Coding Quality Educator - Remote Providence Health & ServicesCoding Quality Educator - RemoteNMRemoteRequsition ID: 443735 Company: Providence Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4010 SS PE OPTIM Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: On-site Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorNM$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.
NewHealth Information Management Coder Lead - Coding CHRISTUS HealthHealth Information Management Coder Lead - CodingSanta Fe, NMCoding Lead will work with Coders as a resource to maintain current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and/or Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coding Leads will work to ensure Coders abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines.
NewRemote Profee Multispecialty Coder Presbyterian Healthcare ServicesRemote Profee Multispecialty CoderNMRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
NewRemote IP Facility Coder with CCS Presbyterian Healthcare ServicesRemote IP Facility Coder with CCSNMRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
Remote Pro Fee Auditor/Educator Presbyterian Healthcare ServicesRemote Pro Fee Auditor/EducatorNMRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NM$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.
IP Facility Coder with CCS - Medical Records Presbyterian Healthcare ServicesIP Facility Coder with CCS - Medical RecordsNMThe IP Facility Coder has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)NM$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Charge Description Master Specialist - Full time, Day, Remote Providence Health & ServicesCharge Description Master Specialist - Full time, Day, RemoteNMRemoteRequsition ID: 429456 Company: Providence Jobs Job Category: Patient Financial Services Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4001 SS RC CHARGE DECR MSTR Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided.
Charge Description Master Specialist - Full time, Day, Remote Providence St. Joseph HealthCharge Description Master Specialist - Full time, Day, RemoteNMRemoteAs a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. The CDM Specialist responds to Hospital ministry inquiries regarding Chargemaster issues and is responsible for the training of Hospital ministry staff regarding the CDM Maintenance process, coding updates and charge capture improvement.
Certified Cardiothoracic Vascular Surgery Coder Presbyterian Healthcare ServicesCertified Cardiothoracic Vascular Surgery CoderNMResponsibilities: Has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
IP Facility Coder Presbyterian Healthcare ServicesIP Facility CoderNMThe IP Facility Coder has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
NewRemote OP Facility Coder - PRN Presbyterian Healthcare ServicesRemote OP Facility Coder - PRNNMRemoteResponsibilities: Has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
NewRemote OP Facility Coder Presbyterian Healthcare ServicesRemote OP Facility CoderNMRemoteResponsibilities: Has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Compliance Auditor -Remote Providence Health & ServicesCompliance Auditor -RemoteNMRemoteRequsition ID: 442859 Company: Providence Jobs Job Category: Compliance Job Function: Legal/Compliance/Risk Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS COMPLIANCE Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT.
Coordinator Charge Capture - Orthopedic CHRISTUS HealthCoordinator Charge Capture - OrthopedicSanta Fe, NMCommunicates regularly with clinical staff as questions arise regarding the accuracy and compliance of charge entry; demonstrates a good working relationship with various clinical and non-clinical departments. • Identifies patterns by department and facility, identifies education opportunities, and communicates with Coding, Nurse Auditors, and clinical managers as needed to ensure accurate charge capture.
Billing Specialist EL CENTRO FAMILY HEALTHBilling SpecialistNMPosition Overview: Under the direction of the Chief Financial Officer (CFO), the Billing Specialist collaborates with the External Billing Consultant and CFO, as needed, to carry out various clerical tasks related to maintaining clinic patient accounts. Who We Are: As a Federally Qualified Health Center (FQHC) and 501(c)(3) nonprofit, El Centro Family Health is dedicated to providing affordable, accessible, and high-quality healthcare to the people of Northern New Mexico.
Remote PRN IP Facility PCS/ICD Coder Presbyterian Healthcare ServicesRemote PRN IP Facility PCS/ICD CoderNMRemoteSummary: Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Responsibilities: Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Remote IP Facility CCS Coder Presbyterian Healthcare ServicesRemote IP Facility CCS CoderNMRemoteSummary: Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Responsibilities: Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Remote PRN IP Facility PCS/ICD coder Presbyterian Healthcare ServicesRemote PRN IP Facility PCS/ICD coderNMRemoteSummary: Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Responsibilities: Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Billing Specialist El Centro Family HealthBilling SpecialistEspañola, NMPosition Overview: Under the direction of the Chief Financial Officer (CFO), the Billing Specialist collaborates with the External Billing Consultant and CFO, as needed, to carry out various clerical tasks related to maintaining clinic patient accounts. As a Federally Qualified Health Center (FQHC) and 501(c)(3) nonprofit, El Centro Family Health is dedicated to providing affordable, accessible, and high-quality healthcare to the people of Northern New Mexico.
