Available Jobs

  • Wound Care Nurse Practitioner (Louisiana)

    Wound Care Nurse Practitioner

    Description

    The Certified Nurse Practitioner (Nurse Practitioner) or PA, in collaboration and consultation with physicians, staff RN’s and other health care professionals, provides comprehensive wound management to patients. Under the supervision of a physician, the Advanced Registered Nurse Practitioner (ARNP) or PA is responsible for providing high quality wound care services for patients residing in Skilled Nursing Facilities; additional responsibilities may include outpatient wound care clinics or in hospital-based settings.

    The Nurse Practitioner provides leadership by serving as clinical expert, educator and liaison between the patient and the medical, nursing and interdisciplinary staff with the goal of wound healing and improved patient outcomes

    Responsibilities

    • Must be dependable and keep scheduled appointments in facilities as assigned.
    • Demonstrates knowledge and skill in assessment and performing local wound care including: debridement techniques, cleansing, dressings, pressure relief, pain control and odor control in nursing facility or clinic settings.
    • Ability to evaluate, recommend, and facilitate the need for DME (Durable Medical Equipment) for patients with debility and rehabilitation needs.
    • Understanding and application of current infection control techniques, wound care supplies and treatment protocols.
    • Maintains accurate and timely documentation of patient encounters in electronic medical record.
    • Analytical ability and clinical knowledge necessary to make recommendations concerning the development and management of departmental programs, policies, goals and staffing needs as it relates to wound care.
    • Ability to collaborate and communicate with peers and other inter-disciplinary health care providers.
    • Ability to complete assignments with minimum supervision.
    • Professionalism
    • Ability to work and schedule appointments independently
    • Excellent communication and organizational skills
    • Assist in the wound care/Pressure Ulcer Prevention Program in order to improve clinical outcomes

     Qualifications

    • Master’s degree or higher; Wound care experience preferred but not mandatory;
    • Graduate of an approved school of nursing with a current unencumbered Registered Nurse license
    • Minimum of 1 year of clinical experience in patient care environment with direct wound and ostomy assessment and treatment skills.
    • Completion or active enrollment in a wound certification program, i.e. American Academy of Wound Management (CWS), Wound, Ostomy, and Continence Nursing (WOCN), Wound Care Education Institute (WCC), or equivalent program.
    • Strong communication skills.
    • Professional presentation and outgoing personality.
    • Knowledge and experience working with computers and electronic health records.
    • Driver’s license issued by the Department of Motor Vehicles
    • Ability to practice autonomously, valid and unrestricted driver’s license Excellent verbal and written communication skills in a professional environment, ability to set priorities while managing multiple tasks, detail oriented with excellent communications and organizational skills
  • Wound Care Nurse Practitioner (Mississippi)

    Wound Care Nurse Practitioner

    Description

    The Certified Nurse Practitioner (Nurse Practitioner) or PA, in collaboration and consultation with physicians, staff RN’s and other health care professionals, provides comprehensive wound management to patients. Under the supervision of a physician, the Advanced Registered Nurse Practitioner (ARNP) or PA is responsible for providing high quality wound care services for patients residing in Skilled Nursing Facilities; additional responsibilities may include outpatient wound care clinics or in hospital-based settings.

    The Nurse Practitioner provides leadership by serving as clinical expert, educator and liaison between the patient and the medical, nursing and interdisciplinary staff with the goal of wound healing and improved patient outcomes

    Responsibilities

    • Must be dependable and keep scheduled appointments in facilities as assigned.
    • Demonstrates knowledge and skill in assessment and performing local wound care including: debridement techniques, cleansing, dressings, pressure relief, pain control and odor control in nursing facility or clinic settings.
    • Ability to evaluate, recommend, and facilitate the need for DME (Durable Medical Equipment) for patients with debility and rehabilitation needs.
    • Understanding and application of current infection control techniques, wound care supplies and treatment protocols.
    • Maintains accurate and timely documentation of patient encounters in electronic medical record.
    • Analytical ability and clinical knowledge necessary to make recommendations concerning the development and management of departmental programs, policies, goals and staffing needs as it relates to wound care.
    • Ability to collaborate and communicate with peers and other inter-disciplinary health care providers.
    • Ability to complete assignments with minimum supervision.
    • Professionalism
    • Ability to work and schedule appointments independently
    • Excellent communication and organizational skills
    • Assist in the wound care/Pressure Ulcer Prevention Program in order to improve clinical outcomes

     Qualifications

    • Master’s degree or higher; Wound care experience preferred but not mandatory;
    • Graduate of an approved school of nursing with a current unencumbered Registered Nurse license
    • Minimum of 1 year of clinical experience in patient care environment with direct wound and ostomy assessment and treatment skills.
    • Completion or active enrollment in a wound certification program, i.e. American Academy of Wound Management (CWS), Wound, Ostomy, and Continence Nursing (WOCN), Wound Care Education Institute (WCC), or equivalent program.
    • Strong communication skills.
    • Professional presentation and outgoing personality.
    • Knowledge and experience working with computers and electronic health records.
    • Driver’s license issued by the Department of Motor Vehicles
    • Ability to practice autonomously, valid and unrestricted driver’s license Excellent verbal and written communication skills in a professional environment, ability to set priorities while managing multiple tasks, detail oriented with excellent communications and organizational skills
  • Health Information Management Coding Supervisor

    Health Information Management Coding Supervisor

    Definition and Role

    Under direction, supervises the work of staff who review, interpret, code and abstract medical records information according to standard classification systems; performs the most advanced medical records coding and abstraction duties; performs data quality reviews and prepares complex reports as required; and performs other related duties as assigned.  This is a first-level supervisory class. An incumbent has supervisory responsibilities for assigning, directing, monitoring and evaluating the work of subordinate staff on a regular basis, as well as performing the most technically difficult coding and abstracting duties in the division.

    Qualifications

    A combination of experience, education, and/or training which substantially demonstrates the following knowledge, skills and abilities:

    Thorough Knowledge and Skills of:

    1. Principles and practices of hospital administration; principles and practices of leadership and supervision; principles of work planning and organization.
    2. Advanced principles and practices of medical record keeping; advanced medical terminology, anatomy, and physiology, as well as the states, sequence, progression and description of diseases as they apply to medical record coding and abstraction.
    3. Advanced functions of a hospital medical records division; legal aspects of medical record administration.
    4. Advanced elements of ICD-9/10-CM, CPT, and HCPCS Level II coding systems.
    5. The APC structure and regulatory requirements.
    6. Current hospital reimbursement systems and associated regulatory review practices.
    7. Governmental and Joint Commission (JCAHO) standards for medical records.
    8. Appropriate methods for auditing and reviewing information for quality control purposes.
    9. The operation of standard office equipment; standard business computer hardware and software.
    10. The business and professional relationships and ethics involved among hospitals, physicians and patients.

    Skill and Ability to:

    1. Plan, assign and supervise specialized and routine medical records technical and clerical work.
    2. Make difficult decisions regarding technical issues with substantial independence.
    3. Read, interpret and evaluate complex technical reports and information.
    4. Understand and apply anatomical, physiological and medical terminology.
    5. Audit both outpatient and inpatient medical records to verify the appropriateness of diagnostic codes medical record abstracts.
    6. Work with physicians and others to ensure complete and accurate information and optimal reimbursement based on coding and abstracting of medical records.
    7. Operate a personal computer.
    8. Maintain complex records, compile statistics and prepare complex technical reports.
    9. Communicate clearly and concisely, both orally and in writing.
    10. Provide excellent public relations and courteous customer service; establish and maintain cooperative working relationships with others including physicians, nurses, administrators, managers, vendors, contractors and other health care industry personnel.

    Specific Expectations

    1. Pass a pre-employment physical/medical assessment and background check.
    2. Be willing to work in an environment with potential exposure to potentially hazardous and infectious substances/organisms such as bodily fluid or blood.

    EXAMPLES OF EXPERIENCE/EDUCATION/TRAINING

    Any combination of training, education and/or experience which provides the knowledge, skills and abilities and required conditions of employment listed above is qualifying. An example of a way these requirements might be acquired is:

    Experience:

    If certified as a CCS: requires two years of journey level coding experience at a level comparable to the class of Health Information Management Coder II in Monterey County.

    If registered as an RHIT or RHIA: requires one year of journey level coding experience at a level comparable to the class of Health Information Management Coder II in Monterey County.

    Education:

    Equivalent to graduation from high school.

