• Submit accurate insurance claims via SimplePractice, verifying CPT codes, diagnosis codes, payer IDs, and fees prior to submission; monitor claim status on a bi-monthly cadence and process resubmissions, reconsiderations, and appeals as needed. • Generate and send invoices for deductibles, coinsurance, no-show fees, and private pay balances; follow up with patients on outstanding amounts and manage accounts escalated to collections per company policy. • Verify patient benefits including deductibles, coinsurance, and visit limits prior to billing; identify and communicate insurance red flags, ensure required agreements are signed, and track deductible accumulation. • Review EOBs to confirm payment accuracy, match payments to dates of service, and identify discrepancies; reconcile insurance payments against internal records and investigate mismatches or missing payments. • Identify cases where insurance payments are sent directly to patients and initiate follow-up via portal, SMS, or email to collect and apply outstanding payments; escalate unresolved cases as needed. • Maintain Admin Notes in SimplePractice, Trello tracking cards, and internal spreadsheets for audit readiness; manage pre-authorizations, pre-certifications, and auto accident workflows; communicate clearly with patients on coverage, billing responsibilities, and payment expectations.

Role Description Medical Records Technician (Coder - Outpatient and Inpatient) analyzes and abstracts patients' health records and assigns alpha-numeric codes for each diagnosis and procedure. To perform this task, he/she must possess expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). - This position is in the Health Information Management Service (HIMS) at the VA Western New York Health Care System (VAWNYHCS). - MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings. GS-4 - Applies knowledge of medical record content, medical terminology, anatomy & physiology, diseases processes, and official coding guidelines to assign codes to the most basic and routine outpatient and inpatient services. - Selects and assigns codes from the current versions of the International Classification of Diseases (ICD) Clinical Modification (CM) and Procedure Coding System (PCS) for inpatient facility MS-DRG coding, and Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS) for inpatient professional coding and outpatient coding. - Incumbent with instruction from a senior coder or supervisor learns to select diagnosis, operation, or procedure codes based on the accepted coding practices, guidelines, conventions and policy. GS-5 - Establishes the primary and secondary diagnosis and procedure codes for billable outpatient encounters for one specialty or subspecialty following applicable regulations, instructions, and requirements for allowable reimbursement. - Links the appropriate diagnosis to the procedure and/or determines level of E/M service provided. - Uses basic knowledge of the CPT and HCPCS coding systems for Third Party Insurance cost recovery. - Codes less complex Operating Room procedures reported in the Surgical Package of the VistA hospital system. - Updates ICD diagnosis and procedure codes for the quarterly inpatient and Contract Nursing Home census for assigned inpatient admissions. - Applies ICD and CPT coding systems and guidelines and selects proper codes using the current code set and the encoder product suite. - Incumbent updates any assigned billable long stay (30+ days) inpatient admissions to reflect all patient conditions and care up for monthly billing. GS-6 - Assigns codes to documented patient care encounters (inpatient and outpatient) for one or more specialty and subspecialty health care services provided by the VAMC. - Incumbent has knowledge of medical terminology, anatomy & physiology, diseases, treatments, diagnostic tests, and medications to ensure proper code selection. - Incumbent selects and assigns codes from the current version of one or more coding systems depending on regular/recurring duties. - Incumbent monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VAMC. - Uses skill and knowledge of the organization and structure of the patient health record to capture and justify code assignment. - Incumbent at the direction of the supervisor assists in orienting and instructing new personnel and/or students from affiliated health information or medical record technology programs. GS-7 - Receives minimal monitoring. MRTs (Coder) perform a combination of inpatient and outpatient coding duties. - Selects and assigns codes from current versions of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records. - Incumbent adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or evaluation and management (E/M) code to ensure ethical, accurate, and complete coding. - Performs a comprehensive review of the patient health record to abstract medical, surgical, ancillary, demographic, social, and administrative data to ensure complete data capture. - Incumbent expertly searches the patient health record to find documentation justifying code assignment based on an expanded knowledge of the organization and structure of the patient record. GS-8 - Incumbent is at the journey level for this assignment. MRTs (Coder) at this level perform the full scope of inpatient and outpatient coding duties. - MRTs (Coder) select and assign codes from current versions of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records. - Directly consults with the clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record. - Independently plans and executes tasks related to medical record coding and documentation. - Incumbent expertly searches the patient health record to find documentation justifying code assignment based on an expanded knowledge of the organization and structure of the patient record. Qualifications - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management. - Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more that included courses in anatomy and physiology, medical terminology, basic ICD diagnostic/procedural, and basic CPT coding. - Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. Requirements - Certification: Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must have either: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. - Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Benefits - Not specified in the provided job description. Company Description - Not specified in the provided job description.