Field Reimbursement Manager - Kidney (Central Southwest - AZ, NM, TX, OK) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (Central Southwest - AZ, NM, TX, OK)NM$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly 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.
Scheduler - Oncology Surgery CHRISTUS HealthScheduler - Oncology SurgerySanta Fe, NMThis is supported by gathering patient-specific demographic and provider information to accurately assess the nature of the request and determine the appropriate appointment area; properly advising patients regarding the need for co-payments and referral authorizations to ensure the patient arrives on time and is prepared for their procedure or visit; Through this process, the Oncology Scheduling Coordinator responds to and interacts with a variety of individuals including patients, customers, referring physicians, clinical staff and family members. Regularly meets with providers (physician, PA, nurse, et.al.) to review their overall status, including reviewing and resolving patient or scheduling issues, and reviewing upcoming activities that may impact provider’s schedule and/or patient care.
Scheduler - Chemotherapy CHRISTUS HealthScheduler - ChemotherapySanta Fe, NMThis is supported by gathering patient-specific demographic and provider information to accurately assess the nature of the request and determine the appropriate appointment area; properly advising patients regarding the need for co-payments and referral authorizations to ensure the patient arrives on time and is prepared for their procedure or visit; Through this process, the Oncology Scheduling Coordinator responds to and interacts with a variety of individuals including patients, customers, referring physicians, clinical staff and family members. Regularly meets with providers (physician, PA, nurse, et.al.) to review their overall status, including reviewing and resolving patient or scheduling issues, and reviewing upcoming activities that may impact provider’s schedule and/or patient care.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)NM$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Medical Director - ENT CVS Health CorpMedical Director - ENTNM$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Senior Software Development Engineer CVS Health CorpSenior Software Development EngineerNM$83,430–$222,480 / yearCVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world. Currently, we are seeking a Senior Software Development Engineer with deep expertise in Java/JEE, Spring Boot, RESTful microservices, and Kafka to lead the design and development of scalable, secure cloud-native solutions.
Application Security Engineer Ryder System IncApplication Security EngineerSanta Fe, NMCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Staff Software Development Engineer CVS Health CorpStaff Software Development EngineerNM$106,605–$284,280 / yearFurthermore, the Staff Engineer role includes closely working with a team of engineers to drive delivery excellence, partner with business and other IT leaders to build digital assets, provide expert level support to resolve complex issues and provide RCA, identify gaps in systems in current digital eco system and provide solutions to enhance overall performance. CVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world.
Staff Development Engineer - Fulfillment CVS Health CorpStaff Development Engineer - FulfillmentNM$106,605–$284,280 / yearCollaborate closely with engineering, platform, and business teams to deliver cost optimized, scalable solutions-leveraging cloud cost profiling tools, storage tiering strategies, service right sizing, and architectural simplification. Apply advanced software engineering practices across the full SDLC-including domain driven design (DDD), design patterns, secure coding, automated testing strategies (unit, contract, integration), code quality gates, trunk based development, and continuous observability.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DONM$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
NewPMG Surgery Scheduler-SFMC Presbyterian Healthcare ServicesPMG Surgery Scheduler-SFMCSanta Fe, NMUtilizing Epic template management software and computerized staffing tools, the ideal candidate must demonstrate independent decision-making to handle real-time operational disruptions like emergency add-ons and cancellations. This full-time healthcare position requires exceptional patient communication skills via phone and MyChart, a high dedication to scheduling accuracy, and a strong commitment to collaborating with medical providers to deliver seamless patient care.
NewSurgery Scheduler Presbyterian Healthcare ServicesSurgery SchedulerSanta Fe, NMUtilizing Epic template management software and computerized staffing tools, the ideal candidate must demonstrate independent decision-making to handle real-time operational disruptions like emergency add-ons and cancellations. This full-time healthcare position requires exceptional patient communication skills via phone and MyChart, a high dedication to scheduling accuracy, and a strong commitment to collaborating with medical providers to deliver seamless patient care.