Travel Ultrasound Tech - $2,495 per week in Golden, CO AequorTravel Ultrasound Tech - $2,495 per week in Golden, COGolden, CO$2,495Required Certifications & Licensure:-Health Services\BCLS - Basic life support (Certification for Healthcare Providers).-Registered Diagnostic Medical Sonographer - Breast Specialty (RDMS (BR)) from American Registry for Diagnostic Medical Sonography (ARDMS). Preferred Certifications & Licensure:-N/A Required Education:-N/A Preferred Education:-N/A Required Certifications & Licensure:-Health Services\BCLS - Basic life support (Certification for Healthcare Providers).
Supervisor Coding Professional Fee CommonSpirit HealthSupervisor Coding Professional FeeCentennial, COWith our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Supervises professional fee coders for assigned departments (Primary Care or Specialty Care) for employed providers as well as designated PSA and other practices.
Coord Quality Coding University of Colorado HealthCoord Quality CodingDenver, CO$33.82–$50.73 / hourEmployees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness. Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure.
Coding Outpatient Lead University of Colorado HealthCoding Outpatient LeadDenver, CORemote$25.80–$38.70 / hourEmployees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness. Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure.
Coding Operations Manager American Family Care IncCoding Operations ManagerDenver, CORemote$90,000–$115,000 / yearHeadquartered in Birmingham, Alabama, AFC has grown into the nation's leading provider of accessible healthcare, with more than 400 company-owned and franchised centers across the United States, caring for over 3.5 million patients annually. Today, with more than 400 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nations leading provider of urgent care, accessible primary care, and occupational medicine.
Revenue Cycle Coder Lead-Inpatient Coding CommonSpirit HealthRevenue Cycle Coder Lead-Inpatient CodingEnglewood, COAs one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs.
IT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, Informatics Kaiser PermanenteIT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, InformaticsGreenwood Village, COEssential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; and recognizing and capitalizing on improvement opportunities. Ability and/or having the capacity to learn -knowledge representation- logic to create, maintain subsets of clinical records to support reporting, business intelligence in the areas of best practice alerts, population and healthcare management, quality measurements, and health information exchanges.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Denver, COIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Clinician Coding Liaison - Vascular Advocate Aurora Health IncClinician Coding Liaison - VascularAurora, CORemote$35.50–$53.25 / hourProviding care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystDenver, CORemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
Supervisor Coding, ED University of Colorado HealthSupervisor Coding, EDDenver, CORemote$29.54–$44.31 / hourEmployees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness. Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure.
Managed Services - Revenue Cycle Coding - Senior Manager PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior ManagerCO$124,000–$280,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy . As a Senior Manager, you will leverage your skills and influence to deliver quality results, motivate and coach teams to solve complex problems, and apply sound judgment to recognize when to take action or escalate issues.
Security Testing Specialist - Code Review/Java, .NET, Python Developer The PNC Financial Services Group IncSecurity Testing Specialist - Code Review/Java, .NET, Python DeveloperLakewood, CO$91,000–$185,900 / yearIn addition, PNC generally provides the following paid time off, depending on your eligibility: maternity and/or parental leave; up to 11 paid holidays each year; 9 occasional absence days each year, unless otherwise required by law; between 15 to 25 vacation days each year, depending on career level; and years of service. Access Control (AC), Application Security, Application Security Code Review, Application Security Testing, Building Architecture, Customer Solutions, Disaster Recovery Planning, Information Security, Network Security, Physical Security, Risk Assessments, Security Technologies, Static Application Security Testing (SAST).
Security Testing Specialist - Code Review/Java, .NET, Python Developer PNC BankSecurity Testing Specialist - Code Review/Java, .NET, Python DeveloperDenver, ColoradoAccess Control (AC), Application Security, Application Security Code Review, Application Security Testing, Building Architecture, Customer Solutions, Disaster Recovery Planning, Information Security, Network Security, Physical Security, Risk Assessments, Security Technologies, Static Application Security Testing (SAST) Competencies . In addition, PNC generally provides the following paid time off, depending on your eligibility: maternity and/or parental leave; up to 11 paid holidays each year; 9 occasional absence days each year, unless otherwise required by law; between 15 to 25 vacation days each year, depending on career level; and years of service.
