• Codes and abstracts diagnoses and patient information from outpatient ancillary encounters and enters data into the hospital information system • Verifies abstracted hospital information fields for accuracy and completeness • Monitors daily data printout to assure completion of all outpatient records requiring coding and abstracting • Communicates with physicians or physician office staff when documentation is unclear or insufficient to complete the coding process • Maintains coding proficiency through self-directed continuing education

Role Description Review clinical documentation within the medical record to ensure that all principal diagnosis, secondary diagnoses, and PCS procedures have been coded accurately and completely as well as certain abstract items in compliance with Official Coding Guidelines, UPMC Coding Guidelines, and OIG regulations on fully coded cases as well as cases on those in training. - Assist in training new coding staff. - Review and evaluate focused UPMC electronic health records in Optum, Epic, or Cerner for accurate DRG assignment. - Ensure that all documented principal and secondary diagnoses, including all complications and co-morbidities, and procedures are accurately coded and sequenced according to coding and compliance guidelines utilizing the Optum coding application. - Assist with training of new DRG Specialists and coders as requested. - Focus emphasis of educational communications on accurate and thorough documentation necessary to support the coding of diagnoses. - Formulate physician queries that present indications of a diagnosis that requires clarity in accordance with Compliant Query Practices and UPMC Coding Guidelines. - Identify and report issues and trends to the coding management. - Prepare and present training when requested on accurate code assignment. - Pose initiative thoughts for process improvements within the department. - Provide coding staff with education on a case level on any coding issues identified during reviews. - Counsel/train coders on problems when necessary, in coordination with the Coding Manager. - Assist in correcting deficiencies in DRG assignment in the form of an educational email. - Investigate code assignment from requesting departments to ensure timely, accurate reimbursement when requested. - Function as a resource person to respond to special audits and projects assigned by Management or requested by other departments. Qualifications - 3 years of previous clinical acute care medical/surgical experience to include critical care in conjunction with an expanded knowledge of DRG's. - OR completion of Registered Health Information Administration program (RHIA) or Registered Health Information Technician (RHIT) or CCS AND 3 years of experience with the Prospective Payment System and DRG selection. - OR specific knowledge as a consultant in Medical Record coding and DRG assignment required. Requirements - 3 years’ experience in an inpatient coding role, or clinical acute care medical/surgical experience to include critical care in conjunction with expanded knowledge of coding and DRG assignment. - Knowledge of computer technology, quality assurance activities, DRG methodology background is highly preferred. - Ability to communicate with staff, physicians, healthcare providers, and other health care system personnel in a professional and diplomatic manner required. Licensure, Certifications, and Clearances - Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse (RN). - Act 34. - Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. - Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.

Role Description We are looking for a highly skilled Registered Nurse (RN) to join a growing healthcare team as a Medical Virtual Assistant. The ideal candidate has hands-on experience with OASIS documentation, medical coding, and EMR systems, along with strong attention to detail and the ability to work independently in a fast-paced environment. - Complete and review OASIS documentation accurately - Perform medical coding and ensure proper documentation standards - Maintain and update patient records within EMR systems - Support clinical and administrative healthcare processes - Review medical documentation for accuracy and completeness - Coordinate with providers and healthcare staff as needed - Assist with day-to-day virtual healthcare operations Qualifications - Registered Nurse (RN) (Required) - Strong experience with OASIS documentation (Required) - Medical coding experience - Experience using EMR/EHR systems - Excellent English communication skills (written and verbal) - Strong analytical and organizational skills - Ability to work independently and manage multiple priorities Requirements - Previous experience as a Medical Virtual Assistant - Home Health experience - Experience supporting U.S.-based healthcare providers - Familiarity with healthcare compliance and documentation standards

Role Description Boulder Care is seeking a Medical Claims & Billing Specialist who will be responsible for all phases of the revenue cycle, from claims submission through payment posting and denied or outstanding claims resolution. You will also work closely with our Enrollment Team to ensure quick resolution to insurance eligibility issues and other patient billing inquiries. You're a great fit if you are detail-driven and organized with a knack for building and maintaining strong relationships with team members and patients alike. Success in this role - Ensure accurate and timely billing of all claims to the appropriate third party payers - Insurance payment posting and account reconciliation - Identifying and correcting billing errors and resubmitting claims to insurance carriers - Research/rectify third party denials/edits, requests for information and other related correspondence - Follow up with patients for outstanding balances, work with them to set up payment plans, or other assistance - Act as key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs Other Responsibilities - 5% - Other duties as assigned by RCM Leadership Qualifications - 5+ years of experience in a healthcare setting specific to billing and accounts receivable - Ability to interpret and apply insurance payer billing guidelines, claim rules, and contract terms - Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution, and appeals processes - CPT and ICD coding knowledge - Knowledge of ANSI 837 and 835 files, including how to read and interpret - Exceptional written and verbal communication - Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level - Demonstrates problem-solving and analytical skills appropriate for the position - Demonstrates high ethical standards of behavior - Maintains composure under pressure - Regularly demonstrates Boulder’s core values Requirements - Nice to have but not required: Experience with multiple payers - Experience with payment plans and financial assistance applications Work Environment This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, FL, GA, ID, IL, KY, MA, NC, NJ, NV, NY, OH, OR, PA, SC, TN, TX, UT, WA, and WV. Applicants must reside and work in one of those states to be considered. Boulder Care employees are free to use our river-front HQ located in Portland, OR whenever they would like. Expected Hours of Work This is a full-time remote position expected to work 40 hours between Monday-Friday with an 8:30am start time, wiggle room 30 min each way. Compensation The starting pay range for this position is $26 - $29 per hour; base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave). Hiring Timeline - Phone interview - 30 min - Panel interview - 60 min video - Anticipated start date - late June or early July 2026 Benefits - Contribution to meaningful, life-saving work! - Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families - Mental Health Services via Cigna, Doctors on Demand, and EAP for continuous care - 4 weeks of vacation accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment - Sick leave accrued at 1 hr for every 30 hrs paid - 9 Paid Holidays per year - 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment) - 401(k) retirement savings - Remote friendly with hardware provided to complete your work duties Our Values - Patients always come first - Our opportunity is also our duty - Move the industry forward, follow the data - Facts to change minds, empathy to change hearts - Turn bold ideas into even bolder action - Strong individuals, stronger together Boulder Care recognizes the value that lived experience can provide to our organization, community, and patients. Applicants with lived experience and/or training as a peer recovery specialist are encouraged to apply. Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!