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Remote Outpatient Coding Specialist

Health Information Associates

Job Description:

Headquartered in Pawleys Island, SC, Health Information Associates (HIA) is a privately held company and was founded in 1992 by Betsy Bailey, RHIA and Deane Beamer, MHA. Prior to 1992, Mrs. Bailey held Director of HIM positions at two (2) hospitals in Virginia. Mr. Beamer had over thirty (30) years of experience as an Administrator working in various hospitals throughout the southeast.

Since its inception, HIA has partnered with hundreds of hospitals nationwide to provide customized comprehensive coding compliance reviews and educational services as well as coding support. HIA has grown to become a highly respected provider due to its ability to adapt to industry changes while maintaining a cohesive and conservative approach. HIA’s attention to individual client needs, from the smallest critical access hospital to the largest healthcare corporation, has led to the type of long term and mutually beneficial partnerships it is fortunate to share with its clients.

Responsibilities:

  • Codes all requested outpatient acute care facility records using the most accurate and appropriate ICD-10-CM/PCS, and CPT codes in accordance with coding guidelines.
  • Abstracts, codes and assigns necessary demographic and clinical data elements required
  • Uses 3M encoder to ensure appropriate reimbursement.
  • Writes appropriate, non-leading queries.
  • Maintains quality and productivity according to client requirements.
  • Completes all I-10 education as required within established deadlines.
  • Commits to continually improving his/her coding skills by actively participating in all education sessions.
  • Reports to the Coding Services Manager.

Qualifications:

  • RHIA, RHIT, and/or CCS
  • Minimum 3 years outpatient coding experience in an acute care facility.
  • I-10-CM/PCS training
  • Computer proficiency, able to research coding questions and utilize HIA’s internal educational resources.
  • High Speed Internet via Cable (no Satellite or wireless cell based)
  • Independent, focused individual able to work remotely.

Instructions for Resume Submission:

Apply Online: http://www.Click2apply.net/kcmp3b9vw84cbp36

PI98216851

Health Information Technology Online Instructor

Southwest Wisconsin Technical College

Introduction:

SUMMARY: Southwest Tech is seeking qualified candidates for an Online Part-Time Health Information Technology Instructor. This position will develop curriculum, provide instruction, and maintain program integrity in health information technology.

Job Description:

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Assume any assigned instructional responsibilities in the health information technology field
  • Design, facilitate, revise and maintain curriculum using WIDS to promote optimum student learning
  • Work cooperatively with the program staff to provide a quality- learning environment for students
  • Use multiple learning style techniques in all learning settings
  • Manage a group of students in an online environment to meet identified learning outcomes
  • Document students’ performance to provide assessment and evaluative feedback for students to promote learning, growth, and progress
  • Demonstrates current knowledge, skills, and attitudes for the practice of health information
  • Promote appropriate health care work ethic for all students
  • Conduct oneself in a professional and ethical manner consistent with industry standards and regulations
  • Demonstrate flexibility in managing duties and responsibilities
  • Demonstrate collaboration and cooperativeness with Southwest Tech faculty, staff, students and community partners
  • Demonstrate promptness and preparedness for instructional delivery
  • Follow agency policy, procedures, and protocol in all activities
  • Demonstrate concise, clear, and inclusive information in communicating with students, community partners, and Southwest Tech staff
  • Maintain strict confidentiality of student information – Family Educational Rights Privacy Act (FERPA)
  • Demonstrate caring behaviors toward students, community partners, and Southwest Tech staff
  • Design and participate in program recruitment and marketing strategies
  • Provide high quality customer service to both internal and external customers
  • Participate on college committees and the HIT advisory board
  • Participate in accreditation and program review process

Required Qualifications:

EDUCATION/QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and / or abilities required. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

  • RHIT or RHIA with three years experience in Health Information Management
  • Two years of online instruction experience required
  • Experience in curriculum development
  • Experience in WIDS preferred
  • Excellent communicator, including good listening skills
  • Excellent organizational skills
  • Flexible in work schedule

Education Qualifications:

  • BS Degree in related field

Compensation/Benefits:

SALARY: Academic Pay Schedule – BS Range: $47,297 – $75,203
MS Range $52,202 – $83,000
(Pay based on teaching load percentage)

CLOSING DATE FOR APPLICATIONS: July 4, 2017

STARTING DATE: August 1, 2017
All candidates selected for an interview will be required to prepare a 10-minute teaching demonstration.