Paralegal I - Prosecution and Code Enforcement City & County of DenverParalegal I - Prosecution and Code EnforcementDenver, CO$30–$35.62 / hourIts responsibilities include handling city lawsuits, prosecuting ordinance violations, providing victim support in criminal cases, representing the city in investigations and litigation, advising on contractual and transactional matters, offering regulatory and compliance assistance, addressing employment matters for the city's more than 12,000 workers, and providing guidance on local, state, and federal law. Specifically, as the Prosecution Paralegal, you will: Conducts legal and factual research into various cases and/or matters, such as identifying essential witnesses and evidence, interviewing witnesses, memorializing witness statements, and locating needed evidence.
Victim Advocate I - Prosecution and Code Enforcement City & County of DenverVictim Advocate I - Prosecution and Code EnforcementDenver, CO$26.84–$30.20 / hourSpecifically, as the PACE Victim Advocate of City Attorney's Office, you will: Respond to crisis calls, provides information on the criminal justice process: The Victim Advocate candidate will accompany victims to court, assist with obtaining protection orders, answer questions about court cases, offer safety planning, provide referrals to community resources, and staff cases with the prosecutorial team. Its responsibilities include handling city lawsuits, prosecuting ordinance violations, providing victim support in criminal cases, representing the city in investigations and litigation, advising on contractual and transactional matters, offering regulatory and compliance assistance, addressing employment matters for the city's more than 12,000 workers, and providing guidance on local, state, and federal law.
Paralegal I - Prosecution And Code Enforcement City & County of Denver, COParalegal I - Prosecution And Code EnforcementDenver, CO$30–$35.62 / hourIts responsibilities include handling city lawsuits, prosecuting ordinance violations, providing victim support in criminal cases, representing the city in investigations and litigation, advising on contractual and transactional matters, offering regulatory and compliance assistance, addressing employment matters for the city's more than 12,000 workers, and providing guidance on local, state, and federal law. Specifically, as the Prosecution Paralegal, you will: Conducts legal and factual research into various cases and/or matters, such as identifying essential witnesses and evidence, interviewing witnesses, memorializing witness statements, and locating needed evidence.
Victim Advocate I - Prosecution And Code Enforcement City & County of Denver, COVictim Advocate I - Prosecution And Code EnforcementDenver, CO$26.84–$30.20 / hourSpecifically, as the PACE Victim Advocate of City Attorney's Office, you will: Respond to crisis calls, provides information on the criminal justice process: The Victim Advocate candidate will accompany victims to court, assist with obtaining protection orders, answer questions about court cases, offer safety planning, provide referrals to community resources, and staff cases with the prosecutorial team. Its responsibilities include handling city lawsuits, prosecuting ordinance violations, providing victim support in criminal cases, representing the city in investigations and litigation, advising on contractual and transactional matters, offering regulatory and compliance assistance, addressing employment matters for the city's more than 12,000 workers, and providing guidance on local, state, and federal law.
NewLead Coder OnPoint Medical GroupLead CoderSedalia, CO$31–$34 / hourCoding Working directly healthcare providers, and staff to ensure the medical documentation supports the CPT and Diagnosis codes that are being billed out to payers following payer specific guidelines Perform pre-visit planning in Navina as instructed Run day-end report for practice managers 2x per week copy executive directors and coding manager Post visit review and claim submission Working directly with the healthcare providers to ensure correct coding initiatives are met Other coding duties as assigned Productivity Submitting a minimum of 80 - 100 claims per day out of preassigned clinics Dropping claims within 3 days of note completion Policies Work within guidance of Billing Compliance Plan Work within Federal, State and Local Billing Guidelines Attend scheduled coding meetings Maintain coding certification including timely submission of continuing education to AAPC or AHIMA Maintain and follow strict privacy, confidentiality, and safety protocols. Minimum Education/Experience High School Diploma or High School Equivalency Strong computer skills required 5 years healthcare experience 2 years coding experience CPC or AHIMA Certification Preferred Education/Experience Some college – medical, business, accounting focus Bilingual EMR experience preferred – Athenahealth practice management system SUPERVISORY RESPONSIBILITIES This position does not have any supervisory responsibilities JOB ELEMENTS/WORKING CONDITIONS While performing the duties of this job, the employee is regularly required to stand; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)CO$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Medical Front Desk Receptionist American Family Care Ken CarylMedical Front Desk ReceptionistLittleton, ColoradoToday, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient.
