WVU Medicine

Role Description Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. - Perform coding quality audits, provide ongoing feedback and education. - Utilize various coding classifications: ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC, and APR-DRG assignment. Qualifications - Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR - Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR - High School Diploma or Equivalent AND Eight (8) years of coding experience. - Certification in ONE of the following: - Registered Health Information Administrator (RHIA) - Registered Health Information Technician (RHIT) - Certified Outpatient Coder (COC) - Certified Coding Specialist (CCS) - Certified Professional Coder (CPC) Requirements - Bachelor’s degree in Health Information Management or related field (preferred). - Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC, and APR-DRG assignment for multi-specialty coding, E&M coding, procedural/surgical coding. - Knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions (preferred). - Previous supervisory or project management experience (preferred). Core Duties and Responsibilities - Manage activities of designated coding personnel in training for WVU Healthcare. - Manage quality improvement audits and training of designated coding staff. - Act as expert coding resource to coders, clinical documentation improvement, providers, and revenue cycle. - Act as Super user for all Coding-related Electronic Medical Record Systems. - Develop and maintain coding related policies, procedures, query development, work queues, and training materials. - Communicate continually with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators. - Organize, facilitate, perform, track, trend, and report on internal quality reviews. - Design and use audit tools to monitor accuracy of coding, documentation gaps, and billing. - Coordinate audits performed by outside agencies. - Coordinate coding/documentation denial reviews and facilitate appeal letter formation. - Communicate regularly with the Coding Leadership on activities and issues. - Ensure audit recommendations are completed. - Extract and analyze data from various sources and develop action plans. - Assist with onboarding of new Coding Specialists. - Update Coding Specialists on compliance and regulatory changes. - Keep abreast of coding changes, state and federal regulations, and coding resources. - Develop and design curriculum for the WVU Healthcare Coding Certificate Program if needed. Physical Requirements - Must be able to sit for long periods of time. - Must have visual and hearing acuity within the normal range. - Must have manual dexterity needed to operate computer and office equipment. - Must be able to lift, push, or pull 10-20 pounds. Working Environment - Standard office environment. - Visual strain may be encountered in viewing computer screens and written material. - May require travel. Skills and Abilities - Excellent written and verbal communication skills. - Knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques. - Ability to mentor, educate, and train others. - Ensure quality and productivity standards. - Handle high stress and critical situations calmly and professionally. - Concentrate and maintain accuracy during constant interruptions. - Independent decision-making ability. - Ability to prioritize job duties. - Adapt to changes in the workplace and work assignments. - Organizational and time management skills. - Knowledge of anatomy, physiology, and medical terminology. - Analytical and problem-solving skills. - Proficient in office software programs, including medical record and billing systems. - Ability to analyze complex data and reports. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt - United States of America (Exempt) - Company: SYSTEM West Virginia University Health System - Cost Center: 538 SYSTEM HIM CDI

Title: Medicare Member Services Representative – PEAK Location: Home Work - Monongalia County WV (Local) locations Remote time type Full time Job Description: Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Come join our Peak Health team at WVU Medicine as a Member Services Representative, contributing to the foundation for an innovative, Peak Advantage Medicare plan. The Medicare Membership Services Representative will take inbound calls from Peak Health Medicare Advantage members, and providers answering questions ranging from general information to complex inquires on a wide range of issues. This role will work with management and peers on the Peak team to research and resolve member issues and questions. In addition to taking inbound calls, will make outbound calls to members and providers with issue resolution or to gather further information. Candidates should expect to work an 8-hour shift, between the hours of 7:30 am – 8:00 pm Monday – Friday. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School diploma or equivalent EXPERIENCE: 1. One (1) year of experience with handling Medicare claims or related experience PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associate Degree, or greater, in related healthcare field. EXPERIENCE: 1. Three plus years’ experience in a fast-paced call environment with processing and/or customer service experience. 2. Two years’ experience in Medicare benefits 3. Two years’ experience in knowledge of CMS guidelines CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Verify member information while addressing general questions. 2. Responds to and resolves all issues/inquires to assure an efficient and seamless member experience. 