Position Summary: The Quality Review Specialist is responsible for performing periodic TMF Quality Reviews for assigned projects in a timely manner and with high quality. The Quality Reviews are used to evaluate the completeness status of study TMFs and are critical to ensuring TMFs are maintained in an audit-ready manner. The Quality Review Specialist will be assigned responsibility for the less complex and/or smaller studies in the Precision portfolio. Essential functions of the job include but are not limited to: - Performs periodic TMF Quality Reviews for assigned projects in a timely manner and with high quality - Ensures that TMF documentation related to periodic TMF Quality Reviews is generated and filed in the TMF. - Informs the TMF Lead if the TMF is not updated with the information related to countries, sites, contacts and applicable TMF document requirements. - Supported by Manager, monitors and escalates to the TMF Lead document processing issues and inconsistences, missing/incorrect documents filed by the Functional Leads, non-response of the Functional Leads related to periodic Quality Review requests or questions. - During periodic Quality Reviews, supports updates to expected documents and opening of placeholders in TMF, where needed. - Where possible, identifies potential training needs for all team members working in the TMF to encourage high quality and consistent maintenance of the TMF. - Supported by Manager, identifies and escalates to TMF leadership studies at serious risk based on poor quality. Qualifications: Minimum Required: - Bachelor’s degree (or its international equivalent) + 2 years of related experience Other Required: - Established experience and fluency in the Microsoft Office package of programs (Outlook, Word, Excel and PowerPoint) - Experience with eTMF systems and vendors - Working knowledge of FDA & ICH/GCP regulations and guidelines Skills: - Demonstrates solid interpersonal skills - Ability to identify issues and escalate appropriately and effectively - Good organizational skills, time management, and ability to coordinate workload and meet established deadlines Competencies - Demonstrates, or is able to be trained and retain a working knowledge of ICH-GCP, and relevant Precision SOPs and regulatory guidance - Exhibits strong self-motivation, is detail-oriented and able to work and plan independently as well as in a team environment - Demonstrates professionalism, as evidenced by punctuality, ability to deliver on commitments, and maintain positive interactions with internal and external stakeholders - Communicates both verbally and in written form in an efficient and professional manner - Demonstrates values and a work ethic consistent with Precision Values and Company Principles Any data provided as a part of this application will be stored in accordance with our Privacy Policy. For CA applicants, please also refer to our CA Privacy Notice. Precision Medicine Group is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or other characteristics protected by law. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact Precision Medicine Group at QuestionForHR@precisionmedicinegrp.com. It has come to our attention that some individuals or organizations are reaching out to job seekers and posing as potential employers presenting enticing employment offers. We want to emphasize that these offers are not associated with our company and may be fraudulent in nature. Please note that our organization will not extend a job offer without prior communication with our recruiting team, hiring managers and a formal interview process.

Position Summary: The Quality Review Specialist is responsible for performing periodic TMF Quality Reviews for assigned projects in a timely manner and with high quality. The Quality Reviews are used to evaluate the completeness status of study TMFs and are critical to ensuring TMFs are maintained in an audit-ready manner. The Quality Review Specialist will be assigned responsibility for the less complex and/or smaller studies in the Precision portfolio. Essential functions of the job include but are not limited to: - Performs periodic TMF Quality Reviews for assigned projects in a timely manner and with high quality - Ensures that TMF documentation related to periodic TMF Quality Reviews is generated and filed in the TMF. - Informs the TMF Lead if the TMF is not updated with the information related to countries, sites, contacts and applicable TMF document requirements. - Supported by Manager, monitors and escalates to the TMF Lead document processing issues and inconsistences, missing/incorrect documents filed by the Functional Leads, non-response of the Functional Leads related to periodic Quality Review requests or questions. - During periodic Quality Reviews, supports updates to expected documents and opening of placeholders in TMF, where needed. - Where possible, identifies potential training needs for all team members working in the TMF to encourage high quality and consistent maintenance of the TMF. - Supported by Manager, identifies and escalates to TMF leadership studies at serious risk based on poor quality. Qualifications: Minimum Required: - Bachelor’s degree (or its international equivalent) + 2 years of related experience Other Required: - Established experience and fluency in the Microsoft Office package of programs (Outlook, Word, Excel and PowerPoint) - Experience with eTMF systems and vendors - Working knowledge of FDA & ICH/GCP regulations and guidelines Skills: - Demonstrates solid interpersonal skills - Ability to identify issues and escalate appropriately and effectively - Good organizational skills, time management, and ability to coordinate workload and meet established deadlines Competencies - Demonstrates, or is able to be trained and retain a working knowledge of ICH-GCP, and relevant Precision SOPs and regulatory guidance - Exhibits strong self-motivation, is detail-oriented and able to work and plan independently as well as in a team environment - Demonstrates professionalism, as evidenced by punctuality, ability to deliver on commitments, and maintain positive interactions with internal and external stakeholders - Communicates both verbally and in written form in an efficient and professional manner - Demonstrates values and a work ethic consistent with Precision Values and Company Principles Any data provided as a part of this application will be stored in accordance with our Privacy Policy. For CA applicants, please also refer to our CA Privacy Notice. Precision Medicine Group is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or other characteristics protected by law. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact Precision Medicine Group at QuestionForHR@precisionmedicinegrp.com. It has come to our attention that some individuals or organizations are reaching out to job seekers and posing as potential employers presenting enticing employment offers. We want to emphasize that these offers are not associated with our company and may be fraudulent in nature. Please note that our organization will not extend a job offer without prior communication with our recruiting team, hiring managers and a formal interview process.