NewCharge Master Analyst Sutter HealthCharge Master AnalystCentennial, CO$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistCO$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Medical Office Representative Denver Full Time Days AdventHealthMedical Office Representative Denver Full Time DaysLakewood, CO$19.38–$31.01 / hourKnowledge, Skills, and Abilities: Education: Associate and/or higher-level education or completed coursework in health services administration or other related medical or business field. Maintains a working relationship with clinical partners to ensure open communication between clinical, ancillary, and patient access departments, enhancing patient experiences.
Medical Office Representative Full Time Days AdventHealthMedical Office Representative Full Time DaysEnglewood, CO$19.38–$31.01 / hourKnowledge, Skills, and Abilities: Education: Associate and/or higher-level education or completed coursework in health services administration or other related medical or business field. Maintains a working relationship with clinical partners to ensure open communication between clinical, ancillary, and patient access departments, enhancing patient experiences.
Medical Office Representative AdventHealthMedical Office RepresentativeLone Tree, CO$19.38–$31.01 / hourKnowledge, Skills, and Abilities: Education: Associate and/or higher-level education or completed coursework in health services administration or other related medical or business field. Maintains a working relationship with clinical partners to ensure open communication between clinical, ancillary, and patient access departments, enhancing patient experiences.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)CO$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)Denver, ColoradoOne or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)Denver, CO$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Optometric Technician West Point OpticalOptometric TechnicianColorado Springs, ColoradoThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
NewRevenue Cycle Specialist Stride Community Health CenterRevenue Cycle SpecialistDenver, CO$22–$26 / hourAs one of Colorado's largest Federally qualified healthcare centers (FQHC), we offer comprehensive services-including primary care, dental, pharmacy, behavioral health, health education and outreach services across 13 clinics in the Denver Metro area. Verify validity of account balance by researching, reviewing, and ensuring accuracy or payment and adjustment posting Review and interpret explanation of benefits (EOB) for denials and reimbursement underpayments.
Optometric Technician- $2500 SIGN-ON BONUS Pearle VisionOptometric Technician- $2500 SIGN-ON BONUSLone Tree, ColoradoThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Ophthalmic Technician Pearle VisionOphthalmic TechnicianColorado Springs, ColoradoThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. Ability to provide enthusiastic and concise communication to meet/exceed customer expectations as well as foster positive and results-oriented associate, doctor and host relationships.
Optometric Technician Pearle VisionOptometric TechnicianCastle Rock, ColoradoThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Optometric Technician Park MeadowsOptometric TechnicianLone Tree, ColoradoThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Billing Specialist Infusion Pharmacy / Remote BrightSpring Health ServicesBilling Specialist Infusion Pharmacy / RemoteEnglewood, CORemote$20–$22 / hourThe home infusion market is positioned for rapid growth driven by the aging population, increase in chronic diseases, robust pipeline of infusible drugs coming to market, and an industry shift from hospital delivery settings to lower-cost, high-quality alternative providers such as Amerita. Process confirmed tickets in "unworked" status within 48 hours of confirmation date; assign appropriate status to ensure proper handling by branch and billing personnel; make necessary demographic changes to reduce rejections of submitted electronic and paper claims.
Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementDenver, CORemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.
Medical Front Desk Receptionist American Family Care IncMedical Front Desk ReceptionistLittleton, COmagazine as one of the fastest-growing companies in the U.S., AFCs stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nations leading provider of urgent care, accessible primary care, and occupational medicine.
