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Nemours is seeking a Hospital Coding Coordinator to join our team in Delaware.

As one of the nation´s premier pediatric health care systems, Nemours provides world-class clinical care in four states -- Delaware, Florida, New Jersey and Pennsylvania. The Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE, offers intensive and acute inpatient and outpatient services covering more than 30 pediatric specialties. Ranked as one of the nation´s 25 Best Children´s Hospitals by Parents magazine in 2009, we care for thousands of children in the Delaware Valley, across the country and around the world. Extending the world-class care of the duPont Hospital for Children, the Nemours Children´s Clinic provides convenient community-based physician services and collaborative partnerships with health and hospital systems across the Delaware Valley. Job Summary:- Coordinate and manage the daily workflow of coding area of the Health Information Management Department. - To insure proper coding and abstracting of the hospitals inpatient accounts according to established ICD-9-CM and CPT coding procedures and guidelines.- Perform quality reviews, training of new coding staff, and other managerial duties within the Coding section of the department including the ability to code all hospital accounts.- Leadership role in development of a Clinical Documentation Improvement Program, provide training and in-services on appropriate clinical documentation practices to the Medical Staff.- Will play a pivotal role in the implementation and training of the new ICD10 codes.- Will work closely with the Charge Defense Auditor on any/all RAC, MIP audits regarding coding implications. Job Description:1. Ability to read and comprehend the electronic medical record to help identify all diagnosis, operations and procedures relevant to the current period. - Select, assign and sequence the appropriate ICD-9-CM and CPT codes to patients current period of care according to established sequencing guidelines for optimal reimbursement.- Assignment of the DRG to inpatient records according to established guidelines. - Abstract inpatient records in an accurate manner according to established procedures and guidelines.2. Perform quality reviews of coding staff on a monthly basis, giving feedback and educational sessions when opportunities have been identified. 3. Leadership role in the development and implementation of the Clinical Documentation Improvement Program.- Working with a multidisciplinary team in analyzing current documentation practices, creating and presenting educational programs to the physicians.Job Requirements: - Associates or some college required.- Must have strong coding experience, hospital coding experience preferred. - Qualified Candidate must be a CCS ( Certified Coding Specialist) or working towards a CCSNemours, an equal opportunity employer, is committed to focusing on the best-qualified applicants for our openings.Dont miss out on important health care news and updates from Nemours - connect with us on... Facebook (Fan Page): www.facebook.com/pages/Nemours/90523951091?ref=ts YouTube: www.youtube.com/user/NemoursUpdates Twitter: www.twitter.com/nemours Flickr: www.flickr.com/photos/nemours/

Reports directly to the Regional Director of Patient Accounts and is responsible for assisting the Director in planning, organizing, directing, and managing the activities of, as well as providing leadership for all collection related activities within a specific Region. Develops, recommends, and administers company policies and procedures related to the patient accounting functions. Responsible for ensuring cash collections, days in accounts receivables, adherence to corporate compliance and adjustments are within established goals set for the Regional office. Applications utilized are: Word, Excel, Monarch, GPMS, Brio, and Master Database.JOB RESPONSIBILITIES/DUTIES:1. Assists in the development of short and long term financial goals and objectives for the Patient Accounts Department.2. Assists in the development and in overseeing policies and procedures designed to ensure the appropriate functioning of the department.3. Directs and develops subordinate staff.4. Maintains contact with payers and business partners.5. Responsible for providing feedback to the Hospital Associate management team regarding opportunities for improvement to the front-end process.6. Responsible for managing the accounts receivable in an efficient and effective manner.7. Assists in ensuring the maximization of patient revenue, payment reimbursement, and cash flow.8. Maintains regular and direct contact with various company departments.9. Assumes responsibility for ensuring continued professional growth and development.10. Develops and ensures that departmental customer service/public relations are given appropriate priority and are properly handled.11. Reviews and interprets various information and reports trends, movements, and gives status to the Regional Director of Patient Accounts at least once a month.12. Responsible for overseeing the acquisition process.13. Responsible for working with Provider Enrollment on credentialing/enrolling new physicians, acquisitions and monitoring the progress of all outstanding issues out to Provider Enrollment.14. Responsible for coordinating and formulating audit functions for Patient Accounting.15. Responsible for overseeing and coordinating training function for all policy and procedures, new hires, and ongoing training for existing employees.16. Oversees Appeals Specialist’s duties and ensure commercial appeals efforts are maximized.17. Oversees underpayment and overpayment functions.18. Performs other job-related duties within the job scope as requested by the Regional Director of Patient Accounts.19. Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.20. Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.21. Embodies the principles of the corporate Mission Statement and Philosophy at all times.22. Complies with departmental and company-wide policies and procedures.Requirements • Level of educational degree and years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-9 coding with medical terminology will identify the appropriate candidate. The following ratio of educational degree and years of experience will apply:Degree Years of ExperienceHigh School Diploma 10 + yearsAssociate’s Degree 7 + yearsBachelor’s Degree 5 + yearsMaster’s Degree 3 + years• Ability to read, analyzes, and interprets common and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conforms to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.• Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.• Ability to define problems collects 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.

Be MovedTo a Career with a Central Florida Healthcare Leader

At Orlando Health, you can develop the career that is right for your individual goals. As a family of specialty and community hospitals, each has its own character, a natural extension of the specialized services offered. It is our mission that unifies us to offer superior service and provide quality healthcare to the people of Central Florida. We are currently seeking the following professional:Physician Coder Senior for Physician PracticesThis position will support a variety of physician practices at a variety of locations. In this role, you will serve as a mentor to Physician Coders in the physician practices. Assign workload to specialty team coders daily. Accurately and efficiently access hospital billing and information systems to secure and assemble all necessary physician records in order to accurately code and bill professional physician and/or physician extender services. Review medical records and code physician services utilizing current ICD-9 and CPT classifications systems. Verify billable physician services by reviewing physician documentation. Follow up on issues or trends found within the documentation of a particular physician for evaluation and refer to auditor as necessary. Assemble and input coding results into the current Practice Management billing system in order to expedite proper billing. Collaborate with members of the specialty team to consistently monitor financial goals within their specialty in order to satisfy corporate goals. Interface with Central Business Office to ensure appropriate and complete follow-up of patient accounts in order to maximize reimbursement. Batch and balance daily charges, checking provider, place of service, rate of service, referring physician, diagnoses and procedures. Communicate effectively with physicians, physician extenders, physician offices, members of the coding team and the manager.Candidates must have a high school diploma or equivalent with four years of certified coding and billing experience in a professional or physician practice coding. Completion of coding certification program required. Must have thorough knowledge of CPT ICD-9 as evidenced by results of coding skills test. Working knowledge of anatomy, physiology and medical terminology required. Must have computer/typing literacy. Requires one of the follow national certifications: Certified Professional Coder (CPC) through the American Academy of Professional Coders renewed every year; Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA) renewed every year or Certified Coding Specialist - Physician (CCS-P) through the American Health Information Management Association (AHIMA) renewed every year.

The Manager of the Coding Team is responsible for providing leadership and direction to the CHWMF Coding Team and to ensure, through programs of education, auditing, support and evaluation, appropriate coding practices throughout the organization. The Manager will oversee a team of coding professionals who will interact regularly with CHWMFs physicians, clinic and system management and individual coders in a way which ensures CHWMF coding practices are consistent, accurate and efficient. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. * Provides leadership and direction to the CHWMF Coding and Physician Education Team. * Recruits, develops, organizes and provides leadership to a team which: * Develops and conducts education programs on a regular basis designed to improve the accuracy and consistency of coding by coders and physicians throughout CHWMF. Conducts regular coding audits at all CHWMF clinics on at least an annual basis. * Develops a resource platform for the Coding Department that houses policies, procedures, best practices and various points of information. * Works with others to periodically analyze coding data in CHWMFs clinics to identify coding variations and determine the cause and the appropriateness of such variation and presents such findings to appropriate business leaders. * Develops and delivers programs and educational content that ensures that CHWMF coders code in a manner consistent with relevant laws, regulations and standards. * Supports clinic coding efforts in periods of extreme backlog. * Prepares and provides Coding Department budgets to CHWMF leadership. * Assists the organization in reviews relating to internal or external investigations. * Ensures that members of the coding team perform their job functions competently in a manner consistent with CHWMFs Mission, Vision and Values. * Conducts performance evaluations for members of the Coding Department. * Supports the Compliance team members in ensuring CHWMF coding compliance. * Monitors changes in law, policy and coding standards and advises CHWMF stakeholders and leadership on the impact of those changes. 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, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Required: Excellence in academic achievement with an undergraduate degree, and certified as a coder by the American Health Information Management Association (AHIMA). Minimum eight (8) years coding experience. At least four(4) years experience in a supervisory capacity of coders in a hospital or clinic setting. Demonstrated ability to manage a multi-clinic system coding and education program Demonstrated ability to develop and conduct education programs for coders and physicians. Experience conducting efficient and regular coding reviews and evaluating the quality and efficiency of coding practices is also required.

Preferred Health Partners (PHP) is a multispecialty physician group practice specializing in outpatient healthcare services all under one roof for the diverse populations of Brooklyn

JOB OVERVIEW: ( Capitation Billing Workflow)This position is responsible for the assessment and analysis of diverse data related to the revenue cycle, maintenance of the core files of the practice management system, synchronization of EmblemHealth and other capitated membership rosters with patient insurance records, and supports all processes in the physician billing revenue cycle.ESSENTIAL FUNCTIONS:1.Reviews revenue cycle patterns by procedure, diagnosis, payment, contractual adjustment, denial, insurance type and insurance groupings. Analyzes and reports variances. 2.Researches and challenges questionable determinations, and identifies work-flow opportunities to prevent or minimize claim rejections and denials at payer level.3.Identifies revenue cycle problems and opportunities, and works to provide effective, practical solutions. 4.Works with cross functional departments to research and resolve issues. 5.Concisely communicates findings and recommendations, both verbally and in writing. 6.Keeps appraised of rules and regulations affecting reimbursement and stays current through appropriate journals and personal contacts of such developments in the industry as may increase the effectiveness of operations. 7.Conforms to all applicable HIPAA and Billing Compliance policies and guidelines. 8.Performs other duties and responsibilities as assigned by the Revenue Cycle Manager SKILLS REQUIRED:1.Must possess a strong understanding of the healthcare revenue cycle. 2.Must demonstrate investigative, analytical, and critical thinking skills.3.Must have knowledge of electronic billing systems for front end and back end functions and show willingness to learn new systems, applications and programs4.Ability to work independently, follow through and handle multiple tasks/special projects simultaneously. 5.Must be able to function in a complex, agile, fast-moving workplace and adapt to a changing environment. 6.Must have superior collaboration and interpersonal communication skills, flexibility and responsiveness. 7.Must have excellent documentation, communication and presentation skills. 8.Must be a motivated individual with a positive and exceptional work ethic with the ability to interact positively and constructively with employees, professional clinical staff and senior management.EXPERIENCE REQUIRED:1.Four years experience in a health care revenue cycle setting with working knowledge of large multi-specialty capitated group practice environment.2.Practical experience of services related to insurance verification and management of patient information. 3.Practical, hands on experience with CMS-1500 electronic claim billing. 4.Knowledge of payer reimbursement / payment policies, medical terminology, and coding (ICD-9, CPT, etc).5.Computer experience (MS Word, Excel, Access, and Outlook). 6.Experience and proficiency with practice management and billing software.EDUCATION REQUIREMENTS:1.Bachelors Degree in health or other related field, or some related college or equivalent advanced knowledge of the health care industry. 2.Advanced certifications preferred (e.g. Registered Health Information Technician, RHIT).3.Equivalent combination of education and experience may be considered.

ESSENTIAL DUTIES & RESPONSIBILITIES:• Review and analysis of current and historical financial information• Creation and maintenance of key spreadsheets used in preparation of monthly reports• Assist in the preparation of the Regions annual budget• Assist in the creation of pro forma models for new business opportunities• Perform research and provide timely communication on inquiries regarding monthly financial reports• Create ad hoc reports as needed• Provide reporting and financial analysis support to members of regional management team• Required to provide timely support and proactive feedback on all issues• Perform special projects, as required• Act as back-up to Sr. Financial Analyst as requiredRequirementsEDUCATION AND EXPERIENCE:• 3+ years of experience in financial analysis and budgeting• Healthcare experience is preferred• Accounting related experience is a plus• trong understanding of financial statements• Bachelors Degree in Finance or AccountingHARDWARE AND SOFTWARE:• Strong working knowledge of Excel, Word and Crystal Reports

The University of California, Irvine, has a Billing Manager career opportunity in the School of Medicine, Physicians Billing Group (PBG).

The incumbent serves as the principal billing manager for assigned department(s)/division(s). This position is responsible for the complex and comprehensive management, analysis, organizational development and education of all activities related to professional fee billing and collections for PBG and clients. Essential to this position is a comprehensive understanding of all patient care services, registration and scheduling, billing activity and financial reporting in adherence to University guidelines. Responsible for managing, analyzing and overseeing all the daily operations of the billing units, including but not limited to: registration, batching, coding, charge entry, collections, audits and reporting. Responsible for the development, implementation and quality assurance of all policies and procedures as they relate to PBG operations to provide maximum efficiency and reimbursement. Effective communication of billing issues and trends between PBG and the respective assigned departments as well as the various internal units of PBG. UCI offers excellent benefits including a minimum of 3 weeks vacation per year.

Director of Coding - Finance Administration - Rhode Island Hospital/Hasbro Children´s Hospital - Providence, RI - Main 1The Director of Coding working in the Finance Administration Department reports to Vice President Finance, RIH/TMH. Directs medical record coding activities for Rhode Island Hospital and The Miriam Hospital. Develops and implements programs and processes that ensure highest standards of coding quality are maintained relative to accuracy, completeness and timeliness and which support reimbursement appropriate for services rendered. Functions as expert resource to others within the organization that are engaged in coding patient records (i.e. diagnostic imaging, ambulatory services and others). Rhode Island Hospital/Hasbro Children´s Hospital is a private, 719-bed, not-for-profit hospital and academic medical center. Founded in 1863, Rhode Island Hospital is the state´s largest general acute care hospital and is a Level 1 Trauma Center. Rhode Island Hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations and the largest teaching hospital for The Warren Alpert Medical School of Brown University. Rhode Island Hospital/Hasbro Children´s Hospital has more than 6,300 dedicated employees and 1,420 affiliated physicians. The hospital ranks in the top 50 hospitals in the country and Hasbro Children´s Hospital has been ranked among the top 30 children´s hospitals by Parents magazine. The hospital anticipates a 19% growth in staff over the next 10 years. The hospital is situated on a beautiful 69-acre campus in Providence, Rhode Island. Five to seven years progressively more responsible management experience in medical coding. Experience must demonstrate effective diagnostic-related group coding, preferably in similar operationally complex healthcare environment. Experience should also demonstrate expert level knowledge of ICD-9/ICD-10 and CPT-4 coding methodologies, effective written and oral communication skills, highly effective management and team-building skills and demonstrated commitment to quality improvement. Bachelors degree in Healthcare Administration, Business Administration, Nursing, Finance or related field.Current certification by American Health Information Management Association as Registered Health Information Administrator with Certified Coding Specialist credential.You´ll enjoy competitive compensation, outstanding benefits, tuition reimbursement, relocation assistance and the opportunity to make your mark at Rhode Island Hospital/Hasbro Children´s Hospital and far beyond.

Global Healthcare Alliance based in Houston, provides medical billing services to healthcare providers and web-based claims software for IPA´s and health plans.

Global Healthcare is looking for an Account (Collection) Manager. Job SummaryThis individual will have a critical role in A/R Management, Client Satisfaction & will be involved in the critical stages of system implementation with our client offices. This position will require travel, based on the clients assigned and may involve overnight stays during the implementation stage. The ideal candidate will have exemplary knowledge of professional medical billing procedures and practices, including all aspects of billing and collections. Tasks include participating in the development of training tools for collection staff, assisting with the writing and implementing policies and procedures, development of audit procedures for tickler files, adjustments and write offs. Candidate must have be able to interpret payer contracts to understand expected reimbursement and must have experience with billing procedures, appeals and collection processes. Role will include reviewing the client’s month end data to identify process improvement in all aspects of collections.Roles and Responsibilities• In coordination with Assistant Director, manage collection staff to achieve established collection and day revenue in accounts receivable goals for specific clients assigned• Analyze denial data, financial reports, fee schedules, payer trends, and A/R measurement statistics with Assistant Director and present findings in a timely manner (monthly) to client or clients management team• Participate in the implementation process for new clients with GHA implementation team• Provide ideas and recommendations for collector training tools, including a training plan and a sign off document to ensure new collectors have thorough knowledge of system and goals• Acts as a Liaison between client offices and collections team to ensure GHA is proactive in resolving any client issues that may occur• In coordination with Assistant Director, complete audits, and be able to benchmark client’s data against national and regional levels of productivity (i.e. MGMA, TMA, etc)• Provide enhancement ideas to further improve the software package(s) offered by our organization• Maintain client logs and document all issues, resolutions and client meetings• Approve collector and refund coordinator adjustments and refund requests to MSO clients• Build and improve customer service by presenting findings in a positive and proactive manner with all internal and assigned external customers Qualifications• BA/BS degree in healthcare, business administration or finance preferred and/or equivalent or at least 7 years relevant experience• 5-7 years experience in revenue cycle management with an emphasis on client relations/customer service, physician billing/collections, and training• Strong computer systems and physician practice management system experience• Knowledge system implementation processes• Ability to clearly and professionally present information to large and small groups• Flexibility, able to perform multiple tasks simultaneously to balance staff and client needs• Ability to develop training materials and competency testing• Strong analytical skills • Knowledge of medical terminology/coding• Excellent customer service skills• Self-motivated/directed with exemplary organizational skills• Excellent written and verbal communication skills

Description:Plans, staffs and manages the coding section of the Health Information Management Department. Performs audits to ensure the accuracy of all coding, abstracted data and data entered into the computer systems. Reviews clinical documentation for improvement opportunities. Provides education on improving clinical documentation. Reviews denied claims for accuracy and presentation of coded data for reimbursement. Leads initiatives to improve clinical documentation to improve patient safety, accurately reflect quality of care delivered and provide robust data base for research and performance improvementRequirements:- Bachelor or Associates degree in HIM or related field.- RHIA (Registered Health Information Administrator) or RHIT (Registered Health Information Management Technician) required.- 3 years of coding experience.- 2 years of supervisory experience.- CCS (Certified Coding Specialist) preferred.- Knowledge of medical record practices, policies and procedures, legal and regulatory requirements is required.- Extensive knowledge of ICD-9CM, CPT and DRG assignment.