Role Description The Clinical Appeal Writer audits medical necessity justification for air transport evaluation and submission of all medical necessity appeals for government payors. They utilize clinical flight experience, established clinical standards and protocols, to validate air medical necessity and appeal payment denials. - Conducts audits of the medical necessity appeals for all payor sources in the role of advocate for the patient and GMR. - Ensures appeal timelines are met by moving the assigned book of business through the appeals process and updates appeals database. - Works with fixed deadlines and demonstrates willingness to meet and exceed performance metrics. - Works with the Appeal team to determine the best approach to each clinical denial in order to maximize claim reimbursement and minimize the financial risk to patients and GMR. - Maintains strict confidentiality of all protected health information and cooperates fully with all information security guidelines related to the scope of work. Qualifications - Minimum of five years in Emergency department (ED), Intensive Care Unit (ICU), flight or ambulance experience or job experience equivalent. - Supervisory/leadership experience preferred (i.e.: team leader, FTO, charge nurse, preceptor, educator, etc.). - Proficient in Word, Excel, Office 365. - Current RN licensure is required. - Bachelor’s degree in nursing or equivalent is preferred. - CFRN, CEN or CCRN is preferred. Requirements - Excellent written communication skills. - Ability to define and identify problems, collect data, establish facts, and draw valid conclusions. - Ability to respond to inquiries or complaints from customers in a positive and productive manner. - Ability to calculate numbers, correct entries, and post to records. - Ability to gather data from hospital and EMS charts, phone calls, emails, colleagues, and internet research, then compile information and prepare reports and letters. - Ability to use independent judgment and to manage and impart confidential information. - Ability to research local EMS protocols, hospital referrals, and standards of care. - Ability to review clinical charts and development of constructive feedback. Benefits - Hourly Compensation: $33.65 (this position is bonus eligible). - Work Schedule: Full Time.

• Performs concurrent analytical reviews of clinical and coding data to improve physician documentation for all conditions and treatments from point of entry to discharge. • Ensures an accurate reflection of the patient condition in the associated Diagnosis Related Group (DRG) assignments, case-mix index, severity of illness (SOI), and risk of mortality (ROM) profiling, and reimbursement. • Facilitates the resolution of queries and educates members of the patient care team regarding documentation guidelines. • Collaborates with coding professionals to ensure accuracy of diagnostic and procedural data.

Role Description Opensity Solutions is seeking a permanent, full-time Document Specialist working 40 hours/week with full medical, dental, and vacation benefits. Specialists are responsible for providing document production, administrative, and clerical support. Under general direction from the coordination team, the specialist will also be responsible for managing their assigned tasks in the day-to-day operations of the client. This position requires engaging with client personnel to provide task updates and to inspire collaboration with the end-user. This position will work Monday - Friday 3pm - 11:30 pm EST regardless of location. Responsibilities - Create, revise, reformat, and convert documents using various support software including Microsoft Office applications, PDF editing tools, and transcription software. - Prepare and edit complex documents, spreadsheets, charts. - Provide coordination and administrative support for special projects. - Efficient handling of time-sensitive and confidential materials. - Perform document diagnostic activities related to troubleshooting document inconsistencies. - Create and/or revise work product using direct keyboard entry, scanner, or electronic conversion methods of input; transcribes audio and digital dictation including deposition transcripts as required. - Spell check, proofread and/or cross-check documents to ensure accuracy and completeness. - Maintain up-to-date knowledge of specialized applications and upgrades to achieve maximum efficiency and productivity with the Document Services applications. - Provide feedback and insight into each team member’s performances when requested. - Promote and encourage teamwork, confidence, and positive attitudes. - Provide directions, instructions, and guidance to the team. - Assist with reviewing re-works or poor job outputs from team members. Requirements - HS Diploma or GED. - 2-5 years working in document outsourcing or legal industry preferred. - Ability to learn the responsibilities listed above through a combination of in-person training, remote training, and self-guided learning. - Strong initiative required; ability to work independently with minimal direct supervision. - Working knowledge of Microsoft applications (Outlook, Word, Excel, and PowerPoint). - Experience working with Adobe Acrobat or Kofax for the manipulation of PDF files a plus. - Excellent skills in spelling, grammar, punctuation, sentence structure, and proofreading. - Ability to organize and prioritize multiple assignments. - Ability to excel under pressure within established timeframe and provide quality work product. - Possess strong communication, interpersonal, teamwork, and customer service skills. Compensation The compensation range for this role is 22.00 to 26.00 USD per hour and may be eligible for an annual bonus. Actual compensation within that range will be dependent upon the individual's location, skills, experience, and qualifications. Equal Opportunity Employer Opensity is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all applicants and employees and do not discriminate on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran or military status, or any other characteristic protected by applicable federal, state, or local law. Employment decisions at Opensity are based on qualifications, merit, and business needs. This policy applies to all aspects of employment, including recruitment, hiring, promotion, compensation, training, discipline, and termination. Opensity is committed to providing reasonable accommodations for qualified individuals with disabilities, for pregnancy-related conditions, and for sincerely held religious beliefs, in accordance with applicable law. We do not tolerate retaliation against individuals who raise concerns or participate in an investigation related to equal employment opportunity.

• Review, analyze, and summarize large volumes of medical records for peer review cases • Extract key clinical findings, diagnoses, treatment history, medications, procedures, provider notes, and timelines • Organize complex medical information into concise and accurate summaries • Support Independent Review Organization (IRO) workflows and peer review processes • Prepare documentation and case summaries for physician reviewers • Collaborate with providers and reviewers as needed to ensure complete documentation • Provide nursing home scribing and clinical documentation support when needed • Review orders, vital signs, and patient information within nursing home EHR systems • Maintain HIPAA compliance and confidentiality when handling patient records • Adapt quickly to new technologies and evolving workflows