Product Security Engineer Candid HealthProduct Security EngineerCO$180,000–$258,000 / yearMedical billing is expensive because it's nuanced and hard - maybe ~100x harder than credit card payment processing - and because it's traditionally done by armies of humans who track and manage complex rules and processes specific to individual insurance companies with little or no supporting software. We're rethinking medical billing from the ground up, building software backed by best-in-class data science (and, soon, a dash of machine learning) to automate much of this complexity so healthcare providers can get paid dramatically more easily and inexpensively.
Palliative Care Nurse Practitioner CompassusPalliative Care Nurse PractitionerDenver, CO$123,260–$139,917 / yearThe Palliative Care Nurse Practitioner provides palliative care for patients facing chronic, complex, and /or life-threatening conditions at various locations within the flow of patient care. Meaningful Work: Make an impact every day by honoring the quality of life of our patients, supporting them and their families with compassion, and creating moments that truly matter.
NewMedical Director - Spine And Brain Surgery - Remote UnitedHealth Group Inc.Medical Director - Spine And Brain Surgery - RemoteDenver, CORemote$248,500–$373,000 / yearTotal cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
NewUM Medical Director - Plastic Surgeon - Remote Anywhere In US UnitedHealth Group Inc.UM Medical Director - Plastic Surgeon - Remote Anywhere In USDenver, CORemote$248,500–$373,000 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
NewMedical Director - General Surgery - Remote From Anywhere UnitedHealth Group Inc.Medical Director - General Surgery - Remote From AnywhereDenver, CORemote$248,500–$373,000 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadDenver, CO$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Denver, CORemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
DRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadDenver, CO$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Field Reimbursement Manager (Seattle, Denver or Salt Lake City) Recordati SpAField Reimbursement Manager (Seattle, Denver or Salt Lake City)Denver, CORemoteServe as subject matter experts on issues of coverage, access and reimbursement by providing compliant, limited support to US health care providers (HCPs) and their office staff in navigating the reimbursement landscape for products of Recordati Rare Diseases Inc. (RRD) after the HCP made an independent decision to prescribeCollaborate with HCP staff and Specialty Pharmacy to follow up with accounts that have outstanding prior authorization or appeals submissions. The FRM is responsible for providing access and reimbursement education to healthcare providers (HCPs)and office personnel, including information regarding medical policies, prior authorization requirements, coding and billing, product access via buybill or specialty pharmacy with the goal of minimizing barriers to therapy.
Pre-Authorization Specialist University of ColoradoPre-Authorization SpecialistDenver, CO$51,360–$61,632 / yearIf you work, visit, or volunteer in healthcare facilities or clinics operated by our affiliated hospital or clinical partners or by CU Anschutz, you will be required to comply with the vaccination and medical surveillance policies of the facilities or clinics where you work, visit, or volunteer, respectively. Job Summary: The Orthotics Pre-Authorization Specialist is responsible for managing all aspects of Durable Medical Equipment (DME) precertification and preauthorization within the Department of Orthopedics.
Vigilance Writer LancesoftVigilance WriterDenver, CO$40Overview : The Global Product Monitoring Vigilance Report Writer develops, establishes, and maintains quality assurance methodologies, systems, and medical device industry best practices which meet customer, regulatory, and client requirements;serves as a post-market vigilance (reportable event) and surveillance subject matter expert and representative to improve awareness, visibility, and communication on quality/compliance initiatives to support departmental, divisional, and corporate quality goals and priorities;works on problems of diverse scope where analysis of data requires evaluation of identifiable factors;demonstrates good judgment in selecting methods and techniques for obtaining solutions;and networks with senior internal and/or external personnel in own area of expertise. Working knowledge/experience with global, multi-country vigilance reporting requirements for medical devices and demonstrated knowledge of country-specific differences and requirements.
NewEpic Revenue Cycle Senior Consultant Deloitte Touche Tohmatsu LtdEpic Revenue Cycle Senior ConsultantDenver, CO$116,200–$229,100 / yearPartner with Patient Access, revenue cycle operations, Health Information Management (HIM)/coding, and Patient Financial Services (PFS) leadership to translate requirements into Epic design, manage decision logs and change control, and document build specifications and test scripts. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.