3. Maintains open channels of member communications doing outreach as required. 4. Understanding of Medicare claims processing, and related inquiries. 5. Meets all production and quality standards, maintaining work queues according to department standards. 6. Effectively communicates with internal and external staff. 7. Elevates issues to next level of supervision, as appropriate. 8. Ensures accuracy of information gathered and shared on a member’s behalf. 9. Attends all required training classes, demonstrating proficiency and ability to learn. 10. Other duties as deemed appropriate by the Management Team. 11. Maintain accurate documents, including timekeeping records PHYSICAL REQUIREMENTS: 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. 1. Ability to sit for extended periods of time. 2. Ability to answer phone calls for extended periods of time. 3. Lifting 10-25 lbs. 4. Travel Requirement: 0%-25% WORKING 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. 1. Standard office environment with electrical equipment (i.e., telephone, personal computer, copier, fax machines, etc.) 2. Computer Software/Systems include but not limited to Microsoft Office Professional Suite (Outlook, Word, Excel, Access) Internet Explorer and EPIC SKILLS AND ABILITIES: 1. Working Knowledge of administrative and clerical procedures and systems such as word processing and managing files and records. 2. Ability to take direction and to navigate through multiple systems simultaneously. 3. Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette. 4. Ability to solve problems with predefined methods and guidelines to drive improved efficiencies and customer satisfaction. 5. Familiarity with Medical insurance services process. 6. Requires exceptional attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. 7. Ability to work remotely – this includes reliability, self-motivation, focus & time management skills. Additional Job Description: Candidates should expect to work an 8-hour shift, between the hours of 7:30 am – 8:00 pm Monday – Friday. - will have weekend rotations Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: PHH Peak Health Holdings Cost Center: 2501 PHH Risk Admin

Role Description Partner with departmental leadership to develop, drive and execute HR best practice policies, programs and training in the areas of: - Change management - Talent assessment - Career development - Employee retention - Succession planning - Workforce planning - Employee engagement Qualifications - Master’s degree in Human Resources, Business Administration, Industrial Relations or related field and three (3) years of professional Human Resources experience with emphasis in an HR generalist role - OR Bachelor’s degree in Human Resources, Business Administration, Industrial Relations or related field and five (5) years of professional Human Resources experience with emphasis in an HR generalist role. - Professional Human Resources (PHR) or Senior Professional in Human Resources (SPHR) certification and/or SHRM-CP and SHRM-SCP certification. - Strong HR generalist experience with an emphasis in workforce and succession planning, compensation, change management and/or retention programs. - Demonstrated success in consulting effectively with senior level management and influencing business unit leaders. - Recent work experience in a healthcare setting. Requirements - Formulate partnerships across assigned departments to deliver value added service to management and employees that reflects the business objectives of the organization. - Attend department meetings to better understand the activities occurring in the business. - Serve as an advisor to the leadership team by providing insight, coaching and HR related solutions to functional and business leaders in the effective management and development of their employees. - Serve as a change agent to assist in successful change management of each business/service line. - Drive talent growth initiatives throughout the organization through talent assessment model and career development. - Lead workforce planning initiatives through the facilitation of talent planning. - Partner with leaders to deliver succession and replacement planning programs. - Research, develop and partner with leadership to implement employee retention strategies and programs. - Facilitate ideas and strategies to promote a healthy employee engagement. - Work regularly with HR disciplines including but not limited to compensation, benefits, employee relations, CEOD, and disability management. - Assist in the administration of local audits. Benefits - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Exempt) - Company: WVUH West Virginia University Hospitals - Cost Center: 556 WVUH HR Business Partners and Employee Relations Physical Requirements - Extended periods of sitting. - Extended periods of computer usage. - Required to walk to various areas throughout the departments or medical complex. This may require the use of elevators and/or stairs. Working Environment - Standard, high volume office environment. Skills and Abilities - Must have and maintain a working knowledge of federal and state labor laws related to all aspects of human resources. - Must have an ability to organize and prioritize multiple projects. - Must have and demonstrate an ability to communicate both orally and in writing in a clear and concise manner. - Must have strong analytical and problem solving skills. - Must have ability to maintain high level of confidentiality. - Must have the ability to interface with management and employees at all levels of the organization.

