Manager, Coding Compliance - Pediatrics Central Administration Washington University in St LouisManager, Coding Compliance - Pediatrics Central AdministrationSt. Louis, MO$68,100–$105,500 / yearThis leader is responsible for overseeing a team reviewing complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Skills: Accounting, Code Compliance, Coding Compliance, Compliance Management, Healthcare Auditing, Health Care Regulation, Health Insurance Portability & Accountability Act (HIPAA), ICD Coding, Medical Billing and Coding, Organizing, Supervisory Management, Trend Analysis, Trend Reporting.
Coding Quality Audit Inpatient Coordinator BJC HealthCareCoding Quality Audit Inpatient CoordinatorMORemoteQuality audits are inclusive of assessing compliance with federal and state regulatory coding guidelines, focusing on appropriate assignment of all diagnoses, procedures and DRG's to ensure accurate coding for reimbursement and clinical services (Quality Measures, Severity of Illness, Risk of Mortality). In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
Coding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorMO$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
NewCoding Business Analyst II - Content Updates Centene Corporation GroupCoding Business Analyst II - Content UpdatesMO$56,200–$101,000 / yearMonitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.
NewCoding Business Analyst II - Repository Updates Centene Corporation GroupCoding Business Analyst II - Repository UpdatesMO$56,200–$101,000 / yearMonitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.
NewCoding Business Analyst II - Policy Review Centene Corporation GroupCoding Business Analyst II - Policy ReviewMO$56,200–$101,000 / yearMonitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.
Manager Coding Compliance (Hybrid) - Surgery Washington University in St LouisManager Coding Compliance (Hybrid) - SurgerySt. Louis, MO$68,100–$105,500 / yearThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321St. Louis, MOIn 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.
Sr. Compliance Coordinator (Billing & Coding) BJC HealthCareSr. Compliance Coordinator (Billing & Coding)MORemoteConducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding. Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation.
Managed Services - Revenue Cycle Coding - Senior Manager PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior ManagerMO$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.
Project Manager I, II, or III - Code Enforcement (Electrical Plan Reviewer) St. Louis County (MO)Project Manager I, II, or III - Code Enforcement (Electrical Plan Reviewer)Clayton, MOReview and analyze plans and calculations for compliance with NFPA 70 National Electrical Code Identify discrepancies and provides technical assistant to arrive at acceptable design solutions Determines appropriate action for revisions if necessary Provides assistance and information to the general public and various agencies Performs other duties as assigned. Graduation from an accredited college or university with a Bachelors Degree in Electrical Engineering Preference may be given to applicants with related experience, knowledge of construction codes and a professional license or any equivalent combination of training and experience.
R&D Engineer - Codes, Standards & Product Testing MiTek Industries IncR&D Engineer - Codes, Standards & Product TestingMOWith nearly 5,600 team members worldwide, MiTek collaborates across the building industry to enable and accelerate transformational breakthroughs in design and construction to transform the way the industry designs, makes, and builds. Today, MiTek delivers software, services, engineered products, and automated solutions that enable the building industry to improve efficiencies by optimizing the balance between off-site and on-site.
Rapid Response/Code Team Clinical Nurse - Nights BJC HealthCareRapid Response/Code Team Clinical Nurse - NightsILMemorial, offering medical and surgical services plus critical care, is an accredited Chest Pain Center with PCI by the Society of Cardiovascular Patient Care and is designated as an Acute Stroke Ready Hospital by the Illinois Department of Public Health. Memorial Hospital Shiloh, a 94-bed, all-private suite hospital was recognized with Magnet status in 2018 and provides emergency care, labor & delivery, nursery, medical and surgical services plus critical care.
Rapid Response/Code Team Clinical Nurse BJC HealthCareRapid Response/Code Team Clinical NurseILMemorial, offering medical and surgical services plus critical care, is an accredited Chest Pain Center with PCI by the Society of Cardiovascular Patient Care and is designated as an Acute Stroke Ready Hospital by the Illinois Department of Public Health. Memorial Hospital Shiloh, a 94-bed, all-private suite hospital was recognized with Magnet status in 2018 and provides emergency care, labor & delivery, nursery, medical and surgical services plus critical care.
