MEDICAL BILLING & CODING COORD Louisiana State University Health Sciences Center New OrleansMEDICAL BILLING & CODING COORDNew Orleans, LAIncludes filing and follow up of third-party insurance claims, receiving payments from self-pay patients, posting and reconciliation of payments in the clinical software system. Substitution: high school diploma or equivalent and either a CCA, CCS, or equivalent medical coding certification or 4 years of medical or dental billing experience may be substituted for degree.
UTILITY SENIOR SERVICES MANAGER (BILLING DIRECTOR) (CLASS CODE 3095) City of New OrleansUTILITY SENIOR SERVICES MANAGER (BILLING DIRECTOR) (CLASS CODE 3095)New Orleans, LAPublic safety employees such as commissioned law enforcement officers hired by the New Orleans Police Department (NOPD), firefighters hired by the New Orleans Fire Department (NOFD), emergency medical technicians hired by the New Orleans Emergency Medical Services (NOEMS) and the recruits for these positions hired by these departments are excluded from this provision. VETERANS PREFERENCE: On original entrance examinations, veterans (as defined in Article X, Section 10(2) of the Constitution of the State of Louisiana), disabled veterans, certain spouses and parents of veterans shall receive additional credit if claimed as provided on the Veterans Preference claim form which can be obtained in this office.
Coding Quality Auditor Houston Methodist HospitalCoding Quality AuditorLAp>SKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Knowledge of an electronic medical record and imaging systems Working knowledge of medical terminology, anatomy and physiology Proficiency with electronic encoder application AHIMA designated ICD-10 Approved Trainer preferred. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities.
Coding Manager- Wound Care- Full Time RestorixHealthCoding Manager- Wound Care- Full TimeMetairie, LAProvide monthly coder productivity report to VP, Revenue Integrity (report to include average number of charts coded per hour, lag time between, "Ready to Code" and "Coding Complete" and "Coding Inquiry Follow-Up Complete" and "Coding Complete" by the 10th of the following month. ADDITONAL RESPONSIBILITIES: Assist Coders, Revenue Cycle Representatives (RCR), Revenue Cycle Directors (RCD) and other internal staff engaged with responsibilities related to or responsible for coding of charts for specific/previously identified hospitals/centers with POR contractual arrangements.
Billing and Accounts Receivable Manager Deloitte Touche Tohmatsu LtdBilling and Accounts Receivable ManagerLARemote$140,000–$160,000 / yearp>Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html. As an Epic Billing and Accounts Receivable Manager you will help deliver back-end revenue cycle management (RCM) services, including billing and claims submission, A/R follow-up, denials management, payment posting, and credits and refunds, for health care provider client.
Coding Specialist InfinxCoding SpecialistNew Orleans, LAFull timeThe Medical Coder assigns accurate diagnosis and procedure codes for inpatient, outpatient, and ambulatory encounters including clinic visits, ambulatory surgery, observation, emergency department, and ancillary services. Resolve coding-related claim rejections and denials by reviewing payer responses, applying corrected codes or modifiers, providing supporting documentation, and following claims through to resolution.
Coding Specialist TIS International (USA) IncCoding SpecialistNew Orleans, LAThis marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S. Summary Description: The Medical Coder assigns accurate diagnosis and procedure codes for inpatient, outpatient, and ambulatory encounters including clinic visits, ambulatory surgery, observation, emergency department, and ancillary services. Resolve coding-related claim rejections and denials by reviewing payer responses, applying corrected codes or modifiers, providing supporting documentation, and following claims through to resolution.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorLA$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Coding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorWork At Home, LA$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories CRC (HCC)CPMA (Certified Professional Medical Auditor), CDEO (Certified Documentation Expert Outpatient) or CPC-I (Certified Professional Coding Instructor) preferred.
NewSenior Coder - PB Professional Coding - Cardiology Specialty Louisiana Childrens Medical Center IncSenior Coder - PB Professional Coding - Cardiology SpecialtyNew Orleans, LAEssential Function: The Coding Senior will be responsible applying the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determining the MS-DRG and APR-DRG assignment of in patient records across multiple specialties (cardiology, cardiothoracic surgery, trauma, orthopedics, general medicine and surgery, pediatrics, obstetrics, newborns, etc.) or applying the appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties (i.e. family medicine, internal medicine, cardiology [IR], cardiothoracic surgery, interventional radiology, trauma, orthopedics, general surgery, urology, gynecology, etc.). Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding.
