UNKNOWN

ADAPTED_NOW

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

YEAR

Become a part of our caring community and help us put health first The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 will be responsible for arranging educational sessions with assigned providers aimed at quality of care and documentation improvements. + Identify educational needs based on reports + Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. + Provider onsite education, based on business needs + Collaboration with other market provider facing role + Utilize data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. + Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions. + Participate in cross-functional teams to improve documentation, data integrity, and workflow processes Use your skills to make an impact Required Qualifications + AHIMA or AAPC CPC (Certified Professional Coder) Certification + 3 or more years of medical coding education and/or auditing in a healthcare setting experience + Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets + Experience with speaking with leadership, webinars public speaking and/or presentation skills with healthcare providers + Risk Adjustment knowledge + Familiar with coding guidelines + Live in South Carolina, North Carolina or Georgia Preferred Qualifications + Bachelor's Degree + CRC -Certified Risk Adjustment Coder + Experience interacting with healthcare providers + Strong technical knowledge of all Microsoft Office applications + Strong attention to detail and exceptional follow up skills + Valid Driver's license and reliable transportation + Medicare Risk Adjustment knowledge Additional Information Work at home - with ability to travel (up to 5%) to surrounding provider offices As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. #LI-BB1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Humana

Coding Educator

FEED

In this role, you will audit patient encounter forms, patient accounts, electronic billing reports, and all Health Care Financing Administration (HCFA) forms to ensure accuracy in coding and charges. Provide accounting staff and others with data needed for general ledger balancing, cost analysis, government agency reporting, and corrections processed.

HOUR

JOB TITLE: Billing Specialist DEPARTMENT: Billing FLSA: Full-Time; Hourly/Non-Exempt DURATION: OPEN UNTIL FILLED This is an onsite position with the possibility of hybrid/remote opportunity in the future. POSITION PURPOSE: The Billing Specialist will prepare and perform the billing of all third-party claims to appropriate payers accurately within reimbursement guidelines. In this role, you will audit patient encounter forms, patient accounts, electronic billing reports, and all Health Care Financing Administration (HCFA) forms to ensure accuracy in coding and charges. ESSENTIAL DUTIES AND RESPONSIBILITIES:<ul><li>Track and reconcile all denied claims on a daily basis with documentation on the original denial form.</li><li>Assist staff with patient information, demographics, and historical data reports.</li><li>Provide accounting staff and others with data needed for general ledger balancing, cost analysis, government agency reporting, and corrections processed.</li><li>Update patient account with missing information needed to bill third parties. </li><li>Correspond with reimbursement agencies to verify paper and electronic submissions have been received.</li><li>Research and correct denials/rejections in a timely manner.</li><li>Analyze aged reports and work accordingly to ensure maximum reimbursement on submitted claims.</li></ul> QUALIFICATIONS: Minimum of 2-3 years of Billing experience (required), preferably in a Federally Qualified Health Care (FQHC). Must be familiar with medical billing standard concepts, practices, terminology, and procedures. Experience with Medicare, Medicaid, and other third-party payors, handling appeals, denials, and reconsiderations. Previous EHR experience required, preferably EPIC. EPIC Experience preferred EDUCATION/CERTIFICATION: Certification in Billing and Coding (required) HIRING RANGE: $17 to $20/hour BENEFITS:·    Medical ·    Dental·    Vision ·    Parental Leave·    Tuition Reimbursement·    403b Retirement·    Paid Time Off·    10 Paid Holidays (including birthday) EQUAL OPPORTUNITY EMPLOYER OIC, Inc. is an equal-opportunity employer. OIC, Inc. offers equal opportunities to applicants and employees and makes all employment-related decisions based exclusively on job-related qualifications. Our policies and hiring practices ensure non-discrimination based on any protected characteristics. DIVERSITY STATEMENT OIC, Inc. is committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients is essential to fulfilling OIC, Inc.’s vision and goals. <a href="https://www.econdev.org/" rel="nofollow">https://www.econdev.org/</a> <a href="https://www.rockymountchamber.org/" rel="nofollow">https://www.rockymountchamber.org/</a> Due to the volume of applications received, please do not contact the OIC Human Resources Department to check the status of an application, as we will be unable to provide this information over the phone. All applicants will be reviewed and those deemed most qualified will be contacted for an interview. Thank you for your interest in employment with OIC, Inc. <img alt="" height="1" src="https://jbgr.la/t/v/H4sIAAAAAAAA_6tWyspP8kxRslIyNjcxMFbSUUrKTyxKAYsYAXklmbmpxSWJuQVKVnmlOTm1ehHmKUGFKeVlJWGOFWFRuZYWkWmGRUmhOW7GTqVVESU-eUnpaSH-FslZKYEA7CZaDlwAAAA=" width="1"/>

