Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
04/15/2024
Full time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
04/15/2024
Full time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
04/15/2024
Full time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As a Risk Adjustment Specialist, you will serve as the relationship owner and strategic partner for the Provider Market across the state of Southern California. Your primary goal is to drive provider engagement and the adoption of Optum Risk Adjustment programs through a consultative approach. If you reside in Southern California, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner and Strategic Partner for key markets/provider groups in collaboration with Market Leadership Provide guidance and consultative feedback to groups, MSOs and IPAs to drive provider engagement and adoption of Optum program and provide recommendations for improvement (Strategy Meetings) Partner with business owners to identify methods to execute on key goals and initiatives Effectively manage In-Office Assessment Program Ability to review risk adjustment key performance data (Prevalence, RAF, recapture, etc.) to assist in development of programs and initiatives for risk accuracy Collaborate and coordinate with stakeholders and project teams Deliver effective presentations with targeted audiences that include senior leadership with groups and MSOs Provide program progress and updates to leadership Work in collaboration with team coders to execute education at provider level Work with senior leaders to continue to drive progress and performance. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Work with the business to develop program success metrics and ongoing performance metrics Provides solid leadership and judgment; effectively build and deepen relationships across business Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost Ability to travel 70% of time throughout the region, mostly day trips You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of experience working in the healthcare market 5+ years of experience working in the risk adjustment space Intermediate level of experience analyzing and interpreting data to create tactical action plans Demonstrated ability to influence and to drive projects without formal authority Proven ability to develop and present to senior leadership/executives Currently reside in the Southern California market Ability to travel 50-75% of the time within your designated territory Preferred Qualifications: CPC, CRC or other coding certification 1+ years of coding performed at a health care facility Clinical work experience (i.e. LPN, RN, NP) Experience in management position in a physician practice Experience within the healthcare payer market Expertise in chronic condition areas (i.e. oncology, diabetes, etc.) Knowledge of the Healthcare industry including physician practices, market access, insurance, managed care, organized delivery systems, STARs/HEDIS, Value based care and risk adjustment models Knowledge of billing/claims submission and other related actions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. In this position as a Coding & Clinical Auditor / DRG Specialist RN, you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification Expert knowledge of and the ability to: identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance Must be fluent in the application of current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations, in addition to demonstrating working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing Solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment Writes clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements Maintain and manages daily case review assignments, with a high emphasis on quality Provide clinical support and expertise to the other investigative and analytical areas Will be working in a high-volume production environment that is matrix driven You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Unrestricted RN (registered nurse) CCS/CIC or will obtain within 6 months of hire 3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies Expert knowledge of ICD -10-CM coding including but not limited to; expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM) Expert knowledge of ICD-10-PCS coding including but not limited to; expert knowledge of the structural components of PCS including but not limited to; selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers Preferred Qualifications: Experience with prior DRG concurrent and/or retrospective overpayment identification audits Experience with readmission reviews of claims Experience with DRG encoder tools (ex. 3M) Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry Healthcare claims experience Managed care experience Knowledge of health insurance business, industry terminology, and regulatory guidelines Soft Skills: Ability to use a Windows PC with the ability to utilize multiple applications at the same time Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail Ability to work independently in a remote environment and deliver exceptional results Excellent time management and work prioritization skills Physical Requirements and Work Environment: Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer Have a secluded office area in which to perform job duties during the work day Have reliable high - speed internet access and a work environment free from distractions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $33.75 to $66.25 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
04/07/2024
Full time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. In this position as a Coding & Clinical Auditor / DRG Specialist RN, you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification Expert knowledge of and the ability to: identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance Must be fluent in the application of current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations, in addition to demonstrating working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing Solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment Writes clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements Maintain and manages daily case review assignments, with a high emphasis on quality Provide clinical support and expertise to the other investigative and analytical areas Will be working in a high-volume production environment that is matrix driven You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Unrestricted RN (registered nurse) CCS/CIC or will obtain within 6 months of hire 3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies Expert knowledge of ICD -10-CM coding including but not limited to; expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM) Expert knowledge of ICD-10-PCS coding including but not limited to; expert knowledge of the structural components of PCS including but not limited to; selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers Preferred Qualifications: Experience with prior DRG concurrent and/or retrospective overpayment identification audits Experience with readmission reviews of claims Experience with DRG encoder tools (ex. 3M) Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry Healthcare claims experience Managed care experience Knowledge of health insurance business, industry terminology, and regulatory guidelines Soft Skills: Ability to use a Windows PC with the ability to utilize multiple applications at the same time Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail Ability to work independently in a remote environment and deliver exceptional results Excellent time management and work prioritization skills Physical Requirements and Work Environment: Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer Have a secluded office area in which to perform job duties during the work day Have reliable high - speed internet access and a work environment free from distractions All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $33.75 to $66.25 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Commercial Accounting Coordinator - Remote Opportunity - ( 210006KB ) Description About KinderCare Education KinderCare Education