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.

Employment Type: Full timeShift: Day Shift Description: POSITION PURPOSE Work Remote Position (Pay Rate: $19.2123-$28.8184) Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location. Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts. Provides training and guidance to lower level colleagues and provide problem resolution as needed. This position reports directly to a Supervisor Billing & Follow-Up. ESSENTIAL FUNCTIONS Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions Performs daily activities as part of the billing and follow-up team in support of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates issues affecting accurate billing and follow-up activities. Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner. Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information. Performs all follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays. Tasks will be routed to the correct workflows with the objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and accurate manner. Researches claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution. Proactively follow up on delayed payments by contacting patients and third-party payers and determining the cause for delay and supplying additional data as required. May prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc. Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing, and as new systems, processes or payers are created. Provides problem resolution to billing and follow-up issues as needed. Other duties as needed and assigned by the supervisor. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. MINIMUM QUALIFICATIONS High school diploma or Associate's degree in Accounting or Business Administration or related field, and a minimum of three (3) or more years' of direct experience and relevant knowledge of revenue cycle functions and systems working within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred. Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel. Completion of regulatory/mandatory certifications and skills validation competencies preferred. Excellent verbal and written communication and organizational abilities. Strong interpersonal skills are necessary in dealing with internal and external customers. Accuracy, attention to detail and time management skills. Ability to work independently. Ability perform billing and follow-up activities in a prompt and accurate manner in order to reduce potential financial loss to the patient and the Ministry Organization. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health. PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards. Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues. Manual dexterity is needed in order to operate a keyboard. Hearing is needed for extensive telephone and in person communication. The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen. The noise level is low to moderate. Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Must possess the ability to comply with Trinity Health policies and procedures. The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Role Description 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. - Maintaining standards for coding data quality and integrity. - Productivity within established guidelines. - 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. Company Description 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. 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. Today, we are a 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. 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.