Opportunities Industrialization Centers

Billing Specialist

Accounting

Billing

Centers for Medicare and Medicaid Services (CMS)

Cost Analysis

Epic Systems

General Ledger Accounting

Government Reporting

Healthcare

Medicaid

Medical Billing

Medical Record System

Medical Treatment

Medicare

Patient Care

Reimbursement Guidelines

Time Management

Brightmove

FULL_TIME

Participates in billing and payer trainings, payer workgroups, and professional FQHC forums; represents the organization in meetings with payers, clinically integrated networks, and Accountable Care Organizations to remain current on regulatory requirements, reimbursement models, and best practices. Manages and maintains billing configurations within the electronic health record (EHR), clearinghouse, and related revenue cycle applications; collaborates with internal IT and vendor support teams to ensure accurate setup, maintenance, and functionality of payer mappings, claim rules, and fee schedules.

Company OverviewContentnea Health is a Community Health Center providing comprehensive medical, dental and behavioral health services for members of our communities in Greene, Pitt and Pamlico counties in eastern North Carolina.Job SummaryPerforms professional management and analytical functions to lead and coordinate all aspects of the revenue cycle, ensuring accurate billing, efficient collections, and maximized reimbursement. Responsibilities and Duties<ol><li>Oversees billing and collections operations to ensure timely, accurate claim processing, denial resolution, and compliance with payer requirements.</li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Establishes and communicates production standards and goals; directs internal staff and external vendors to meet performance targets and maintains timely claim submission and denial resolution.</li><li>Coordinates and manages clearinghouse and payer portal access, ensuring appropriate user rights and quarterly review of institutional and provider data for accuracy.</li><li>Conducts regular meetings with internal and external billing teams to address issues, monitor performance, and support effective revenue cycle communication.</li><li>Manages enrollment and credentialing staff to ensure maintenance of accurate provider data in payer systems to prevent billing disruptions.</li></ol></li></ol><ol start="2"><li>Supervises the patient financial counseling team, directing daily activities and assisting with processes to ensure appropriate communication of patient financial responsibilities, accurate application of assistance programs, and compliance with financial policies.</li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Supervises financial counselors to ensure timely communication of patient financial responsibilities, working collaboratively with billing staff, practice managers, and front desk staff to support patient understanding prior to scheduled appointments. </li><li>Ensures consistent and accurate application of the Sliding Fee Discount Program (SFDP), including quarterly audits and performance reporting for policy compliance.</li><li>Monitors and directs financial counseling staff in carrying out collection activities, including establishing and maintaining payment plans, following up on outstanding balances, and securing patient payments in alignment with organizational policy.</li><li>Directs financial counselors in assisting patients with enrollment in available assistance programs (e.g., ACA, Medicaid eligibility, Fee Waiver and Reduction Policy, or other external support programs) to promote patient access to care.</li></ol></li></ol><ol start="3"><li>Manages revenue cycle management (RCM) activities to ensure all financial transactions, claims, and collections are accurate, timely, and compliant with payer and regulatory requirements.</li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Maintains organized documentation for RCM functions, including remittance advices, payer correspondence, fee schedules, and related records.</li><li>Monitors claim submission, rejection, and denial trends to ensure timely filing and resolution in accordance with organizational benchmarks.</li><li>Ensures reconciliation of payments and adjustments in patient accounts, resolution of credit balances, and processing of refunds per policy.</li><li>Reviews small balance write-offs, ensures write-offs are completed in accordance with policy, and prepares and submits the quarterly Medicare credit balance report to the Chief Financial Officer for approval within required deadlines.</li><li>Collaborates with practice Managers and the Chief Operating Officer to maximize self-pay collections, resolve patient billing concerns, and ensure monthly processing of patient statements.</li><li>Develops, updates, and implements written departmental procedures, and works cross-functionally to improve verification and pre-authorization processes that support collection goals.</li></ol></li></ol><ol start="4"><li>Serves as a subject matter expert and operational lead for billing, coding, Federally Qualified Health Center (FQHC) standards, value-based payment arrangements and revenue cycle system configurations.  </li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Manages and maintains billing configurations within the electronic health record (EHR), clearinghouse, and related revenue cycle applications; collaborates with internal IT and vendor support teams to ensure accurate setup, maintenance, and functionality of payer mappings, claim rules, and fee schedules.</li><li>Participates in billing and payer trainings, payer workgroups, and professional FQHC forums; represents the organization in meetings with payers, clinically integrated networks, and Accountable Care Organizations to remain current on regulatory requirements, reimbursement models, and best practices.</li><li>Monitors coding accuracy and collaborates with quality improvement staff to strengthen documentation, optimize encounter-level coding, and maximize performance in value-based and incentive programs.</li><li>Communicates payer, program, SFDP, coding, and billing updates in writing to internal staff and external billing vendors, ensuring timely implementation of operational and configuration changes across systems.</li><li>Reviews revenue cycle performance summaries and key performance indicators (KPIs) and supports the implementation of recommended process improvements and revenue optimization strategies.</li></ol></li></ol><ol start="5"><li>Leads Revenue Cycle Data Analysis and Performance Optimization.</li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Performs detailed, ongoing analysis of revenue cycle performance data to identify trends, variances, root causes, and areas of poor performance across billing and collections activities by payer, service line, provider, or location.</li><li>Uses revenue cycle analytics to target underperforming payers, workflows, and processes and develops corrective strategies to improve claim outcomes, reduce denials, accelerate resolution, and strengthen collection performance.</li><li>Evaluates and modifies electronic health record (EHR) and revenue cycle system configurations, workflows, and claim edit rules as needed to correct billing and collections issues and enhance operational efficiency and accuracy.</li><li>Develops and presents comprehensive revenue cycle reports, dashboards, and data-driven recommendations to senior leadership, including the Chief Financial Officer and Chief Operating Officer, to support decision-making, strategic planning, and revenue optimization initiatives.</li></ol></li></ol><ol start="6"><li>Provides management to departmental staff.</li></ol><ol><li style="list-style-type:none"><ol style="list-style-type:lower-alpha"><li>Contributes to development of the budget; maintains and monitors the departmental budget.</li><li>Determines the most effective method for assigning responsibilities and duties to department employees.</li><li>Maintains job descriptions, procedures and other documentation related to the organization of the department.</li><li>Assigns duties and responsibilities, and ensures employees receive instruction/training needed to complete their job responsibilities.</li><li>Ensures that employees are aware of and adhere to all company policies and procedures, and conveys all senior management communications and directives.</li><li>Reviews departmental work for thoroughness and accuracy, and provides specific instructions on completion of tasks/responsibilities.</li><li>Prepares and conducts performance appraisals for immediate staff. </li><li>Conducts hiring, disciplinary, and termination procedures.</li></ol></li></ol><div><div><div class="msocomtxt"></div></div></div><div><div><div class="msocomtxt">Qualifications and Skills</div></div></div>Bachelor's Degree in Business Administration or Informatics.  Current knowledge of third-party payers, special programs, Sliding Fee Discount Program, and Chapter 9 and 16 of the Health Center Compliance Manual. Maintains current knowledge of FQHC payment methodologies and general billing rules through participation in continuing education. Possesses an extensive and detailed knowledge of medical terminology, procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing and of insurance policies and contracts for multiple insurance vendors. Possesses advanced knowledge and proficiency in revenue cycle data analysis, including interpretation of key performance indicators (KPIs), trend analysis, root cause identification, and development of data-driven recommendations to improve billing and collections performance. Able to evaluate, modify and optimize EHR and revenue cycle system configurations based on analytical findings and operational performance data. Exhibits expertise in developing and delivering detailed revenue cycle reports, dashboards, and performance analyses used to support leadership decision-making, strategic planning, and revenue optimization initiatives. Strong technical proficiency with revenue cycle reporting tools, data visualization platforms, and advanced Excel or business intelligence applications. Experience in an FQHC and with eClinicalWorks highly preferred.Powered by JazzHR