Medical Collector- Medicare and Managed Medicare Louisiana Childrens Medical Center IncMedical Collector- Medicare and Managed MedicareNew Orleans, LAWhile our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Conduct relevant research to complete the appeals process to include assessing, complete and accurate documentation, tracking, responding to, and / or resolving appeals with third party payers in a timely manner.
Billing Specialist Omega HospitalBilling SpecialistMetairie, LAFull timeThe Billing Specialist is responsible for collecting, posting, and managing patient account payments. Address and resolve any billing discrepancies or inquiries from patients and insurance companies.
Reimbursement/Billing Specialist Trucept IncReimbursement/Billing SpecialistMetairie, LAFinancial Counseling, Patient Relations); Receive, document, and respond to all patient correspondence in a prompt and courteous manner; accurately document all actions taken to reconcile outstanding balances; Assist patients in coordinating appeal processes with their insurance company; Review self-pay undistributed and credit balance accounts and provide refunds to patients as necessary; Accurately post EFT, cash and checks made payable to IV Services, LLC., to the billing system; Ensure that all transactions are completed within the appropriate guidelines, policies and regulations, typically the same day received; Process electronic remittance files, payor work queues, and generate payment reports to balance; Communicate with IV Services, LLC., staff, insurance companies, financial institution and third-party payors to resolve issues related to proper posting of payments; Complete work on special projects, queries and reports as assigned; Other duties may be assigned as needed by management. Education and Experience: An Associate degree in Business, Finance, Health Information Management, or related field preferred; 3-5 years of experience in a healthcare revenue cycle or clinic operations role; 3-5 years of experience in an infusion pharmacy setting; Experience with billing within the Caretend pharmacy platform; Experience billing acute infusion and specialty pharmacy claims.
Reimbursement/Billing Specialist Afinida, Inc.Reimbursement/Billing SpecialistMetairie, LAFull timeFinancial Counseling, Patient Relations); Receive, document, and respond to all patient correspondence in a prompt and courteous manner; accurately document all actions taken to reconcile outstanding balances; Assist patients in coordinating appeal processes with their insurance company; Review self-pay undistributed and credit balance accounts and provide refunds to patients as necessary; Accurately post EFT, cash and checks made payable to IV Services, LLC., to the billing system; Ensure that all transactions are completed within the appropriate guidelines, policies and regulations, typically the same day received; Process electronic remittance files, payor work queues, and generate payment reports to balance; Communicate with IV Services, LLC., staff, insurance companies, financial institution and third-party payors to resolve issues related to proper posting of payments; Complete work on special projects, queries and reports as assigned; Other duties may be assigned as needed by management. Education and Experience:An Associate degree in Business, Finance, Health Information Management, or related field preferred; 3-5 years of experience in a healthcare revenue cycle or clinic operations role; 3-5 years of experience in an infusion pharmacy setting; Experience with billing within the Caretend pharmacy platform; Experience billing acute infusion and specialty pharmacy claims.
Hospital Billing Analyst Deloitte Touche Tohmatsu LtdHospital Billing AnalystNew Orleans, LA$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorLA$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Reimbursement/Billing Specialist AfinidaReimbursement/Billing SpecialistMetairie, LouisianaFinancial Counseling, Patient Relations); Receive, document, and respond to all patient correspondence in a prompt and courteous manner; accurately document all actions taken to reconcile outstanding balances; Assist patients in coordinating appeal processes with their insurance company; Review self-pay undistributed and credit balance accounts and provide refunds to patients as necessary; Accurately post EFT, cash and checks made payable to IV Services, LLC., to the billing system; Ensure that all transactions are completed within the appropriate guidelines, policies and regulations, typically the same day received; Process electronic remittance files, payor work queues, and generate payment reports to balance; Communicate with IV Services, LLC., staff, insurance companies, financial institution and third-party payors to resolve issues related to proper posting of payments; Complete work on special projects, queries and reports as assigned; Other duties may be assigned as needed by management. Education and Experience:An Associate degree in Business, Finance, Health Information Management, or related field preferred; 3-5 years of experience in a healthcare revenue cycle or clinic operations role; 3-5 years of experience in an infusion pharmacy setting; Experience with billing within the Caretend pharmacy platform; Experience billing acute infusion and specialty pharmacy claims.
Medical Coder II Tulane UniversityMedical Coder IIHarahan, LALegally protected demographic classifications (such as a persons race, color, religion, age, sex, national origin, shared ancestry, disability, genetics, veteran status, or any other characteristic protected by federal, state, or local laws) are not relied upon as an eligibility, selection or participation criteria for Tulanes employment or educational programs or activities. REQUIRED BACKGROUND CHECK, PHYSICAL, AND DRUG SCREENING FOR INCUMBENTS WHO HAVE CONTACT OR EXPOSURE TO ANIMALS OR ANIMAL TISSUES: Selected candidates must complete and pass a background check and an occupational health screening as a condition of employment.
