Overview Top candidates will have experience in Same Day Surgery Coding. As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for providing care to patients. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities - Performs the final reconciliation on clinic or provider visits and resolves missing, incomplete, or inconsistent documentation by contacting appropriate personnel. - Reviews, abstracts, and codes multiple or sub specialty services and complex or unusual cases, and assigns appropriate coding classifications. - Interacts with and serves as a resource to coding staff, business office, providers, hospital staff, clinic managers, and other clinical personnel on billing related issues. - Researches and resolves high volume accounts, complex or escalated suspended claims, and compliance issues using appropriate databases and shares this information with other coding staff. - Researches, interprets, and applies regulatory guidelines to coding and reimbursement decisions and educates staff on associated guidelines and resolutions. - Assists in the auditing process. - Trains levels I and II coders and may serve as a project lead. - Assists with backlog to maintain department quality and productivity standards. - Assists with other department coding needs, as requested. - May participate on committees and work groups. - May formally present information to providers and assist in training efforts regarding coding and billing. Knowledge / Skills / Abilities - Demonstrated potential ability to perform the essential functions as outlined above. - Demonstrated leadership, human relations and effective communication skills. - Demonstrated knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations, and health insurance processing. - Demonstrated proficiency in computer software. (e.g. Microsoft Word and Excel). - Ability to maintain certifications through continuing education credits. - Ability to effectively train others. - Knowledge of CMS, AMA, and AHA coding and billing guidelines. Qualifications Qualifications Required - American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification such as: Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS- P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other specialty certification indicated by the department. - Three years of coding, clinical or billing experience. Qualifications (Preferred) Preferred - Experience in organizing and conducting coding or billing education. Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. - This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. Physical Requirements Listening, Sitting, Speaking

The job profile for this position is Quality Review and Audit Analyst, which is a Band 2 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Job Summary: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI). Key Job Functions: • Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Cigna IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set. • Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year. • Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS’ Risk Adjustment. • Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of Quality Audits for vendor coding partners. • Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners. • Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner. • Communicate effectively across all audiences (verbal & written). • Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Cigna IFP Coding Guideline updates and policy determinations, as needed. Education & Experience requirements: The Quality Review & Audit Analyst will have a high school diploma and at least 2 years’ experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC): - Certified Professional Coder (CPC) - Certified Coding Specialist for Providers (CCS-P) - Certified Coding Specialist for Hospitals (CCS-H) - Registered Health Information Technician (RHIT) - Registered Health Information Administrator (RHIA) - Certified Risk Adjustment Coder (CRC) certification Individuals who have a certification other than the CRC must become CRC certified within 6 months of hire. Minimum Qualifications: • Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding guidelines and conventions • Familiarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentation • HCC coding experience preferred • Computer competency with excel, MS Word, Adobe Acrobat • Must be detail oriented, self-motivated, and have excellent organization skills • Understanding of medical claims submissions is preferred • Ability to meet timeline, productivity, and accuracy standards If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 25 - 38 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Department FPG Administration Job Summary The Surgical Scheduler works directly with surgeons in the practice to accurately schedule patients for surgical procedures including pre-admission testing appointments in OR, Oncology, and Endoscopy & Bronchoscopy Lab utilizing a block-scheduling system in a way that best maximizes surgeon satisfaction while also managing the overall utilization of the procedural areas. The Surgical Scheduler is also responsible for ensuring appropriate equipment, room specifications and preferences are selected in order facilitator to accurately support the scheduled case and best facilitate the daily schedule. FPG Patient Access Center - Insurance Authorization Department to address increasing workload demands and ensure timely processing of insurance authorizations across FPG. Required Qualifications - Require one (1) year of previous healthcare experience. Preferred Qualifications - Prefer demonstrated knowledge of medical terminology. - Prefer knowledge of International Classification of Diseases Index (ICD-10) and Current Procedural Terminology (CPT-4). - Prefer effective communication skills, including the ability to handle difficult customer situations. - Prefer the ability to type a minimum of fifty (50) words per minute. - Prefer the ability to work with minimal supervision. - Prefer experience or background in surgery case information/operations. Mandatory Education HS EQ: High School Diploma, GED or Certificate *Please note that a copy or photo of your High School Diploma or GED is required prior to start - or transcripts showing date of completion/graduation (this is collected during our onboarding process). Preferred Education AD: Associate's Degree Hiring for FPG's Insurance Authorizations Department REMOTE job after 90 days introductory period. M-F 8am - 5pm FPG Centralized Access Center 6230 University Parkway Suite 102 Sarasota, FL 34240 Employment Screening Requirements As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary: The Facility Surgical Coder 2 position reports directly to the Supervisor of Coding. Key responsibilities of the role include: - Reviewing documentation in same day surgery and observation medical records, and accurately and completely assigning appropriate ICD-10-CM diagnostic and procedural CPT-4/HCPCS codes to the greatest specificity and assigning the most accurate APC when appropriate. Abstracts demographic and coding information accurately and completely Core Responsibilities and Essential Functions: - Codes and abstracts medical records with a minimum of accuracy. - Accurately and completely assigns appropriate ICD-10-CM diagnostic and CPT-4/HCPCS procedural codes to the greatest specificity, assigning the most accurate DRG/APC, when appropriate and in accordance with Official Guidelines for Coding and Reporting and Facility Coding Guidelines, as applicable - Accurately and completely abstracts all required patient demographic data into the EMR - Accurately assigns correct APC - Meets productivity standards - Queries providers, if needed to further clarify code - Manages additional coding responsibilities, contributing to the CFB (candidate for bill) goals, including but not limited to: resolving coding edits and reminders, correcting abstracting and coding issues in a timely manner (1-2 business days) - Completes and routes problem accounts, ready to code, high dollar and other accounts daily to ensure cases are coded as close to goal date as possible - Completes assigned work by goal date - Assists with coding unassigned or backlogged accounts - Accurately capture the surgical CPT code(s) for pre-certification reconciliation for each of the WHS facilities, as needed - Serves as a mentor to new coders - Assist with cleaning up or escalating missing documentation or other work queues - If proficient, assists with outpatient and emergency coding when needed or assigned - Performs other duties as assigned - Complies with all WellStar Health System policies, standards of work, and code of conduct. Required Minimum Education: - High School Diploma or GED Preferred Certification(s): All certifications are required upon hire unless otherwise stated. - CCS - Cert Coding Specialist - CPC - Cert Prof Coder - RHIA - Reg Health Information Admin - RHIT - Reg Health Information Tech Required Minimum Experience: Minimum 3 years acute care same day surgery and observation coding experience. Required Minimum Skills: - Must have demonstrated maintenance of a or higher accuracy in abstracting, code and DRG assignment while meeting productivity requirements in previous roles. - Ability to work in a remote environment. Computer/data entry experience. - Ability to communicate with various members of the healthcare team. - Ability to use Microsoft (Excel, Word). Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.