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CenterWell logo
CenterWell

CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. Cares for patients with chronic and complex illnesses. Offers personalized clinical and educational services to improve health outcomes and drive superior medication adherence. CenterWell, a Humana company, creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and the fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional, and social wellness of our patients. Part of Humana Inc. (NYSE: HUM). Offers stability, industry-leading benefits, and opportunities to grow yourself and your career. Employs more than 30,000 clinicians committed to putting health first. Provides flexible scheduling options, clinical certifications, leadership development programs, and career coaching.

Consultative Coding Manager

Medical Billing and CodingMedical Billing and CodingOtherRemoteLeadTeam 1,001-5,000

Location

United States

Posted

87 days ago

Salary

$86.3K - $118K / year

Seniority

Lead

No structured requirement data.

Job Description

Consultative Coding Manager

CenterWell

Become a part of our caring community and help us put health first The Consultative Coding Manager extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Consultative Coding Manager works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. You will confirm appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Use your skills to make an impact Required Qualifications - Bachelor's Degree or 6 plus years of technical experience - 2 or more years of management experience - CPC (Certified Professional Coder) Certification - RHIA, RHIT, CCS Certification - MS-DRG auditing or APR auditing experience - Acute in-patient and/or outpatient coding experience - Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications - Athena EMR systems experience Additional Information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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Marathon Health logo

Referrals Coordinator - Remote

Marathon Health

We are Marathon Health. We’re building better, together.

OtherRemoteTeam 1,001-5,000Since 2005H1B Sponsor

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Brown Medicine logo

Medication History Technician Specialist, Remote

Brown Medicine

One of the largest nonprofit, academic, multi-specialty medical groups in RI.

OtherRemoteTeam 201-500Since 1995H1B Sponsor

SUMMARY: Reports to Manager, Pharmacy Operations, under the supervision of a pharmacist and direction of the Medication History Pharmacy Technician Supervisor, the Pharmacy Medication History Technician Specialist, Remote serves as a key and integral part of the progressive pharmacy-managed medication reconciliation practice model. Is responsible for remote services which includes accurately obtaining and compiling current, detailed, and complete home medication history lists and allergies for patients to be admitted to the hospital. Uses all relevant sources to obtain the most current required information including, but not limited to, patient and family interviews, direct contact with outpatient pharmacies, extended care facilities, and provider offices. Accurately documents detailed and verified current home medication list, including relevant related information, in the electronic medical record (EMR). Reviews patient allergy information in EMR, updates as needed. 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The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Establishes and maintains compliance with Brown University Health’s Flexible Work Arrangements Guidelines and Forms. Receives remote notifications of medication reconciliation that need to be completed. Obtains and compiles current, detailed, and complete home medication history list. Medication history list shall include drug name, dose and dose form, frequency, and route of administration for prescription medications, over the counter drugs, and complementary and alternative medications currently taken by the patient. Obtains and compiles patient allergy information including reaction experienced by the patient. Uses all relevant sources to obtain the most current home medication history list and allergy information including, but not limited to, patient and family interviews, direct contact with patients’ outpatient pharmacies, extended care facilities, and provider offices. Communicates home medication list discrepancies identified via the medication history process with the provider and/or pharmacist; hands off unresolvable medication history related issues; tracks follow-up to ensure closure. Refers suspected actual, prevented, and near miss medication errors to a pharmacist for appropriate follow-up and reporting. Serves as a resource to the pharmacist regarding home medication histories and other related information, provides follow-up as deemed appropriate by the pharmacist. Documents detailed and verified current home medication list accurately, including relevant related information, if any, in the electronic medical record (EMR). Ensures patient allergy information, including relevant related information, if any, is correctly documented in EMR, updates if needed. Compiles medication history lists, verifies allergies, and documents in EMR in an efficient and timely manner with the highest level of accuracy. Responds appropriately to providers, nurses and others who request a medication history. Manages, triages, and ensures follow-up in a timely manner. Ensures high quality customer service is provided and displayed at each patient, family, outreach, and team interaction. Exhibits a friendly, pleasant, compassionate, and helpful nature demonstrating a strong customer service orientation when interacting with patients and their families. Directs, triages, or communicates, to the appropriate provider or staff member, questions or inquiries received from the patient and their family which are outside the scope of the medication history technician. Interacts effectively and professionally with other health care providers at all levels including, but not limited to, providers, nurses, and support personnel. Participates in quality assurance activities for the pharmacy-managed medication reconciliation practice model. Participates in quality assessment and improvement activities and medication safety initiatives as they relate to the pharmacy-managed medication reconciliation practice model. Utilizes experience-based knowledge to identify opportunities for improvement related to quality, safety, regulatory, or financial outcomes. Rotates to all applicable medication history work assignments and work shifts. Acknowledges and demonstrates professionalism for self and others. MINIMUM QUALIFICATIONS: EXPERIENCE &BASIC KNOWLEDGE: High school graduate or equivalent degree. Completion of one to two years of college preferred. Maintains current unrestricted Rhode Island Pharmacy Technician licensure. Holds and maintains current National Pharmacy Technician Certification (CPhT) or has a minimum of one-year licensed pharmacy technician work experience in an outpatient pharmacy setting, sits for National Pharmacy Technician Certification (CPhT) exam within first 6 months of hire, and achieves and maintains National Pharmacy Technician Certification (CPhT) within 12 months of hire. Applies for and obtains a Rhode Island Tech II license immediately after notification of successful CPhT certification. Minimum one-year pharmacy technician experience in an outpatient pharmacy setting. Strong customer service presence and verbal and written communication skills necessary to interact with patients, families, physicians/practitioners, nursing, and ancillary support staff. Strong focused and active listening skills including ability to listen attentively while blocking out distractions and to identify key points and ideas. Must possess solid computer skills including Microsoft Office Suite, as well as email and calendar applications. Must be comfortable in using internet web applications and multiple pharmacy and system-wide applications. Work is exact and requires the ability to pay attention to detail and to stay focused to avoid serious error in compiling and documenting home medication lists and verifying allergies. Must be able to multi-task and reprioritize as needed, while maintaining the highest-level accuracy and customer service standards. WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS: Employee will be responsible to establish a secure workspace environment to protect the confidentiality of sensitive information. Sensitive information includes confidential information, protected health information (PHI), and protected identifiable information (PII). Employee will be responsible for costs associated with setting up, furnishing, and managing their remote employee workspace and for costs of maintaining appropriate internet connectivity to access Brown University Health Information Services resources. Work may require extended periods of time spent sitting. Work requires the visual acuity and manual dexterity necessary to operate a computer and input data into EMR using a typical keyboard and computer mouse to navigate screens on a computer monitor. New hires into this position must successfully pass a drug screen in conformance with Rhode Island State Law. INDEPENDENT ACTION: Performs independently within department policies and practices. Refers specific complex problems to supervisor where clarification of departmental policies and procedures may be required. SUPERVISORY RESPONSIBILITY: None. Pay Range: $19.97-$32.96 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903Work Type: Rotating day and evening shifts. Includes weekdays, weekends, and holidays.Work Shift: VariableDaily Hours: 8 hoursDriving Required: No

United States
$20 - $33 / hour
Job Closed