Medical Assistant III InclusiveCareMedical Assistant IIIMarrero, LAESSENTIAL FUNCTIONS: Clinical Support: Assist in the preparation and examination of patients, including taking vital signs (blood pressure, pulse, temperature, weight). GENERAL SUMMARY OF DUTIES: The Medical Assistant II provides advanced clinical and administrative support to healthcare providers and patients.
NewMedical Biller - CBO Hospital Services - AR Follow Up Louisiana Childrens Medical Center IncMedical Biller - CBO Hospital Services - AR Follow UpNew Orleans, LAAssists patients with understanding their financial obligations, setting up payment arrangements, completing financial assistance applications, coordinating care with the providers, securing grants/resources with external sources (Drug Therapy Reimbursement) and when necessary, makes appropriate referrals to Parish Medicaid, Medicaid, or Emergency Medicaid. Completes the patient registration and admissions process and ensures all required forms are completed and other paperwork / documents are gathered and accurate: Requests and documents patient demographic, insurance, guarantor, MSP, and PCP/Referring Physician information and validates against current system.
NewMedical Biller - Physician Services Louisiana Childrens Medical Center IncMedical Biller - Physician ServicesNew Orleans, LAAssists patients with understanding their financial obligations, setting up payment arrangements, completing financial assistance applications, coordinating care with the providers, securing grants/resources with external sources (Drug Therapy Reimbursement) and when necessary, makes appropriate referrals to Parish Medicaid, Medicaid, or Emergency Medicaid. Completes the patient registration and admissions process and ensures all required forms are completed and other paperwork / documents are gathered and accurate: Requests and documents patient demographic, insurance, guarantor, MSP, and PCP/Referring Physician information and validates against current system.
Business Operations and Reimbursement Manager Tulane UniversityBusiness Operations and Reimbursement ManagerNew Orleans, LAResponsible for maintaining TUMG Master Fee Schedule, tracks payer fee schedule updates and coordinates with vendors to ensure timely and accurate uploads and performing in-depth payer reimbursement and variance analysis, supporting payer negotiations, and advising on strategic pricing decisions. Experience with hospital or clinical charge description master (CDM) and payer fee schedules; knowledge of global fees, professional fees, and technical fees; experience in medical billing, collections, and coding practices and procedures.
Fraud Waste and Abuse - Sr. Analyst CVS Health CorpFraud Waste and Abuse - Sr. AnalystLA$46,988–$112,200 / yearActivities include reviewing billing activity for state agency referrals, assisting in the investigation and triage of FWA complaints, coordination with other departments and assist in prevention activities including training of internal staff and internal departments. Analyst, Fraud, Waste, and Abuse (FWA) will assist in detecting, investigating, remediating and referring to state regulatory agencies incidents of FWA arising in connection with medical, behavioral, transportation, and other healthcare services.
Medical Claim Analyst Crawford & CoMedical Claim AnalystNew Orleans, LAKeeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Team Manager for direction. Approves payments of medical bills on lost time disability claims, within payment authority, after compensability has been determined by the Team Manager or claim technician/handler.
Designer (Civil Engineering and Design) Ampirical Solutions LLCDesigner (Civil Engineering and Design)Metairie, LA$25.51–$44.25 / hourPrepare design drawing packages including grading and drainage, erosion and sediment control, and access roads for electrical substations on power generation projects using Civil 3D based on direction of Engineer. Assist with 3D modeling, ensuring correct reference files are attached and model reference directory is up to date; develop 3D models utilizing drawings, sketches, and design skills.
Sales Representative MedKoderSales RepresentativeMandeville, LouisianaWith a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work. Sales Presentations: Conduct engaging, high-impact presentations and product demonstrations (virtual and in-person) that clearly articulate the value of our services, using compelling storytelling and data-driven insights to captivate physicians, administrators, coders, and revenue cycle leaders.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistLA$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, LA$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
AR Specialist TIS International (USA) IncAR SpecialistNew Orleans, LACandidates must be experienced working natively in client source systems and must be capable of billing claims directly to payers include Medicare DDE/FISS, state Medicaid portals, and payer-specific direct submission channels. Submit clean claims directly to payers via Medicare DDE/FISS, state Medicaid portals, and payer-specific direct submission channels, working natively in client EHR and billing systems rather than exclusively via clearinghouse.
