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Somos especialistas em tecnologia, dados e design, impulsionando a transformação digital de grandes players do mercado há mais de 10 anos, nos setores financeiro, seguros e mobilidade. Com mais de 450 profissionais, estamos presentes no Brasil e Europa, atendendo aos mercados da América Latina, Europa e América do Norte, desenvolvendo produtos digitais de alta qualidade e com foco em resultados de negócios. Certificada pelo 7° ano consecutivo como Great Place to work aqui na ília acreditamos que pessoas mudam o mundo, e investimos nelas. Nossas awesome deliveries são feitas de pessoas para pessoas, afinal awesome people make awesome deliveries!
Junior Personnel Department Analyst - Affirmative for People with Disabilities (PCD)
Location
Brazil
Posted
37 days ago
Salary
0
Seniority
Junior
No structured requirement data.
Job Description
Junior Personnel Department Analyst - Affirmative for People with Disabilities (PCD)
ília
Role Description - Processar o fechamento e conferência da folha de pagamento; - Atuar com eSocial, FGTS Digital, DCTFWeb e demais obrigações legais; - Conduzir rotinas de rescisão, férias, admissão; - Realizar manutenção do cadastro de funcionários e controle de ponto; - Acompanhar e gerenciar processos de benefícios, como vale-transporte, vale-alimentação, plano de saúde, entre outros benefícios; - Atendimento aos colaboradores para esclarecimento de dúvidas relacionadas à folha, benefícios, férias, rescisões e outros temas de DP; Qualifications - Experiência prévia em Departamento Pessoal e sistemas de folha; - Vivência prática com eSocial, DCTFWeb e FGTS Digital; - Vivência prática em Google Sheets e Excel. Requirements - Conhecimento em acordos e convenções coletivas; - Formação/Cursando superior em Administração, Recursos Humanos, ou áreas correlatas. Benefits - Nossa contratação é CLT- 40h semanais com jornada flexível, sendo executada de forma remota. - Para Saúde e bem-estar: - Plano de Saúde e Odontológico SulAmérica extensivo a dependentes; - Vale Alimentação/Refeição em cartão flexível Caju benefícios; - Seguro de Vida; - Auxílio Home-Office em cartão flexível Caju benefícios; - Wellhub (Gympass); - Sesc – extensivo a dependentes, com acesso aos serviços em todo o Brasil; - TotalPass. - Para o seu Desenvolvimento: - ília University: Universidade Corporativa com mais de 20 mil cursos disponíveis para desenvolvimento pessoal e profissional; - Language Academy: Escola de idiomas para ílians; - í-talks e Chapter: Momentos e cerimônias em que o time compartilha práticas, estudos, projetos e ideias. - Benefícios não convencionais: - Plano de Saúde PET - Guapeco; - Onhappy – benefício de viagem a lazer, com liberdade para você viajar com quem quiser; - BYOD - Alugamos o seu notebook pessoal te pagando um valor mensal para que você o use; - Seu Niver, seu bolo! - Seu Networking Vale Prêmio - Programa de premiação a indicação de novos funcionários.
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Coding/CDI Denials Analyst
UT Southwestern Medical CenterWith over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals.
Role Description The Coding/CDI Denials Analyst primary responsibilities are to review coding denials for inpatient hospital medical records, for accuracy of assigned codes, and ensure all Official Coding Guidelines and conventions were followed. Also, to ensure the clinical evidence and provider documentation supports the assigned codes and DRG. - Compose and submit appeal letters as appropriate. - Identify coding trends/opportunities for root causes of denials relevant for additional education to individual Coders/CDI Specialists and/or the entire Coding/CDI Teams. - Report these trends/opportunities to the Lead Denials Analyst to ensure education is developed and provided to the Coders and/or CDI Teams. - Identify and communicate front-end activities that influence the denials/appeals process, seeking opportunities for process improvement. Qualifications - 3 to 5 years acute hospital-based Coding and/or CDI experience or an equivalent combination of education and experience may be considered. - Denials and Appeals experience in an acute Hospital setting. - Experience working in a remote environment. - Licenses and Certifications: - (RHIA) Registered Health Information Administrator - (RHIT) Registered Health Information Technician - (CCS) Certified Coding Specialist - (CCDS) Certified Clinical Documentation Specialist - (CDIP) Certified Documentation Improvement Practitioner - Preferred: RN with CDI experience. Requirements - Review coding and/or clinical denials, ensuring all coding guidelines and conventions were followed. - Ensure all clinical evidence and provider documentation supports the assigned codes and DRG. - Compose an effective appeal utilizing appropriate coding guidelines, relevant and effective clinical documentation, current industry guidelines, evidence-based medicine, and local and national medical management standards and protocols. - Identify coding and/or documentation trends for root causes of denials. - Identify and communicate DRG changes and financial impact. - Identify coding and clinical educational opportunities and report these to the Lead Denials Analyst. - Identify front-end activities that influence denial/appeals process. - Support the Quality Standards set by UTSW and the HIM Coding & CDI Department. - Maintain an expert level of knowledge of Coding/CDI guidelines and practices. - Other duties as assigned. Benefits - PPO medical plan, available day one at no cost for full-time employee-only coverage. - 100% coverage for preventive healthcare - no copay. - Paid Time Off, available day one. - Retirement Programs through the Teacher Retirement System of Texas (TRS). - Paid Parental Leave Benefit. - Wellness programs. - Tuition Reimbursement. - Public Service Loan Forgiveness (PSLF) Qualified Employer.
