HIM Coding Supervisor -- Coding & Data Registry -- Document Center Building Charleston Area Medical Center Health System IncHIM Coding Supervisor -- Coding & Data Registry -- Document Center BuildingCharleston, WVAssociate's Degree (Required) Experience: 5 yrs coding experience with at least 3 of the years with progressive coding; dependent on coding specialty - outpatient coding experience with strong grasp of coding guidelines and rules or inpatient experience with strong grasp of coding and rules; experience in Clinical Documentation Improvement Substitution: May substitute 5 yrs progressive coding experience in addition to required experience for the Associates Degree in Health Information Technology. The position will also act as a liaison with Clinical Documentation Specialists and Coders to settle differences in coding and DRG assignment; with Coders and Patient Accounts to resolve coding and billing issues; and provide clinical and documentation clarification facility-wide.
Medical Coding Auditor-Pea Ridge Business Center Valley Health SystemMedical Coding Auditor-Pea Ridge Business CenterHuntington, WVRemoteJob Summary: The Medical Coding Auditor protects company assets by completing coding documentation and quality & program audits to ensure support of services billed, complying with all federal and state regulations and internal controls, and recommending improvements in internal control structure. Primary Responsibilities (illustrative): Follows established protocols, selects and reviews a percentage of records to assess coding documentation, billing and/or reimbursement practices for compliance with all regulations for federal and state agencies, third-party payers, and organization policy.
Coding Auditor-Educator West Virginia University MedicineCoding Auditor-EducatorMonongalia County, WVEXPERIENCE: Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the "Teaching Physician Guidelines" for Professional Coding Positions preferred. Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager.
HB-PB Coding Spec II West Virginia University MedicineHB-PB Coding Spec IIMercer County, WVReviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. This position is an integral part of an overall compliance program effort as it pertains to hospital/physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives along with hospital coding.
NewProfessional Coding Specialist II - Anesthesia West Virginia University MedicineProfessional Coding Specialist II - AnesthesiaKanawha County, WVReviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. This position is an integral part of an overall compliance program effort as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives.
NewProfessional Coding Spec II - Outreach West Virginia University MedicineProfessional Coding Spec II - OutreachMercer County, WVReviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. This position is an integral part of an overall compliance program effort as it pertains to physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives.
Inpatient Hospital Coding Specialist III West Virginia University MedicineInpatient Hospital Coding Specialist IIIMonongalia County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD). Responsible for obtaining accurate and complete documentation in the medical record for accurate coding/MS-DRG assignment, severity of illness and risk of mortality for each medical record.
Hospital Coding Spec II Cancer Center West Virginia University MedicineHospital Coding Spec II Cancer CenterWetzel County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Hospital Coding Spec II PBB West Virginia University MedicineHospital Coding Spec II PBBMarion County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Inpatient Hospital Coding Specialist II West Virginia University MedicineInpatient Hospital Coding Specialist IIMonongalia County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Hospital Coding Spec II-PBB Clinic West Virginia University MedicineHospital Coding Spec II-PBB ClinicMarion County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Inpatient Hospital Coding Manager West Virginia University MedicineInpatient Hospital Coding ManagerMonongalia County, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Bachelor's degree in Healthcare Management, Business, Finance or Accounting AND Five (5) years of in-depth experience within healthcare operations, patient account services, revenue cycle operations, healthcare auditing, or coding/billing either from a consulting perspective or as an employee/manager OR; Associate's Degree in Health Information Technology AND Seven (7) years of in-depth experience within healthcare operations, patient account services, revenue cycle operations, healthcare auditing, or coding/billing either from a consulting perspective or as an employee/manager OR; In Lieu of Bachelor or Associate's Degree, Nine (9) years of experience of in-depth experience within healthcare operations, patient account services, revenue cycle operations, healthcare auditing, or coding/billing either from a consulting perspective or as an employee/manager. Maintains strong understanding of coding metrics, leadership skills, project management, and leads the team in building plans to support operational departments to achieve optimal practice performance through strong analytical capabilities, process improvement identification, and technology enhancements.
