NewRN, DRG Coder / Clinical Auditor Pivotal Placement ServicesRN, DRG Coder / Clinical AuditorBaton Rouge, LA$90,000–$104,841 / yearHeadquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.
NewSenior Coding Educator Humana IncSenior Coding EducatorLARemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
STEM Coding/Robotics-Magnet Teacher East Baton Rouge Parish School SystemSTEM Coding/Robotics-Magnet TeacherLASummary: The job of Classroom Teacher is done for the purpose/s of providing support to the instructional process by serving as a teacher with specific responsibility for supervising students within the classroom and other assigned areas; developing lesson plans and delivering group and individual student instruction within established curriculum guidelines; collaborating with other teachers, other professional staff, and administrators in addressing instructional and/or classroom issues; and responding to a wide range of inquiries from students' parents or guardians regarding instructional program and student progress. Oversees assistant teachers, student teachers, instructional assistants, volunteers and/or student workers for the purpose of ensuring the operation of an effective and efficient classroom structure that supports the teacher and students in achieving classroom and individual goals.
NewSupervisor - Accounts Receivable Baton Rouge GeneralSupervisor - Accounts ReceivableBaton Rouge, LAWith clinics located throughout Baton Rouge and the surrounding areas, our physician group provides patients with comprehensive care and a full suite of specialties, including internal and family medicine and specialty care. Working knowledge of medical billing processes , including CPT/HCPCS coding basics, claim submission workflows, and insurance payer requirements is required .
NewProgram Integrity SURS Clinician State Of LouisianaProgram Integrity SURS ClinicianBaton Rouge, LADevelop cases while conferring with staff from the Centers for Medicare and Medicaid (CMS), Federal Bureau of Investigations (FBI), Medicaid Fraud Control Unit (MFCU), Office of Inspector General (OIG), United States Attorney and other governmental agencies participating in the review/investigations. Interpret claims and encounter histories by utilizing professional clinical publications such as the Current Procedural Terminology (CPT) manuals and companion guides, Healthcare Common Procedure Coding System (HPCS) and International Classification of Diseases (ICD) books.
NewRevenue Cycle Specialist - Lab LED FastStartRevenue Cycle Specialist - LabBaton Rouge, LAThis position is responsible for ensuring accurate front-end processes for laboratory patients-including registration, insurance verification, and medical necessity/ABN workflows-while also supporting downstream billing, coding, reimbursement, and denial management. The role requires a strong understanding of lab operations, CPT/HCPCS and ICD-10 coding, ABN regulations, payer policies, and the communication skills necessary to collaborate with physicians and clinical staff.
Clinic Receptionist Prime Occupational MedicineClinic ReceptionistBaton Rouge, LAFull timeLearn new tasks, remember processes, maintain focus, complete tasks independently, make timely decisions in the context of a workflow, ability to communicate with employees and visitors, ability to complete tasks in situations that have a speed or productivity quota. The worker is required to have close visual acuity to perform an activity such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
Benefits Operations - CW Account Advisor I MindlanceBenefits Operations - CW Account Advisor IBaton Rouge, LAThis role reports to this job: SUPERVISOR, CUSTOMER SERVICE Necessary Contacts: Enrollment & Billing, Claims, Provider Relations, Benefit Operations, Network Administration, Sales/Marketing, Accounting and Legal departments as well as members, providers, groups, brokers, other plans, insurance companies, Social Security Administration and Centers for Medicare and Medicaid Services (CMS). Familiarity with medical and health insurance terminology preferred Conflict resolution skills and remains calm under pressure/stressful situations Must be able to to demonstrate critical thinking and problem solving skills Demonstrate attention to detail The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers.
Senior Coder - Specialty Surgeries LCMC HealthSenior Coder - Specialty SurgeriesLouisianaCommunicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs assignment and all required modifiers.
Medical Billing Office Specialist Pathology Group of LouisianaMedical Billing Office SpecialistBaton Rouge, LAFull timeAt Pathology Group of Louisiana , our mission is to provide the finest quality pathology services to patients, referring physicians, outpatient surgery centers and hospitals with the greatest accuracy in the most cost-effective manner as rapidly as possible. • Work the Demographic Queue to verify and update patient personal and payer-related information prior to claim creation and submission, ensuring accurate billing data and minimizing insurance rejections and denials.
Claims Recoup & Collect Anlyst TriWest Healthcare AllianceClaims Recoup & Collect AnlystBaton Rouge, LARemoteFull timeUnder limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.
Account Advisor I - Call Center Blue Cross and Blue Shield of LouisianaAccount Advisor I - Call CenterBaton Rouge, LARemotePursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._. + Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.
NewPatient Registration Front Desk RKM Primary CarePatient Registration Front DeskLivingston, Louisiana$15–$20.16Since 1999, our mission is to provide open access to quality patient-centered healthcare in the communities in which we live. Qualifications/Skills: Ability to facilitate communication effectively with co-workers and patients.
Front Desk Patient Registration Clerk RKM Primary CareFront Desk Patient Registration ClerkPort Allen, Louisiana$15–$20.16Since 1999, our mission is to provide open access to quality patient centered healthcare in the communities in which we live. Qualifications/Skills: Ability to facilitate communication effectively with co-workers and patients.
Patient Registration Clerk RKM Primary CarePatient Registration ClerkBaton Rouge, Louisiana$15–$20.16Since 1999, our mission is to provide open access to quality patient centered healthcare in the communities in which we live. Qualifications/Skills: Ability to facilitate communication effectively with co-workers and patients.