Role Description Reporting to SNP Care Management Leadership, the SNP Lead Care Manager will be an integral member of the health plan’s medical management team. This position is responsible for onboarding new employees and mentoring members of the SNP care management team including: - Providing education - Performing documentation audits - Building clinical team members' expertise through direct feedback and real-time coaching This position is committed to the constant pursuit of excellence in improving the health status of our members and community. This team member will have high organizational visibility and responsibility in ensuring overall excellence in all areas of care management. Qualifications - Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC). - Five (5) years of healthcare clinical experience. - Two (2) years’ Care Management, Case Management or Population Health experience. Requirements - Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma. - Management of Medicare and/or Medicaid and/or SNP populations. - One (1) year SNP Care Management experience. Core Duties and Responsibilities - Participate in activities related to care management program build, implementation, oversight, and delegation. - Assist in ensuring compliance with CMS SNP Model of Care (MOC) expectations, NCQA standards, and Medicare Advantage regulatory requirements. - Assist in the development and implementation of policies and procedures related to the Care Management process. - Assist with monitoring performance standards, productivity and ensuring staff coverage to meet the needs of the department. - Formulates, implements and evaluates educational strategies for staff. - Maintains a working knowledge of the requirements of regulatory and compliance entities. - Mentors new Care Managers and assists with training. - Provides support and coaching to Care Managers and other clinical team members. - Perform data collection and analysis of trends to determine areas of opportunity and strategies for better practices for the Care Management team. - Takes escalated calls or fills-in for the Care Manager team during high-peak periods. - Assist in quarterly reporting of delegated case management processes to meet accreditation standards. - Assist in submission of required documents/policies during application process to accrediting body. - Provides clinical, procedural or interpretational assistance. - Ability to present complex ideas and data to a wide variety of stakeholders from frontline employees to executive c-suite. - Establishes and maintains cooperative and positive working relationships with key stakeholders across the organization. - Participates in the Interdisciplinary Care Team (ICT) in conjunction with the SNP CM team, PCP and beneficiary/caregiver. - Assists in using Peak Health’s analytics tools to monitor HRA timeliness, care plan compliance, ICT effectiveness, utilization trends, and quality outcomes. - Serve as a key liaison between SNP Care Management, Peak Health providers, pharmacy, behavioral health partners, and community agencies. - Support escalation and review of high-risk, high-need member cases to ensure appropriate interventions, community resource connections, and care plan adjustments. - Assist Peak’s Quality Management and Compliance teams to support Stars improvement, HEDIS performance, utilization management coordination, and audit readiness. Physical Requirements - Ability to stand and walk short distances for eight or more hours. - Frequent bending, stooping, or stretching. - Ability to lift 30 pounds and push 50 pounds. Working Environment - Standard office environment. - Some travel may be required to offsite meetings. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Exempt) - Company: PHH Peak Health Holdings - Cost Center: 2403 PHH Medical Management

Role Description To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospitals, clinics and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding assignment, severity of illness and risk of mortality for each medical record. This position is an integral part of an overall compliance program effort as it pertains to hospital/physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives along with hospital coding. Responsible for analyzing and resolving issues of missing charges and problem accounts by researching information regarding department reimbursement. Responsible for the coding of the more complex patient classes i.e. inpatient, observations, same day care, etc. This position will be able to code a variety of patient classes along with Split Claim processes required for Critical Access hospitals. Qualifications - High School Diploma or Equivalent. - Current HIM or Coding Certification through one of the following: - American Health Information Management Association (AHIMA) - American Academy of Professional Coders (AAPC) - Two (2) years of medical coding experience. Requirements - Two (2) years of physician office coding experience. Core Duties and Responsibilities - Reviews and accurately interprets medical record documentation from all accounts to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure. - Performs the coding/billing Split Claims process to ensure correct coding and reimbursement for appropriate accounts. - Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas. - Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals. - Assures the accuracy, quality, and timely review of data needed to obtain a clean bill. - Contacts physicians or any persons necessary to obtain information required to accurately code assignments. - Works and communicates with other offices in any manner necessary to facilitate the billing process. - Monitors on an ongoing basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed. - Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts. Physical Requirements - Must be able to sit for long periods of time. - Must have visual and hearing acuity within the normal range. - Must have manual dexterity needed to operate computer and office equipment. - Must be able to lift, push or pull 10-20 pounds. Working Environment - Standard office environment. - Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material. - May require travel. Skills and Abilities - Must be able to concentrate and maintain accuracy during constant interruptions. - Must possess independent decision-making ability. - Must possess the ability to prioritize job duties. - Must be able to handle high stress situations. - Must be able to adapt to changes in the workplace. - Must be able to organize and complete assigned tasks. - Must possess excellent written and verbal communication skills. - Must meet quality and productivity standards. - Must possess knowledge of anatomy, physiology and medical terminology. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) - Company: SYSTEM West Virginia University Health System - Cost Center: 548 SYSTEM HIM Coding Analysis