Contentnea Health

Revenue Cycle Manager

Analysis Skills

Auditing

Behavioral Health

Benchmarking

Best Practices

Budget Management

Business Administration

Business Intelligence Software

Calendar Management

Claims Processing

Communication Skills

Community Health

Credit Processing

Credit Reports

Credit and Collections

Cross-Functional

Data Analysis

Data Quality

Data Visualization Tools

Database Report Tools

Decision Support

Disciplinary Action

Documentation

Fee Schedule

Financial Analysis

Financial Compliance

Financial Management

Financial Planning

Financial Policies

Financial Transactions

Head of Finance

Healthcare Reimbursement

Incentive Programs

Informatics

Insurance

Leadership

Medical Coding

Medical Diagnosis

Medical Terminology

Network Integration

Operational Audit

Organizational Skills

Patient Education

Performance Analysis

Performance Management

Performance Metrics

Performance Reviews

Performance Tuning/Optimization

Problem Solving Skills

Procedure Implementation

Process Development

Process Improvement

Quality Management

Reconciliation

Regulatory Compliance

Regulatory Requirements

Reimbursement

Reporting Dashboards

Revenue Analysis

Revenue Management

Revenue Planning

Revenue/Sales Reporting

Root Cause Analysis

Strategic Planning

Systems Administration/Management

Technical Support

Third-Party Payer

Trend Analysis

Vendor/Supplier Evaluation

partner JazzHR

This role will provide one-on-one and group training to faculty physicians, advanced practitioners, and billing and coding staff as well as ensure the organization complies with federal and state regulations and laws, and other third-party payor billing guidelines. · Ensure that written front desk and coding policies and procedures are followed and updated to ensure adherence to HIPPA, Medicare, Medicaid, FQHC, HRSA, and state and federal guidelines and regulations.

