Remote Pro Fee Quality Reviewer Guidehouse IncRemote Pro Fee Quality ReviewerWashington, DCRemote$56,000–$94,000 / yearWhat You Will Do: The Coding Quality Reviewer shall report directly to the Pro Fee Quality Review Supervisor and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as performed by the Guidehouse coding team by utilizing ICD-10 CM, CPT and HCPCS 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.
Statistician Code360StatisticianHyattsville, MarylandRemoteIdentifying data priorities in the areas of health care resources and utilization; Plan and implement sample surveys and evaluation studies to address data priorities; Develop survey methodologies that address the unique data collection requirements of national surveys of health care providers and institutions; Apply sampling theory and design to complex, multi-stage national probability surveys of health care providers and institutions; Develop data reduction methods and analysis of data from national surveys of health care providers and institutions; Apply and modify established methods, modeling techniques, and procedures in conducting analysis to improve sample surveys or experimental designs and to conduct evaluations of data collection, reduction and processing. Prepare reports, manuals and other directives necessary to convey medical coding information and improve the quality of our data; Design and develop new mathematical statistical models, methods and/or techniques such as sample and survey designs for related data collection; Evaluate data resulting from application of mathematical statistic tools, model, method and techniques to the public health area; Contribute to various project reports and presentations, including memos summarizing interim project findings; reports describing final algorithm methodology and application; and presentations to stakeholders and Federal partners; and.
Professional Fee Coder Seattle Children's HospitalProfessional Fee CoderWashingtonRemoteTogether, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho – the largest region of any children’s hospital in the country. Seattle Children’s welcomes people of all experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families.
Patient Accounts Specialist I - Medicaid Team MedStar Health Research InstitutePatient Accounts Specialist I - Medicaid TeamBaltimore, MD$18.70–$32.72 / hourThe team works closely with other internal MedStar Health departments including advocacy, CFC and billing to ensure patients who receive retro-eligible Medicaid are billed timely and within the specific state requirements. 1-2 years' experience in patient accounting, accounts receivable or related healthcare field required or an equivalent combination of experience and college education in accounting, finance or healthcare administration required.
Manager, Clinical Documentation Integrity Shady Grove Adventist HospitalManager, Clinical Documentation IntegrityGaithersburg, MD$105,664.42–$158,496 / yearWe do this by offering: • Work life balance through nonrotating shifts • Recognition and rewards for professional expertise • Free Employee parking • Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire • Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available) • Paid Time Off • Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period • Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance • Subsidized childcare at participating childcare centers • Tuition Reimbursement • Employee Assistance Program (EAP) support. • Required and active certification for: • CCDS (Certified Clinical Documentation Specialist), CDIP (Clinical Documentation Improvement Practitioner) or equivalent • Other certifications preferred: • Certified Documentation Expert Inpatient (CDEI) • Certified Coding Specialist (CCS) • Maintains current working knowledge of Coding Clinic Guidelines and federal updates to DRG system (MS, APR, AP etc) • Knowledge of medical terminology, anatomy, physiology, microbiology, and disease processes.
Lead Client Service Specialist HEALTH CARE FOR THE HOMELESS, INC.Lead Client Service SpecialistBaltimore, MDWorking closely with the Director of Community Operations, and interdisciplinary teams, the Lead CSS supports efficient clinic operations, staff development, quality improvement initiatives, and client-centered service delivery. Provides andmodelscustomer service excellence marked by culturally competent, client-centered, ethical, respectful, inclusive, and professional interactions with clients, staff, partners, and the broader community.
Financial Eligibility Specialist Chase Brexton Health Services IncFinancial Eligibility SpecialistBaltimore, MDJOB SUMMARY: The Financial Eligibility Specialist determines applicant eligibility for third party reimbursement, processes data necessary for admission of new patients into health services, ensures proper coding for insurance billing, and handles inquiries from prospective applicants and patients. Cultural competence and the ability to work with providing individualized care that respects and empowers patients of all ages, races, gender identities, religions, sexual orientations, ethnicities, and socioeconomic statuses.
AI & Data Engineering Lead (Manager) - Pharma Commercial Data Warehouse Parab Consulting Group IncAI & Data Engineering Lead (Manager) - Pharma Commercial Data WarehouseWashington, DCPharma Commercial Data Domain Expertise (Critical)This role requires demonstrated, working knowledge of the following IQVIA and third-party pharmaceutical data assets: Sales & Demand DataIQVIA DDD / NPA / NSP: Deep understanding of sub-national prescriber-level (DDD), national prescription audit (NPA), and national sales perspectives (NSP) data structures, including product hierarchies, outlet types, and projection methodologies. AI-Ready Data Architecture & EnablementFeature Store & ML-Ready Datasets: Design and build curated, governed feature stores and ML-ready datasets on Snowflake to accelerate data science workloads including patient propensity models, next-best-action engines, formulary prediction, and treatment-pathway classifiers.
