-PB West Virginia University MedicineCredit Balance Specialist-PBMonongalia County, WVol>Resolves credit balances identified through Epic work queues, an internal credit balance report, billing, cash posting, or payer or patient/guarantor request. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in preforming duties throughout the work shift.
Employee Training Specialist West Virginia University MedicineEmployee Training SpecialistMonongalia County, WVli>Coordinates and provides appropriate training of new employees and re-training for current employees to assure appropriate to assure appropriate revenue cycle processing and patient experience including patient registration, schedule management, insurance eligibility, and Point of Service Collections. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
Master Social Worker - MSW Fresenius Medical Care AG & Co KGaAMaster Social Worker - MSWWVSupports the Fresenius Kidney Care (FKC) commitment to the Quality Indicators and Outcomes and Quality Assessment and Improvement (QAI) Activities, including those related to patient satisfaction and quality of life and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FKC Quality Goals. PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior and accepted methods of social work practice.
NewInsurance Specialist -Temp West Virginia University MedicineInsurance Specialist -TempBridgeport, WVli>Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification.
Coding Auditor-Educator West Virginia University MedicineCoding Auditor-EducatorMonongalia County, WVEXPERIENCE: Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the "Teaching Physician Guidelines" for Professional Coding Positions preferred. Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager.