Role Description This position is responsible for reviewing patient medical records to facilitate modifications to clinical documentation through concurrent (pre-bill) interaction with providers and other members of the healthcare team to promote accurate capture of clinical severity of illness and risk of mortality (later translated into coded data) and to support the level of service rendered to relevant patient populations. CDIS exhibits expert knowledge of clinical documentation requirements, MS-DRG Assignment, case mix index (CMI) analysis, clinical disease classifications, major and non-major complications and comorbidities (MCCs or CCs), and quality-driven patient outcome indicators. Interacts as needed with internal customers to include but not limited to hospital staff, physicians, and other revenue cycle team members. Actively participates in department and hospital performance initiatives when needed to ensure ULH success. Responsibilities - Completes initial medical record reviews of all inpatient patient accounts (all payers) within 24-48 hours of admission for a specified patient population to: - Evaluate and review inpatient medical records daily, concurrent with patient stay, to identify opportunities to clarify missing or incomplete documentation. - Assign the principal diagnosis, pertinent secondary diagnoses, procedures for accurate MS-DRG assignment, score risk of mortality and severity of illness and initiate a review worksheet. - Conduct follow-up reviews of patients every 2-3 days to support and assign a working or final MS-DRG assignment upon patient discharge, as necessary. - Formulate clinically compliant and credible physician queries regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary. - Proactively collaborate with physicians to discuss and clarify documentation inconsistencies to ensure accuracy of the medical record and appropriate capture of the course of treatment provided to the patient. - Educate providers about identification of disease processes that reflect SOI, complexity, and acuity to facilitate accurate application of code sets. - Gather and analyze information pertinent to documentation findings and outcomes, and use this information to develop action plans for process improvements. - Collaborate with case managers, nursing, and other ancillary staff regarding interaction with physicians concerning documentation opportunities and to resolve physician queries prior to discharge. - Communicate/completes Clinical Documentation Improvement (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution with appropriate leadership. - Remain abreast and current on training of new hires and ongoing CDIS professional staff development as well as participate in CDI-related continuing education activities to maintain certifications and licensures. - Collaborate with HIM/coding professionals to review and resolve DRG mismatches for individual problematic cases and ensure accuracy of final coded data in conjunction with CDI managers, coding managers, and/or physician advisors. - Identify patterns, trends, variances, and opportunities to improve documentation review processes. - Aid in identification and proper classification of complication codes and present on admission (POA) determination (patient safety indicators/hospital-acquired conditions) by acting as an intermediary between coding staff and medical staff. - Contribute to a positive working environment and perform other duties as assigned or directed to enhance the overall efforts of the organization. Qualifications - CDIS candidate must have and maintain current licensure as a RN, RHIA, RHIT or possess an active CCS (AHIMA) or CPC-H (AAPC) coding credential. - CDIS must have 3+ years of acute care experience as a RN or 3+ years inpatient coding experience as a RHIA/RHIT/CCS/CPC-H. - Must have advanced clinical expertise and extensive knowledge of complex disease processes with broad clinical experience in an inpatient setting. - Certified Clinical Documentation Specialist or Clinical Documentation Improvement Professional (CCDS or CDIP) credential is required within 12 months of employment. Requirements - Working knowledge of medical terminology and Official Coding Guidelines. - Ability to work independently, self-motivate, and adapt to the changing healthcare arena. - Excellent verbal and written communication skills, analytical thinking, and problem solving with strong attention to detail. - Proficiency in organizational skills and planning, with an ability to multitask in a fast-paced environment. - Proficiency in computer use, including database and spreadsheet analysis, presentation programs, word processing, and Internet research. - Working knowledge of federal, state, and private payer regulations as well as applicable organizational policies and procedures. - Working knowledge of quality improvement theory and practice, core measures, safety, and other required reporting programs. - Ability to formulate clinically compliant and credible physician queries.

Role Description The Sr Prior Authorization Specialist promotes an excellent patient experience by ensuring authorizations are in place for services performed at Children's Minnesota prior to their admission to our facilities to secure payment and reduce the out of pocket costs to our patients and families. This position is responsible for all duties associated with prior authorizations including: - Reviewing insurance benefits - Understanding third party requirements - Securing authorizations for services - Appealing pre-service authorization denials - Appealing authorization related claim denials Qualifications - High School Diploma or GED - Post-secondary education in a related field preferred - Three years' experience in a healthcare or related field - Preferred experience: Three years' experience in medical billing/prior authorization/insurance Requirements - Knowledge in governmental and commercial payors, medical billing requirements, and prior authorizations - Demonstrated knowledge of Prior Authorization operations and medical office and/or hospital procedures - Ability to interpret and cascade payor requirements as they relate to insurance prior authorizations - Ability to effectively work in both a team environment and independently - Ability to establish and maintain effective working relationships with providers, patients, families, and employees - Ability to effectively work in a remote environment and connect via multiple communication channels (phone, email, text, etc.) - Knowledge of how prior authorization functions impact billing, clinical teams, the quality of care and the patient experience - Ability to meet and exceed departmental quality, production and prior authorization standards - Ability to review and resolve denials pertaining to Prior Authorizations - Ability to suggest workflows that improve efficiency and experience - Ability to mentor and motivate a remote team that delivers exceptional customer service via multiple communication channels (phone, email, text, etc.) - Skill in Microsoft Office - Skill in written and oral communication Benefits - Medical, dental, vision, retirement, and other fringe benefits - Positions that require night, weekend or on-call work may be eligible for shift differentials or premium pay