Instructions for Resume Submission:

Internal and External applicants complete and submit the online employment application at https://www.swtc.edu/about/job-opportunities.

For questions regarding the application process please contact Human Resources at humanresources@swtc.edu or 608.822.2314.

Apply Online: https://www.swtc.edu/about/job-opportunities

Mid-Revenue Cycle Supervisor

Gundersen Health System

Introduction:

Gundersen Health System is where caring meets excellence through a comprehensive health network of wholly owned services and regional partners. It’s where nationally recognized quality meets dedicated, compassionate professionals, caring for patients in all stages of life.

Gundersen Health System is located in La Crosse Wisconsin, has nearly 7,500 employees, including more than 1,550 nurses, serve residents of western Wisconsin, southeast Minnesota and northeast Iowa. We are a dynamic healthcare organization anchored by a large, multi-specialty integrated practice and a Level II trauma and teaching hospital.

Job Description:

Gundersen Health System is looking for an experienced and knowledgeable Supervisor to oversee our Mid-Revenue Cycle Coding Services. The supervisor will oversee the daily operations of the professional services coding and charge capture/review staff.

Required Qualifications:

Work Experience:
3-4 years of healthcare experience including increasingly responsible assignments as a team leader, project manager, or supervisor.

License and Certifications:
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician Based (CCS-P) or Registered Health Information Technician (RHIT)
Valid Driver’s License (DL)

Preferred Qualifications:

Work Experience:
5-7 years of varied experience in professional services coding.

Education Qualifications:

Required:
Associate degree in Business or a health related field
Evidence of completion of ICD-10, CPT, and HCPCS training.

Desired:
Bachelor’s degree in Business or a health related field

Instructions for Resume Submission:

Please visit our website to apply:
http://www.gundersenhealth.org/careers/

Gundersen Health System is an Equal Opportunity Employer.

Apply Online: http://www.gundersenhealth.org/careers/

HIM Analyst – Enterprise Content Management

UW Health

Job Description:

Under the supervision of the HIM Supervisor – Enterprise Content Management (ECM), this position is responsible for review, development, and approval of all documentation tools used/displayed within the medical record, up to and including paper, computer generated, EHR direct entry documentation (including Smart Phrases, Smart Text, Smart Links, Smart Forms, Doc Flowsheets, Smart Sets, Order Sets, and Letters), and ancillary documentation systems that feed into the UW Health EHR. This position is the key contact and works closely with the EHR Implementation Teams, clinical, technical, physicians, and administrative personnel across UW Health while participating in the building and testing of the system content development. This position is responsible for ensuring smooth functionality between all systems. It is also the role of the ECM Analyst to determine what paper elements are not good candidates for the EHR and then to work closely with the Document Imaging Workgroup to set up scanning for those developed paper documents. As paper forms are eliminated, the ECM Analyst works with all clinical sites to develop downtime documentation tools as well as to maintain the Medical Records Forms Library on the organizational intranet. Ongoing/regularly scheduled review and update of paper documentation tools is required.

The role of this employee is to research and conduct analysis of state and federal laws, CMS and other regulatory requirements with regards to documentation in the medical record. Errors in documentation within the medical record can result in a negative legal/ risk management, patient safety, state and federal as well as regulatory accreditation outcome. The role of the ECM Analyst is to ensure all standards are followed, and it’s this position’s role to identify and bring forward compliance issues. Conducting thorough analysis of build and bringing noncompliant elements to the attention of the HIM Supervisor – ECM and Legal Medical Record Committees, when warranted. The incumbent is responsible for documentation, implementation and communication of system changes. This position is a resource to clinicians for the build and ongoing maintenance of system-level and personal documentation smart tools, working in close collaboration with the Senior Business Systems Analyst – ECM. In addition, this position is responsible for the ongoing management of the UW Health Forms and Electronic Content Database, quality assurance processes, addressing database problems, and serve as a resource to staff with regards to all review/approval and build of documentation tools via paper or any electronic method.

This position also coordinates, schedules and maintains minutes for the Legal Medical Record Committee, which is a subcommittee of the Medical Record Committee and includes members from Legal, Risk Management, Quality, IS and HIM, and meets on a monthly (or more frequently when needed) basis.

Work Schedule: 100% FTE, 40 hours per week. Monday- Friday 8:00 AM- 4:30 PM. Hours may vary based on the operational needs of the department.

UW Health offers a competitive compensation and benefits package. Work experience that is relevant to the position will be taken into consideration when determining the starting base pay.

We are an Equal Employment Opportunity, Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Required Qualifications:

Education Minimum Training in areas of health information technology, medical terminology, personnel management, and records management normally acquired through two years of college level study.
Preferred Associate degree or college level study leading to a Registered Health Information Technician (RHIT) certification by the American Health Information Management Association or an associate degree in information technology
Work Experience Minimum At least two year experience with Electronic Medical Record (EMR) technology, larger project management/prioritization

Additional years of education such as Registered Health Information Administrator (RHIA), may be substituted for years of experience.

Preferred Previous Information Governance and/or HER Content management experience

Previous Release of Information experience

Licenses & Certifications Minimum
Preferred Registered Health Information Technician (RHIT) or Registered health Information Administrator (RHIA)

Epic Care Ambulatory certification

Epic Care Inpatient certification

Epic Release of Information certification

Required Skills, Knowledge, and Abilities

  • Advanced knowledge of medical terminology, anatomy, physiology and disease processes sufficient to clearly understand the content of medical records, understand the information needs of care providers and to translate these needs into operational systems
  • Extensive knowledge of inpatient and outpatient medical chart order
  • Advanced skills in information technology experience with demonstrated application knowledge in order to build/develop new content within the EHR, as well as to communicate with other technical professionals
  • Ability to identify documentation and medical record form(s) problems and make independent decisions within the scope of one’s job responsibilities
  • Effective leadership skills with ability to communicate in a clear and concise manner
  • Effective organizational, planning, controlling, scheduling and project management activities
  • Demonstrated success in developing and providing training programs
  • Strong oral and written communication skills with ability to maintain composure in difficult and complex communications with physicians and other professionals
  • Strong analytical skills to translate current system set-up and procedures into Health Link effectively.
  • Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information
  • Advanced knowledge of and ability to use computers including various software programs such as word processing, spreadsheets and databases
  • Operational knowledge of information systems to include paper-based medical records, computer supported clinical information, knowledge of chart tracking, incomplete chart processing and database applications
  • Knowledge of TJC standards, federal and state regulations and UWHC hospital policies and procedures governing and completeness, accuracy and timeliness of medical record documentation
  • Knowledge of indices and filing systems necessary to file, store, and retrieve records and information from paper and electronic record systems
  • Effective human relations abilities:
  • Ability to collaborate within alliances and promote teamwork
  • Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders
  • Details oriented and ability to be self-motivated to complete duties in a timely manner
  • Ability to work in a team environment and to collaborate with a variety of professionals
  • Techniques and problem analysis/ resolution skills
  • Ability to instruct and motivate employees and identify areas in need of improvement
  • Ability to work occasional off-hours schedules as required
  • Critical thinking looking at documents and or electronic information
  • Attention to detail with strong organizational skills – exceptional proofreading skills
  • Work on multiple tasks at any one time while maintaining high quality standards

Physical Requirements: Sedentary: Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties.

Instructions for Resume Submission:

Apply Online: https://uwhealth.taleo.net/careersection/uwh_cs_external/jobdetail.ftl?job=170021XU&tz=GMT-05%3A00

Health Information Access Specialist

UW Health

Introduction:

Join our team and be part of the talent that makes UW Health the best work and academic environments.

Job Description:

The Health Information Access Specialist is responsible for advanced level problem solving, organizing, training, and communicating within the department.

This position is responsible for processing release of information requests for urgent, STAT, research, billing, patient use, and many other purposes. Release is performed by this person using multiple sources of media. This position also serves as the electronic health record external access support contact providing appropriate support and/or access to information while maintaining the utmost patient confidentiality, as well as supporting the contracted release of information vendor. The incumbent also manages the advance medical directive process of review and acceptance/rejection, scanning and acknowledging receipt of an advance directive via letter to the patient. Rejected documents may require staff to work with the patient to ensure accuracy of forms. This position approves, flags, and scans/indexes all verbal and exchange of information authorizations for UW Health. This includes working with the patient and their families, and ternal staff to ensure the document is valid prior to scanning it into the EMR. The incumbent provides medical record retrieval services to select UW health specialty care clinics. The incumbent is expected to make independent, on-the-spot decisions, which are typically in response to state statutes and federal regulations.