operatesmore than 1,380early learning centers,andmore than560Champions sites, supported by a corporate team ofnearly 600headquarters employees in Portland, Oregon. In 2019, KinderCare Educationearned their thirdGallup Great Workplace Award one of only 39companies worldwide towin this award. In neighborhoods with our KinderCare Learning Centers that offer early childhood education and child care for children six weeks to 12 years old At work through KinderCare Education at Work , family benefits for employers including on-site and near-site early learning centers and back-up care for last-minute child care In local schools with our Champions before and after-school programs. Job Summary: Do you love Accounting and Real Estate? Then this is an opportunity for you! We are looking for someone who will be supporting the Asset Management team by being responsible for auditing/processing all lease related payables, for KinderCare's real estate portfolio. Occupancy Cost focus. Build and maintain effective relationships with landlords, their representatives, Legal and Finance departments in support of day-to-day real estate interactions, processing functions and payments related to leases. Job Responsibilities: Process incoming landlord invoices from department email to excel tracking log. In depth audit and reconciliation of landlord common area maintenance (CAM) billings. To ensure cost savings in compliance with the lease. Read and interpret lease language to determine tenant financial obligations. Work with Landlords on reconciliation discrepancies or overcharges. Maintain tracking logs, work logs, and alerts according to documented process including lease-related action dates, and requirements, upcoming lease expirations, renewal options, and other obligations and rights. Lease renewal process such as tracking dates and pulling materials for lease renewal meetings. Assist Lease Compliance Specialists with lease administration duties, maintaining files, and administrative tasks. Work under leadership direction to ensure that all processes are either Sarbanes-Oxley compliant or can be quickly adapted to be compliant. Related duties as assigned. Qualifications Experience and Education: A minimum of two years combined experience in the fields of real estate coordination, commercial lease coordination, real estate accounting, or a minimum of five years of general accounting experience. College degree strongly preferred. Knowledge, Skills, and Abilities: Strong knowledge, of general business administration and accounting/finances required. Extensive experience with Lucernex or related database system. Expertise in Microsoft Excel is required. Strong analytical and oral/written presentation skills. Experience with research, reporting, legal document review desired. Attention to detail and accuracy. Incumbent will need to be flexible to adjust to changing needs of Department. Oracle experience helpful. KinderCare Education employs more than 32,000 team members across 1,700 locations nationwide. Our devoted family of education providers leads the nation in accreditation and includes KinderCare Learning Centers, KinderCare Education at Work, Champions Before- and After-School Programs, Cambridge Schools , Knowledge Beginnings and The Grove School. KinderCare Education is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law. Primary Location : US-Oregon-Portland Other Locations : US-Remote Opportunity Job : National Support Center Organization : NSC Schedule : Permanent Shift : Standard Job Type : Full-time Day Job Travel : No Job Posting : Oct 28, 2021, 5:53:28 PM
11/06/2021
Full time
Commercial Accounting Coordinator - Remote Opportunity - ( 210006KB ) Description About KinderCare Education KinderCare Education operatesmore than 1,380early learning centers,andmore than560Champions sites, supported by a corporate team ofnearly 600headquarters employees in Portland, Oregon. In 2019, KinderCare Educationearned their thirdGallup Great Workplace Award one of only 39companies worldwide towin this award. In neighborhoods with our KinderCare Learning Centers that offer early childhood education and child care for children six weeks to 12 years old At work through KinderCare Education at Work , family benefits for employers including on-site and near-site early learning centers and back-up care for last-minute child care In local schools with our Champions before and after-school programs. Job Summary: Do you love Accounting and Real Estate? Then this is an opportunity for you! We are looking for someone who will be supporting the Asset Management team by being responsible for auditing/processing all lease related payables, for KinderCare's real estate portfolio. Occupancy Cost focus. Build and maintain effective relationships with landlords, their representatives, Legal and Finance departments in support of day-to-day real estate interactions, processing functions and payments related to leases. Job Responsibilities: Process incoming landlord invoices from department email to excel tracking log. In depth audit and reconciliation of landlord common area maintenance (CAM) billings. To ensure cost savings in compliance with the lease. Read and interpret lease language to determine tenant financial obligations. Work with Landlords on reconciliation discrepancies or overcharges. Maintain tracking logs, work logs, and alerts according to documented process including lease-related action dates, and requirements, upcoming lease expirations, renewal options, and other obligations and rights. Lease renewal process such as tracking dates and pulling materials for lease renewal meetings. Assist Lease Compliance Specialists with lease administration duties, maintaining files, and administrative tasks. Work under leadership direction to ensure that all processes are either Sarbanes-Oxley compliant or can be quickly adapted to be compliant. Related duties as assigned. Qualifications Experience and Education: A minimum of two years combined experience in the fields of real estate coordination, commercial lease coordination, real estate accounting, or a minimum of five years of general accounting experience. College degree strongly preferred. Knowledge, Skills, and Abilities: Strong knowledge, of general business administration and accounting/finances required. Extensive experience with Lucernex or related database system. Expertise in Microsoft Excel is required. Strong analytical and oral/written presentation skills. Experience with research, reporting, legal document review desired. Attention to detail and accuracy. Incumbent will need to be flexible to adjust to changing needs of Department. Oracle experience helpful. KinderCare Education employs more than 32,000 team members across 1,700 locations nationwide. Our devoted family of education providers leads the nation in accreditation and includes KinderCare Learning Centers, KinderCare Education at Work, Champions Before- and After-School Programs, Cambridge Schools , Knowledge Beginnings and The Grove School. KinderCare Education is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law. Primary Location : US-Oregon-Portland Other Locations : US-Remote Opportunity Job : National Support Center Organization : NSC Schedule : Permanent Shift : Standard Job Type : Full-time Day Job Travel : No Job Posting : Oct 28, 2021, 5:53:28 PM
Donnelley Financial Solutions
Palo Alto, California
