Manager, RHEMA IQVIA Holdings IncManager, RHEMAWashington, DC$95,700–$239,200 / yearThis role leads coding analyses, reimbursement assessments, client engagements, and strategic market access initiatives while providing project leadership and mentoring junior staff. Typically 5-10 years of inpatient facility and/or outpatient professional coding experience plus reimbursement, consulting, market access, provider strategy, or revenue cycle experience.
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.
Outpatient Coder, Senior University of Maryland Baltimore Washington Medical CenterOutpatient Coder, SeniorBaltimore, MD$28.41–$40.35 / 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.
SR. OUTPATIENT CODER University of Maryland Baltimore Washington Medical CenterSR. OUTPATIENT CODERBaltimore, MD$28.41–$40.35 / 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.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Baltimore, MDRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Medical Records Technician (Coder/Audit/Training) U.S. Department of DefenseMedical Records Technician (Coder/Audit/Training)Washington, DC$51,210–$66,574 / yearSPECIALIZED EXPERIENCE: One year of specialized experience which includes, 1) Assisting in auditing coders and/or providers to identify inaccurately coded services in accordance with coding regulations; 2) Identifying errors, trends, and/or concerns regarding diagnosis, Current Procedural Terminology (CPT), Evaluation and Management (E/M) errors and converting that data into training material; and 3) Providing guidance and functional knowledge to improve coding accuracy. For each relevant work experience, make sure you include the employers name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement.
Patient Access Associate II MedStar HealthPatient Access Associate IIBaltimore, Maryland$18.70–$32.72 / hourFull timeConfirms 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.
Patient Access Associate II (Part-time Night Shift) MedStar HealthPatient Access Associate II (Part-time Night Shift)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.
Managed Care Payment Integrity Liaison MedStar HealthManaged Care Payment Integrity LiaisonColumbia, MD$65,062–$117,291 / yearExperience 5-7 years of experience in both managed care operations and/or tertiary hospital revenue cycle required Deep understanding of managed care reimbursement models (DRG, APC, per diem, etc.) required Strong working knowledge of denials, underpayments, and appeals workflows, as well as billing compliance and payer policies required Experience with all forms of Managed Care plans and commercial payer negotiations preferred Familiarity with payer portals and contract modeling tools preferred Familiarity with Marylands Health Services Cost Review Commission preferred Familiarity with EPIC preferred. General Summary of Position The Managed Care Payment Integrity Associate will bridge the gap between managed care and revenue cycle ensuring accurate reimbursement and minimizing payment delays.
NewSenior Patient Access Operations Coordinator Children's National HospitalSenior Patient Access Operations CoordinatorWashington, DC$57,969.60–$96,616 / yearPlease note that it is the policy of Children's National Hospital to ensure a "drug-free" work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Monitor and supervise quality control of staff in registration process; well versed in all Patient Access functions; maintain and monitor billing system and review monthly reports; required to work at least 2 shifts a month on a different site or different shift.
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.
Field Reimbursement Manager Immunology Gastroenterology - Rockville MD AbbVie IncField Reimbursement Manager Immunology Gastroenterology - Rockville MDRockville, MDThe amount and availability of any bonus, commission,incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole and absolute discretion unless anduntil paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law. Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of thisposting based on the job grade for this position.
HIM Clinical Documentation Specialist University of Maryland Baltimore Washington Medical CenterHIM Clinical Documentation SpecialistGlen Burnie, MD$38.67–$58.05 / hourBachelors degree in Health Information Management, Nursing, or related field • RHIA, RHIT, CCS, or CDIP certification • 3-5 years of experience in clinical documentation improvement or related field • In-depth knowledge of medical terminology and coding systems (e.g., ICD-10, CPT) • Proficiency in electronic health record (EHR) systems • Strong understanding of healthcare compliance and regulations, including HIPAA • Excellent written and verbal communication skills • Exceptional attention to detail and accuracy • Analytical mindset with the ability to identify trends and patterns in clinical documentation • Knowledge of quality metrics and performance improvement methodologies • Familiarity with clinical workflows and healthcare operations • Strong organizational skills and ability to manage multiple priorities efficiently • Demonstrated ability to work collaboratively with healthcare providers and multidisciplinary teams • Commitment to ongoing professional development and staying current with industry trends. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation.
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.
NewSupervisory Medical Records Administration Specialist U.S. Department of DefenseSupervisory Medical Records Administration SpecialistWashington, DC$78,788–$98,530 / yearFOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. Specialized Experience: One year of specialized experience which includes managing outpatient & inpatient medical records programs, leading other medical records technicians, including assigning and distributing workload, assisting with medical records audits, and providing education and training on medical record documentation and coding guidelines.
Remote IP Quality Reviewer Guidehouse IncRemote IP Quality ReviewerMcLean, VARemote$65,000–$108,000 / yearWhat You Will Do: The Coding Quality Reviewer shall report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as defined in quality review policies and facility guidelines utilizing ICD-10 CM/PCS and CPT 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.
DRG Coder, Registered Nurse Pivotal Placement ServicesDRG Coder, Registered NurseBaltimore, MD$90,000–$104,841 / yearHeadquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm specializing in healthcare talent—from frontline staff to executive leadership—in both clinical and non-clinical roles. We are seeking an experienced DRG Coder / Clinical Auditor (RN) to conduct comprehensive DRG quality and validation audits of inpatient medical records.
NewPatient Relations Coordinator/Receptionist Jeffrey P Haggquist Do PLLCPatient Relations Coordinator/ReceptionistWashington, DC$19–$22 / hourFull timeThe Patient Relations and Billing Coordinator provides excellent communication with our patients, coordinates revenue cycle and medical insurance billing, delivers administrative support to clinic leadership, and assists with clinic operations. We would create your schedule (typically an 8-hour shift) in coordination with the schedules of other administrative staff members.
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.
Workers Compensation - Medical Bill Review - Operations Analyst (Remote) BerkleyWorkers Compensation - Medical Bill Review - Operations Analyst (Remote)Manassas, VirginiaRemote$75,000–$95,000 / yearQualifications: MBR business process SME including experience with MBR E2E process from a business/operations perspective; firm understanding of integrated services and workflows including FS/UCR, Nurse and code review, PPO, negotiations, adjustor bill adjudication; workers compensation regulatory environment experience/understanding; Demonstrated application of successful critical thinking and complex problem solving skills; Experience in a role requiring deep understanding of and experience working with MBR and integrated services technology – not at a developer level – but from a business analyst perspective; Experience gathering business requirements and clearly documenting complex scenarios and use cases to communicate MBR issues accurately for resolution; Communication experience with varied audiences including leadership and peers in business/operational & technology roles; Client-facing acumen. You will work directly with Berkley Operating Units to investigate bill processing issues and are responsible for problem-solving, identifying and triaging issues to technical teams, directly interfacing with multiple vendors to facilitate issue resolution, issue documentation, tracking, and reporting.