Institutional Insurance and reimbursement expert for one or more of the following business lines: outpatient pharmacy, durable medical equipment, skilled nursing facility, home health agency or continuing care retirement center. Performs all aspects of the billing and collection processes for the individual business lines across the enterprise. These processes include service pre-certification, insurance coverage review and personal responsibility determination, communications with patients, claim submissions, denial review, rebilling, appeals, and accounts receivable management. Utilizes skills in problem solving, customer service, and communications (verbal and written) in interactions with patients and internal customers to resolve a variety of account, billing and payment issues for patients, physicians, nurses, pharmacists, technicians and social workers. Interprets, applies and communicates Mayo Clinic policies regarding financial aspects of patient care to assure optimal reimbursement for both the patient and Mayo Clinic. The schedule will be: - Available: 16 Hours week - M-F between 7am-6pm - Night and Weekend, as needed - Must be available to work after holiday, if requested - Peak season (Jan - Mar) requests may be up to 40 hours per week - Available for Up to 25 hours for 6 weeks for training Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

About Us A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond. Position Summary Reporting to the Manager, Background & Authorization, the Payer Authorization Coordinator will manage initial and reauthorizations for Medicaid and Non-Medicaid payers in all States for Careforth consumers. This individual will procure, track, and document electronic authorizations and manage oral and written communications related to authorization activity as appropriate. The Payer Authorization Coordinator will work with branch staff and medical billing staff to identify issues and will maintain the payer information in the system of record for consumers and temporary databases as needed. This position will work with external payer/partner organizations to correct and/or expedite authorizations for services with Careforth/Caregiver Homes. The Payer Authorization Coordinator will be familiar with state and payer regulations and the specific process requirements for all participating partners. What You Will Do - Coordinate the required authorizations with payers for Careforth consumers and members as required by state regulations and Careforth policy - Enter accurate information into the systems of record, as well as payer systems to ensure regulatory and compliance deadlines are met - Work collaboratively with branch staff, Careforth management, and payer representatives to reconcile disparities within data received and data entered (i.e. level of care) telephonically and via email - Work closely with internal stakeholders to assure continuity of care for existing consumers and prompt authorization approvals for new referrals - Maintain payer information and consumer information as appropriate to maintain continuous authorization coverage through data entry (e.g. dates of service, renewal dates, etc.) - Ensure payer authorizations are compliant with all necessary state and federal regulations - Create and maintain thorough and compliant documentation, including routine and adhoc updates - Develop tracking and outreach systems to assure continuation of coverage - Provide routine updates to internal stakeholders on the status, content, and issues related to specific payers/state operations; Act as subject matter expert for rules and processes related to each payer - Perform other duties as assigned What You Will Bring - Associate’s Degree preferred and/or equivalent experience - Minimum of 2 years’ experience in the health care field; experience with insurance and authorizations is highly preferred - Understanding of Medicare, Medicaid and other third-party insurance billing practices and eligibility for services is required - Ability to multitask in a fast paced, ever evolving work environment - Proficiency with Microsoft Office, excel proficiency required - Excellent oral and written communication skills - Excellent customer service and organizational skills as well as attention to detail You'll Benefit From At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you: https://careforth.com/careers/#benefits The pay range for this position is $18.45 - $24.87 hourly. The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location. #LI-Remote except for CA Join Our Award Winning Team Founded in Boston, Careforth's caregiver programs and services improve health outcomes, keeping care at home longer. Additionally, our programs provide financial benefit to caregivers and cost savings to state agencies and health plans. At Careforth, we understand the challenges of caregiving and are committed to supporting family caregivers at every turn. Caregivers play a critical role in the future of healthcare—and so can you. Apply now! For more information, please visit www.Careforth.com. Careforth is an Equal Opportunity Employer* DISCLAIMER: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. *Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law. Careforth strives to create experiences that are accessible and welcoming to everyone, including making www.careforth.com and the careers site accessible to any and all users. If you would like to contact us regarding the company’s diversity, equity and inclusion initiatives, inquire about a specific accessibility need or the accessibility of our website, or if you need assistance completing an application process, please contact People & Culture at 866-797-2333.

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic data base and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Responsibilities · Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. · Ability to code government and state models. This includes code everything projects. · Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. · Ability to maintain a 95% accuracy rate on all coding projects. · Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures. Requirements · Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended. · Strong organizational skills · Technical savvy with high level of competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook. · Strong written and verbal communication skills · Ability to work independently in a remote environment · Private lockable office space to ensure security of Member PHI · Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding. · Completion of an accredited medical coding program with current unencumbered credentials. Required education: · CPC Certification Required experience: · Risk Adjustment coding: 3 years · Coding: 5 years Supervision Received · General supervision is received weekly Compensation Range $ 22.36- $32.45 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

The Corporate Coder (“CC”) functions under the direction of the Health Information Corporate Coding Manager. The CC is responsible for accurate coding and abstracting of clinical information from the medical record. The CC is responsible for maintaining standards for coding data quality and integrity, as well as productivity within established guidelines. The CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC’s and/or other projects where indicated. Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many "firsts" in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. Careers at Tenet At Tenet Healthcare, the heart of what we do centers on caring with compassion, which ultimately creates a bond between our caregivers and patients. Everyone contributes to these moments, whether providing care directly or supporting those who do. As an organization, we provide employees with resources, tools and support to serve our patients and customers in the best way possible. We also take care of one another, helping team members further develop their career pathways and maximize their potential.