Description: Donnelley Financial Solutions (DFIN) is a leader in risk and compliance solutions, providing insightful technology, industry expertise and data insights to clients across the globe. We're here to help you make smarter decisions with insightful technology, industry expertise and data insights at every stage of your business and investment lifecycles. As markets fluctuate, regulations evolve and technology advances, we're there. And through it all, we deliver confidence with the right solutions in moments that matter. Summary: Acts as a project manager and service liaison between customer, sales, and multiple production platforms. Advocates on behalf of the client with a proactive, collaborative approach to all departments and the production team. Uses experience and knowledge, including that of XBRL, to provide advisory and consultant services to clients to provide direction in meeting their project needs and goals to achieve and meet all regulatory requirements of the client. Works directly with clients to develops an overall plan to coordinate the production of client documents, electronic SEC filings and print production in order to achieve the objectives of the service agreement in compliance of customer expectations, company policy, and profit and quality requirements. Applies understanding of customer's business needs in building solid customer relationships, monitoring customer satisfaction, and providing consulting in conjunction with sales. May participate in support roles in sales presentations and client site visits with sales force. May serve in leadership roles within shifts or project teams to lead successful accomplishment of the above objectives. Has primary responsibility for all steps of service delivery, including Composition and Manufacturing through final disposition of the customer product. Responsibilities: Work assignments are often routine but on occasion may be non-routine and require some deviation from accepted practice and procedures to complete. Assignments are given in terms of subject area concerned, with specific objectives and possible problems identified. Follow guidelines which may include company and/or departmental policies and procedures, and rules and regulations that are well established but may require some deviation from normal operating procedures when completing more unique assignments. Engage customers to gather job requirements and translate customer requirements into detailed workflow instructions and oversee workflow across multiple departments such as Composition, Desktop, Prepress, Manufacturing & Shipping. Engage clients in Filing, Print, Word Processing and XBRL to provide them with the best possible experience. Responsible for researching and compiling all required data elements needed to prepare the appropriate electronic filing and/or composition of SEC EDGAR filings, prospectuses, annual reports and other financial compliance documents. Provide quality review for other Account Specialists to ensure all information is accounted for and accurate before commencement of composition, print orders or filing of online EDGAR filings. Confer with customers and/or customers legal counsel throughout Composition to keep them informed of the status of jobs, solicit additional information needed for current jobs and coordinate changes to jobs. Ensure final documents are signed off and approved for print or positing to online systems. Additional Responsibilities: May coordinate production of printed documents and components with other internal plants and/or external vendors. Engage appropriate departments to verify the issue and determine the root cause on issues that arise. Communicate with customers regarding the resolution of issues. Monitor progress of jobs throughout production, conferring with manufacturing operations on counts and final runs and ensure the final product meets customer requirements and company standards. May tally the final production runs and work performed to assemble paperwork for billing purposes. Maintain continuing education and training in new Financial Services platforms and technologies as they are implemented and introduced into the service offerings. Mentor and train Account specialist 1 and 2 levels. Management and coordination of projects for new and existing clients including managing the client experience and interaction with other team members. May present internal and client presentations regarding Financial Services products and offerings relevant to specific client needs. Performs other related duties and participates in special projects as assigned. Basic Qualifications: The qualifications below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor degree in discipline related to functional work or role with 5-7 years of relevant work experience managing all Financial Services products, including Printed Documents and SEC. A degree in Accounting/Finance, or accountancy experience, would be a strong positive. Filings OR demonstrated ability to meet the job requirements through a comparable number of years of applicable work experience. Preferred Qualifications: Able to apply broad work experience and knowledge when analyzing complex problems. Must be able consistently identify critical elements, variables and alternatives to develop solutions. Must be able to organize/prioritize existing resources and incorporate new information, as needed, to implement the most effective solutions. Able to communicate clearly and courteously with those who need to know of decisions/actions/problems. Able to apply excellent business acumen and collaborative skills when resolving problems. Able to apply excellent functional computer knowledge in utilizing Microsoft Windows, or other technical tools in completing assignments. Able to apply expertise in all the tools or applications used to complete work assignments. Able to mentor junior level team members in the use of tools and/or systems in the position. Requires excellent communication skills with ability to state messages in a clear manner by using language that is easy for others to understand. Able to explain programs policies and procedures in language that is understood by others. Must be able to modify communication style both formal and informal to match the appropriate level of the audience targeted. Requires strong understanding of the impact of a message on the organization or customer. Able to write with the clarity and precision necessary for the work being performed. It is the policy of Donnelley Financial Solutions to select, place and manage all its employees without discrimination based on race, color, national origin, gender, age, religion, actual or perceived disability, veteran's status, actual or perceived sexual orientation, genetic information or any other protected status. If you are a qualified individual with a disability or a disabled veteran, you have the right to request a reasonable accommodation if you are unable or limited in your ability to use or access jobs.dfinsolutions.com as a result of your disability. You can request a reasonable accommodation by sending an email to .#BI-Remote
11/05/2021
Full time
Description: Donnelley Financial Solutions (DFIN) is a leader in risk and compliance solutions, providing insightful technology, industry expertise and data insights to clients across the globe. We're here to help you make smarter decisions with insightful technology, industry expertise and data insights at every stage of your business and investment lifecycles. As markets fluctuate, regulations evolve and technology advances, we're there. And through it all, we deliver confidence with the right solutions in moments that matter. Summary: Acts as a project manager and service liaison between customer, sales, and multiple production platforms. Advocates on behalf of the client with a proactive, collaborative approach to all departments and the production team. Uses experience and knowledge, including that of XBRL, to provide advisory and consultant services to clients to provide direction in meeting their project needs and goals to achieve and meet all regulatory requirements of the client. Works directly with clients to develops an overall plan to coordinate the production of client documents, electronic SEC filings and print production in order to achieve the objectives of the service agreement in compliance of customer expectations, company policy, and profit and quality requirements. Applies understanding of customer's business needs in building solid customer relationships, monitoring customer satisfaction, and providing consulting in conjunction with sales. May participate in support roles in sales presentations and client site visits with sales force. May serve in leadership roles within shifts or project teams to lead successful accomplishment of the above objectives. Has primary responsibility for all steps of service delivery, including Composition and Manufacturing through final disposition of the customer product. Responsibilities: Work assignments are often