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.
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.
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.
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.
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.
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.
Front Desk Receptionist Foot and Ankle Clinic of the VirginiasFront Desk ReceptionistCharleston, WVPart timeThis role is responsible for a wide range of tasks, including patient service, appointment scheduling, data entry, electronic health record (EHR) management, and patient education. Facilitate patient flow by notifying providers of arrivals, monitoring delays, and communicating updates to patients and staff.
Cornea Reimbursement Liaison - Charlotte, NC | Charleston, WV | Columbia, SC | Richmond, VA Glaukos CorpCornea Reimbursement Liaison - Charlotte, NC | Charleston, WV | Columbia, SC | Richmond, VACharleston, WVRemoteThis individual appropriately educates HCPs and their office staff on clinical documentation, securing treatment approvals, patient tracking, claim submission, reconciliation management, patient education, drug inventory, patient copay assistance and drug acquisition channels. Specific responsibilities include but are not limited to: Provides HCPs and their office staff education on how to interpret benefit verifications including PA requirements, calculation of patient cost share and drug acquisition options for specific patients enrolled in GPS.
Patient Accounts Resolution Specialist -- Patient Accounts -- General Hospital Charleston Area Medical Center Health System IncPatient Accounts Resolution Specialist -- Patient Accounts -- General HospitalCharleston, WVReview assigned work items daily to resolve "at risk, past due, and technical denial" claim issues Work with coding to resolve coding related denials Work with Utilization Review to resolve authorization related denials and appeals Use various payer web portals and DDE systems to obtain claim information that will help in resolution Contact payers by phone to resolve claim issues Contact Physician offices to obtain necessary information needed to resolve claims Manually and accurately resolve claims in Suspense (Medicare only) Ensure that medical records and itemized statement are submitted and received when requested by payers (work with contracted agencies as applicable) Follow proper workflow assigned by management Ensure accurate rebilling of claims to avoid denials Communicate billing errors that can be prevented to Department Manager, Supervisor, or Team Lead Communicate identified system related issue to Department Manager, Supervisor, or Team Lead Accurately, Professionally, and thoroughly document necessary information necessary to resolve outstanding balances in encounter timeline Ensure that result driven follow up is be accomplished and documented. Other duties as assigned Skills: Healthcare billing and collection knowledge Ability to interpret a payer explanation of benefit (EOB) Ability to identify and resolve claim issues Excellent communication and customers service skills Computer and keyboarding skills Knowledge of Microsoft software applications (Excel and Word) a plus Cerner knowledge a plus.
Front Desk Receptionist US Foot and Ankle Specialists CareersFront Desk ReceptionistCharleston, West VirginiaThis role is responsible for a wide range of tasks, including patient service, appointment scheduling, data entry, electronic health record (EHR) management, and patient education. Facilitate patient flow by notifying providers of arrivals, monitoring delays, and communicating updates to patients and staff.
AD, Access & Reimbursement (ADAR) CV - Lexington, KY NovartisAD, Access & Reimbursement (ADAR) CV - Lexington, KYCharleston, West VirginiaRemoteAccess And Reimbursement Strategy (Inactive), Agility (Inactive), Analytical Skill (Inactive), Analytical Thinking, Cross-Functional Collaboration, Customer-Centric Mindset (Inactive), Employee Development, Finance, Go-to-Market Strategies, Healthcare Policies, Healthcare Sector Understanding (Inactive), Health Economics, Health Technology Assessment (HTA), Innovation, Inspirational Leadership, Market Access Strategies, People Management, Process Management, Project Management, Public Affairs, Real World Evidence (RWE), Regulatory Compliance, Risk Management, Value Propositions Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staff in order to support integration of those products into office processes and workflows.
Field Reimbursement Manager - Kidney (Capitol - WV, VA, MD) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (Capitol - WV, VA, MD)WV$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly 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.
Pre-Certification Specialist Charleston Area Medical Center Health System IncPre-Certification SpecialistCharleston, 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. Correspond with medicare and various insurance companies to facilitate obtaining pertinent data on compliance, authorizations, verifications, progress notes, medical necessity guidelines and precertification and pre-authorization requirements.
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.
Bilingual Customer Service Representative ibexBilingual Customer Service RepresentativeCharleston, West VirginiaArkansas, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Vermont, Virginia, West Virginia, Wisconsin, and Wyoming. Researching and consistently providing accurate information to resolve all member and provider inquiries through verbal and written communications through all channels including phone, email, web portal, and chat interactions.
Bilingual Customer Service Representative IBEX Holdings LtdBilingual Customer Service RepresentativeCharleston, WVArkansas, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Vermont, Virginia, West Virginia, Wisconsin, and Wyoming. About the role: Bilingual Customer Service Representatives will be working directly with the customer to answer general inquiries, address concerns, and assist with requests about products and services across multiple lines of business.
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.
Revenue Cycle - Project Manager Charleston Area Medical Center Health System IncRevenue Cycle - Project ManagerCharleston, WVBachelor's Degree (Required) Bachelor's degree in business, Health Administration, or a Related Field • Experience: 3+ years of experience in healthcare revenue cycle management, billing, or consulting. The 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.