RN Readmission Manager, Payment Integrity Centene Corporation GroupRN Readmission Manager, Payment IntegrityMD$87,700–$157,800 / yearEducation/Experience: Bachelor's degree in Healthcare Administration, Business, Public Health, Health Information Management, Nursing, or a related field required; an additional four (4) years of directly related experience may be considered in lieu of a degree. License/Certification: Active Health Information Management or coding credentials required, such as RHIT, RHIA, CCS, CIC, or CCDS or Registered Nurse licensure or higher clinical qualification, in combination with a coding credential, required.
NewHealthcare Claims Payment Policy Managing Consultant Guidehouse IncHealthcare Claims Payment Policy Managing ConsultantMcLean, VAExperience supporting third-party administrator or claims operations implementation, including translating policy into business requirements, clarifying reimbursement logic, supporting testing, resolving operational questions, and tracking implementation issues. Experience leading a team or workstream, including setting priorities, assigning work, reviewing deliverables, coordinating subject matter experts, tracking deadlines, and communicating status, risks, and decisions to leadership.
["Lead Client Service Specialist","Lead Client Service Specialist"] Health Care["Lead Client Service Specialist","Lead Client Service Specialist"]BaltimoreWorking closely with the Director of Community Operations, and interdisciplinary teams, the Lead CSS supports efficient clinic operations, staff development, quality improvement initiatives, and client-centered service delivery. Provides andmodelscustomer service excellence marked by culturally competent, client-centered, ethical, respectful, inclusive, and professional interactions with clients, staff, partners, and the broader community.
NewSurgical Scheduler TalentBurst, Inc.Surgical SchedulerAlexandria, VA$20.30–$25.37 / hourThis role receives scheduling requests from various sources, including providers, call centers, and clinics, and schedules the procedure following established guidelines and leadership directions. Identifies and improves scheduling workflow deficiencies through collaboration with surgeons and clinical leadership, focusing on simplification, clarity, and ease of operation.
Pre-Certification Coordinator I - Pediatric Allergy & Pulmonary Medicine Washington University in St LouisPre-Certification Coordinator I - Pediatric Allergy & Pulmonary MedicineWashingtonThe 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. Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre-payment of un-coded services.
RCMI Senior Solution Technical Expert (SSTE) - Patient Access Guidehouse IncRCMI Senior Solution Technical Expert (SSTE) - Patient AccessMcLean, VA$80,000–$133,000 / yearAssist with development, maintenance, and iterative improvement of working groups/project teams, including charter development, schedule working group/project meetings, track tasks to completion, and assist with planning and execution of workshops/summits. The Revenue Cycle Modernization & Innovation (RCMI) Senior Solution Technical Expert (SSTE) - Patient Access assists the Military Health System client developing and providing training concerning the optimization, reconfiguration, and enhancements to the RCM capabilities related to patient access within an EHR.
Claims Analyst Lumen Solutions Group, Inc.Claims AnalystBaltimore, MDThe ideal candidate will have strong experience in claims research, data validation, data entry, and Excel, with the ability to analyze issues, maintain accurate records, and support day-to-day claims operations. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.
Principal Software Architect PeopleNTech LLCPrincipal Software ArchitectAlexandria, VARemote$85–$90 / hourArchitecture & Platform Governance Own and evolve the cross-platform architecture spanning (C++/C# Windows applet, BHFTP transmitter, ASP.NET Proactive portal), (cloud SaaS, instrument fleet API, data pipeline), and Unity Next (QC engine, LIS/HL7 integration, Unity Connect middleware, peer-comparison analytics). On-Instrument & Integration Systems Guide Applet architecture: C++ Win32 service host, IMonitoredEntity driver plugin model (Drives Info, Running Processes, System Info, ME Collect), DCC output contract, and AppletSoftwareUpdateManager CAB update pipeline.
Senior Medical Officer GuidehouseSenior Medical OfficerRockville, MD$85,000–$141,000 / yearWhat You Will Do: We are looking for a Senior Medical Officer to support the National Institute of Allergy and Infectious Diseases (NIAID), Division of Microbiology and Infectious Diseases (DMID), by providing clinical safety oversight, medical review, and clinical trial support services. 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.
Manager Physician Encounter Strategy Engagement Mid-Atlantic Permanente Medical Group PCManager Physician Encounter Strategy EngagementWashington, DC$100,453–$125,566 / yearReporting to the Director, Physician Encounter Strategy & Engagement, the Manager, Physician Encounter Strategy & Engagement provides leadership, oversight, and strategic direction for programs supporting clinician documentation and coding activities across Primary Care, Medical and Surgical Specialties, and Acute and Core Service Lines. Mid-Atlantic Permanente Medical Group is comprised of more than 1,700 Permanente physicians and nearly 300 staff professionals who come together to make a positive impact on the health and lives of more than 800,000 members in Virginia, Maryland, and the District of Columbia.
Inpatient Coder, Senior University of Maryland Baltimore Washington Medical CenterInpatient Coder, SeniorBaltimore, MD$30.26–$42.37 / hourStrong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland.
SR. INPATIENT CODER University of Maryland Baltimore Washington Medical CenterSR. INPATIENT CODERBaltimore, MD$30.26–$42.37 / hourPartnering with the University of Maryland School of Medicine, University of Maryland School of Nursing, and University of Maryland, Baltimore, who educate the states future healthcare professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban, and rural communities across the state of Maryland. Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.