This position requires considerable amount of knowledge of Epic EHR (electronic health record) and Release of Information modules, and UW Health policies regarding privacy and security of protected health information (PHI), as well as excellent organizational, communication and interpersonal skills necessary to support the wide variety of customers both internal and external to UW Health. This is needed in order to ensure that the UW Health EHR and patient’s PHI remains secure while maintaining and/or releasing critical information to meet the organization’s mission of patient care, research, teaching and community outreach.
Work Schedule: Monday – Friday, 8:00 AM – 4:30 PM. This is a full-time position with 40 hours per week. Additional hours could be required to assist with department operational needs.

UW Health offers a competitive compensation and benefits package. Work experience that is relevant to the position will be taken into consideration when determining the starting base pay.

We are an Equal Employment Opportunity, Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Required Qualifications:

  • Education Minimum High School Diploma or equivalent
  • Preferred Education in Health Information Management, Nursing Assistant, Medical Assistant, or other related field
  • Work Experience Minimum Two (2) years progressively responsible medical records management experience. Education in Health Information Management, or related field, may be substituted for years of experience.

Preferred Licenses & Certifications:

Minimum Preferred RHIT or RHIA, Certified Medical Assistant, Certified Nursing Assistant

Required Skills, Knowledge and Abilities:

  • Excellent verbal and written communication skills
  • Knowledge of indices and filing systems necessary to file, store, and retrieve information from paper and electronic record systems preferred (terminal digit filing preferred)
  • Ability to locate, read, interpret State and Federal (HIPAA) Statutes/Regulations regarding using and disclosing protected health information, advance medical directives, declaration to physicians, and other miscellaneous legal documents
  • Know how to respond to such documents and identify when urgent action is required
  • Ability to examine the record and verify patient identification
  • Ability to examine a form and determine its proper placement within the paper or electronic record
  • Ability to identify nonstandard forms and determine action required
  • Advanced knowledge of medical terminology, medical record format, content and medical documentation order
  • Advanced knowledge of anatomy, physiology and disease processes sufficient to clearly understand the content of the medical records, understand the information needs of the care providers, and to associate a medical condition with the standard exams and procedures
  • Detail orientated and ability to be self-motivated to complete duties in a timely manner
  • Excellent interpersonal communication and team skills in a complex organizational setting
  • Ability to react to frequent changes in duties and volume of work
  • Excellent internal and external customer service skills with the ability to remain calm, be patient and respond professionally to all requests
  • Ability to work in a team environment and to collaborate with a variety of professionals
  • Knowledge of and experience with conflict resolution techniques and problem analysis/resolution skills preferred
  • Knowledge of UW Health organizational structure preferred
  • Excellent technological skills sufficient to work on computers and scanners including various software programs such as Epic, all MicroSoft products, Adobe Acrobat, OnBase, with skills to manipulate multiple document formats
  • Ability to perform routine maintenance and adjust setting on the scanning equipment preferred
  • Ability to maintain patient and employee confidentiality.

Physical Requirements:

Light: Ability to lift up to 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Even though the weight lifted may only be a negligible amount, a job is in this category when it requires walking or standing to a significant degree.

Instructions for Resume Submission:

Apply Online: https://uwhealth.taleo.net/careersection/uwh_cs_external/jobdetail.ftl?job=170021T0

Cardiovascular Clinical Reviewer

SSM Health – St. Mary’s Hospital

Introduction:

St. Mary’s is a 440-bed tertiary referral hospital offering inpatient and outpatient treatment and diagnostic services in primary care and nearly all specialties. Medical/surgical areas of special focus include the Family Birth Center, pediatrics, Neuroscience Center, geriatrics, orthopedics, emergency services and more. St. Mary’s is affiliated with the University of Wisconsin School of Medicine’s three-year family practice residency program. Since 1912, St. Mary’s has provided service to much of south-central Wisconsin including Dane County and 17 other nearby counties. In the growing city of Sun Prairie, northeast of Madison, St. Mary’s Emergency Clinic provides services to more than 30,000 residents.

Job Description:

The Cardiovascular Clinical Reviewer (CCR) is responsible for the collection and submission of accurate and reliable data to cardiac procedural, interventional, and surgical registries including ACTION-GWTG Registry, Cath PCI Registry, ICD Registry, STS National Database, and STS/ACC TVT Registry. The CCR works closely with the members of the Departments of Cardiology and Cardiovascular Surgery to identify opportunities for clinical quality improvement. The CCR also works closely with system process and performance improvement leaders to set and achieve goals related to identified opportunities. This position requires clinical knowledge, robust experience with computer software and web applications, experience gathering information in a complex tertiary care environment, and comfort sharing data and information with clinical, performance/process improvement, and administrative teams.

Required Qualifications:

Applicants with an Associate Degree in Nursing or related clinical field and a minimum of 10 years of experience in the care of cardiac procedural, vascular procedural, and/or cardiovascular surgical patients will be considered.
Computer, internet, and Microsoft Office Suite (Word, Excel) expertise is required
Ability to complete all pre-training, on-site training, and post-training; ability to build relationships across disciplines and gain alignment for cardiovascular and vascular outcomes and quality of care

Preferred Qualifications:

Bachelor’s degree in Nursing with a minimum of 5-years of experience in the care of cardiac procedural and/or cardiovascular surgical patients or a Bachelor’s Degree in a health informatics field and a minimum of 5 years of experience managing cardiovascular patient registries is preferred
Certification in the use of lean and six sigma improvement methodologies are highly desired
Microsoft Access and PowerPoint experience is preferred
Experience with database entry/management is preferred
Basic statistical knowledge is preferred
Experience with quality/process improvement methodologies and/or patient safety knowledge is preferred

Instructions for Resume Submission:

Apply Online: http://jobs.ssmhealthcareers.com/us/en-us/Job-Details/Cardiovascular-Clinical-Reviewer-Job/SSM-Health-St-Marys-Hospital-Madison/XjdP-jf1083-ct106350-jid72198615

Health Information Technician 1

University of Wisconsin Oshkosh Student Health Center

Introduction:

This position is responsible for the operational management of health information services, medical coding/billing, and reception services for the Student Health Center. Knowledge of overall clinic operations, office policies and procedures, medical report preparation methods and procedures, state and federal regulations related to electronic medical records, HIPAA and privacy regulations, and proficiency with electronic medical records (EMR) software are essential to coordinate these functions.

Candidate should possess strong attention to detail, and high language, reasoning, and critical thinking abilities. Knowledge of medical terminology, statutes, administrative rules and regulations concerning the confidentiality of health care information, medical ethics, health facility organization, coding, billing, financial account reconciliation and insurance processes is required. Independent decision making abilities are required to identify problems and seek and implement solutions. Must be able to exercise sound judgement and discretion in a variety of complex situations, function well in a fast-paced environment, and be able to work on and prioritize many tasks simultaneously while responding in a compassionate, calm manner to meet the needs of patients, co-workers, and others.

After training, proficiency is required with PeopleSoft Student Information System, PyraMed Electronic Medical Record software and the Forward Health Portal. Candidate should be skilled in the regular use of Microsoft Word, spreadsheet and database software, and the use of internet, electronic mail, and EHR software. Strong oral and written communication skills, excellent organizational skills, careful attention to detail and the ability to work independently while handling a variety of tasks simultaneously are required.

Job Description:

Medical Record Duties (35%)

1. Maintain confidentiality and HIPAA compliance for all health records and related correspondence and/or communication. Monitors state and federal mandates regarding medical record confidentiality, reporting requirements and procedures for release of information and revises operational standards as needed.

2. Assign diagnosis and/or procedure codes, utilizing standard classification systems such as the International Classification of Diseases (ICD) in collaboration with providers.

3. Requests medical information from other health agencies/medical providers via phone, fax, and mail as needed in compliance with state and federal regulations and ensures all documentation is scanned into the EMR.

4. Follow statutory guidelines and other regulations to independently evaluate and respond appropriately to requests from individuals, families, legal representatives, insurance companies, healthcare providers or government agencies for the release of patient health information.

5. Working knowledge of college health service EMR to perform billing, coding and cashiering for patient visits.

6. Manually checks enrollment in Student Information System if not automatically populated in the EMR.

7. Labels Patient Alerts in the EMR as individual circumstances require.

8. Provides training and direction to health care staff regarding medical record completion, management and confidentiality requirements. Assists staff with EMR functionality and troubleshooting, technical support and reporting.

9. Updates clinical dictionaries in EMR software as needed.

10. Assist providers, medical informatics associate, and director in collecting health-related information.

11. Evaluates active medical files for both completeness and quality of documentation and monitors and manages accuracy of entries and updates to web portal scheduling software. Contacts providers and other health care staff as needed to remedy identified record deficiencies.

12. Mentors and delegates responsibilities to Student Employees as needed.

Front Office Organization, Medical Reception and Appointment Scheduling: (35%)

1. Answers telephones and assists walk-in patients requesting care. Assesses the nature and urgency of the patients’ medical need and notifies health care professionals of possible emergencies on telephone or in waiting room. Schedules patient per set scheduling guidelines determining the most appropriate visit type and timing of appointment to ensure optimal patient care.

2. Responds quickly and appropriately to emergency situations, e.g., cardio-pulmonary arrest, patient hostility, fire, patient and staff evacuation, etc. Participates in scheduled drills according to established policies and procedures.

3. Checks in patients and interprets SHC policies for students, faculty, staff, and visitors regarding fees, no shows, check-in times, etc. Responds to general inquiries regarding services, hours, patient care, and patient billing. Instructs patients on how to complete patient data forms, history forms, and consent forms both on paper and via web portal.

4. Determines eligibility for service, validates student ID, obtains and updates address, telephone, birth date, FPOS status and other pertinent records utilizing EMR and explains payment options to patients.

5. Creates group appointments and bursar charges for special events such as flu clinics, TB clinics, sports physicals, etc.

6. Monitors reception and patient waiting area to maintain an appropriate atmosphere.

7. Prepares the front office for the day’s business, including starting computers, and turning over phones.

8. Plans front office work schedules and assigns work to ensure coverage of all duties. Responsible for communicating with all areas of clinic regarding daily clinic business, changes, etc., and works closely with medical providers to ensure smooth and efficient operation during peak periods of activity.

9. Maintains protocols and policies for front office.

10. Does not supervise other staff, however may provide work direction to student employees.

Insurance Coding, Billing & Financial Recordkeeping Duties: (25%)

1. Possesses knowledge of ICD-10 and CPT coding for software, billing, and insurance purposes.

2. Verifies accuracy of medical ICD-10 and CPT codes on encounter forms.

3. Enters new and revised ICD-10 and CPT codes in the EMR.

4. Invoices charges on patient visit encounters within the EMR Billing Workplace, and responds to questions regarding patient accounts.

5. Audits coding and accuracy of charges in the EMR Patient Workplace (chart).

6. Submits and verifies the accuracy of claims for Family Planning Only Services (FPOS) through the Forward Health Portal.

7. Posts FPOS payments received. Attempts to recover maximum allowable charges for services. Posts payments and adjustments to student accounts through the Insurance Payment Workplace.

8. Updates pricing of goods and services as well as the EMR financial schedules.

9. Develops and prepare statistical and financial reports.

10. Sets semester eligibility and plan updates in Student Information System.

11. Counts cash and reconciles cash/checks and Titan Card dollar with EMR reports. Completes applicable deposit forms and daily deposit.

12. Processes daily payments as needed, corrects billing and coding errors.

13. Verifies accuracy of Bursar reports from the UWO Student Financials Department and the EMR Bursar report.

Miscellaneous Duties: (5%)

1. Handles sensitive information with discretion and confidentiality, responding to inquiries and complaints from patients, staff and the public.

2. Attends meetings, in-services, job related seminars, and other continuing education classes.

3. Participates in and contributes to quality assurance/improvement activities such as performing random audits of medical record documentation, monitoring the quality of patient care by reviewing patient documentation against clinical pathways or performing special projects as assigned.

4. Organize, update, and save documents to shared drive.

5. Helps orient and train new employees.

6. Perform opening and closing day procedures.

7. Compile utilization statistics.

8. Other duties as required.

Departmental Core Competencies:

1. Demonstrates empathy, caring, and understanding of students and their needs when seeking health care.

2. Continually seeks methods and opportunities to improve the quality of care delivered to students.

3. Anticipates, identifies and adopts to change willingly. Supports others in identifying potential solutions to work problems. Provides leadership in the areas of medical records and privacy of PHI (Protected Health Information).

4. Applies ethical and legal principles to the collection, use, and dissemination of medical information.

5. Develops skills and behaviors to manage multiple tasks and maximize work performance individually and as a team member.

6. Maintains appropriate standards of safety, hygiene and infection control for the Student Health Center environment.

7. Demonstrates the ability to sensitively, effectively and professionally interact with persons from diverse cultural, socioeconomic and professional backgrounds.

8. Interacts effectively and professionally with staff and all university departments assisting with students’ academic/athletic health care requirements.

Required Qualifications:

1. Minimum three (3) years of office experience, preferably in a medical setting.

2. Level of knowledge equivalent to that ordinarily acquired through completion of two year medical record technician course or credentialed as a Registered Health Information Technician (RHIT).

3. Experience with public speaking.

Preferred Qualifications:

1. Level of knowledge equivalent to that ordinarily acquired through completion of a four year health information management course or credentialed as a Registered Health Information Administrator (RHIA).

Instructions for Resume Submission:

Please visit the UW Oshkosh Human Resources website (http://careers.hr.uwosh.edu/cw/en-us/job/494607/health-information-technician-1) to apply for this job.

Apply Online: http://careers.hr.uwosh.edu/cw/en-us/job/494607/health-information-technician-1

Revenue Management Educator – SHP

Security Health Plan – Marshfield Clinic Health System, Inc.

Job Description:

Security Health Plan serves more than 225,000 people in a 40-county area in northern, western and central Wisconsin. We offer a variety of health insurance options for employer groups, individuals of all ages, and families of various income levels.

The Security Health Plan Revenue Management Educator is accountable for the successful development, implementation and delivery of educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action, quality improvement and risk management plans. The Educator provides overall educational support and coding quality assurance activities to both internal and external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Services (DHS).

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.

Required Qualifications:

  • Bachelor’s degree with an emphasis in a business or medical field, or a registered nurse degree; Bachelor of Science in Nursing
  • Completion of courses in Current Procedural Terminology(CPT), and ICD-9, ICD-10 and Hierarchical Condition Category (HCC) coding
  • Three years’ experience in a health insurance, nursing, compliance, or auditing related position
  • Knowledge of CPT coding rules, ICD-9 and ICD-10 codes, Healthcare Common Procedure Coding System (HCPCS) codes, HCC coding, use of modifiers, documentation guidelines, CMS Policy requirements, and other reimbursement guidelines required
  • Must have demonstrated knowledge of anatomy/physiology, medical terminology, Word, Excel, Power Point and Access
  • Certified Professional Coder certification awarded by American Academy of Professional Coders required within one year is required.
  • State of Wisconsin Registered Nurse license (if applicable).

Preferred Qualifications:

  • Adult education/training and curriculum development. Certified Risk Adjustment Coder awarded by American Academy of Professional Coders.

Instructions for Resume Submission:

Inquires can be directed to Beth Westlund, Human Resources at westlund.bethany@marshfieldclinic.org

Apply directly through:
https://marshfieldcliniccss.igreentree.com/CSS_External/CSSPage_Referred.ASP?Req=MC161925

or through our Career Center at:
https://marshfieldclinic.org/careers
(https://marshfieldclinic.org/careers) Reference job# MC161925

Marshfield Clinic
1000 N Oak Ave.
Marshfield WI 54449

Marshfield Clinic is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

Utilization Management Specialist

Gundersen Health System

Introduction:

If you’re looking for a place to work where superior healthcare changes lives and communities, consider Gundersen Health System, the leading provider of primary and specialized care in western Wisconsin, southeast Minnesota and northeast Iowa. Search for jobs (https://www.gundersenhealth.org/careers/job-opportunities/) , find careers, and change your life.

We are seeking detail orientated candidates who are energized by working in a fast past environment to be part of the Utilization Management Team!

Typical hours are Monday thru Friday day shift with rotating Saturday every other month. Possible option of reduced FTE (72 or 64 hours every two weeks).

RHIT license or RN license required.