Role Description Responsible for securing patient data based upon comprehensive data elements, financial education/counseling, insurance verification, provision of clinical information for pre-certification, authorization and third party claims management. A Clinical Pharmacy Technician will work independently gathering and submitted patient information with oversight of a pharmacist as needed. They will be responsible for performing pharmacy related functions in compliance with departmental policies and procedures that provide optimal pharmaceutical care. Qualifications - High school diploma or Equivalent. - Must possess current licensure as required by state board where services will be provided: - MD: Pharmacy Technician Student Permit or Pharmacy Technician License through Maryland Board of Pharmacy - OH: Pharmacy Technician Trainee License or Certified or Registered Pharmacy Technician License through Ohio Board of Pharmacy - PA: Pharmacy Technician Trainee or Pharmacy Technician License through the Pennsylvania Board of Pharmacy - WV: Pharmacy Technician Trainee or Pharmacy Technician License through West Virginia Board of Pharmacy - Remote Workers Only: Must additionally hold Pharmacy Technician Trainee License or Pharmacy Technician License issued by state of residence. - Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) OR if applicant has two (2) or more years of pharmacy specific experience, must be obtained within 15 months of hire. Requirements - Associates degree OR Post high school education in a science field of study OR graduate of a pharmacy technician training program. - Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) upon hire. Core Duties and Responsibilities - Drafts various correspondence letters and sends to referral source when necessary. - Gathers and documents patient demographics, insurance information, needs assessment, patient history, and other data as needed. - Initiates refill/follow up calls and schedules delivery as needed. - Provides information and answers to patient/caregiver questions and refers to clinician when appropriate or requested. - Identifies all patients requiring pre-certification or pre-authorization at the time services are requested or when notified by another hospital or clinic department. - Contacts insurance company or employer to determine eligibility and benefits for requested services. - Maintains patient records in a timely and complete manner. - Assists the pharmacist with the process of filling and labeling the prescriptions. - Calculates initial measurements for compounds and maintains compounds logs. - Provides monographs and other required medication guides with each prescription. - Maintains proper storage of medications (i.e. security, temperature controlled items, etc.). - Demonstrates the knowledge and skills necessary to communicate to the infant, pediatric, adolescent, adult and/or geriatric patient per the established age-specific education/standard. - Works with coordinators and manager to develop and attain quarterly objectives. - Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. - Communicates problems hindering workflow to management in a timely manner. - Assists in the training of pharmacy technicians. - Initiates charge anticipation calculations. Accurately identifies anticipated charges to assure identification of anticipated self-pay portions. - Certain duties cannot be assigned to Pharmacy Technicians because these duties can only be performed by pharmacists. These restrictions are regulated at state and federal levels and must be followed closely: - Only pharmacists can receive oral prescriptions from prescribers or prescribers’ authorized designees. - Only pharmacists can consult with prescribers or prescribers’ designees about patients’ prescriptions. - Only pharmacists can provide confidential patient information to other health professionals or insurance companies. - Only pharmacists can check medications before dispensing them to patients. - Only pharmacists can consult with patients about prescribed medication use and other health issues. - Only pharmacists can recommend over-the-counter medications. Physical Requirements - While performing the duties of this position, the employee is required to walk and stand or sit for long periods of time. - Must be able to lift 30 pounds and must be able to push 50 pounds. - Dexterity required to finger, handle, and reach. Working Environment - The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Skills and Abilities - Must be able to use computers and software applications. - Knowledge of drugs, drugs dosing, side effects, indications, contraindications and proper administration preferred. - Knowledge of rules, policies and regulations related to the disbursal of pharmaceutical drugs preferred. - Must be able to work accurately, efficiently, and safely in a fast-paced environment. - Must be polite and respectful when communicating with staff, physicians, patients and families. - Must demonstrate flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs. - Must be able to communicate effectively verbally and in writing and place high emphasis on customer service. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) - Company: UNTWN Uniontown Hospital - Cost Center: 230 UNTWN Pharmacy - Address: 500 W Berkeley Street, Uniontown, Pennsylvania Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law.

