Managed Care Payment Integrity Liaison MedStar HealthManaged Care Payment Integrity LiaisonColumbia, MD$65,062–$117,291 / yearExperience 5-7 years of experience in both managed care operations and/or tertiary hospital revenue cycle required Deep understanding of managed care reimbursement models (DRG, APC, per diem, etc.) required Strong working knowledge of denials, underpayments, and appeals workflows, as well as billing compliance and payer policies required Experience with all forms of Managed Care plans and commercial payer negotiations preferred Familiarity with payer portals and contract modeling tools preferred Familiarity with Marylands Health Services Cost Review Commission preferred Familiarity with EPIC preferred. General Summary of Position The Managed Care Payment Integrity Associate will bridge the gap between managed care and revenue cycle ensuring accurate reimbursement and minimizing payment delays.
NewSenior Patient Access Operations Coordinator Children's National HospitalSenior Patient Access Operations CoordinatorWashington, DC$57,969.60–$96,616 / yearPlease note that it is the policy of Children's National Hospital to ensure a "drug-free" work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Monitor and supervise quality control of staff in registration process; well versed in all Patient Access functions; maintain and monitor billing system and review monthly reports; required to work at least 2 shifts a month on a different site or different shift.
Medical Billing & Collections Specialist NuVasive Clinical ServicesMedical Billing & Collections SpecialistColumbia, MarylandNuVasive Clinical Services, a subsidiary of Globus Medical Inc., is a leading provider of intraoperative neuromonitoring (IOM) services to surgeons and healthcare facilities, through the acquisitions of Impulse Monitoring, Biotronic NeuroNetwork, Safe Passage, and others. As a Medical Billing and Collections Specialist with NuVasive Clinical Services, you will provide administrative support in the billing and collections function of the medical revenue cycle process.
Patient Access Associate II MedStar Health Research InstitutePatient Access Associate IIBaltimore, MD$18.70–$32.72 / hourConfirms coverage using online electronic verification systems; selects appropriate insurance codes and may obtain authorizations by utilizing online electronic verification system or other resources such as HDX EVS or Blueline; follow up on insurance authorizations and referrals if needed. This includes greeting patients providing information answering phones registering outpatients and/or inpatients coding lab accounts and entering orders as required.
Managed Care Payment Integrity Liaison MedStar Health Research InstituteManaged Care Payment Integrity LiaisonColumbia, MD$65,062–$117,291 / yearExperience 5-7 years of experience in both managed care operations and/or tertiary hospital revenue cycle required Deep understanding of managed care reimbursement models (DRG, APC, per diem, etc.) required Strong working knowledge of denials, underpayments, and appeals workflows, as well as billing compliance and payer policies required Experience with all forms of Managed Care plans and commercial payer negotiations preferred Familiarity with payer portals and contract modeling tools preferred Familiarity with Marylands Health Services Cost Review Commission preferred Familiarity with EPIC preferred. General Summary of Position The Managed Care Payment Integrity Associate will bridge the gap between managed care and revenue cycle ensuring accurate reimbursement and minimizing payment delays.
Patient Access Associate II (Part-time Night Shift) MedStar Health Research InstitutePatient Access Associate II (Part-time Night Shift)Baltimore, MD$18.70–$32.72 / hourConfirms coverage using online electronic verification systems; selects appropriate insurance codes and may obtain authorizations by utilizing online electronic verification system or other resources such as HDX EVS or Blueline; follow up on insurance authorizations and referrals if needed. This includes greeting patients providing information answering phones registering outpatients and/or inpatients coding lab accounts and entering orders as required.
Pre-Certification Coordinator II - Pediatric Endocrinology Washington University in St LouisPre-Certification Coordinator II - Pediatric EndocrinologyWashingtonCommunication, Detail-Oriented, Epic EHR, Fast-Paced Environments, Health Insurance Portability & Accountability Act (HIPAA), Insurance Claim Processing Software, Insurance Precertification, Insurance Terminology, Interpersonal Communication, Medical Coding Software, Multitasking, Organizational Savvy, Prioritization Grade . Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and non-surgical procedures, outpatient testing, and medications; notifies financial counselor for pre-payment of un-coded services.
Medical Practice Representative III-Medicine (Reisterstown) University of Maryland Faculty Physicians IncMedical Practice Representative III-Medicine (Reisterstown)Reisterstown, MDExhibits advanced level of skill in managing provider schedules and scheduling appointments accurately and effectively, including communicating patient responsibilities (obtaining a referral, bringing a co-pay, presenting identification and an insurance card at check in) and other events as part of the practice pre-visit activities. Exact salary will ultimately depend on multiple factors, which may include the successful candidates geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.
Medical Practice Representative III- Dermatology University of Maryland Faculty Physicians IncMedical Practice Representative III- DermatologyBaltimore, MDHigh school diploma or general education degree (GED) Three to five years medical office experience Current knowledge of payer requirements for referrals and preauthorization Experience in front and back office operations Knowledge of billing and coding for medical services Strong customer service skills PC proficiency. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographical location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/ training and other qualifications.
Medical Practice Representative III - Dept of Medicine Reisterstown University of Maryland Faculty Physicians IncMedical Practice Representative III - Dept of Medicine ReisterstownReisterstown, MDExhibits advanced level of skill in managing provider schedules and scheduling appointments accurately and effectively, including communicating patient responsibilities (obtaining a referral, bringing a co-pay, presenting identification and an insurance card at check in) and other events as part of the practice pre-visit activities. Exact salary will ultimately depend on multiple factors, which may include the successful candidates geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.