• Coordinate and process invoices from vendors and expense them to the appropriate purchase orders • Troubleshoot issues related to vendor invoices (expected cost vs. invoiced costs) • Enter/post A/P invoices in our industry-designed order processing/accounting application • Enter/Post Invoices to our clients • Print client invoices and distribute via email • Review and resolve issues related to invoices sent to clients, charges to credit cards for completed projects • Provide support to meet the sales team’s objectives • Achieve full understanding of company policies and processes to apply them to our client/vendor orders and inquiries

Role Description As a Cardiovascular Disease Specialist, you will drive meaningful patient impact by leveraging our scientific expertise and serving as the primary contact for customers within your assigned territory. As a key member of the local Customer Team, you will collaborate closely with Account Executives, Integrated Delivery Systems leaders, and other field colleagues to deliver seamless, patient-focused solutions. This is a field-based sales role responsible for the Metro Detroit Territory covering Detroit, Sterling Heights, Dearborn and surrounding areas. Travel (%) depends on the needs of the territory and where the selected candidate resides, and overnight travel may be required about 25% of the time to support client meetings and ensure comprehensive territory coverage. In this role, you will develop and manage relationships with various health care customers, including cardiologists, primary care, and other health care professionals. You will regularly engage with various health care settings, such as physicians’ offices, integrated delivery systems, pharmacies, and hospital clinics, to effectively execute your responsibilities. Key Responsibilities - Develop and execute a territory-level business plan in alignment with company policies, standards, and ethics. - Maintain current product knowledge and certifications for the company’s portfolio. - Conduct balanced and compliant product sales discussions with health care providers and business professionals to align customer needs with company products according to product labeling. - Provide management with regular updates on customer needs, marketplace dynamics, and progress toward quality goals. - Be knowledgeable on headquarter approved information regarding approved company products, disease, and marketplace. - Monitor business performance against objectives using company tools to support effective planning and sales impact. Qualifications - This position's band level will be evaluated based on candidate's qualifications. Requirements - S1 Level: Bachelor’s degree (BA/BS), or High school diploma or equivalent with 0-3 years of relevant work experience, which may include professional sales, marketing, military service, or roles within healthcare or scientific fields such as pharmaceuticals, biotechnology, or medical devices. - S2 Level: Bachelor’s degree (BA/BS), or High school diploma or equivalent with 3+ years Sales experience or a minimum of high school diploma with at least 6 years of relevant work experience which may include professional sales, marketing, military service, or roles within healthcare or scientific fields such as pharmaceuticals, biotechnology, or medical devices. - Able to analyze complex data and leverage insights to develop strategic sales plans. - Comfortable using digital tools and platforms to engage with healthcare professionals. - Flexible and adaptable to changing market conditions and customer expectations. - Proven track record of success in both educational and professional environments, demonstrating strong interpersonal, analytical, and communication skills. - Works well both independently, with excellent organizational and time management skills, and collaboratively within team-oriented settings. - Valid driver’s license. - Demonstrate strong ability at building and maintaining customer relationships by understanding and addressing their needs effectively. - Reside in the territory or within 25 miles of the workload center for designated metro territories, or within 75 miles for non‑metro territories; if outside these distances, candidates must be willing to relocate at their own expense. Preferred Experience and Skills - Background in sales, account management, consultative roles, or customer service. - Experience analyzing metrics to evaluate progress toward goals. - Minimum of 3 years of relevant sales experience. - Cardiovascular sales experience with established relationships with cardiologists and endocrinologists. - Experience launching products and succeeding in competitive markets. - Ability to simplify complex information and convey technical details clearly. - Proficient in using advanced analytics to generate customer insights and drive sales. - Comfortable leveraging multi-channel tools and technology to expand sales reach and impact. - Demonstrates a proactive learning approach and an agile growth mindset. Required Skills - Account Management - Customer Needs Assessments - Customer Relationship Management (CRM) - Health Economics - Interpersonal Relationships - Lead Generation - Market Analysis - Product Knowledge - Sales Forecasting - Sales Metrics - Sales Pipeline Management - Sales Reporting - Sales Strategy Development - Sales Training - Self Motivation Benefits - Medical, dental, vision healthcare and other insurance benefits (for employee and family) - Retirement benefits, including 401(k) - Paid holidays, vacation, and compassionate and sick days Salary Range The salary range for this role is $79,200.00 - $124,700.00. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. An employee’s position within the salary range will be based on several factors including, but not limited to relevant education, qualifications, certifications, experience, skills, geographic location, government requirements, and business or organizational needs. Travel Requirements 25% travel may be required. Flexible Work Arrangements Remote work options available.