Charge Integrity Specialist - Revenue Integrity Louisiana Childrens Medical Center IncCharge Integrity Specialist - Revenue IntegrityNew Orleans, LAWhile our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. SKILLS AND ABILITIES: Due to its service focus, this position requires interpersonal and communication skills, analytic and organizational skills, critical -thinking and the ability to meet deadlines.
Payor Contract Reimbursement Specialist II Tulane UniversityPayor Contract Reimbursement Specialist IINew Orleans, LAExperience with hospital or clinical charge description master (CDM) and payor fee schedules; knowledge of global fees, professional fees, and technical fees; experience in medical billing, or coding practices and procedures. Supports operational decision-making through communication with Tulane University Medical Group (TUMG) leadership, maintains payor relationships, and contributes to revenue optimization strategies.
AR Specialist InfinxAR SpecialistNew Orleans, LouisianaCandidates must be experienced working natively in client source systems and must be capable of billing claims directly to payers include Medicare DDE/FISS, state Medicaid portals, and payer-specific direct submission channels. Submit clean claims directly to payers via Medicare DDE/FISS, state Medicaid portals, and payer-specific direct submission channels, working natively in client EHR and billing systems rather than exclusively via clearinghouse.
Care Management Associate, Engagement Hub - Work From Home CVS Health CorpCare Management Associate, Engagement Hub - Work From HomeWork At Home-Louisiana, LA$18.50–$38.82 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubLA$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Senior Coder - Specialty Surgeries Louisiana Childrens Medical Center IncSenior Coder - Specialty SurgeriesNew Orleans, LACommunicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs assignment and all required modifiers.
Claims Specialist- Liab Crawford & CoClaims Specialist- LiabNew Orleans, LAVerifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves within designed authority, as necessary, during the processing of the claim. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
Certified Professional Coder - REMOTE- Full Time RestorixHealthCertified Professional Coder - REMOTE- Full TimeMetairie, LARemotePrimary Responsibilities: Review and interpret medical record documentation to properly assign CPT (Current Procedural Terminology), HCPCS (Healthcare Common Procedure Coding System) and ICD-10 CM (International Classification of Diseases, 10th Clinical Modifications) codes according to current coding rules and instructions. The coder holding this position must be able to work as part of the integrated Revenue Integrity / Revenue Cycle team, including Revenue Cycle Directors, Revenue Integrity Auditors, fellow Coders, Coding Supervisor and Vice President of Revenue Integrity.
LPN-Office Management Home Health Care 2000LPN-Office ManagementNew Orleans, LAFull timeThe Office LPN/Position is responsible for charting clinical staff/patient encounters in real time, such as during a home health care visit in patient's home or from a clinician's dictated information pertaining to the patient's encounter. · Follows the plan of care in providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes.
Director - Hospital Revenue Cycle - Revenue Cycle Solutions Ochsner Clinic FoundationDirector - Hospital Revenue Cycle - Revenue Cycle SolutionsNew Orleans, LouisianaThe Director of Hospital Revenue Cycle develops, evaluates and implements individual training plans and staff development programs for each functional area; provides ongoing training for new and existing staff; monitors regulatory issues, federal and state, that impact the department for compliance; and coordinates staff assignments according to volume of work and areas of responsibility to ensure that all assigned tasks are completed timely. The Director s is responsible for the strategic planning, direction and direct accountability for hospital revenue cycle operations including billing, coding, compliance, service line accounts receivable, technology integration, quality assurance and operations support for the hospital central business office (CBO).
