Single Path Coding Spec II (Same Day Surgery) West Virginia University MedicineSingle Path Coding Spec II (Same Day Surgery)Monongalia County, WVApplies clinical knowledge of disease processes, physiology, pharmacology and surgical techniques by reviewing and interpreting all clinical documentation. This position is responsible for the accurate assignment of procedures and diagnostic codes to patient records using different forms of coding classification systems.
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.
Hospital Coding Spec II Cancer Center West Virginia University MedicineHospital Coding Spec II Cancer CenterWetzel 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.
Hospital Coding Spec II PBB West Virginia University MedicineHospital Coding Spec II PBBMarion 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.
PB Enterprise Coding Supervisor West Virginia University MedicinePB Enterprise Coding SupervisorHarrison County, WVExtensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Hospital Supervising 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 Supervisors. Will assist with the implementation and facilitation of ongoing medical coding/abstracting, auditing, monitoring, and physician/coder educational activities for existing and new clinics, locations and hospitals.
Benefits Configuration Analyst West Virginia University MedicineBenefits Configuration AnalystMonongalia County, WVPerform research on various coding methods and facilitate all plans to resolve all discrepancies and coordinate with all clinical and non-clinical groups to manage documents according to required guidelines. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Associate degree in health information, healthcare, or related field AND One (1) year of experience in health insurance, medical coding, claims processing or related field.
Clinical Denial Specialist - Diagnosis Related Grouping (DRG) West Virginia University MedicineClinical Denial Specialist - Diagnosis Related Grouping (DRG)Monongalia County, WVMINIMUM 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'. Current Licensed Practical Nurse license issued by the state in which services will be provided or current multi-state Licensed Practical Nurse license through the enhanced Nurse Licensure Compact (eNLC).
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.
Clinical Optimization Specialist - Signature Service Line West Virginia University MedicineClinical Optimization Specialist - Signature Service LineMorgantown, WVThis role will report to the Heart and Vascular Assistant Vice President of Finance and partner directly with Revenue Cycle teams, as well as collaborate with HVI physicians, APPs, and IT analysts to optimize documentation workflows and clinical templates within Epic's EMR. MINIMIM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 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).
NewClinical Revenue Cycle Educator West Virginia University MedicineClinical Revenue Cycle EducatorMonongalia County, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 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). The Clinical Revenue Cycle Educator provides leadership, coordination, and delivery of training programs across clinical revenue cycle functions, including CDI, coding, denials and utilization review.
Physical Therapist UnitedHealth Group IncPhysical TherapistBuckhannon, WVClinical ›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.
Field Reimbursement Manager - Kidney (Capitol - WV, VA, MD) Vertex PharmaceuticalsField Reimbursement Manager - Kidney (Capitol - WV, VA, MD)West VirginiaCompliantly 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.
Cancer Registrar - Remote West Virginia University MedicineCancer Registrar - RemoteBridgeport, WVRemoteResponsible for accurately coding complete, and concurrent abstraction of oncology patient data to be utilized by administration, clinical trials, research, state and national reporting, maintaining certifications, accreditations, and quality improvement within the Oncology Services. Abstracting: Accurately completes an electronic abstract on each eligible primary including all medical, social, family, work, and environmental histories, cancer identification, staging, all treatment, and follow up information using regulations from all available resources.
Rehab Clinical Coordinator West Virginia University MedicineRehab Clinical CoordinatorWVIn addition to supporting pre-admission screening and real-time functional outcome data capture, the role acts as a key resource for staff, patients, and families, while driving improvements in authorization accuracy, denial prevention, and overall operational performance through data analysis and cross-functional collaboration. Ability to organize and prioritize time and tasks to achieve a well-coordinated work effort and to effectively meet work schedules including an ability to integrate multiple factors which may have an impact on patient care.
Pre-Authorization Scheduling Coordinator Bariatric Clinic West Virginia University MedicinePre-Authorization Scheduling Coordinator Bariatric ClinicWVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High school diploma or equivalent required AND One year of recent experience in a physician/hospital scheduling and registration or business office environment OR; Completed Medical Assistant (MA) degree OR; Associate Degree. Responsible for accurate and timely interviewing of patients and/or relative in a courteous manner to obtain registration data based upon comprehensive data elements to complete the registration process.
Informatics Consultant CVS Health CorpInformatics ConsultantWV$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 LeadMorgantown, WVFull 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.
Insurance Claims Specialist PB West Virginia University MedicineInsurance Claims Specialist PBMonongalia 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.
Insurance Claims Specialist HB West Virginia University MedicineInsurance Claims Specialist HBMonongalia 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.