Rapid Response/Code Team Clinical Nurse - Part Time BJC HealthCareRapid Response/Code Team Clinical Nurse - Part TimeILMemorial, offering medical and surgical services plus critical care, is an accredited Chest Pain Center with PCI by the Society of Cardiovascular Patient Care and is designated as an Acute Stroke Ready Hospital by the Illinois Department of Public Health. Memorial Hospital Shiloh, a 94-bed, all-private suite hospital was recognized with Magnet status in 2018 and provides emergency care, labor & delivery, nursery, medical and surgical services plus critical care.
Certified Coder (Hybrid) - Physicians Billing Service Washington University in St LouisCertified Coder (Hybrid) - Physicians Billing ServiceSt. Louis, MO$25.30–$37.94 / hourCertified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA). Required Qualifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee's department).
Manager, Financial Reporting Physician Practice Clients Wipfli LLPManager, Financial Reporting Physician Practice ClientsClayton, MORemoteWipfli LLP is a licensed independent CPA firm that provides attest services to its clients, and Wipfli Advisory LLC provides tax and business consulting services to its clients. Proficiency in accounting software, specifically, Intaact, QuickBooks Online, NetSuite, Bill.com, Microsoft Office Suit and a demonstrated ability to embrace new technologies.
Certified Medical Coder Affinia HealthcareCertified Medical CoderSt. Louis, MOFull timeIdentifies clinician services provided but not adequately documented in the medical advise supervisor and clinicians of deficiencies to support charge capture of all billing services. Position Summary: Verifies and ensures the accuracy, completeness, specificity and appropriateness of diagnosis codes on services rendered.
Patient Billing/Services Representative II (Shiloh, IL) - Medical Oncology Washington University in St LouisPatient Billing/Services Representative II (Shiloh, IL) - Medical OncologyIL$17.89–$26.35 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Certified Coder (Remote) - Pediatrics Central Administration Washington University in St LouisCertified Coder (Remote) - Pediatrics Central AdministrationMORemote$25.30–$37.94 / hourCertified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA). Required Qualifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee's department).
Manager, Financial Reporting - Physician Practice Clients Wipfli Advisory LLCManager, Financial Reporting - Physician Practice ClientsClayton, MissouriRemoteFull timeWipfli LLP is a licensed independent CPA firm that provides attest services to its clients, and Wipfli Advisory LLC provides tax and business consulting services to its clients. Proficiency in accounting software, specifically, Intaact, QuickBooks Online, NetSuite, Bill.com, Microsoft Office Suit and a demonstrated ability to embrace new technologies.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorMO$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and 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.
Insurance Billing/Collection Assistant II (Hybrid) - Physicians Billing Service Washington University in St LouisInsurance Billing/Collection Assistant II (Hybrid) - Physicians Billing ServiceSt. Louis, MO$17.34–$25.40 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Telephone Communications. Position Summary Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records and claims, contacting insurance companies as well as other related duties to expedite payments from various payers for physician services.
Insurance Billing/Collections Assistant II (Hybrid) - Physicians Billing Service Washington University in St LouisInsurance Billing/Collections Assistant II (Hybrid) - Physicians Billing ServiceSt. Louis, MO$17.34–$25.40 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Telephone Communications. Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies as well as other related duties to expedite payments from various payers for physician services.
Clinical Application Support Specialist Jardogs.aiClinical Application Support SpecialistHillsboro, IllinoisExceptional verbal and written communication skills, with a proven ability to explain complex information clearly and concisely to diverse audiences (including busy healthcare providers). You will be the primary point support contact for users with concerns with medical billing, focusing on explaining the logic behind our AI-driven medical coding suggestions and ensuring a smooth user experience.
NewInpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerSt. Louis, MO$79,000–$99,750 / yearWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Insurance Billing/Collection Assistant III (Remote) - Department of Medicine - Business Office Washington University in St LouisInsurance Billing/Collection Assistant III (Remote) - Department of Medicine - Business OfficeMORemote$20.57–$30.84 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Team Leadership, Telephone Communications. Performs advanced follow-up on insurance billing and collection activities, makes collection calls, verifies the accuracy and completeness of insurance records, and claims, contacts insurance companies and/or collection agencies as well as other related duties to expedite payments from various payers for physician services.
