<p>We are looking for a skilled Clinical Consultant to join our team on a long-term contract basis. This position offers an exciting opportunity to support a strategic benefit digitization initiative within the healthcare industry. You will play a key role in implementing standardized coding practices, ensuring regulatory compliance, and contributing to the success of digital transformation efforts.</p><p><br></p><p>Responsibilities:</p><p>• Apply standardized coding practices to accurately interpret and digitize benefit structures across diverse markets.</p><p>• Develop and maintain groupings of procedures and service codes to align with benefit plans.</p><p>• Manage quarterly and annual updates of industry-standard codes and ensure benefit plan codes are current.</p><p>• Execute coding solutions for both standard and nonstandard benefit requests, addressing stakeholder needs.</p><p>• Ensure compliance with regulatory mandates by updating coding practices as required.</p><p>• Provide expert consultation and respond to inquiries related to benefit coding from project teams and business partners.</p><p>• Collaborate with cross-functional teams to support successful implementation of benefit digitization projects.</p><p>• Offer guidance on coding methodologies and contribute to enhancing member and provider experiences.</p><p>• Support long-term cost management initiatives by leveraging coding expertise in digitization efforts.</p>
<p>The Acute Coding Appeals Specialist reviews and writes appeals for inpatient DRG denials to support accurate code assignment and reimbursement. This role applies advanced ICD-10, DRG, CMS, and payer-specific knowledge to defend coding decisions, ensure compliance, and address billing and documentation concerns.</p><p><br></p><p>Key Responsibilities</p><ul><li>Review inpatient DRG denials and draft well-supported appeal letters using ICD-10-CM/PCS, HCPCS, NCCI, CMS, and CMG guidelines.</li><li>Analyze clinical documentation to validate the originally assigned DRG and ensure compliance with regulatory standards.</li><li>Research payer policies, government regulations, and industry guidelines to strengthen appeal arguments.</li><li>Maintain detailed documentation, tracking spreadsheets, and root cause analyses for denial trends.</li><li>Collaborate with client coding and CDI teams to provide education based on appeal outcomes.</li><li>Meet established productivity and quality standards while maintaining coding certification requirements.</li><li>Stay current on coding updates, regulatory changes, and reimbursement rules.</li><li>Deliver professional, organized, and customer-focused communication with clients.</li></ul>
<p>We are seeking a Collections Specialist with hospital experience to manage patient account collections and ensure timely payment while maintaining compliance with hospital financial policies. This fully remote role is responsible for contacting patients, insurance companies, and internal departments to resolve outstanding balances and support revenue cycle objectives.</p><p>Key Responsibilities</p><ul><li>Contact patients via phone, email, and mail regarding past-due balances.</li><li>Follow up with insurance companies and third-party payers to resolve unpaid claims.</li><li>Review patient accounts for accuracy, applying payments, adjustments, and necessary corrections.</li><li>Set up payment arrangements for patients in accordance with hospital policies.</li><li>Document all interactions and account updates in the hospital financial system.</li><li>Collaborate with hospital departments to resolve account disputes and clarify billing questions.</li><li>Escalate complex issues to management as needed.</li><li>Support month-end reporting and collection metrics tracking.</li></ul><p><br></p>
We are looking for a dedicated Medical Front Desk Specialist to join our team in Golden Valley, Minnesota. In this role, you will serve as the first point of contact for patients, ensuring a welcoming and efficient experience. This long-term contract position is an excellent opportunity to apply your administrative and customer service expertise in a healthcare environment.<br><br>Responsibilities:<br>• Welcome patients and visitors warmly while maintaining an attentive and inviting atmosphere.<br>• Execute patient check-in and check-out procedures, ensuring accuracy in documentation.<br>• Verify insurance details, demographic information, and collect required forms and payments.<br>• Coordinate appointment scheduling, rescheduling, and confirmations to optimize clinic operations.<br>• Respond promptly to patient portal inquiries, addressing concerns and providing necessary information.<br>• Manage and update patient records in the electronic medical records system with precision.<br>• Prepare and oversee daily schedules and calendars for healthcare providers.<br>• Process incoming mail, faxes, referrals, and medical record requests efficiently.<br>• Work collaboratively with clinical staff to streamline workflow and minimize patient wait times.<br>• Address patient inquiries regarding billing, appointments, or paperwork, resolving issues efficiently.