Pharmacy Revenue & Reimbursement Analyst
Texas Health ResourcesLocated in Arlington Texas, Texas Health Resources is a nonprofit, faith-based healthcare provider that has been providing a wide range of healthcare services to the communities th
Role Description Bring your passion to Texas Health so we are Better + Together Work Location: Remote Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion) Department Highlights: - Gain a sense of accomplishment by contributing to a teamwork environment. - Remote Position What You Will Do: - Revenue Analysis - Facilitate and support claims processing, rebills, appeals, and follow-up with PBMs and health plans; identify appeal opportunities and manage payor communications to recover underpayments or resolve payment variances. - Monitor and report aging accounts receivable and key performance metrics (e.g., DSO, applied cash). - Support 340B revenue optimization activities by monitoring payor and accumulator impacts (where applicable), identifying claim-level variances, and collaborating with pharmacy operations and finance to resolve 340B-related reimbursement issues. - Develop reports, dashboards, and ad-hoc analysis for payment variances, denials, underpayments, and other trends to support decision-making and process improvements. - Identify trends related to denials and underpayments; collaborate with appropriate teams to implement improvement initiatives. - Payment Integrity - Analyze reimbursement from pharmacy claims to validate payment accuracy, ensure compliance with contracted rates, and reconcile claims activity with remittances to ensure payment efficacy. - Perform 340B payment integrity and audit support activities by analyzing claim-level eligibility/accumulator impacts (as applicable), researching exceptions, and preparing documentation for internal/external reviews. - Support 340B split billing and vendor processes (as applicable), including data validation, claim qualification troubleshooting, and reconciliation of replenishment/accumulation outputs. - Support maintenance of third-party payor pharmacy fee schedules, pharmacy charge masters, and contracted pharmacy payment methodologies; evaluate payor contract performance and reimbursement arrangements and support negotiations with data-driven insights. - Revenue Integrity - Provide education stakeholders to drive optimal revenue capture. - Serve as the system expert on medication-related compliance billing and charging topics. - Develop policies and/or guidelines to improve revenue integrity, charge capture, and billing compliance. - Actively research and stay current with important pharmacy billing and revenue related compliance and optimization topics to guide appropriate organizational decisions. Qualifications - Bachelor's Degree in Business, Finance, Analytics, Healthcare Administration, Accounting, or related field (Required). - Or H.S. Diploma or Equivalent with 10 Years CPhT and 10+ years of experience with pharmacy revenue cycle, retail pharmacy operations and billing, as well as 340B (Required). Requirements - 3 Years Experience in healthcare and/or pharmacy reimbursement, revenue cycle, or financial analysis; experience working with PBMs, health plans, or healthcare provider systems (Required). - Or 5 Years Pharmacy reimbursement analysis, collections, or revenue integrity experience; 340B program experience (e.g., split billing/accumulation oversight, claim qualification troubleshooting, audit support, or contract pharmacy operations) preferred. - Epic experience (Preferred). - CPhT - Certified Pharmacy Technician (Upon Hire Required). - Other ASHP Pharmacy Revenue Cycle Certificate (12 Months Required). Company Description
Human Centered Design Analyst
C-HITC-HIT, a CMMI Maturity Level 5 company, focuses on delivering information technology and professional services to Federal and State agencies. "C-HIT is an EOE, including disability and veterans.”
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