Medical Coding Specialist Ensemble Health PartnersMedical Coding SpecialistOhioRemoteRemain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.
Coding Auditor - Ambulatory/Professional Coding/Profee Huron Consulting GroupCoding Auditor - Ambulatory/Professional Coding/ProfeeDelaware, OH$26.44–$52.40 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
Outpatient Hospital Coding Supervisor ProMedicaOutpatient Hospital Coding SupervisorOhioRemoteBy collaborating with stakeholders, implementing process improvements and supporting coding policies and systems, you will help ensure timely account completion and maintain effective coding operations. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges.
Certified Professional Medical Coding Auditor TegriaCertified Professional Medical Coding AuditorOhioOur lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way. The role may recommend improvements to coding procedures as guidelines and requirements evolve, escalates findings that may signal a compliance or revenue concern to coding leadership for evaluation, and provides supporting documentation that leadership relies on when determining next steps.
DRG Senior Educator, Coding Ensemble Health PartnersDRG Senior Educator, CodingOhioRemoteThe DRG Senior Coding Educator acts as a subject matter expert to educate, train, and develop/revise processes in coordination with leadership to assist in achieving CDI’s goal of facilitating accurate and complete documentation for coding and the capture of severity, acuity, and risk of mortality and most accurate Diagnosis Related Group (DRG) assignments. Collaborate with CDI leadership and other clinicians to facilitate the ongoing relevance of department specific orientation content, educational materials, and training programs/resources.
Acute Coding Appeals Specialist Ensemble Health PartnersAcute Coding Appeals SpecialistOhioRemoteUnder indirect supervision, the Coding Appeals Specialist is responsible for reviewing and writing appeals for inpatient Diagnosis Related Group, (DRG) denials in order to support the assigned DRG and to address the clinical documentation utilized in the decision-making process to support the validity of the assigned codes. Draws on ICD10CM, ICD10PCS, HCPCS, NCCI, CMS and CMG coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns.
Coding Supervisor Ensemble Health PartnersCoding SupervisorOhioRemoteThorough working knowledge of coding classification systems to include Diagnosis Related Groups, (DRGs) and All Patient Refined - Diagnosis Related Groups, (APR-DRGs.). 3 years of coding experience in either pro-fee or acute care setting to include inpatients, outpatients, and emergency department records or provider coding.
Inpatient Medical Coding Manager Huron Consulting GroupInpatient Medical Coding ManagerDelaware, OH$90,000–$130,000 / yearREQURIED SKILLS: Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members. is directly responsible for the daily oversight of coding operational processes and workflow, including but not limited to delivering timely and accurately coded cases for facility billing and for reporting hospital and provider quality metrics.
Director, Client Coding Integration Ensemble Health PartnersDirector, Client Coding IntegrationOhioThe Client Coding Integration Director provides strategic leadership for client coding integration across the organization's revenue cycle management operations. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position.
Engineer III - CICD Code Signing Automation (Remote) CrowdStrike IncEngineer III - CICD Code Signing Automation (Remote)OHRemote$120,000–$180,000 / yearAbout the Role: On the Engineering Systems team at CrowdStrike, we operate and maintain many of the systems and services that support the build, test, signing, and deployment of our software to the cloud and to our customers, as well as providing consultation, troubleshooting, and engineering support for the creation and maintenance of the pipelines that provide those functions. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
NewMedical Coder & QA, Clinical Reviewer Ohio LivingMedical Coder & QA, Clinical ReviewerOhioCurrent unencumbered license for the state of Ohio to practice as a Licenses Practical Nurse (LPN) preferred Certificate for OASIS Specialist-Clinical Certificate for OASIS Specialist-Clinical Certificate for OASIS Specialist-Clinical. Responsible to process Home Health Starts of Care (SOC) or Hospice Admission Plans of Care timely working with their assigned Home Health and Hospice office.
Charge Audit Analyst Sutter HealthCharge Audit AnalystOH$42.41–$63.62 / hourPosition Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.
Optometric Technician West Point OpticalOptometric TechnicianDelaware, OhioThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Account Follow-Up Representative I Harris Computer SystemsAccount Follow-Up Representative IDelaware, OHRemote$18–$26 / hourTimely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient's insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals.
Senior Investigator, Special Investigations Unit (SIU) CVS HealthSenior Investigator, Special Investigations Unit (SIU)OhioRoutinely handles cases that are sensitive or high profile, those that are national in scope, complex cases, or cases involving multiple perpetrators or intricate healthcare fraud schemes. Bachelor's degree or equivalent experience (A bachelor's degree, or an associate's degree with an additional four+ years working on health care fraud, waste, and abuse investigations and audits).
Professional Billing Representative| Professional Billing, Full-Time Memorial HealthProfessional Billing Representative| Professional Billing, Full-TimeMarysville, OhioAccounts Receivable Management: Manages account review and processing from system WQs, insures timely follow-up on all unpaid claims within appropriate billing cycle; manages system denial remark module, taking steps to rectify current denial. Employee performs within the prescribed limits of the hospital’s and department’s Ethics and Compliance program and is responsible to detect, observe and report compliance variances to their immediate supervisor, or upward through the chain of command, the Compliance Officer, or the hospital hotline.
NewBilling Representative | Patient Financial Services Memorial HospitalBilling Representative | Patient Financial ServicesMarysville, OHVerifies and updates patient account demographic and financial information, processing Real-Time Eligibility (RTE); contacting account guarantor and/or payer as appropriate for demographic and financial clarification. What Youll Do: Ensures insurance claims are sent timely and accurately to government, commercial and managed care plans, adhering to payer timely filing requirements.
NewBilling Representative | Patient Financial Services Memorial HealthBilling Representative | Patient Financial ServicesMarysville, OhioVerifies and updates patient account demographic and financial information, processing Real-Time Eligibility (RTE); contacting account guarantor and/or payer as appropriate for demographic and financial clarification. Knowledge of revenue cycle functions, understanding of health insurance and government programs, billing processes, managed care contracts, coordination of benefits with ability to interpret explanation of benefits desired.
Billing Supervisor Ensemble Health PartnersBilling SupervisorOhioRemoteThe Supervisor will work with multiple disciplinaries including but not limited to Patient Access, Coding, Follow Up, Denials and any additional Revenue Management departments needed to aid in effort to ensure timely account review related to unbilled workflow. Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.
Clinical Quality Coder II Sutter HealthClinical Quality Coder IIOH$35.04–$52.56 / hourSKILLS AND KNOWLEDGE: Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC, as well as medical terminology and abbreviations of disease, illness and injury process. Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines.