This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. This telework opportunity allows you to customize your schedule as a 1099 independent contractor. - Evaluate medical records - Provide clinical summaries - Engage in peer communications - Answer specific questions posed by our clients We are on the lookout for talented professionals in the following area: - Endocrinology - With direct experience prescribing and treating gender dysmorphia patients Be a part of a team that values your skills and dedication to improving patient care. Your expertise is vital to helping us deliver high-quality healthcare assessments. Qualifications - Board Certified in Endocrinology - Current, unrestricted Washington Medical License - 5+ years of clinical practice experience - Attends all required orientation and training - Maintains proper credentialing, state licenses, and any certifications or requirements necessary to perform the job Requirements - Independent consultant role allows for schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct this work based on your scheduled availability - No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions Benefits - Dane Street offers a streamlined case flow and a user-friendly work portal - We facilitate all communication, organize and sort all medical records, support all administrative processes, prep cases extensively, and ensure the quality and timely delivery of all determinations/reports - A chronological listing of medical records as well as all treatment guidelines used to make a determination are provided in an easy, click-to-view format - Dane Street offers initial training as well as an ongoing point of contact should you have any questions about completing reviews

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. 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 This position will be responsible for Split Claim processes required for Critical Access hospitals. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School Diploma or Equivalent.                                                                                                           2. Current HIM or Coding Certification through ONE of the following: - American Health Information Management Association (AHIMA) - American Academy of Professional Coders (AAPC) EXPERIENCE: 1. Two (2) years of medical coding experience. PREFERRED QUALIFICATIONS: EXPERIENCE: 1.Two (2) years of physician office coding experience 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. Reviews and accurately interprets medical record documentation from all accounts in order 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 that is identified. Assigns hospital and/or professional codes to a variety of patient classes (i.e. I/P, OBS, SDC, etc.) 2. Performs the coding/billing Split Claims process to ensure correct coding and reimbursement for appropriate accounts. 3. Assures that quality and timely coding, charging and abstraction of accounts are completed daily for assigned specialty areas. 4. 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. 5. Assures the accuracy, quality, and timely review of data needed to obtain a clean bill. 6. 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. 7. Monitors on an on-going basis provider documentation. Performs audits to assess provider coding accuracy and follows up with provider education as needed. 8. Provides assistance to Revenue Cycle Operations in claim development functions to resolve problem patient accounts. 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. Must be able to sit for long periods of time. 2. Must have visual and hearing acuity within the normal range. 3. Must have manual dexterity needed to operate computer and office equipment. 4. Must be Able to lift, push or pull 10-20 pounds. 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. 2. Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material. 3. May require travel. SKILLS AND ABILITIES: 1. Must be able to concentrate and maintain accuracy during constant interruptions. 2. Must possess independent decision-making ability. 3. Must possess the ability to prioritize job duties. 4. Must be able to handle high stress situations. 5. Must be able to adapt to changes in the workplace. 6. Must be able to organize and complete assigned tasks. 7. Must possess excellent written and verbal communication skills. 8. Must meet quality and productivity standards. 9. 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: 548 SYSTEM HIM Coding Analysis

🚨 Now Hiring: RN Case Manager – Los Angeles, CA Region 🚨 💻 Work from home + local field travel 💰 Salary: $87,000 – $101,000 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We’re looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRN) ✨ Workers’ Comp Case Management experience a plus 📍 Location Requirement Candidates must be based in one of these California areas: San Fernando, Van Nuys, Santa Clarita, Granada Hills, Panorama, Valencia, Oxnard, Westlake Village, Palmdale, or Chatsworth. ✅ Your Impact: You’ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You’ll support patients/employees receiving benefits under insurance lines including Workers’ Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the community! Why Crawford? Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com. When you accept a job with Crawford, you become a part of the One Crawford family. Our total compensation plans provide each of our employees with far more than just a great salary - Pay and incentive plans that recognize performance excellence - Benefit programs that empower financial, physical, and mental wellness - Training programs that promote continuous learning and career progression while enhancing job performance - Sustainability programs that give back to the communities in which we live and work - A culture of respect, collaboration, entrepreneurial spirit and inclusion Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Specialty Admission Coordinator is responsible for managing specialty medication referrals from receipt through insurance clearance to ensure timely and accurate patient access to therapy. This role serves as the key point of contact for benefit investigation, prior authorization, coordination with internal stakeholders (pharmacy and nursing staff) and financial counseling with patients. The coordinator plays a critical role in ensuring referrals meet payer requirements and in facilitating seamless communication between patients, providers, pharmacy staff and the sales team. This is a remote position. Monday-Friday 8:30am-5:30pm (MST or PST) Responsibilities - Owns and manages the specialty referral from initial intake through insurance approval - Conducts timely and accurate benefit investigation, verifying both medical and pharmacy benefits - Identifies and confirms coverage criteria, co-pays, deductibles and prior authorization requirements - Prepares and submits prior authorization requests to appropriate payers - Maintains clear, timely communication with pharmacy teams, sales representatives and prescribers regarding the status of each referral and any outstanding information - Coordinates and delivers financial counseling to patients, including explanation of out-of-pocket costs, financial assistance options and next steps - Ensures all documentation complies with payer and regulatory requirements - Updates referral records in real-time within computer system - Collaborates with patient services and RCM teams to support a smooth transition to fulfillment - Tracks and reports referral statuses, turnaround times and resolution outcomes to support process improvement Supervisory Responsibility: No Qualifications - High school diploma or GED required; Associate’s or Bachelor’s degree preferred. - Minimum of 2 years of experience in a healthcare, specialty pharmacy, or insurance verification role. - Experience working with specialty medications, including benefit verification and prior authorization processes. - Experience in patient-facing roles is a plus, especially involving financial or benefit discussion. - Familiarity with payer portals. - Strong understanding of commercial, Medicare, and Medicaid insurance plans. - Proven track record of communicating effectively with internal and external stakeholders. - Desired: Experience in Microsoft BI. Experience in Outlook, Word, and PowerPoint. Requirements - Percentage of Travel: 0-25% - To perform this role will require constant sitting and typing on a keyboard with fingers, and occasional standing, and walking. - The physical requirements will be the ability to push/pull and lift/carry 1-10 lbs. Company Description Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com . Follow us on Facebook , LinkedIn , and X . Salary Range USD $21.00 - $29.00 / Hour