     Physical Requirements

    The physical and sensory requirements for this classification include:

    1. Mobility and Lifting: Frequent sitting for extended periods of time; frequent standing; frequent lifting up to 25 pounds.
    2. Visual: Constant ability to read information, including close up; constant ability to use a computer screen; frequent use of good overall vision, including color perception.
    3. Dexterity: Constant eye and hand coordination and manual dexterity to write, operate a computer keyboard and finely manipulate small objects.
    4. Hearing/Talking: Constant ability to hear normal speech; frequent ability to hear and talk on the telephone and in person.
    5. Emotional/Psychological: Constant ability to make decisions and concentrate. 6. Special Requirements: Frequent exposure to dust.

    Job Responsibilities and Duties

    Nothing in this specification restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

    1. Supervises and performs a wide range of activities pertaining to the review and coding of inpatient and outpatient medical record information.
    2. Establishes, implements and maintains a formalized review process for coding compliance, including a formal review (audit) process; designs and uses audit tools to monitor the accuracy of clinical coding.
    3. Performs data quality reviews on inpatient records to validate the International Classification of Diseases Manual (ICD-9-CM), and other codes; verifies Diagnosis Related Group (DRG) group appropriateness; checks for missed secondary diagnoses and procedures and ensures compliance with all DRG mandates and reporting requirements; monitors Medicare and other DRG paid bulletins and manuals, and reviews the current Office of the Inspector General (OIG) work plans for DRG risk areas.
    4. Performs data quality reviews on outpatient encounters to validate the ICD-9-CM, the Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) Level II code and modifier assignments; verifies Ambulatory Payment Classification (APC) group appropriateness; checks for missed secondary diagnoses and/or procedures; ensures compliance with all APC mandates and outpatient reporting requirements; monitors medical visit code selection against facility specific criteria for appropriateness; assists in the development of such criteria as needed.
    5. Creates and monitors inpatient case mix reports and the top DRG’s in the facility to identify patterns, trends and variations in the facility’s frequently assigned DRG groups; investigates and evaluates potential causes for changes or problems; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances.
    6. Creates and monitors outpatient service mix reports and the leading medical visit, surgical service, significant procedure, and ancillary Ambulatory Payment Classifications (APC’s) assigned in the facility to identify patterns, trends, and variations in the facility’s frequently assigned APC groups; takes appropriate steps in collaboration with the right staff to effect resolution or explain variances. Health Information Management Coding Supervisor 2
    7. Continuously evaluates the quality of clinical documentation to identify incomplete or inconsistent document for inpatient and/or outpatient encounters that impact the code selection and resulting APC/DRG groups and payment; brings concerns to the attention of the HIM Supervisor and/or medical staff for resolution.
    8. Provides or arranges for training of facility healthcare professionals in the use of technical coding guidelines and practices, proper documentation techniques, medical terminology and disease as they relate to the DRG, APC and other data quality management.
    9. Maintains knowledge of current and required coding certifications as appropriate; may perform the most technical complex and difficult coding and abstraction work.
    10. Selects, assigns, and trains subordinate technical and clerical staff; directs, monitors and evaluates work; reviews and makes decisions regarding leave requests; initiates and implements disciplinary action as needed; assists with and promotes the recruitment and retention of qualified staff as assigned.
    11. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association; reports areas of concern to the Director of Health Information Management.
    12. Assists the Director by serving as a facility representative for DRG’s and/or APC’s by attending coding and reimbursement workshops and bringing back information as appropriate; communicates any DRG/APC updates published in third-party payer newsletters, bulletins and/or provider manuals; shares information with facility staff as directed.
    13. Stays informed about transaction code sets, Health Insurance Portability and Accountability Act (HIPPA) requirements and other future issues impacting health information management functions; keeps abreast of new technology in coding and abstracting software and other forms of automation.
    14. Demonstrates and maintains competency in the use of computer applications, particularly the coding and abstracting software and hardware currently in use by the Health Information Management division.
    15. Monitors unbilled account reports for outstanding services or un-coded discharges to reduce accounts receivable days for inpatients and/or outpatients; performs periodic claim form reviews to check code transfer accuracy from the abstracting software and the charge master; may serve on a charge master maintenance committee.
    16. In partnership with appropriate personnel, recommends and implements standardized, organization-wide coding guidelines and documentation requirements; develops and implements training and educational programs for physicians and coders.
    17. Consults with other divisions and individuals regarding data quality management.
    18. Collects and prepares data for studies involving inpatient stays and outpatient encounters for clinical evaluation purposes; prepares and maintains a variety of complex records and reports.
    19. Performs other related duties as assigned.
  • Billing and Coding Specialist

    Billing and Coding Specialist

    Definition and Role

    Responsible for all aspects of medical billing including assisting patients with bills, posting EOBs, billing claims, resolving and appealing denials, and identifying credit balances 1-3 years of experience in medical billing is required. Ideal candidate will possess exceptional customer service skills, excellent communication and interpersonal skills with both co-workers and customers, knowledge of ICD-10, CPT and HCPS coding, experience with medical billing and compliance with insurance company guidelines, ability to interpret payor remits for payment posting and working denials, ability to appeal payor denials, excellent problem solving skills and computer proficiency. Experience with Wound Care is a plus.

    Qualifications

    A combination of experience, education, and/or training which substantially demonstrates the following knowledge, skills and abilities:

    Thorough Knowledge and Skills of:

    1. Principles and practices of hospital administration; principles and practices of work planning and organization.
    2. Reviewing medical procedures as documented by nurse practitioners and doctors.
    3. Elements of ICD-9/10-CM, CPT coding systems.
    4. You must be driven and self-disciplined.
    5. Must be organized in dealing with patient files and documents.
    6. Current hospital reimbursement systems.
    7. Have attention to detail is an important job requirement, especially when using medical coding as a means of communication.
    8. Proper phone etiquette is necessary since phone conversations with patients and insurance carriers will be frequent.
    9. The operation of standard office equipment; standard business computer hardware and software.
    10. The business and professional relationships and ethics involved among hospitals, physicians and patients.
    11. Able to translate medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities.

    Skill and Ability to:

    1. Plan and organize routine medical records technical and clerical work.
    2. Act as a liaison between the facility and payment parties.
    3. Investigate the claim, verify its information, and update the database.
    4. Read, interpret and enter information into the facility’s database using medical coding protocol to produce a statement or claim.
    5. Understand and apply medical terminology.
    6. Work with physicians and others to ensure complete and accurate information and optimal reimbursement based on coding.
    7. Operate a personal computer.
    8. Ensure health providers are paid for medical services rendered.
    9. Communicate clearly and concisely, both orally and in writing.
    10. Provide excellent public relations and courteous customer service; establish and maintain cooperative working relationships with others including physicians, nurses, administrators, managers, vendors, contractors and other health care industry personnel.

    Specific Expectations

    1. Pass a pre-employment physical/medical assessment and background check.
    2. Be willing to work in an environment with potential exposure to potentially hazardous and infectious substances/organisms such as bodily fluid or blood.

    EXAMPLES OF EXPERIENCE/EDUCATION/TRAINING

    Any combination of training, education and/or experience which provides the knowledge, skills and abilities and required conditions of employment listed above is qualifying. An example of a way these requirements might be acquired is:

    Experience: At least two years of experience in medical office as a billing/coder.  ICD9/ICD10.

    Education:

    Equivalent to graduation from high school.

    Certified as a CCS preferred, but not required.

    Physical Requirements

    The physical and sensory requirements for this classification include:

    1. Mobility and Lifting: Frequent sitting for extended periods of time; frequent standing; frequent lifting up to 25 pounds.
    2. Visual: Constant ability to read information, including close up; constant ability to use a computer screen; frequent use of good overall vision, including color perception.
    3. Dexterity: Constant eye and hand coordination and manual dexterity to write, operate a computer keyboard and finely manipulate small objects.
    4. Hearing/Talking: Constant ability to hear normal speech; frequent ability to hear and talk on the telephone and in person.
    5. Emotional/Psychological: Constant ability to make decisions and concentrate.
    6. Special Requirements: Frequent exposure to dust.

    Job Responsibilities and Duties

    Nothing in this specification restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

    1. Verify and enter patient demographic and insurance information into practice management software Abstract information from medical record and assign appropriate codes as necessary.
    2. Prepare and submit claims to third party insurance carriers either electronically or by hard copy billing.
    3. Post charges, payments and adjustments.
    4. Understand insurance benefits including copays, deductibles and coinsurance.
    5. Interpret, post, and balance Explanation of Benefits and Remittance Advices.
    6. Research, correct, and re-submit rejected and denied claims.
    7. Review delinquent accounts and make payment arrangements with patients.
    8. Prepare appeals for denied claims.
    9. Respond to third party carriers request for medical record documentation.
    10. Answer patient’s billing questions.
    11. General sorting, filing, scanning and faxing of documents.
    12. Performs other related duties as assigned.