DRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadHanover, MD$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
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.
Medical Billing Specialist Erickson Senior LivingMedical Billing SpecialistBaltimore, MarylandAs 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. We help people live better lives by fulfilling our promises of a vibrant lifestyle, financial stability, and focused health and well-being services for those who live and work with us.
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.
Medical Practice Representative Iii- Orthopaedics University of Maryland Faculty PhysiciansMedical 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.
Medical Practice Representative Iii- Dermatology University of Maryland Faculty PhysiciansMedical Practice Representative Iii- DermatologyBaltimore, 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.
Medical Practice Representative III - Ob/Gyn University of Maryland Faculty PhysiciansMedical 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 candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.
DevOps Engineer w/Automation and coding background Syntricate Technologies IncDevOps Engineer w/Automation and coding backgroundReston, VANote: The manager is extremely picky – candidates need very strong automation skills and he wants candidates who come from a coding background. • Collaborate with cross-functional teams, including product managers, designers, and other developers.
Business Analyst II - Payment Integrity Datamining Elevance Health IncBusiness Analyst II - Payment Integrity DataminingHanover, MD$64,764–$97,146 / yearFor URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position¿ work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.
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.
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.
NewPatient Access Associate I (PRN) MedStar Health Research InstitutePatient Access Associate I (PRN)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.
NewBusiness Analyst II - Payment Integrity Datamining Elevance HealthBusiness Analyst II - Payment Integrity DataminingHanover, MD$64,764–$97,146 / yearFor URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position¿ work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.
Manager Charge Description Master & Revenue Integrity Greater Baltimore Medical CenterManager Charge Description Master & Revenue IntegrityTowson, MD$89,456.67–$161,022 / yearExamples include Epic Reporting Workbench, SlicerDicer, Cogito, Tableau, Microsoft Power BI, SQL-based reporting tools, Crystal Reports, SSRS (SQL Server Reporting Services), and healthcare revenue cycle dashboards used to monitor revenue cycle KPIs, charge capture trends, reconciliation status, lost revenue opportunities, billing variances, denial patterns, and revenue integrity workplan progress. Ensures CDM updates are coordinated with clinical systems, Epic applications, billing workflows, and affected operational departments to support accurate charge generation and downstream revenue cycle processes.
NewLead Charges And Claims Specialist (Chesapeake Specialty Care) University of Maryland Faculty PhysiciansLead Charges And Claims Specialist (Chesapeake Specialty Care)Annapolis, MDThis position is responsible for overseeing daily charge and claim activities, ensuring the timely and accurate submission of claims, resolving complex billing issues, monitoring team performance, and providing training and support to Charges and Claims Specialists. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.
Clinical Coordinator for Pain Management Lifestream Health CenterClinical Coordinator for Pain ManagementBowie, MDFull timePharmacy, Medication, and Inventory OversightPharmacy Tech Supervision: Provide direct operational oversight, workflow management, and day-to-day supervision of the Pharmacy Technician (focusing on operational accountability, metrics, and adherence to practice SOPs rather than clinical/legal pharmacy licensure).Pharmacy Operations & Vendor Liaison: Support general pharmacy operations, act as the pharmacy rep liaison, and co-manage the sample closet. Interdepartmental Collaboration & Quality ImprovementAdministrative Liaison: Partner with the Practice Manager to seamlessly align administrative and clinical workflows, serving as an operational backup during approved absences to maintain clinic continuity.
Learning & Development Specialist (Claims Trainer / Customer Service Trainer) Lumen Solutions Group, Inc.Learning & Development Specialist (Claims Trainer / Customer Service Trainer)Baltimore, MDThe ideal candidates will have strong Instructor-Led Training (ILT) experience, exceptional presentation and facilitation skills, and the ability to effectively train both virtually and in person. CareFirst BCBS is seeking two Learning & Development Specialists to design and deliver engaging training programs for adult learners in a corporate healthcare environment.
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.
Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical CareDialysis Clinical Manager Registered Nurse - RNDale City, VirginiaOther: • Collaborates closely with, providing oversight as needed to, the Clinical Manager/Charge RN acting as nurse manager, the Medical Director, and the physicians regarding the direct patient care responsibilities within the facility to ensure the provision of outstanding quality of patient care, as defined by the FMS quality goals, and compliance with the pertinent company policies and procedures. • Demonstrated leadership competencies and management skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management and decision making.
Remote Pro Fee Quality Reviewer GuidehouseRemote Pro Fee Quality ReviewerDistrict of ColumbiaRemoteThe 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.