routine but on occasion may be non-routine and require some deviation from accepted practice and procedures to complete. Assignments are given in terms of subject area concerned, with specific objectives and possible problems identified. Follow guidelines which may include company and/or departmental policies and procedures, and rules and regulations that are well established but may require some deviation from normal operating procedures when completing more unique assignments. Engage customers to gather job requirements and translate customer requirements into detailed workflow instructions and oversee workflow across multiple departments such as Composition, Desktop, Prepress, Manufacturing & Shipping. Engage clients in Filing, Print, Word Processing and XBRL to provide them with the best possible experience. Responsible for researching and compiling all required data elements needed to prepare the appropriate electronic filing and/or composition of SEC EDGAR filings, prospectuses, annual reports and other financial compliance documents. Provide quality review for other Account Specialists to ensure all information is accounted for and accurate before commencement of composition, print orders or filing of online EDGAR filings. Confer with customers and/or customers legal counsel throughout Composition to keep them informed of the status of jobs, solicit additional information needed for current jobs and coordinate changes to jobs. Ensure final documents are signed off and approved for print or positing to online systems. Additional Responsibilities: May coordinate production of printed documents and components with other internal plants and/or external vendors. Engage appropriate departments to verify the issue and determine the root cause on issues that arise. Communicate with customers regarding the resolution of issues. Monitor progress of jobs throughout production, conferring with manufacturing operations on counts and final runs and ensure the final product meets customer requirements and company standards. May tally the final production runs and work performed to assemble paperwork for billing purposes. Maintain continuing education and training in new Financial Services platforms and technologies as they are implemented and introduced into the service offerings. Mentor and train Account specialist 1 and 2 levels. Management and coordination of projects for new and existing clients including managing the client experience and interaction with other team members. May present internal and client presentations regarding Financial Services products and offerings relevant to specific client needs. Performs other related duties and participates in special projects as assigned. Basic Qualifications: The qualifications below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor degree in discipline related to functional work or role with 5-7 years of relevant work experience managing all Financial Services products, including Printed Documents and SEC. A degree in Accounting/Finance, or accountancy experience, would be a strong positive. Filings OR demonstrated ability to meet the job requirements through a comparable number of years of applicable work experience. Preferred Qualifications: Able to apply broad work experience and knowledge when analyzing complex problems. Must be able consistently identify critical elements, variables and alternatives to develop solutions. Must be able to organize/prioritize existing resources and incorporate new information, as needed, to implement the most effective solutions. Able to communicate clearly and courteously with those who need to know of decisions/actions/problems. Able to apply excellent business acumen and collaborative skills when resolving problems. Able to apply excellent functional computer knowledge in utilizing Microsoft Windows, or other technical tools in completing assignments. Able to apply expertise in all the tools or applications used to complete work assignments. Able to mentor junior level team members in the use of tools and/or systems in the position. Requires excellent communication skills with ability to state messages in a clear manner by using language that is easy for others to understand. Able to explain programs policies and procedures in language that is understood by others. Must be able to modify communication style both formal and informal to match the appropriate level of the audience targeted. Requires strong understanding of the impact of a message on the organization or customer. Able to write with the clarity and precision necessary for the work being performed. It is the policy of Donnelley Financial Solutions to select, place and manage all its employees without discrimination based on race, color, national origin, gender, age, religion, actual or perceived disability, veteran's status, actual or perceived sexual orientation, genetic information or any other protected status. If you are a qualified individual with a disability or a disabled veteran, you have the right to request a reasonable accommodation if you are unable or limited in your ability to use or access jobs.dfinsolutions.com as a result of your disability. You can request a reasonable accommodation by sending an email to .#BI-Remote
Overview Have you ever considered a career in medical billing, but have been told that you need specific experience or education in order to get the job? Do you want to work for a stable, yet fast-growing company that is recognized as one of the leaders in its field? If so, then we may have the right opportunity for you! Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women's and children's health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services. As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia. Don't have a car or think that Conshohocken is too far away... Well, we have great news for you!! We are located across the street from the Miquon Train Station which is on Septa's Manayunk/ Norristown Regional Rail line. This is a 7 minute commute from the Manayunk Station, 15 minutes from the North Broad Station, 25 minutes from the Jefferson Station and 35 minutes from 30th Street Station. We have an immediate FULL-TIME entry-level clerk position in our Cash Posting department available! Position Summary: The Payment Posting Clerk provides administrative and clerical support to Payment Posting Management staff by sorting department mail, working with refund checks as well as live checks, mailing W-9 forms to insurance companies, completing Medicaid adjustments and other duties as assigned. Pay Rate - $12.00 per hour Hours- Monday-Friday-Dayshift hours Employment Status- Full-Time, in office (This is NOT a remote position) Responsibilities Sort refund checks & distribute the ones that need to be reviewed to the refund specialists Sort departmental mail to work or deliver to employees, supervisors and manager Distribute the incoming faxes to the correct area Process the collection agency checks Work live checks to see if they should be deposited or returned Mail W-9 forms to insurance companies when necessary Identify & print the remits for the refund checks & verify all information before checks are sent to insurance companies Complete Medicaid adjustment forms for all payers that require them Identify the patients for closed lock box clients & prepare them for deposit Responsible for adhering to Information Security Policies and ensuring Envision is as secure as possible. Qualifications Proof of High School Diploma or General Education Degree (GED) Ability to work independently Excellent verbal communication/interpersonal skills Detail oriented person Previous work experience in an office environment required Some computer skills required We offer a comprehensive benefits package that includes : Medical, Dental, Vision and Prescription benefits available on your first day of employment! Generous PTO (paid time off) package including 9 paid holidays per year 401(k) 15% discount with Septa (Monthly pass) Comprehensive company paid training Monday-Friday work week Opportunities for growth and advancement If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit . Envision Physician Services is an Equal Opportunity Employer.