Benefits Configuration Analyst West Virginia University MedicineBenefits Configuration AnalystMonongalia County, WVPerform research on various coding methods and facilitate all plans to resolve all discrepancies and coordinate with all clinical and non-clinical groups to manage documents according to required guidelines. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Associate degree in health information, healthcare, or related field AND One (1) year of experience in health insurance, medical coding, claims processing or related field.
Clinical Denial Specialist - Diagnosis Related Grouping (DRG) West Virginia University MedicineClinical Denial Specialist - Diagnosis Related Grouping (DRG)Monongalia County, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Associate degree in healthcare administration, Nursing, Health Information Management, or related field AND Five (5) years of experience in hospital billing, acute care setting, CDI, inpatient coding, or revenue cycle'. Current Licensed Practical Nurse license issued by the state in which services will be provided or current multi-state Licensed Practical Nurse license through the enhanced Nurse Licensure Compact (eNLC).
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)WV$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.
Medical Records Coder 1 Charleston Area Medical Center Health System IncMedical Records Coder 1Charleston, WVEffectively utilize the APCpro features of 3M with the 3M encoder and grouper software to identify appropriate assign modifiers, make appropriate changes to charges, notify departments to make changes, identify missing documentation, and prepare the account as a clean claim for billing to the third party payer. Participate in the Coding Hotline by responding to callers+ needs for coding advice, identify callers needs that must be referred to a higher level of coding skill, and overall act as a liaison between coding and other departments that need coding services.
Rehabilitation Administrative Coordinator West Virginia University MedicineRehabilitation Administrative CoordinatorWVScheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: BMC Berkeley Medical Center Cost Center: 219 BMC Physical Therapy Jefferson Address: 2500 Hospital Drive Martinsburg West Virginia. Schedules all procedures performed in the outpatient department of rehabilitation, coordinates, and performs administrative function of the department and other assigned special projects.
Engagement Center Representative EncovaEngagement Center RepresentativeCharleston, WVOur current footprint includes: Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin. Analyzes information received from the customer, triages facts to determine what is being requested, and determines what action is to be taken Interact with other associates across the organization to answer questions, provide support or assist in problem resolution for customers and agents.
Engagement Center Representative Encova Mutual Insurance GroupEngagement Center RepresentativeCharleston, WVOur current footprint includes: Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin. Analyzes information received from the customer, triages facts to determine what is being requested, and determines what action is to be taken Interact with other associates across the organization to answer questions, provide support or assist in problem resolution for customers and agents.
NewPatient Financial Clearance Specialist West Virginia University MedicinePatient Financial Clearance SpecialistMonongalia County, WVResponds daily to telephone or email inquiries and performs appropriate actions; Documents all actions taken in the appropriate locations; Serves as a resource to staff and patients for insurance related issues; Knowledge of current contracted and non-contracted insurance plans; Follows through and makes corrections in demos and insurances as they are discovered. Thorough understanding and working knowledge of CPT codes, medical terminology, ability to read and explain back EOB for all insurance types; excellent interpersonal, verbal, and written communication; excellent organizational, analytical; excellent time management and multi-tasking abilities.
Office Manager -PC West Virginia University MedicineOffice Manager -PCBridgeport, WVMust be highly skilled with computer systems used by both physician offices and hospitals to capture data accurately and consistently to permit an appropriate claim for payment to be completed as well as to appropriately capture other needed information. The incumbent oversees the daily operations of the medical office consistent with good business practices and in conformance to overall institutional practices, including personnel management, financials, budgets, accounts payable, accounts receivable, payroll and purchasing.
NewOffice Manager-PC West Virginia University MedicineOffice Manager-PCWVMust be highly skilled with computer systems used by both physician offices and hospitals to capture data accurately and consistently to permit an appropriate claim for payment to be completed as well as to appropriately capture other needed information. The incumbent oversees the daily operations of the medical office consistent with good business practices and in conformance to overall institutional practices, including personnel management, financials, budgets, accounts payable, accounts receivable, payroll and purchasing.
Clinical Optimization Specialist - Signature Service Line West Virginia University MedicineClinical Optimization Specialist - Signature Service LineMorgantown, WVThis role will report to the Heart and Vascular Assistant Vice President of Finance and partner directly with Revenue Cycle teams, as well as collaborate with HVI physicians, APPs, and IT analysts to optimize documentation workflows and clinical templates within Epic's EMR. MINIMIM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
NewInpatient Audit Specialist FT DatavantInpatient Audit Specialist FTCharleston, WVRemote$35–$45 / hourAs an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical CareDialysis Clinical Manager Registered Nurse - RNMartinsburg, West 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.