Insurance Billing/Collection Assistant II (Remote) - Department of Medicine - Business Office Washington University in St LouisInsurance Billing/Collection Assistant II (Remote) - Department of Medicine - Business OfficeMORemote$17.34–$25.40 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Telephone Communications. Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies as well as other related duties to expedite payments from various payers for physician services.
Insurance Billing/Collection Assistant II (Remote) - Neurology Washington University in St LouisInsurance Billing/Collection Assistant II (Remote) - NeurologyMORemote$17.34–$25.40 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Telephone Communications. Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies as well as other related duties to expedite payments from various payers for physician services.
Insurance Billing/Collection Assistant II (Remote) - Pre-Certification Services Washington University in St LouisInsurance Billing/Collection Assistant II (Remote) - Pre-Certification ServicesMORemote$17.34–$25.40 / hourSkills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Telephone Communications. Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records, and claims, contacting insurance companies as well as other related duties to expedite payments from various payers for physician services.
NewField Reimbursement Manager - Immunology Dermatology - Jonesboro, AR Johnson & JohnsonField Reimbursement Manager - Immunology Dermatology - Jonesboro, ARSt. Louis, MOJohnson & Johnson Innovative Medicine's Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Jonesboro, AR; North Little Rock; Saint Louis, MO; Ballwin, MO; and Cape Girardeau, MO territories. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)MO$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.
Patient Billing/Services Representative II - Neurology Washington University in St LouisPatient Billing/Services Representative II - NeurologyMO$17.34–$25.40 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Patient Billing/Services Representative II - Otolaryngology/Pediatric ENT Washington University in St LouisPatient Billing/Services Representative II - Otolaryngology/Pediatric ENTMO$17.34–$25.40 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
NewPatient Billing/Services Representative II - Medicine Multispecialty Center - Sunset Hills Washington University in St LouisPatient Billing/Services Representative II - Medicine Multispecialty Center - Sunset HillsSt. Louis, MO$17.89–$26.35 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Patient Billing/Service Representative II - Obstetrics and Gynecology Washington University in St LouisPatient Billing/Service Representative II - Obstetrics and GynecologyMO$17.34–$25.40 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Patient Billing/Services Representative II - Department of Medicine Washington University in St LouisPatient Billing/Services Representative II - Department of MedicineSt. Louis, MO$17.34–$25.40 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Communication, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Professional Etiquette, Scheduling, Team Collaboration. The Patient Billing/Services Representative (PSR) is a patient-facing role that obtains insurance information and referral forms as well as counsels patients on financial assistance when seen in department for services.
Accounts Receivable Specialist Oral Surgery PartnersAccounts Receivable SpecialistSaint Louis, MissouriRemoteThe specialist communicates regularly with internal teams and external customers to address outstanding balances, verify account information, and support efficient cash flow operations. The Accounts Receivable Specialist is responsible for managing the full cycle of accounts receivable processes to ensure accurate and timely collection of payments.
Patient Billing/Services Representative I - WUCA Nash Pediatrics Washington University in St LouisPatient Billing/Services Representative I - WUCA Nash PediatricsSt. Louis, MO$16.23–$21.88 / hourSkills: Customer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Prioritization, Professional Etiquette, Scheduling, Team Collaboration. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Medical Assistant Apprentice Washington University in St LouisMedical Assistant ApprenticeSt. Louis, MO$15.25–$21.33 / hourPerforms select administrative and certain clinical duties under the direction of a licensed healthcare professional; administrative duties may include scheduling appointments, maintaining medical records, patient billing, and coding medical information for insurance purposes; clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and providing medical attention as directed by physician or nursing staff. We typically hire Medical Assistants to work the clinic back office where they room patients, document in electronic medical record, perform clinical skills associated with the specialty, perform blood draws, phone triage, schedule tests or order lab work, provide patients with follow-up instructions.