08/31/2021
Full time
Overview Have you ever considered a career in medical billing, but have been told that you need specific experience or education in order to get the job? Do you want to work for a stable, yet fast-growing company that is recognized as one of the leaders in its field? If so, then we may have the right opportunity for you! Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women's and children's health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services. As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia. Don't have a car or think that Conshohocken is too far away... Well, we have great news for you!! We are located across the street from the Miquon Train Station which is on Septa's Manayunk/ Norristown Regional Rail line. This is a 7 minute commute from the Manayunk Station, 15 minutes from the North Broad Station, 25 minutes from the Jefferson Station and 35 minutes from 30th Street Station. We have an immediate FULL-TIME entry-level clerk position in our Cash Posting department available! Position Summary: The Payment Posting Clerk provides administrative and clerical support to Payment Posting Management staff by sorting department mail, working with refund checks as well as live checks, mailing W-9 forms to insurance companies, completing Medicaid adjustments and other duties as assigned. Pay Rate - $12.00 per hour Hours- Monday-Friday-Dayshift hours Employment Status- Full-Time, in office (This is NOT a remote position) Responsibilities Sort refund checks & distribute the ones that need to be reviewed to the refund specialists Sort departmental mail to work or deliver to employees, supervisors and manager Distribute the incoming faxes to the correct area Process the collection agency checks Work live checks to see if they should be deposited or returned Mail W-9 forms to insurance companies when necessary Identify & print the remits for the refund checks & verify all information before checks are sent to insurance companies Complete Medicaid adjustment forms for all payers that require them Identify the patients for closed lock box clients & prepare them for deposit Responsible for adhering to Information Security Policies and ensuring Envision is as secure as possible. Qualifications Proof of High School Diploma or General Education Degree (GED) Ability to work independently Excellent verbal communication/interpersonal skills Detail oriented person Previous work experience in an office environment required Some computer skills required We offer a comprehensive benefits package that includes : Medical, Dental, Vision and Prescription benefits available on your first day of employment! Generous PTO (paid time off) package including 9 paid holidays per year 401(k) 15% discount with Septa (Monthly pass) Comprehensive company paid training Monday-Friday work week Opportunities for growth and advancement If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit . Envision Physician Services is an Equal Opportunity Employer.
SUMMARY Supports client accounts and laboratory logistics by proactively providing customer support to clients, patients, Prometheus sales representatives, and other departments including marketing and billing. Serves as frontline lead generating resource and promotes Prometheus' products and services to health care practitioners (HCPs), staff and all decision-makers related to the products' use primarily through outbound customer contact such as telephone and email. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Responsible for outbound communication of availability of test results upon issuance Maintains strict adherence to provided call plan (list of targets) and executes identified strategy for lead generation / escalation. Designs and implements a remote-based communication productivity plan for assigned territory to ensure effective reach and frequency to targeted customers to maximize sales Makes outbound customer contact using multiple means (such as telephone, email, fax) to schedule virtual sales presentations to target decision-makers for Regional Sales Specialists Conducts lead qualification activities on behalf of Regional Sales Specialists in an attempt to schedule more in depth reviews of product portfolio Identifies areas where upselling / add-on opportunities exist Educates HCPs on entire Prometheus product suite where and when appropriate Logs all interactions within CRM in a timely fashion Enters new customer data and update changes in the company customer database. Identifies and investigates customer concerns. Addresses and or communicates with appropriate company personnel to promptly solve customer problems Handles inbound calls triaged from Client Customer Service group; identifies optimal solutions for customer needs Notifies HCPs of abnormal and cancelled test results via phone or fax on a daily basis SUPERVISORY RESPONSIBILITIES This job has no supervisory responsibilities. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. This along with the requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Strong presentation skills; ability to effectively convey concepts in a clear, concise and professional manner through telephone and face-to-face interactions. Excellent interpersonal, time management and organizational skills. Adaptable, open to change, and able to work in ambiguous situations and respond to new information and unexpected circumstances. Able to productively and proactively contribute to a team environment while demonstrating ability to manage workload and priorities independently. Ability to function productively within a fast-paced, multi-tasking, entrepreneurial environment. Ability to work on telephone and computer simultaneously. Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day. EDUCATION and/or EXPERIENCE Generally requires 2 years' experience in a related medical customer service role or inside sales functions. Healthcare, biotech, and/or medical billing setting highly preferred. Computer literacy is essential with proficiency in Microsoft Word, Excel, and PowerPoint. Candidate should possess analytical and problem solving skills; have very good verbal and written communication skills. Previous handling of inbound and outbound call center phones preferred . LANGUAGE SKILLS Ability to write routine reports and correspondence. Excellent verbal communication skills with ability to speak effectively with customers or employees of organization. Ability to develop and maintain strong and effective working relationships with internal and external customers. MATHEMATICAL SKILLS Ability to calculate figures and amounts such as discount, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. REASONING ABILITY High skills: Ability to define problems, collect data, establish facts and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables surrounding the analysis of managed market strategies and contracting. CERTIFICATES, LICENSES, REGISTRATIONS None Required PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet. All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or other protected class.
