Where You’ll Work The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave. One Community. One Mission. One California Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. - Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities as it pertains to risk adjustment. - Ensure that the diagnosis codes for each chronic or major medical condition have been captured and work to educate providers on opportunities to improve documentation on medical conditions. - Review clinical documentation across the network to identify patterns and trends in clinical documentation. Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines. - Develop education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category (HCC) coding capture. - Participate network performance improvement initiatives. - Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security. ***This position is remote. Job Requirements Minimum Qualifications: - Associates degree or equivalent work experience- CPC, CRC, CCS, CCS-P, or RHIT- Advanced knowledge of CPT and ICD-10 coding- Knowledge of federal and state guidelines on all coding systems and sponsored programs.- Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements.- Must possess the ability to work independently with strong organizational, communication and interpersonal skills to support the management of multiple priorities, at multiple practice locations, with significant attention to detail for completion of both verbal and written external communications.- Computer literacy of medical information system, records management software, encoders.- Must have excellent verbal communication skills.- Proficiency in MS office (Outlook, Excel, Word). Preferred Qualifications: - 2-3 years of experience in risk adjustment/HCC coding strongly preferred

Under general supervision, computes, bills, posts, and collects patient accounts. Possesses ability to elicit and evaluate information, sometimes of a highly personal and sensitive nature from a broad spectrum of individuals and agencies; maintains confidentiality; reads, interprets, and applies regulations, policies, and procedures; works with minimal supervision and with extensive detail; coordinates functions and works cooperatively with others; and organizes work and set priorities to meet deadlines. Performs all other duties as assigned by Centralized Billing Director. Special Qualifications Computer literate. High school diploma with secondary school preferred. CPC Certification preferred. Knowledge of business office functions and third party payor billing, including reimbursement methods and requirements preferred. Customer service and proper telephone etiquette required.

Wage Range: $28.83 - $46.14 per hour Healthcare medical billing and reimbursement Remote in Washington State only Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity. Job Summary: Responsible for the identification, appeal, resolution and reporting of all third-party payer claim denials at EvergreenHealth. Must have the ability to communicate and coordinate effectively with all levels of the institution and payer representatives. Responsible for analyzing denial activity to identify trends and denial sources and assists with the development of reports needed to investigate denial issues. Prepares, compiles, distributes and analyzes regular reports of denials and the financial impact. Primary Duties: 1. Identifies and captures claims denials from third-party payers in denial tracking software and/or alternative denial tracking tools on a daily basis and updates throughout the appeal process as activities and responses occur. 2. Responsible for the submission of written letters of appeal to third-party payers within allotted timeframes to prevent financial penalties. 3. Works with Case Management, Health Information Management and Patient Financial Services to gather supporting documentation to strengthen the appeals process. 4. Maintains contact with payers about disputed claims and updates system documentation of ongoing efforts for each claim. 5. Generates reports of denial activity including but not limited to analysis of trends, financial impact, success rate of appeals and root causes. Submits reports to the Director of Revenue Integrity on a monthly basis and as needed. 6. Monitors private payer resources and websites to identify changes in payer requirements and incorporates into denial management processes. Distributes relevant updates to other departments (e.g. Patient Access, PFS, etc.) as necessary. 7. Performs other duties as assigned. License, Certification, Education or Experience: REQUIRED for the position: ● Associate's degree in related area or equivalent combination of education and experience ● 3 years of experience in a hospital or insurance industry setting ● High degree of knowledge regarding health care services reimbursement methodologies ● Knowledge of claim forms and remittance advices including coding and billing practices ● Experience in healthcare billing and reimbursement ● Ability to interpret contract language ● Working knowledge of medical terminology DESIRED for the position: ● Bachelor's degree ● Proficiency in Cerner and Meditech systems Benefit Information: Choices that care for you and your family At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being. - Medical, vision and dental insurance - On-demand virtual health care - Health Savings Account - Flexible Spending Account - Life and disability insurance - Retirement plans (457(b) and 401(a) with employer contribution) - Tuition assistance for undergraduate and graduate degrees - Federal Public Service Loan Forgiveness program - Paid Time Off/Vacation - Extended Illness Bank/Sick Leave - Paid holidays - Voluntary hospital indemnity insurance - Voluntary identity theft protection - Voluntary legal insurance - Pay in lieu of benefits premium program - Free parking - Commuter benefits View a summary of our total rewards available to you as an EvergreenHealth team member by clicking on the link below. EvergreenHealth Benefits Guide

Total Rewards "Your life - our Mission" OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF. Expected pay for this position is $20.21 - $23.77/hour. Actual pay will be determined by experience, skills and internal equity. This is an Hourly position. Overview This is a remote work from home position, must reside in IL or MI. Would need to be able to travel to the office for training in Peoria and for other required, rare occasions. Occasional in office attendance will be required. POSITION SUMMARY: The Patient Financial Navigator ensures that each patient has a complete and accurate OSF medical record, which includes patient demographics, insurance coverage, responsible guarantor, and registration precision in a manner which the patient understands the services they are receiving, their financial responsibilities for the services provided, and expectations of them pre and post service. Financial education will be provided to patients to provide clarity regarding their estimated out of pocket expenses and assistance with bill pay options. The Patient Financial Navigator is expected to be knowledgeable on payment alternatives, grants, programs, and any other type of assistance to educate and support the patient on their financial options. This involves determining a patient's payer source including, but not limited to, obtaining authorization from the payer which includes identifying if services need an authorization, referral, or pre-determination as well as if the procedure is a covered benefit, if the payer is out of network, and be able to assist the patient who has questions on an existing bill or invoice. They must be capable of communicating clearly and concisely, both verbally and in writing, with peers, supervisors, payors, physicians, patients, and other departments. Qualifications REQUIRED QUALIFICATIONS: Experience: Associate's Degree and one year of customer service/relations experience; or High School Diploma and 2 years' experience in a call center, healthcare, and/or public health setting. Other skills/knowledge: Excellent interpersonal and communication skills. Solid computer skills, including proficiency with Microsoft software. Strong analytical and problem solving skills, with the ability to be detail oriented. PREFERRED QUALIFICATIONS: ​Education: Bachelor's Degree in Business Administration or Healthcare related field. Experience: Experience in patient registration, patient accounts, patient finance, insurance benefits, financial assistance programs, public health, social services, or other community based background. Experience in medical billing, including working with insurance companies, third party administrators and collections with emphasis on customer phone contact. Advanced knowledge of CTP4, ICD 10, HCPCS and modifiers. Knowledge of medical terminology. OSF HealthCare is an Equal Opportunity Employer.