Lead Pre-Certification Coordinator (Remote) - Department of Medicine Washington University in St LouisLead Pre-Certification Coordinator (Remote) - Department of MedicineMORemote$22.78–$34.21 / hourPosition performs various professional services to ensure medical, drug, and diagnostic testing authorizations are obtained in an efficient manner and that reimbursement is maximized through required interaction with third-party payers; leads the pre-certification team to perform and manage the daily workload; responds and resolves questions from the pre-certification staff in an educational and timely manner; is is a liaison between department facilities and physician offices. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
NewPatient Billing/Services Representative I - WUCA Nash Pediatrics WUCAPatient Billing/Services Representative I - WUCA Nash PediatricsSaint Louis, MissouriCustomer Service, Effective Written Communication, Epic EHR, Financial Information, Insurance, Interpersonal Relationships, Medical Billing and Coding, Medical Insurance Claims, Office Organization, Organizing, Prioritization, Professional Etiquette, Scheduling, Team Collaboration Grade . The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorMO$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and 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.
Risk Adjustment Compliance Project Manager Medica Health Plans IncRisk Adjustment Compliance Project ManagerMO$70,200–$105,315 / yearThe Risk Adjustment Compliance Project Manager is responsible for leading compliance focused initiatives that ensure the accuracy, integrity, and regulatory adherence of Medica's Risk Adjustment programs across Medicare Advantage, Medicaid, and ACA lines of business. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the positions scope and responsibility, internal pay equity and external market salary data.
PATIENT SERVICES REPRESENTATIVE MEDICAL Anchorage Neighborhood Health Center IncPATIENT SERVICES REPRESENTATIVE MEDICALMODecision Making/Judgment: Approaches problems and decisions methodically and objectively; involves others as needed; uses sound judgment in making decisions and understanding the impact to themselves, customers, their team, and the organization; conducts the appropriate analysis to identify the symptoms and root cause of issues; makes timely decisions. Accountability: Takes ownership for delivering on commitments; owns mistakes and uses them as opportunities for learning and development; openly discusses his/her actions and their consequences both good and bad; has an ability to identify strengths and developmental opportunities and leverages insight to make adjustments to improve their effectiveness; courage to have difficult conversations.
Clinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-MO, MORemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Clinical Nurse Reviewer Zelis Healthcare, Inc.Clinical Nurse ReviewerSt. Louis, MO$59,000–$75,050 / yearThe Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Nurse Assessment Coordinator - RN National HealthCare CorpNurse Assessment Coordinator - RNMOIf you are interested in working as a Registered Nurse for a leader in senior care, share NHCs values of honesty and integrity, and have a heart for the geriatric patient, please apply today and find out more about us at nhccare.com/locations/st-charles/. Works with interdisciplinary team to assure timely completion of Care Area Triggers and Patient Care Plans.
Patient Care Associate I - Ophthalmology Washington University in St LouisPatient Care Associate I - OphthalmologySt. Louis, MO$16.23–$21.88 / hourPerforms select administrative and certain clinical duties under the direction of a licensed healthcare professional; administrative duties may include scheduling appointments, maintaining medical records, patient billing, and coding medical information for insurance purposes; clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and providing medical attention as directed by physician or nursing staff. Skills: File Maintenance, Healthcare Environments, Interpersonal Communication, Medical Terminology, Microsoft Office, Office Administration, Office Procedures, Oral Communications, Patient Communications, Stenography.
Patient Care Associate (Trainee) - Orthopedic Surgery Washington University in St LouisPatient Care Associate (Trainee) - Orthopedic SurgerySt. Louis, MO$15.25–$20.56 / hourPerforms select administrative and certain clinical duties under the direction of a licensed healthcare professional; administrative duties may include scheduling appointments, maintaining medical records, patient billing, and coding medical information for insurance purposes; clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and providing medical attention as directed by physician or nursing staff. Prepares treatment rooms for patient examinations, keeping the rooms neat and clean; cleans and sterilizes equipment, instruments, rooms, etc. and appropriately disposes of contaminated supplies.