01/31/2021
Full time
SUMMARY Supports client accounts and laboratory logistics by proactively providing customer support to clients, patients, Prometheus sales representatives, and other departments including marketing and billing. Serves as frontline lead generating resource and promotes Prometheus' products and services to health care practitioners (HCPs), staff and all decision-makers related to the products' use primarily through outbound customer contact such as telephone and email. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Responsible for outbound communication of availability of test results upon issuance Maintains strict adherence to provided call plan (list of targets) and executes identified strategy for lead generation / escalation. Designs and implements a remote-based communication productivity plan for assigned territory to ensure effective reach and frequency to targeted customers to maximize sales Makes outbound customer contact using multiple means (such as telephone, email, fax) to schedule virtual sales presentations to target decision-makers for Regional Sales Specialists Conducts lead qualification activities on behalf of Regional Sales Specialists in an attempt to schedule more in depth reviews of product portfolio Identifies areas where upselling / add-on opportunities exist Educates HCPs on entire Prometheus product suite where and when appropriate Logs all interactions within CRM in a timely fashion Enters new customer data and update changes in the company customer database. Identifies and investigates customer concerns. Addresses and or communicates with appropriate company personnel to promptly solve customer problems Handles inbound calls triaged from Client Customer Service group; identifies optimal solutions for customer needs Notifies HCPs of abnormal and cancelled test results via phone or fax on a daily basis SUPERVISORY RESPONSIBILITIES This job has no supervisory responsibilities. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. This along with the requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Strong presentation skills; ability to effectively convey concepts in a clear, concise and professional manner through telephone and face-to-face interactions. Excellent interpersonal, time management and organizational skills. Adaptable, open to change, and able to work in ambiguous situations and respond to new information and unexpected circumstances. Able to productively and proactively contribute to a team environment while demonstrating ability to manage workload and priorities independently. Ability to function productively within a fast-paced, multi-tasking, entrepreneurial environment. Ability to work on telephone and computer simultaneously. Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day. EDUCATION and/or EXPERIENCE Generally requires 2 years' experience in a related medical customer service role or inside sales functions. Healthcare, biotech, and/or medical billing setting highly preferred. Computer literacy is essential with proficiency in Microsoft Word, Excel, and PowerPoint. Candidate should possess analytical and problem solving skills; have very good verbal and written communication skills. Previous handling of inbound and outbound call center phones preferred . LANGUAGE SKILLS Ability to write routine reports and correspondence. Excellent verbal communication skills with ability to speak effectively with customers or employees of organization. Ability to develop and maintain strong and effective working relationships with internal and external customers. MATHEMATICAL SKILLS Ability to calculate figures and amounts such as discount, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. REASONING ABILITY High skills: Ability to define problems, collect data, establish facts and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables surrounding the analysis of managed market strategies and contracting. CERTIFICATES, LICENSES, REGISTRATIONS None Required PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet. All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or other protected class.