Role Description Lead efforts to design, innovate, and implement solutions as needed to improve systems and processes. Advocate for customers to understand business needs and identify improvement/productivity opportunities. Possesses critical thinking skills to assess analytical needs and determine the appropriate course of action. Manage successful relationships across project teams and facilitate the development of optimal solutions. Use of performance improvement, project management, cost accounting, industrial engineering, and technological skills will be employed to work with all levels of WVUHS management and medical staff. Continuous learning of current database structure and business intelligence tools are required to confer with customers and other members of the application teams. Effectively communicate across all levels of the organization. Qualifications - Master’s degree in Information Technology/Computer Science, Engineering, Business Management, Business Administration, Accounting, or Hospital Administration, OR 4 years of data analytics experience required. - This position will require an EPIC official designation of “Proficient” within the new hire probationary period. Requirements - 1 year experience working with relational database structures including design, testing, troubleshooting problems and/or training. - 1 year of experience in data analysis and/or health care planning background. - 1 year of experience with reporting tools such as Crystal Reports. - Experience with Structured Query Language (SQL/Oracle) and/or Business Objects. - Internal employees must meet all mandatory competencies in current position in order to qualify for promotion within IT. Preferred Qualifications - Familiarity of applications to be supported preferred. Core Duties and Responsibilities - Maintains a thorough understanding of the database structure and business intelligence tools to create required analytical solutions. - Serves as first point of contact for data analytics and process improvement. - Performs data analysis and creates queries, programs, and automation. - Uses analytical methods to ensure reported data is meaningful and accurate. - Demonstrates technical ability in data analytics using various systems and tools such as Tableau, Microsoft Office Suite, and SAP products. - Attends courses in performance improvement activities, system design, technical training, statistical analysis, and other appropriate subjects. - Leads data requirements gathering for problem identification, resolution, and solution design. - Provides analytical insights from data to drive strategic business decisions. - Project Coordination - Identifies need for cross-functional teams to ensure projects are completed. - Reviews, identifies, and documents any issues, barriers, or risks and brings them to management’s attention. - Provides Project/Task Coordination Services to customers as assigned. - Manages workload and balances quality of work with deadlines to fulfill user expectations and project goals. - Manages expectations and engages management to review/resolve any potential changes to project scope, expected deliverables, etc. - Implements changes while adhering to the change control policy and procedures for the project in order to deliver a successful solution to the customer. - Communicates to all parties the natures, significance, and risk factors of corresponding projects. - Participates in post-implementation review of projects. - Gathers customer requirements to understand business needs and translate into actionable solutions. - Team Building - Participates in training and professional development sessions. - Offers assistance and support to co-workers. - Contributes to building positive team spirit and cohesiveness. - Balances team and individual responsibilities. - Works proactively and cooperatively in group problem-solving situations. - Engages peers/employees in improving the quality of the work. Physical Requirements 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. Working 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. Skills & Abilities - Ability to handle and maintain confidential information. - Ability to work well under high stress conditions. - Ability to work independently or cooperatively as a team member. - Ability to adapt to various workloads and assignments. - Ability to work with multi-disciplinary groups and facilitate meetings. - Must have reading and comprehension ability. - Must be able to type. - Must be able to read and write legibly in English. - Possess good oral and written communication skills. - Ability to prioritize tasks. - Must have independent decision-making ability. - Ability to work in a fast-paced and rapidly changing environment. - Must be flexible. Additional Job Description Experience with Epic Systems and a hospital system background are desired. Scheduled Weekly Hours 40 Shift Exempt/Non-Exempt: United States of America (Exempt) Company SYSTEM West Virginia University Health System Cost Center 5816 SYSTEM IT Health Plan

Role Description To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospital and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies. Responsible for obtaining accurate and complete documentation in the medical record for accurate coding/MS-DRG assignment, severity of illness and risk of mortality for each medical record. Must code inpatients and/or interventional RAD cardiology/radiology 90% of current FTE status. Responsible for the coding of the highly complex patient classes i.e. inpatient, interventional, etc. Qualifications - High School Diploma or Equivalent. - Current HIM or Coding Certification through one of the following: - American Health Information Management Association (AHIMA) - American Academy of Professional Coders (AAPC) - Three (3) years of hospital inpatient coding or interventional radiology (IRAD) hospital coding experience. Requirements - Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program. - Codes inpatient and/or IRAD 90% of current FTE status. - Reviews and accurately interprets medical record documentation from all hospital accounts to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD). - Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation. - Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.). - Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas. - Maintains and enhances current levels of coding knowledge through quality review, attendance and participation at clinical in-services and coding seminars, internal meetings, study of circulating reference materials, and inclusion of updates to coding manuals. - Assures the accuracy, quality, and timely review of