Clinical Denials Specialist West Virginia University MedicineClinical Denials SpecialistMonongalia County, WVThis includes but is not limited to, denial investigation, follow-up with insurance companies, billing, auditors and clinics/hospital departments, non-clinical appeal writing, accurate and timely account adjustments all while ensuring compliance with all federal, state, third-party billing regulations and contract agreements. Manages and distributes incoming mail in an accurate and timely manner; includes Epic documentation, logging incoming correspondence, uploading to document warehouse and routing mis-directed mail; processes outgoing certified mail.
Clinical Revenue Cycle Educator West Virginia University MedicineClinical Revenue Cycle EducatorMonongalia County, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC). The Clinical Revenue Cycle Educator provides leadership, coordination, and delivery of training programs across clinical revenue cycle functions, including CDI, coding, denials and utilization review.
Revenue Cycle Support Specialist West Virginia University MedicineRevenue Cycle Support SpecialistWVThis includes handling insurance correspondence, patient billing inquiries, claim follow-ups, denial management letters, and internal communications to ensure accurate, timely, and compliant resolution of revenue cycle issues. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.
Records Management Coordinator Pine Lodge CenterRecords Management CoordinatorBeckley, West Virginia$17–$19 / hourFull timeAs a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Responsibilities: The Records Management Coordinator is responsible to maintain, secure and store all written and electronic records within the nursing center in accordance with federal/state regulations and the Genesis' records management program.
Nurse Practitioner - PRN Amedisys, Inc.Nurse Practitioner - PRNBluefield, West VirginiaPer diemOverview: Nurse Practitioner - PRN - Hospice PRN Schedule: Flexible - Days, Evening and Weekends Make a difference every day as an Amedisys nurse practitioner Join Amedisys-one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and growth come together to help patients heal where they feel most comfortable, at home. Must meet physician-nurse practitioner restrictive collaborative requirements specific to state assigned to work by the Company and supply a copy of all active collaborating physician agreements and indicate whether these will be transferable to your employment with Amedisys.
Medical Director MPO CVS Health CorpMedical Director MPOWV$174,070–$374,920 / yearIn this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. Additional responsibilities may include: Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
Physical Therapist UnitedHealth Group IncPhysical TherapistBuckhannon, WVClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. As members of the Optum family of businesses we are dedicated to helping people feel their best including our team members who create meaningful connections with patients their families each other and the communities we serve.
Home Health Account Executive UnitedHealth Group IncHome Health Account ExecutiveWVClinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support›. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Field Reimbursement Manager - Kidney (Capitol - WV, VA, MD) Vertex PharmaceuticalsField Reimbursement Manager - Kidney (Capitol - WV, VA, MD)West VirginiaCompliantly 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.
Bioinformatician -- Health Services & Outcomes Research -- Chesterfield Bldg 4-Center for Learning & Charleston Area Medical Center Health System IncBioinformatician -- Health Services & Outcomes Research -- Chesterfield Bldg 4-Center for Learning &Charleston, WVThe Bioinformatician will provide high level professional and technical skills in support of systems development, analyzing large datasets, using computational tools to solve problems in healthcare, clinical care, or research with responsibilities including algorithm design, data management, computational programing, statistical analysis, and change management. Preferred: A doctorate in informatics with background in computer science, including writing code for data analysis, statistics, machine learning, data processing and visualization, and competency in verbal and written communication.