Company Overview: At ADT, we've been in the business of helping save lives for more than 145 years. As the number one smart home security provider serving residential and business customers, our people are our most important asset. Headquartered in Boca Raton, FL and at more than 200 locations across North America, our employees help empower our customers to live more secure and confident lives. Join our team and help us protect what matters most. For more information, visit or follow us on Twitter , LinkedIn , Facebook and Instagram . Essential Duties/Responsibilities Confirm RFP specifications can be met (district capabilities and coverage) Assume project lead role on large scale fire life safety, security and monitoring opportunities Discuss areas of gaps with Commercial Real Estate Sourcing Team members and ensure ADT Commercial's participation Ensuring the team remains focused and on track, including addressing any conflicts or bottlenecks Engage with Local District Operations teams to assist with project estimates, bookings, change orders, and billing. Prepare Pre-qualification documents Assist in identifying sub-contractors to execute work Work with subcontractors to acquire pricing for services as needed for RFP scopes that cannot be self-performed. Secure local team members and authorized subcontractors to perform site surveys Develop execution strategies with Local District and Client Operations teams to implement service scopes Understanding of SmartSheet to track site survey data entry Prepare RFX questions and address scope clarifications Ensure Salesforce data entry using designed CRE naming convention Collect pricing data from sales team and service partners Prepare scope description, exclusions, clarifications Utilize MMB to create and track job execution progress (including milestones, schedules, staffing, communication) Serve as a subject matter expert on client calls (related to fire & life safety and security services/projects) Assist with on-boarding of new portfolio accounts within commercial real estate vertical Conduct deep dive analysis to identify existing client accounts/agreements to ensure proper onboarding Update compliance portals (ex: Avetta, ISN, GRMS, Coupa) Assist with data collection for internal monthly/quarterly CRE spend reports utilizing data from Sales Pilot and Salesforce Maintain relationship with National Accounts Coordinators (NAC's) to ensure service delivery and KPI metrics Work with CRE team/legal to upload amendments/SOW from existing client accounts to add services Create and assign individual salesforce opportunities with input from CRE team (established clients) Coordinate with sales team members to ensure on-time completion of client proposals Support CRE team in establishing new relationships Facilitate introductory calls with new clients to outline service inbound procedure & understand KPI's Provide and coordinate representation at trade shows and industry events
01/19/2021
Full time
Company Overview: At ADT, we've been in the business of helping save lives for more than 145 years. As the number one smart home security provider serving residential and business customers, our people are our most important asset. Headquartered in Boca Raton, FL and at more than 200 locations across North America, our employees help empower our customers to live more secure and confident lives. Join our team and help us protect what matters most. For more information, visit or follow us on Twitter , LinkedIn , Facebook and Instagram . Essential Duties/Responsibilities Confirm RFP specifications can be met (district capabilities and coverage) Assume project lead role on large scale fire life safety, security and monitoring opportunities Discuss areas of gaps with Commercial Real Estate Sourcing Team members and ensure ADT Commercial's participation Ensuring the team remains focused and on track, including addressing any conflicts or bottlenecks Engage with Local District Operations teams to assist with project estimates, bookings, change orders, and billing. Prepare Pre-qualification documents Assist in identifying sub-contractors to execute work Work with subcontractors to acquire pricing for services as needed for RFP scopes that cannot be self-performed. Secure local team members and authorized subcontractors to perform site surveys Develop execution strategies with Local District and Client Operations teams to implement service scopes Understanding of SmartSheet to track site survey data entry Prepare RFX questions and address scope clarifications Ensure Salesforce data entry using designed CRE naming convention Collect pricing data from sales team and service partners Prepare scope description, exclusions, clarifications Utilize MMB to create and track job execution progress (including milestones, schedules, staffing, communication) Serve as a subject matter expert on client calls (related to fire & life safety and security services/projects) Assist with on-boarding of new portfolio accounts within commercial real estate vertical Conduct deep dive analysis to identify existing client accounts/agreements to ensure proper onboarding Update compliance portals (ex: Avetta, ISN, GRMS, Coupa) Assist with data collection for internal monthly/quarterly CRE spend reports utilizing data from Sales Pilot and Salesforce Maintain relationship with National Accounts Coordinators (NAC's) to ensure service delivery and KPI metrics Work with CRE team/legal to upload amendments/SOW from existing client accounts to add services Create and assign individual salesforce opportunities with input from CRE team (established clients) Coordinate with sales team members to ensure on-time completion of client proposals Support CRE team in establishing new relationships Facilitate introductory calls with new clients to outline service inbound procedure & understand KPI's Provide and coordinate representation at trade shows and industry events
Atrilogy's direct client is seeking a Contract Definition Analyst for an 8+ month contract . This position is 100% Remote. RESPONSIBILITIES Researching, defining, and maintaining reimbursement rules and supporting data tables for use in hospital contract management software Developing methods (logic) for accurately valuing inpatient & outpatient claims with a focus on Medicare valuations Answering valuation-related support tickets from clients Research and define evaluation logic primarily for Medicare hospital claims valuation, with some commercial logic on occasion as well Locate and research CMS hospital-reimbursement websites and occasionally commercial payer websites for adjudication rules Download provider manuals, reimbursement policies, and medical policies for use in hospital and applicable commercial payer valuations Create and maintain a schedule of download frequencies necessary for timely and accurate valuation of claims - maintain a schedule for updates Manipulate fee schedules for loading into the contract management software program Provide internal consulting for enhancement of Hospital Claims Scrubbing application Review client claims to verify accuracy of claims valuation Attend and participate in internal and client meetings as needed Engage in process and quality improvement activities to minimize manual efforts QUALIFICATIONS Bachelor's degree or greater in related field, or equivalent combination of education and experience Minimum of 3 years' experience working in the hospital industry Hospital billing