data needed to obtain a clean bill. - Contacts physicians or any persons necessary to obtain information required for accurate code assignments. Works and communicates with other offices in any manner necessary to facilitate the billing process. Physical Requirements - Must be able to sit for long periods of time. - Must have visual and hearing acuity within the normal range. - Must have manual dexterity needed to operate computer and office equipment. Working Environment - Standard office environment. - Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material. - May require travel. Skills and Abilities - Must be able to concentrate and maintain accuracy during constant interruptions. - Must possess independent decision-making ability. - Must possess the ability to prioritize job duties. - Must be able to handle high stress situations. - Must be able to adapt to changes in the workplace. - Must be able to organize and complete assigned tasks. - Must possess excellent written and verbal communication skills. - Must possess the knowledge of anatomy, physiology and medical terminology. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) - Company: SYSTEM West Virginia University Health System - Cost Center: 538 SYSTEM HIM CDI

Role Description Responsible for managing patient account balances including accurate claim submission, compliance with all federal/state and third party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Employs excellent customer service, oral and written communication skills to provide customer support and resolve issues that arise from customer inquiries. Supports the work of the department by completing reports and clerical duties as needed. Works with leadership and other team members to achieve best in class revenue cycle operations. Qualifications - High School diploma or equivalent. - One (1) year medical billing/medical office experience (preferred). Requirements - Submits accurate and timely claims to third party payers. - Resolves claim edits and account errors prior to claim submission. - Adheres to appropriate procedures and timelines for follow-up with third party payers to ensure collections and to exceed department goals. - Gathers statistics, completes reports and performs other duties as scheduled or requested. - Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency. - Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up. - Contacts third party payers to resolve unpaid claims. - Utilizes payer portals and payer websites to verify claim status and conduct account follow-up. - Assists Patient Access and Care Management with denials investigation and resolution. - Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth. - Attends department meetings, teleconferences and webcasts as necessary. - Researches and processes mail returns and claims rejected by the payer. - Reconciles billing account transactions to ensure accurate account information according to established procedures. - Processes billing and follow-up transactions in an accurate and timely manner. - Develops and maintains working knowledge of all federal, state and local regulations pertaining to professional billing. - Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. - Maintains work queue volumes and productivity within established guidelines. - Provides excellent customer service to patients, visitors and employees. - Participates in performance improvement initiatives as requested. - Works with supervisor and manager to develop and exceed annual goals. - Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. - Communicates problems hindering workflow to management in a timely manner. Benefits - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company Description - Company: SYSTEM West Virginia University Health System - Cost Center: 544 UHA Patient Financial Services

Role Description Responsible for accurate and timely resolution of patient’s billing concerns and for implementing collection policies and procedures. Responsible for interviewing and counseling patients for payment arrangements and/or charity assistance and other assigned duties. Works with patients to resolve account balances. Qualifications - High school diploma or equivalent. - One (1) year experience in a healthcare setting. - One (1) year previous customer service experience. Requirements - Accurately posts data (payments, adjustments) as needed. - Communicates problems hindering work flow to management. - Resolves patient billing and third party payer concerns. - Interviews & Counsels patients for payment arrangements and/or charity assistance. - Answers patient questions quickly, accurately, and courteously. - Accurately identifies and screens Medicare charity within established guidelines. - Rebills accounts as necessary. - Works with patients to resolve account balances. Physical Requirements - Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in performing duties throughout the work shift. - Visual acuity must be within normal range. - Must be able to exert in excess of 50 lbs. of force occasionally, and/or up to 25 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. - Must have manual dexterity to operate keyboards, fax machines, telephones, and other business equipment. Working Environment - Exposed to high stress and constant interruptions. - Normal business office surroundings. Skills and Abilities - Professional Interactions at all times. - Excellent oral and written communication skills. - Knowledge of medical terminology preferred. - Knowledge of ICS-9 and CPT coding preferred. - Ability to use tact and diplomacy in dealing with others. - Demonstrated customer service relations. - Analytical skills necessary for problem solving. - Knowledge of Fair Debt Collection Act. - Specialized courses or seminars over and above high school that are directly related to collections, medical field, hospital business office setting. - General knowledge of third party payers, collection laws, and collection procedures required. - Excellent telephone communication skills. - Working knowledge of computer including Microsoft Word and Excel. - Demonstrates the knowledge and skills necessary to communicate to all patients per the established age specific education/standard. - Maintains current knowledge of Medicare reimbursement process and audit regulations. - Understands the UB92/1500 bill forms contents and EOMB’s. - Ability to understand written and oral communication. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Day (United States of America) - Exempt/Non-Exempt: United States of America (Non-Exempt) - Company: SYSTEM West Virginia University Health System - Cost Center: 656 SYSTEM Customer Service