Field Reimbursement Manager - Kidney (East Texas-Louisiana) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (East Texas-Louisiana)LA$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
Field Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN)LA$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
Student Support Strategic Initiatives Manager NOLA Public SchoolsStudent Support Strategic Initiatives ManagerNew Orleans, Louisiana$50,400–$78,735 / yearMedicaid DutiesCoordinates the district’s Medicaid program and ensures compliance by communicating with providers and collaborating with the contracted billing agent; Maintains the District Medicaid billing and documentation system; Downloads eSER Student Eligibility File to provide to Medicaid documentation system for upload; Directs input of Student Speech, Vision, Hearing, O/T, P/T Evaluations into the district documentation system for Medicaid Billing; Oversees the completion of the Annual Medicaid Cost Reporting; Participates in State Medicaid Monitoring Audit; Implements transportation billing for Medicaid, when applicable; Maintains weekly meetings with the third-party Medicaid contracted provider; Ensures that all Claims are processed timely with third-party biller; Works with Student Support Staff to rectify Medicaid Documentation issues; Reviews documentation system logs, billing statements, and cost reports to ensure maximum funds are recouped by the district; Develops a strategy, across all funding areas (Early and Periodic Screening, Diagnosis and Treatment; Nursing; Behavioral Health; Therapy; Personal Care Services; ABA; Optometry; Physician; and Special Transportation) in collaboration with the third-party Medicaid provider to maximize funding opportunities through the Medicaid program; Attends all Medicaid convenings and training opportunities and share information with the third-party Medicaid provider; Collaborates with LEA Schools and Non-LEA Contracted Services Schools to eliminate challenges faced with Documentation and Billing and provide training/support as needed. Contract ResponsibilitiesCoordinates all 3rd party service contracts maintained in the department to prevent any disruption of services to students; Drafts contracts, route them to the appropriate departments, and follow all procurement guidelines as it relates to contract management; Follows-up with appropriate staff and external providers to ensure timely completion of contracts and submit completed contracts to the appropriate departments and team members; Maintains a contract tracking system to ensure appropriate funds are available and contracts are up to date; Coordinates all Requests for Proposals (RFPs) in collaboration with the Purchasing Department; Participates in construction of RFPs and monitor the progression of RFPs to completion and ensures that awarded Contractors/Providers have executed agreements in place for the appropriate time-frames; Reviews and validates all invoices and service verification documents submitted by contracted service providers; Prepares Shared Services MOU’s with non-LEA Charter Schools; Prepares Shared Services billings to non-LEA Charter Schools and forward to Finance for dissemination.
SIU Senior Investigator (Must reside in Louisiana) CVS Health CorpSIU Senior Investigator (Must reside in Louisiana)LA$46,988–$91,800 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Professional Services Coder II, PRN Tulane UniversityProfessional Services Coder II, PRNNew Orleans, LAMust demonstrate the ability to communicate clearly and professionally, act as a liaison among providers, administrators (DBON) and the coding staff and respond timely and accurately to inquiries. This position is responsible for the timely abstraction and coding of professional surgical services based on provider documentation, ensuring that all services are in compliance with the Tulane University Medical Group Guidelines.
Patient Access Liaison, Manager - Krystexxa - New Orleans, LA (Rare Disease) Amgen IncPatient Access Liaison, Manager - Krystexxa - New Orleans, LA (Rare Disease)New Orleans, LAIn addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include: A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. The Patient Access Liaison, Manager is a field-based patient access and reimbursement specialist responsible for supporting patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies.
Patient Access Liaison -Tepezza - New Orleans, Louisana Amgen IncPatient Access Liaison -Tepezza - New Orleans, LouisanaNew Orleans, LA$158,394–$185,578 / yearIn addition to the base salary, Amgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including: Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. The Patient Access Liaison (PAL) is a field-based patient access and reimbursement specialist responsible for supporting patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies.
Revenue Cycle Precertification Nurse- LPN- PRN- Remote Ochsner Health SystemRevenue Cycle Precertification Nurse- LPN- PRN- RemoteNew Orleans, LARemoteEven though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. Coordinates with physician and/or staff for appropriate level of care setting and essential clinical documentation to support medical necessity of services ordered and works collaboratively with Case Management to establish level of care for direct admits and inpatient stays.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)LA$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Financial Counselor - Remote Louisiana Childrens Medical Center IncFinancial Counselor - RemoteNew Orleans, LARemoteSedentary: Very light physical requirements- Sedentary Work- Exerting up to 10 pounds of force occasionally (occasionally means activity or conditions exist up to 1/3 of the work day), and/or, a negligible amount of force frequently (frequently means activity or condition exists from 1/3 to 2/3 of the work day) to lift, carry, push, pull, or otherwise move objects, including the human body. Performs financial counseling on all patients prior to treatment, which includes explaining financial obligations and estimated costs of therapies based on insurance benefit plans & billing processes, as well as developing payment arrangements with patient.
NewNational Account Director - Southeast / South Central Melinta Therapeutics LLCNational Account Director - Southeast / South CentralNew Orleans, LAThe ideal candidate possesses deep expertise in Pre-Approval Information Exchange (PIE), budget impact and pro forma modeling, reimbursement strategy, healthcare economics, revenue cycle operations, HUB services, and institutional account management. POSITION: The National Account Director (NAD) will serve as a strategic leader within the Market Access organization, responsible for driving awareness and regional strategies for late-stage investigational products and future label expansions across the acute care and health system environment.