Medical Practice Representative III- Orthopaedics University of Maryland Faculty Physicians IncMedical Practice Representative III- OrthopaedicsBaltimore, MDExact salary will ultimately depend on multiple factors, which may include the successful candidate's geographical location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/ training and other qualifications. May oversee and troubleshoot scheduling and/or patient service issues; serves as lead worker and trainer for junior level staff; and other duties as assigned.
NewMedical Practice Representative III - OB/GYN University of Maryland Faculty Physicians IncMedical Practice Representative III - OB/GYNBaltimore, MDExhibits advanced level of skill in managing provider schedules and scheduling appointments accurately and effectively, including communicating patient responsibilities (obtaining a referral, bringing a co-pay, presenting identification and an insurance card at check in) and other events as part of the practice pre-visit activities. Exact salary will ultimately depend on multiple factors, which may include the successful candidates geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.
Physician Advisor Director Greater Baltimore Medical CenterPhysician Advisor DirectorTowson, MD$148,140.24–$266,652.44 / yearPrincipal Duties and Responsibilities: Serves as physician expert and provides support to care team and Case Management, UR and Social Work staff regarding utilization decisions including screening for appropriateness of hospitalization, Level of Care (LOC), patient billing status management, Length of Stay LOS) management, continued stay decisions, clinical review of patients, utilization review activities, resource utilization/management, denial management issues, transitions of care/discharge planning (TOC/DP) advice, and quality of care issues. Under the co-direction of the Executive Director of Reimbursement, Chief Medical Information Officer, and Associate Chief Medical Officer, the Physician Advisor Director provides leadership to a team of associate Physician Advisors that supports case management, social work, coding team, utilization review, population health, and other clinical members to provide cost efficient, high quality inpatient and observation care at GBMC Hospital.
Field Reimbursement Manager Immunology Gastroenterology - Rockville MD AbbVie IncField Reimbursement Manager Immunology Gastroenterology - Rockville MDRockville, MDThe amount and availability of any bonus, commission,incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole and absolute discretion unless anduntil paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law. Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of thisposting based on the job grade for this position.
Medical Billing Specialist Erickson Senior LivingMedical Billing SpecialistBaltimore, MD$23–$25 / hourWhat you will need: Minimum of 2 years of healthcare accounts receivable third-party billing experience, including billing, collections, cash posting, or other revenue cycle-related functions. As an Medical Billing Specialist, your drive for accuracy directly supports our ability to deliver high quality care to residents and maintain strong relationships with payers and families.
HIM Clinical Documentation Specialist University of Maryland Baltimore Washington Medical CenterHIM Clinical Documentation SpecialistGlen Burnie, MD$38.67–$58.05 / hourBachelors degree in Health Information Management, Nursing, or related field • RHIA, RHIT, CCS, or CDIP certification • 3-5 years of experience in clinical documentation improvement or related field • In-depth knowledge of medical terminology and coding systems (e.g., ICD-10, CPT) • Proficiency in electronic health record (EHR) systems • Strong understanding of healthcare compliance and regulations, including HIPAA • Excellent written and verbal communication skills • Exceptional attention to detail and accuracy • Analytical mindset with the ability to identify trends and patterns in clinical documentation • Knowledge of quality metrics and performance improvement methodologies • Familiarity with clinical workflows and healthcare operations • Strong organizational skills and ability to manage multiple priorities efficiently • Demonstrated ability to work collaboratively with healthcare providers and multidisciplinary teams • Commitment to ongoing professional development and staying current with industry trends. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation.
NewSenior Product Manager (PM/RCM) - Full Time - Remote Experity IncSenior Product Manager (PM/RCM) - Full Time - RemoteMDRemote$107,750–$151,400 / yearResponsibilities: Own day-to-day execution of the Revenue Cycle Management product roadmap, ensuring on-time delivery of capabilities across charge capture, coding, claim creation and submission, payer processing, payment posting, denial management, accounts receivable, patient balances, reporting, and related billing workflows. Deep knowledge of healthcare revenue cycle management, including charge capture, coding, claim submission, clearinghouses, payer adjudication, remittance processing, denial management, accounts receivable, and payment posting.
NewSupervisory Medical Records Administration Specialist U.S. Department of DefenseSupervisory Medical Records Administration SpecialistWashington, DC$78,788–$98,530 / yearFOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. Specialized Experience: One year of specialized experience which includes managing outpatient & inpatient medical records programs, leading other medical records technicians, including assigning and distributing workload, assisting with medical records audits, and providing education and training on medical record documentation and coding guidelines.
Inpatient Coder Omm IT SolutionsInpatient CoderBaltimore, MarylandRemoteMinimum of 3 years ICS-10-CM/ICD-10-PCS coding and abstracting experience with a Level 1 trauma and rehab hospital or 4 years of experience with coding inpatient hospital medical records required . The Inpatient Coder is responsible for reviewing inpatient medical records and assigning accurate ICD-10-CM and ICD-10-PCS codes in accordance with official coding guidelines, regulatory requirements, and Clint policies.
Remote IP Quality Reviewer Guidehouse IncRemote IP Quality ReviewerMcLean, VARemote$65,000–$108,000 / yearWhat You Will Do: The Coding Quality Reviewer shall report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as defined in quality review policies and facility guidelines utilizing ICD-10 CM/PCS and CPT coding classification systems. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.