• Independently performs complex professional coding across multiple specialties and settings • Code complex professional encounters and procedures • Ensure correct sequencing, modifiers, E/M level selection, and documentation alignment • Resolve coding-related edits and denials by identifying root cause • Apply payer medical policies, NCCI concepts, global service considerations • Provide real-time guidance to peers on standard coding scenarios • Participate in internal quality review programs

Role Description The I.T. leader shares power, puts the needs of the employees first and helps people develop and perform as highly as possible. I.T. leadership inverts the norm, which puts the individual contributor as a main priority. Instead of the people working to serve the leader, the leader exists to serve the people. These positions have varying and progressive degrees of detail vs strategic pursuits. The percentage of time spent doing day-to-day tasks will decrease as the individual progresses through leadership. By the time the leader is in a senior role, they will be more focused on strategy execution than the actual individual tasks. The I.T. leader supports a number of I.T. staff, Supervisors and Managers depending on the role and rank within the I.T. organization. Under the leadership of the Manager of Managed Care Applications, the Membership Application Supervisor plays a crucial leadership role in overseeing the accurate and efficient support of enrollment and benefits data through the Epic Systems Tapestry application. You will lead and manage a team of enrollment and benefits application analysts, ensuring accuracy, compliance, and timely issues resolution our enrollment and benefits processes. Acting as the primary point of contact for users of the Tapestry application in relation to enrollment and benefits processing, Membership Application Supervisor will: - Manage the utilization of the Tapestry application to oversee the management and maintenance of accurate enrollment and benefits data ensuring accuracy, integrity, and completeness. - Ensure compliance with industry standards and regulatory requirements related to enrollment and benefits. - Provide expert-level technical support, troubleshoot application-related issues, and resolution of complex problems. - Collaborate with and lead internal teams to understand and address the organization's enrollment and benefits needs, implementing system updates and enhancements. - Work closely with Managed Care Manager on planning and executing strategic objectives and project initiatives. - Provide strategic insights and recommendations and lead teams in the implementation of workflow optimizations to enhance efficiency and user satisfaction, creating and maintaining user-friendly documentation, guides, and best practices for application usage. Qualifications - Bachelor's degree in a related field (Healthcare Administration, Information Systems, etc.) or equivalent experience. - 5+ years of experience in healthcare enrollment and benefits processing, with a minimum of 2 years in a supervisory or leadership position. - Proficiency with the Epic Systems Tapestry application is required. - Epic Certification in Benefits Admin and/or Eligibility & Enrollment Admin required. - Knowledge of healthcare regulations and compliance, including HIPAA, is preferred. Requirements - 5+ years of experience in healthcare data management and or payor contracts, with a minimum of 2 years in a supervisory or leadership position. - Proficiency with the Epic Systems Tapestry application is required. - Epic Certification in Claims Admin and/or Cheers required. - Knowledge of healthcare regulations and compliance, including HIPAA, is preferred. Benefits - Salary $121,000 - $159,300. - Work location: San Ramon/San Joaquin Valley/Sacramento/Remote. Company Description Hill Physicians has much to offer prospective employees. We’re regularly recognized as one of the “Best Places to Work in the Bay Area” and have been recognized as one of the “Healthiest Places to Work in the Bay Area.” When you join our team, you’re making a great choice for your professional career and your personal satisfaction. At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities.

Role Description The Medical Billing Specialist is responsible for all aspects of charge capture including accurate entry of charges, timely charge posting and charge audits. The individual will need to have expertise in medical coding and insurance billing as well as a strong understanding of insurance reimbursement processes and regulations. The successful candidate will work closely with RCM leadership, patients, physicians, and insurance companies to ensure that accurate and timely billing is completed. Responsibilities: - Run and audit various reports to ensure all required billing information has been received and is accurate. - Audit hospital charges and communicate outstanding charges and/or questions with clinical staff. - Review and enter Imaging charges into practice management system. - Review and enter Pathology/Molecular charges into practice management system. - Review and enter Radiation Oncology charges into practice management system. - Create daily charge file from lab software to ensure proper charge capture. - Reconcile scheduled appointments to ensure accurate charge capture and communicate outstanding billing issues with clinical staff and/or providers when applicable. - Audit all charges from interfaced files to ensure accurate charge capture. - Communicate openly with Clinical staff and RCM teams to ensure timely and accurate charge posting. - Review medical records as needed to ensure coding accuracy which includes diagnosis, procedures, and modifiers. - Work assigned Unity tasks daily to resolve any tasks identified by ACE edits, rejections, denials, collectors or other RCM teams. - Identify and work tickets to resolution in various statuses within the Practice Management system daily. - Ability to review, interpret and apply knowledge of billing guidelines and medical policies. - Train with team members or other employees when assigned by management. - Work together as a team with other staff to ensure charges are entered timely and accurately. - Maintain a complete understanding of HCPCS/ICD/CPT oncology coding and specific carrier requirements/knowledge. - Follow policy and procedures outlined by management to ensure standardization of processes. - Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer. Qualifications - Attendance is an essential job function. - Detailed knowledge of billing, HCPCS, CPT and ICD codes. - Previous Charge Entry/Billing experience preferred. - Ability to work effectively with all levels of management and other colleagues, demonstrating initiative, mature judgment and customer service orientation. - Effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations. - Exceptional multi-tasking, organizational skills and superb attention to detail. - Strong analytical skills and ability to meet assigned deadlines. - Strong knowledge of Windows-based applications (Word, Outlook, Excel, etc). - Ability to operate various types of office equipment. - Must possess high degree of professionalism and adaptability. Requirements - High School diploma or equivalent required. - Previous experience in Charge Entry, Billing or Coding required, preferably in an Oncology healthcare setting. - Radiation Oncology/Proton experience a plus. - Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid. Company Description

Role Description Baptist Health is looking for a Medicare Specialist to join their Patient Financial Services team! This is a remote position that requires residency in KY or IN. - Processes claims on a daily basis. - Performs all duties associated with this role including: - Billing - Follow up - Payment auditing - Refunds - Adjustments - Correspondence - Telephone calls Qualifications - High School graduate or equivalent - 1+ year experience in Hospital or Physician Medicare billing required. Associate's degree in accounting, business management or finance may be substituted for 1 year of experience. - Works with minimum supervision, exhibits knowledge of ethical and legal billing procedures, and observes confidentiality in all matters and adheres to HIPAA guidelines regarding PHI. - Relevant computer knowledge and skills required - Understanding of UB04, revenue codes, CPT and HCPC coding required Benefits - If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now! Company Description Baptist Health is an Equal Employment Opportunity employer.