NewHealthcare Price and Transparency Data Analyst Intern Blue Cross and Blue Shield of LouisianaHealthcare Price and Transparency Data Analyst InternBaton Rouge, LouisianaPursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus.
Supervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminBaton Rouge, LARemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Hospice RN-Weekend-PRN UnitedHealth Group IncHospice RN-Weekend-PRNBaton Rouge, LAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. As members of the Optum family of businesses we are dedicated to helping people feel their best including our team members who create meaningful connections with patients their families each other and the communities we serve.
Coder 3 - Hospital FMOL HealthCoder 3 - HospitalBaton Rouge, LAExperience - RHIT/RHIA plus 5 years of acute care coding experience, or RHIT/RHIA with ICD-10 curriculum plus 3 years of acute care coding experience, or 7 years acute care coding experience; CCS substitutes for 1 year of acute care coding experience. The Medical Coder 3 (inpatient and ambulatory surgery) abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 - CM/PCS and CPT codes to patient records according to established procedures.
Director, Prospective Risk Adjustment Operations Blue Cross and Blue Shield of LouisianaDirector, Prospective Risk Adjustment OperationsBaton Rouge, LAThe Director oversees Clinical Documentation Integrity (CDI), provider engagement, Annual Wellness Visit initiatives, in-home and telehealth assessment programs, and other prospective risk adjustment interventions designed to drive accurate HCC capture and improve risk adjustment outcomes. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._.
Senior Clinical Documentation Integrity Specialist Blue Cross and Blue Shield of LouisianaSenior Clinical Documentation Integrity SpecialistBaton Rouge, LAPursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._. The Senior Clinical Documentation Integrity Specialist ensures accurate, complete, and compliant clinical documentation that appropriately reflects severity of illness, risk of mortality, and supports correct reimbursement.
Director, Prospective Risk Adjustment Operations Blue Cross and Blue Shield AssociationDirector, Prospective Risk Adjustment OperationsBaton Rouge, LAThe Director oversees Clinical Documentation Integrity (CDI), provider engagement, Annual Wellness Visit initiatives, in-home and telehealth assessment programs, and other prospective risk adjustment interventions designed to drive accurate HCC capture and improve risk adjustment outcomes. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Claims Reviewer TriWest Healthcare AllianceClaims ReviewerBaton Rouge, LARemoteFull timeProficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.
Sr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerBaton Rouge, LARemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
Field Reimbursement Manager - Kidney (East Texas-Louisiana) Vertex PharmaceuticalsField Reimbursement Manager - Kidney (East Texas-Louisiana)LouisianaCompliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerBaton Rouge, LARemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Senior Ambulatory Surgery Facility Coder LCMC HealthSenior Ambulatory Surgery Facility CoderLouisianaWhile our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Responsible for applying the appropriate ICD-10-CM/PCS and CPT (including charging) diagnostic and procedural codes for emergency, outpatient and/or inpatient encounters and ancillary encounters ambulatory/provider-based clinics.
Development Manager / Technical Lead for Engineering Consultant Moffatt & NicholDevelopment Manager / Technical Lead for Engineering ConsultantBaton Rouge, LAThe firm provides clients worldwide with customized service and a level of excellence that have become the firm's hallmark in several primary practice areas - ports and harbors; coastal, environmental and water resources; urban waterfronts and marinas; transportation, bridges and rail; inspection and rehabilitation; and energy. As part of the IT Group, the Development Manager / Technical Lead is a highly experienced technical leader and working manager responsible for leading and empowering the development team to deliver high-quality software solutions that align with the firm's objectives.
COC Program Manager - OLOL FMOL HealthCOC Program Manager - OLOLBaton Rouge, LAThe Education and Quality Assurance Manager manages the day-to-day operational aspects of the cancer registry by directing the case finding activities and abstracting for over 3,000 cases annually to ensure high quality, timely and complete registry data. Performs a variety of duties related to the management and operations of organizational development of the cancer registry and works collaboratively with the leadership to maintain ongoing accreditation with the American College of Surgeons (ACS), Commission on Cancer (CoC) approvals program.
NewRemote Inpatient Coder 95% Accuracy & ICD Mastery DatavantRemote Inpatient Coder 95% Accuracy & ICD MasteryBaton Rouge, LARemote$32–$42 / hourA leading health data platform company is looking for experienced inpatient coders to join their remote team. Responsibilities include coding patient records, ensuring accuracy, and training junior staff.
Supervisor, Provider Disputes Blue Cross and Blue Shield of LouisianaSupervisor, Provider DisputesBaton Rouge, LAPursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._. + Necessary Contacts: In order to effectively fulfill this position, this position must be in contact with:Various internal and external entities including, but not limited to, all levels of BCBSLA personnel, attorneys, group leaders, members, hospitals, physician offices, and DOI.
Supervisor, Provider Disputes Blue Cross and Blue Shield AssociationSupervisor, Provider DisputesBaton Rouge, LAPursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Necessary Contacts: In order to effectively fulfill this position, this position must be in contact with: Various internal and external entities including, but not limited to, all levels of BCBSLA personnel, attorneys, group leaders, members, hospitals, physician offices, and DOI.
Informatics Consultant CVS Health CorpInformatics ConsultantLA$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Data Conversion Lead MaximusData Conversion LeadBaton Rouge, LAFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Application Security Engineer Ryder System IncApplication Security EngineerBaton Rouge, LACompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Oncology Claims Analyst 1 FMOL HealthOncology Claims Analyst 1Baton Rouge, LAReviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers.