Patient Financial Specialist - Spohn Medical Offices. Christus Health Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely and efficient manner. Performs assigned duties such as, cash posting, customer service, data entry and reviewing of claims for proper billing/collections. Responsible for performing billing, collections and reimbursement services of claims and duties to hospitals supported by the RCBS. In doing so, ensures that all claims billed and collected meets all government mandated procedures for Integrity and Compliance. Performs billing, collections and reimbursement services in a prompt and efficient manner. Provides thorough, courteous and professional assistance to patients, physician offices, insurance companies and other clients on an as needed basis while maintaining strictest confidence. Documents, forwards, resolves incoming mail and correspondence. Demonstrates a level of accountability to ensure data and codes are not changed on claims prior to submission if related to diagnosis, charge and/or other clinical type data that RCBS would not have knowledge of. Ensures all Compliance errors are reported to the Director and maintain records and files of documentation supporting bill changes that are directed by Director and/or Integrity Officer. Responsible to ensure successful implementation of Governmental Regulatory Billing changes, including but not limited to Medicare OPPS effective August 1, 2000. Posted 7 days ago Patient Access Representative - Admitting - PRN. Christus Health Patient Access Representative will facilitate a welcome and courteous environment, while establishing a positive encounter with any patient who is in need of services. Patient Access staff ensures that all data entry is accurate including procedural requirements, data elements, insurance verification, authorization for services, demographic and financial information for each account. Responsible for the successful financial outcome of all patient services to include collections for all patient portions including prior balances. Communicate effectively with patients and families, physicians, nurses, insurance companies and third party payers. Posted 7 days ago Patient Financial Specialist - Financial Services. Christus Health Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely and efficient manner. Performs assigned duties such as, cash posting, customer service, data entry and reviewing of claims for proper billing/collections. Responsible for performing billing, collections and reimbursement services of claims and duties to hospitals supported by the RCBS. In doing so, ensures that all claims billed and collected meets all government mandated procedures for Integrity and Compliance. Performs billing, collections and reimbursement services in a prompt and efficient manner. Provides thorough, courteous and professional assistance to patients, physician offices, insurance companies and other clients on an as needed basis while maintaining strictest confidence. Documents, forwards, resolves incoming mail and correspondence. Demonstrates a level of accountability to ensure data and codes are not changed on claims prior to submission if related to diagnosis, charge and/or other clinical type data that RCBS would not have knowledge of. Ensures all Compliance errors are reported to the Director and maintain records and files of documentation supporting bill changes that are directed by Director and/or Integrity Officer. Responsible to ensure successful implementation of Governmental Regulatory Billing changes, including but not limited to Medicare OPPS effective August 1, 2000. Posted 7 days ago Appeals and Grievance Nurse Registered Nurse II PRN. Christus Health Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant guidelines, determined the viability of the appeal, and manage the appeal process. The Clinical Appeals Nurse is responsible for appealing all inappropriate denials through all possible levels of the appeal process. The RN Clinical Appeals Nurse will actively manage, maintain and communicate denial/appeal activity to appropriate stakeholders, and report suspected or emerging trends related to payer denials. Working with Case Management leadership, this individual will orchestrate education and other performance improvement initiatives to impact clinical quality, improve efficiency and mitigate lost revenue related to medical necessity denials. Key Performance and trends related to denials/appeals will be reported to the facility. Posted 7 days ago Utilization Management Nurse III - Case Management. Christus Health The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. Posted 7 days ago New Grad RN. Del Sol Medical Center The HCA Healthcare StaRN Residency Program is a year-long program designed to give you hands-on experience to help establish valuable clinical and critical thinking skills. As a Resident I Graduate Nurse you will be surrounded by a supportive community of nurse educators, experienced nurses, and fellow residents that promote learning, clinical application, and socialization, shepherding you through the transition from student nurse to registered nurse. Posted 7 days ago Progressive Care Registered Nurse. Methodist Hospital Texsan Do you want to join an organization that invests in you as a(an) Progressive Care Registered Nurse? At Methodist Hospital Texsan, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Posted 7 days ago RN, Registered Nurse -CVOR Surg General. Christus Health CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center. Posted 8 days ago Entry Level Software Developer.Workforce Opportunity Services Workforce Opportunity Services (WOS) is a leading 501(c)(3) nonprofit committed to developing the skills of untapped talent from historically underrepresented communities through partnerships with organizations dedicated to diversifying their workforce. Posted 8 days ago Clinical Rehabilitation Specialist. Lifepoint Rehabilitation Lifepoint Rehabilitation is a leading provider of acute inpatient rehabilitation services with more than 300 hospital-based rehabilitation units, medical/surgical and outpatient therapy settings and more than 30 joint venture inpatient rehabilitation hospitals across the country. We provide high quality, patient-centered care to those who have experienced a loss of function from an injury or illness. Our team conducts comprehensive evaluations to determine each patient’s unique needs, and then creates a multifaceted program using the latest rehabilitation therapies and advanced technologies to support them on their road to recovery. Our goal is to help our patients recover as fully as possible and regain the level of independence they hope to achieve. If you are an enthusiastic individual seeking an environment dedicated to superior patient care and an organization with a strong mission to serve our community, we invite you to apply! Posted 8 days ago