NewMedical Claim Analyst CVS Health CorpMedical Claim AnalystWV$18.50–$35.29 / hourThis function includes, but is not limited to the following: Review provider re-submissions of ClaimsXten, Clinical Validation, Prospective Claim Accuracy, Novologix and DRG claims and resolve or prepare them for review by an Aetna clinician. The Medical Claim Analyst will be part of the Provider Coding and Reimbursement (PCR) team who reviews provider coding and reimbursement denial disputes from providers.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)WV$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
NewPhysician Assistant - Parkersburg, WV Wellbe Senior MedicalPhysician Assistant - Parkersburg, WVParkersburg, West Virginia$99,254–$158,413 / yearThe Physician Assistant role is a key member of the team that will be accountable for the care of their patient panel, maintaining accurate, timely and current patient records, and will as part of our longitudinal model will support assuring patients are followed regularly with initial, urgent, transition of care and follow up appointments as needed to care for their health needs. Job Requirements: Educational/ Experience Requirements : Minimum Master’s Degree in Physician Assistant Studies (ARC-PA) from an accredited PA education program that meets the West Virginia state requirement of Accreditation Review Commission on Education for the Physician Assistant or its successor or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs.
NewPhysician Assistant - Charleston, WV Wellbe Senior MedicalPhysician Assistant - Charleston, WVCharleston, West Virginia$101,500–$156,000 / yearThe Physician Assistant role is a key member of the team that will be accountable for the care of their patient panel, maintaining accurate, timely and current patient records, and will as part of our longitudinal model will support assuring patients are followed regularly with initial, urgent, transition of care and follow up appointments as needed to care for their health needs. Educational/ Experience Requirements : Minimum Master’s Degree in Physician Assistant Studies (ARC-PA) from an accredited PA education program that meets the West Virginia state requirement of Accreditation Review Commission on Education for the Physician Assistant or its successor or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs.
(Hybrid) Research Associate Analyst - Health Affairs Institute West Virginia University(Hybrid) Research Associate Analyst - Health Affairs InstituteCharleston, WVFrom the groundbreaking R1 research at our flagship campus in Morgantown to the career-oriented programs at WVU Potomac State in Keyser, and the technology-intensive programs at WVU Tech in Beckley, the contributions of WVU employees resonate across the state, touching lives and shaping futures. '',''Jun 1, 2026'',''Jun 1, 2026'',''FE/AP'',''FE/AP'',''Exempt'',''Exempt'',''Yes'',''Yes'',''Full-time'',''Full-time'',''false'',''377938'',''377938'',''true'',''377938'',''false'',''Submission for the position: (Hybrid) Research Associate Analyst - Health Affairs Institute - (Job Number: 29560)'',''false'',''377938'',''false'',''true''.
Patient Financial Resolution Advocate West Virginia University MedicinePatient Financial Resolution AdvocateWVCollects deposits/co-payments/deductibles/patient liability payments when applicable, provides the patient a receipt and documents payment in the registration/billing systems. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.
Medical Director - ENT CVS Health CorpMedical Director - ENTWV$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.
Medical Director -Spine CVS Health CorpMedical Director -SpineWVRemote$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. The medical directors are responsible for precertification reviews of claim determinations, and provide clinical, coding and reimbursement expertise using multiple computer based applications.
Lead Software Engineer HealthPlanOne LLCLead Software EngineerWVThe Lead Software Engineer will collaborate with cross-functional teams to design, build, and enhance scalable solutions supporting agent sales and business operations, while driving best practices in software architecture, code quality, and agile delivery. NET (Core/9), with hands-on experience across a diverse suite of applications including Blazor, Razor Pages, legacy WebForms, WCF, and Worker Services.
Informatics Consultant CVS Health CorpInformatics ConsultantWV$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Claims Analyst The Health PlanClaims AnalystCharleston, WVUnder the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviews each claim flag in sequence, totally completing one at a time in accordance with established criteria/payment guidelines.
Medical Oncologist -- Cancer Center Beckley -- Beckley-275 Dry Hill Road Charleston Area Medical Center Health System IncMedical Oncologist -- Cancer Center Beckley -- Beckley-275 Dry Hill RoadBeckley, WVThe employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Senior Software Development Engineer CVS Health CorpSenior Software Development EngineerWV$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.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOWV$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.
Pre-Authorization Scheduling Coordinator Bariatric Clinic West Virginia University MedicinePre-Authorization Scheduling Coordinator Bariatric ClinicWVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High school diploma or equivalent required AND One year of recent experience in a physician/hospital scheduling and registration or business office environment OR; Completed Medical Assistant (MA) degree OR; Associate Degree. Responsible for accurate and timely interviewing of patients and/or relative in a courteous manner to obtain registration data based upon comprehensive data elements to complete the registration process.