Job Description:

The Utilization Management Specialist performs medical necessity review of initial patient placement and continued stay review for hospitalizations. Applies nationally recognized criteria during review of patients’ medical records. Provides communication on review determinations to the attending physician and external review organizations as required by the patients insurance coverage or by Gundersen Health Systems contract. Collaborates with the health care team to assure that patient needs and discharge plans are documented and certified as medically necessary. Monitors patient progress and outcomes towards goals. Assists with management of health care benefits and assists the patient/healthcare team in obtaining necessary services. Participates in performance improvement activities to achieve safe quality patient care and assure compliance with regulations and contracts. Educates physicians, nurses, ancillary staff and patients through formal and informal means. Works as part of a team to review patient medical necessity and level of care consults to the medical staff.

Gundersen Health System is an Equal Opportunity Employer.

Required Qualifications:

EDUCATION: Associate degree in Health Information Management or Nursing from an accredited college of nursing, as recognized by the Accreditation Commission for Education in Nursing or Commission on Collegiate Nursing Education.

WORK EXPERIENCE:1 year of previous experience in Utilization Management, Case Management or equivalent experience within a hospital or insurance company.

LICENSE: Registered Health Information Technician (RHIT) or Registered Nurse (RN) licensed to practice in the state of employment, some positions may require multiple licenses

Preferred Qualifications:

EDUCATION: Bachelor’s degree in Health Information Management or Nursing from an accredited college of nursing, as recognized by the Accreditation Commission for Education in Nursing or Commission on Collegiate Nursing Education.

WORK EXPERIENCE: 2 years working with commercial or government insurance and/or hospital utilization management; case management or equivalent experience (i.e. denial or appeal experience, reimbursement or billing experience, diagnostic or coding background).

LICENSE: Certified Case Manager (CCM)

Instructions for Resume Submission:

Apply Online: https://secure.gundersenhealth.org/ATS/jobDesc.xsql?job=100010127&jt=R&logo=no

Utilization Management Coordinator

Gundersen Health System

Introduction:

If you’re looking for a place to work where superior healthcare changes lives and communities, consider Gundersen Health System, the leading provider of primary and specialized care in western Wisconsin, southeast Minnesota and northeast Iowa. Search for jobs (https://www.gundersenhealth.org/careers/job-opportunities/) , find careers, and change your life.

Job Description:

BASIC FUNCTION:

The Utilization Management Coordinator works with departmental staff and leaders in the planning, developing, coordinating, and executing of a wide range of programs, projects and activities for the Utilization Management team. The coordinator uses performance improvement practices, as well as project planning and management methods to implement changes directed at improvement; measures the extent of improvement achieved; converts data into usable information; facilitates group and team work; and assures that improvement activities are documented and reported. This individual will work independently on most assignments and with supervision for projects that are more complex, multi-departmental, technically challenging, and/or dependent on the degree of financial impact. Requires the ability to carry out professional and confidential support and exercise good judgement and discretion in completing projects and assignments.

MAJOR RESPONSIBILITIES:

  1. Works collaboratively with the Utilization Management team on the management of a patient’s health care benefits and coordination of services at Gundersen Health System.
  2. Assists with documentation in the various departmental databases. Audit, run and review reports as requested to ensure accuracy of information and gather statistics for reporting purposes.
  3. Works collaboratively, with Gundersen Utilization Management Department staff and leadership, Social Services, Care Coordination, physicians, medical directors, hospital nurses, clinical managers, and other medical center personnel. Works collaboratively with all other Gundersen departments to help provide resources to improve patient flow from hospital to discharge.
  4. Works collaboratively with other departments regarding patient issues in regards to billing related to UM department responsibilities.
  5. Ensures compliance with all internal and external policies and procedures, including regulatory and legal requirements associated with denials and appeals processes. Works collaboratively with the Utilization Management Specialists on reviews or regulatory issues. Stays current in industry updates.
  6. Participates in process improvement projects and performance measurements for the Utilization Management Department and Gundersen Health System. Under the direction of the Supervisor assists the team with project plans, deliverables, schedules, and measures of success while considering applicable regulations and corporate policies. This includes assisting the team with system upgrades, new application implementations, and process improvement projects.

    Gundersen Health System is an Equal Opportunity Employer.

Required Qualifications:

Education: Associate degree in Health Information Management

Work Experience:2 years in a health care related field and/or project management experience

License: Registered Health Information Technician (RHIT)

Instructions for Resume Submission:

Apply Online: https://secure.gundersenhealth.org/ATS/jobDesc.xsql?job=100010239&jt=R&logo=n