JOB TITLE:  Billing DirectorDEPARTMENT: Integrated Health ServicesFLSA: ExemptDURATION: Open Until Filled Position Purpose The Billing Director will oversee the preparation and billing of all third-party claims and ensure the appropriate payers are timely and accurately within reimbursement guidelines. This role will provide one-on-one and group training to faculty physicians, advanced practitioners, and billing and coding staff as well as ensure the organization complies with federal and state regulations and laws, and other third-party payor billing guidelines. Promptly process all payments received and document all receivable data for general ledger reporting purposes. Assist the Accounting department during month-end close and train the accounting staff on how to use the billing system.  Essential Duties and Responsibilities ·         Identifies training needs and ensures proper training is developed, provided, and implemented for their staff.·         Promote the mission, vision, and values of the organization.·         Lead the billing team in the creation of best practices for billing documentation.·         Overseeing the billing and coding staff to ensure that billing and coding standards are being adhered to.·         Maintain updated written billing procedures and innovation of billing documentation.·         Manage the update and verify patient Billing Reports.·         Develop and monitor the systems to ensure the accuracy of billing data.·         Oversee administration and maintenance of electronic billing and remittance software.·         Ensure billing reports are reviewed, and appropriate corrective actions are taken if necessary.·         Ensure that written front desk and coding policies and procedures are followed and updated to ensure adherence to HIPPA, Medicare, Medicaid, FQHC, HRSA, and state and federal guidelines and regulations.·         Ensure that all claims, write-offs, and denials are recorded and processed in time for the month-end close.·         Provide the Accounting Manager with a monthly billing revenue, receivable accrual, and write-off report that ensures proper and accurate month-end close.·         Ensure that a system exists to a) track claims billed versus paid and b) follow up on, investigate, and resubmit denied claims.·         Evaluate and cross-train all billers. Ensure billers stay current on regulations, coding, and procedures governing billing from Medicaid, Medicare, private insurers, and state and federal agencies.·         Assist Accounting with collection reconciliation and invoicing to ensure money received represents what patients paid or should have paid. Ensure that the FMC LOG receipts and the EMR system balance.·         Provide Accounting with all third-party billing information.·         Work with Medical Assistants to ensure providers’ notes and procedure codes match and are in line with all payee requirements and company policy and procedures.·         Store and maintain all billing records for audit purposes.·         Assist clinic staff, grantors, vendors, and auditors upon request.·         Ensure that the sliding fee is administered in accordance with HRSA guidelines.·         Ensure that payments to all third parties are accurate and timely.·         Other duties as assigned by the CHOO. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. EDUCATION and/or EXPERIENCE:  Bachelor's degree in Business, Education, Finance, Accounting, Management, or Business Administration. 5+ years as Billing Manager and/or Billing Supervisor OTHER SKILLS AND ABILITIES: Must have good organizational skills and the ability to perform numerous tasks simultaneously in a fast-paced office environment. Good analytical and accounting skills, be detail oriented and have a sense of personal responsibility for your work performance.  HIRING RANGE: $85,000 - $110,000/annually  BENEFITS:·         Medical ·         Dental·         Vision ·         403b Retirement·         Paid Time Off·         10 Paid Holidays (including birthday) EQUAL OPPORTUNITY EMPLOYEROIC, Inc. is an equal opportunity employer. OIC, Inc. offers equal opportunities to applicants and employees and makes all employment-related decisions based exclusively on job-related qualifications. Our policies and hiring practices ensure non-discrimination based on any protected characteristics.DIVERSITY STATEMENTOIC, Inc. is committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our board members, customers, clients, and patients are essential to fulfilling OIC, Inc.’s vision and goals. <a href="https://www.econdev.org/" rel="nofollow">https://www.econdev.org/</a><a href="https://www.rockymountchamber.org/" rel="nofollow">https://www.rockymountchamber.org/</a>Send Resumes to hrinfo@oicone.orgDue to the volume of applications received, please do not contact the OIC Human Resources Department to check the status of an application, as we will be unable to provide this information over the phone. All applicants will be reviewed and those deemed most qualified will be contacted for an interview.Thank you for your interest in employment with OIC, Inc. <img alt="" height="1" src="https://jbgr.la/t/v/H4sIAAAAAAAA_6tWyspP8kxRslIyNje2sFTSUUrKTyxKAYsYAXklmbmpxSWJuQVKVnmlOTm1egV5xt5mYeElgRZGfhnp4XmW2VWhxonmGZmVZVUe7qlGlkmZxV6ZhhZhKYEAdY11tVwAAAA=" width="1"/>

Billing Director

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Coding EducatorHumana

Billing SpecialistOpportunities Industrialization Centers

Revenue Cycle ManagerContentnea Health

Billing DirectorOpportunities Industrialization Centers

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