and/or claims management background, preferred In depth first-hand knowledge of Medicare adjudication methods for Inpatient and Outpatient hospital claims Demonstrated knowledge of coding conventions & the function of each: DRG Codes, Revenue Codes, Occurrence Codes, ICD-10, CPT and HCPCS codes Knowledge of the various types of health insurance payers: Medicare, Medicare Advantage Plans, Commercial Plans, Medicaid, and Medicaid Managed Care Organizations Broad range knowledge of different types of providers, including facility versus non-facility-based valuations Demonstrating overall healthcare reimbursement knowledge by obtaining satisfactory results on a Reimbursement Exam DESIRED SKILLS AND QUALITIES Engaging in deductive reasoning and critical thinking Exhibiting very strong attention to detail and accuracy, which is of paramount importance for role Demonstrating excellent skills in database platforms (Excel, Access, etc.) Working well in a team-oriented structure to achieve goals Meeting short deadlines while working independently, without supervision Analytical skills, Focus, Accuracy, and Timeliness are paramount qualities For immediate consideration please submit your resume in Word format, along with daytime contact information. LOCAL CANDIDATES ONLY PLEASE unless you are willing to relocate yourself at your own expense. Client is unable to provide H-1B Visa sponsorship at this time. All submittals will be treated confidentially. Selected candidate may be asked to pass a comprehensive background, credit and/or drug screening. Principals only, no third parties please. Atrilogy Solutions Group, Inc. (est. 2000), in partnership with Peak17 Consulting (est. 2008), provides organizations of all sizes with high-quality, cost effective information technology (IT) staffing services. Atrilogy has been recognized by Inc. magazine as one of the nation's fastest-growing, privately held companies. Headquartered in Irvine, California, Atrilogy also has offices in Denver, Phoenix, Atlanta, and Dallas with satellite offices in Boston, Jersey City, Las Vegas, Seattle, and Delhi, India. Clients turn to Atrilogy for expertise in: • IT staffing and placement such as Project Managers, Agile/Scrum Masters, Business Analysts, DBAs, Software Engineers, Mobile Developers (iOS, Android), DevOps, Automation, QA, Systems & Network Engineers, Cyber Security / Information Security Specialists, ERP, CRM, Business Intelligence, Data Warehousing, Big Data and Creative (UI/UX, Web Design) Clients tun to Peak17 for expertise in: Operational staffing and placement of Accounting/Finance, Human Resources, and Marketing professionals, as well as Information Technology resources. Atrilogy Solutions Group and Peak17 Consulting are Equal Opportunity Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law, and will not be discriminated against on the basis of disability. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. #JNH - provided by Dice
09/29/2020
Full time
Atrilogy's direct client is seeking a Contract Definition Analyst for an 8+ month contract . This position is 100% Remote. RESPONSIBILITIES Researching, defining, and maintaining reimbursement rules and supporting data tables for use in hospital contract management software Developing methods (logic) for accurately valuing inpatient & outpatient claims with a focus on Medicare valuations Answering valuation-related support tickets from clients Research and define evaluation logic primarily for Medicare hospital claims valuation, with some commercial logic on occasion as well Locate and research CMS hospital-reimbursement websites and occasionally commercial payer websites for adjudication rules Download provider manuals, reimbursement policies, and medical policies for use in hospital and applicable commercial payer valuations Create and maintain a schedule of download frequencies necessary for timely and accurate valuation of claims - maintain a schedule for updates Manipulate fee schedules for loading into the contract management software program Provide internal consulting for enhancement of Hospital Claims Scrubbing application Review client claims to verify accuracy of claims valuation Attend and participate in internal and client meetings as needed Engage in process and quality improvement activities to minimize manual efforts QUALIFICATIONS Bachelor's degree or greater in related field, or equivalent combination of education and experience Minimum of 3 years' experience working in the hospital industry Hospital billing and/or claims management background, preferred In depth first-hand knowledge of Medicare adjudication methods for Inpatient and Outpatient hospital claims Demonstrated knowledge of coding conventions & the function of each: DRG Codes, Revenue Codes, Occurrence Codes, ICD-10, CPT and HCPCS codes Knowledge of the various types of health insurance payers: Medicare, Medicare Advantage Plans, Commercial Plans, Medicaid, and Medicaid Managed Care Organizations Broad range knowledge of different types of providers, including facility versus non-facility-based valuations Demonstrating overall healthcare reimbursement knowledge by obtaining satisfactory results on a Reimbursement Exam DESIRED SKILLS AND QUALITIES Engaging in deductive reasoning and critical thinking Exhibiting very strong attention to detail and accuracy, which is of paramount importance for role Demonstrating excellent skills in database platforms (Excel, Access, etc.) Working well in a team-oriented structure to achieve goals Meeting short deadlines while working independently, without supervision Analytical skills, Focus, Accuracy, and Timeliness are paramount qualities For immediate consideration please submit your resume in Word format, along with daytime contact information. LOCAL CANDIDATES ONLY PLEASE unless you are willing to relocate yourself at your own expense. Client is unable to provide H-1B Visa sponsorship at this time. All submittals will be treated confidentially. Selected candidate may be asked to pass a comprehensive background, credit and/or drug screening. Principals only, no third parties please. Atrilogy Solutions Group, Inc. (est. 2000), in partnership with Peak17 Consulting (est. 2008), provides organizations of all sizes with high-quality, cost effective information technology (IT) staffing services. Atrilogy has been recognized by Inc. magazine as one of the nation's fastest-growing, privately held companies. Headquartered in Irvine, California, Atrilogy also has offices in Denver, Phoenix, Atlanta, and Dallas with satellite offices in Boston, Jersey City, Las Vegas, Seattle, and Delhi, India. Clients turn to Atrilogy for expertise in: • IT staffing and placement such as Project Managers, Agile/Scrum Masters, Business Analysts, DBAs, Software Engineers, Mobile Developers (iOS, Android), DevOps, Automation, QA, Systems & Network Engineers, Cyber Security / Information Security Specialists, ERP, CRM, Business Intelligence, Data Warehousing, Big Data and Creative (UI/UX, Web Design) Clients tun to Peak17 for expertise in: Operational staffing and placement of Accounting/Finance, Human Resources, and Marketing professionals, as well as Information Technology resources. Atrilogy Solutions Group and Peak17 Consulting are Equal Opportunity Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law, and will not be discriminated against on the basis of disability. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. #JNH - provided by Dice