As an RN/LPN Nurse Auditor, your primary focus is to complete reviews on assigned audits as objectively and accurately as possible in order to uphold quality and performance standards. Reviews are conducted based on clinical expertise and the utilization of a range of audit tools.

Job Duties

• Performs reviews of medical charts
• Validate both the coding accuracy and appropriateness of services given to inpatients
• Record audit determinations using an audit tracking system to create a narrative explaining the rationale behind the care given to patients
• If an appeal arises, be able to support findings
• Consult with physicians, patients, and other staff as needed
• Assist with quality assurance functions such as development of coding guidelines as needed
• Maintain all required certifications to ensure ability to perform audits

Education and Experience

• A minimum of an Associate’s Degree in Nursing or a related field is required
• For some positions, a Bachelor’s Degree in Nursing or a related field is preferred
• Must maintain a current Nursing certification in their state of practice
• Some (1-2) years of clinical knowledge or experience in Case Management preferred
• Strong problem solving skills are a must
• Solid computer skills required in suites such as Microsoft Office

As a Marketing Manager, you will report to the Director of Marketing or VP of Sales to develop and refine the company’s advertising and marketing vision. Areas that a Marketing Manager may work in include traffic generation, promotional events, digital marketing, and other public relations activities.

Job Duties

• Leads marketing efforts based around planning, execution, and positioning in order to promote all products and services
• Collaborates with appropriate parties to determine marketing directives to support company goals
• Appropriately prioritizes marketing objectives to support company-wide strategic direction
• Leads product and project development projects, ensuring that all goals are met on time
• Manages leads and campaigns in addition to conducting statistical and data analytics

Education and Qualifications

• Depending on the position, up to 5 years of experience with healthcare marketing or other related field like communications consulting may be required
• Minimum of a few years of experience in project leadership roles
• Generally, a Bachelor’s degree is related for any position
• A Master’s degree is preferred for most positions

As a Basic X-Ray Technician, you will perform a range of diagnostic testing procedures including radiology, bone densitometry, and quality assurance. A Basic X-Ray Technician possesses a working knowledge of imaging practices, and is able to recognize problems and identify basic causes – all within established policies and procedures.

Job Duties

• Prepare patients for radiological procedures
• Take X-rays following established patient care and safety procedures
• Practice procedures that meet or exceed industry standard for safety in order to ensure the protection of patients, and yourself against radiation
• Process and develop radiological film
• Ensure that all radiological equipment is kept in satisfactory working order and is in compliance with all laws and regulations
• Report any malfunctioning equipment to supervisor
• Log all completed radiological procedures
• Perform other duties as assigned

Education and Experience

• High School diploma or equivalent is required, as well as completion of appropriate radiological courses
• No prior experience required for some positions, though prior experience in a radiology department is preferred
• A strong knowledge of anatomy, physiology, and radiology equipment is a must

The primary role of an Administrative Assistant in a healthcare setting is to facilitate the efficient day to day operations of their facility. An Administrative Assistant is often the first human interaction a patient or client has upon entering a facility, and should represent their company accordingly.

Job Duties

• Maintains a calendar containing appointment times, meetings, seminars, conferences, or other engagements. Makes arrangements in a timely manner
• Screens incoming phone calls and routes callers to their appropriate departments
• Accurately records messages and delivers them to the appropriate parties in a timely manner
• Warmly greets visitors, guests, and patients then assesses their needs and works to provide appropriate assistance
• Efficiently compiles and edits a range of correspondence and internal documentation
• Performs other duties as assigned

Education and Qualifications

• A High School diploma or equivalent education is required
• A Bachelor’s degree may be preferred for some positions
• Depending on the position, a couple years of related experience may be required
• Excellent computer and organizational skills are a must

An accountant in a healthcare setting is responsible for the preparation of balance sheet statements and consolidated statements among various other reports. The accountant also makes recommendations related to the accounting of assets and expenditures based on the analysis of financial reports and records.

Job Duties

• Helps maintain journal entries, supporting documentation, and other file documentation procedures in order to leave a clear audit trail
• Creates various types of journal entries on more complex accounting areas
• Prepares reconciliations on more complex accounting areas to ensure balances are accurate and works to create recommendations based on the data
• Gathers information for reconciliation purposes from outside business units and departments
• Approves journal entries, account analyses, and other documentation prepared by fellow accounting staff
• Analyzes changes in income statements on a month-to-month basis
• Performs other duties as assigned

Education and Experience

• Generally, a Bachelor’s degree in Accounting or a related field like Finance or Business Administration from an accredited institution is required
• Depending on the position, a couple years of accounting experience may be required
• Sound computer skills are a must
• Remarkable organizational and interpersonal skills
• Strong knowledge of Microsoft Office applications like Excel, Access, and Outlook
• Strong problem-solving skills
• Ability to work independently

The Utilization management nurses role is to ensure that health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won’t receive unnecessary procedures, ineffective treatment, or unnecessarily extensive hospital stays.

Job Duties and Responsibilities:

• Concurrent review of patient’s clinical information for efficiency
• Ongoing review of precertification requests for medical necessity
• Monitor the activities of clinical and non-clinical staff
• Coordinates patient’s discharge planning needs with the healthcare team
• Employ effective use of knowledge, critical thinking, and skills to:
  • Advocate quality care and enhanced quality of life
  • Prevent patient complications during hospital stay
  • Advocate decreased hospital stay when appropriate
• Maintain accurate records of all patient related interactions
• Prepare monthly patient management and cost savings report
• Work in an intensive, fast-paced environment with minimal supervision
• Ability to stay organized and interact well with others in any situation
• Provide daily updates to Manager of Utilization Management for review

Skills and Qualifications:

• Bachelor’s degree in Nursing
• State licensure as a Registered Nurse (RN)
• Minimum 2 years of prior experience in Utilization Management
• Strong knowledge of word processing and spreadsheet computer programs
• Utilization Management or Case Management certification preferred
• Basic Life Support certification preferred. Must obtain within 60 days of hire if not currently certified.

Collection representatives will notify patients of delinquent accounts by mail or telephone and ensure timely and accurate payments. Representatives will also demonstrate exceptional customer service to patients, insurance carriers, and healthcare professionals.

Job Duties and Responsibilities:

• Contact patients daily to try and resolve outstanding balances
• Contact patients, physician’s offices, or insurance carriers to expedite claims process
• Resolve insurance or patient issues that result in the patient being billed incorrectly
• Maintain accurate and detailed records of steps taken to resolve outstanding debt
• Maintain all patient demographic information and data in collection systems

Skills and Qualifications:

• High school diploma or GED required
• Minimum one year experience in handling reimbursement or medical/insurance billing preferred
• Ability to multitask with the computer and phone while collecting patient data
• Minimum one year experience using Microsoft Excel, Outlook, and Word
• Advanced verbal, written communication, and organization skills
• Ability to work in high pressure, fast paced environment
• Ability to navigate computers and other office machines

The coder is responsible for reviewing, analyzing, and assuring that the final diagnoses and procedures determined for a patient is valid and complete. To assist physicians with understanding the best treatment for a specific patient, the coder assigns coding or appropriate diagnostic or procedure code to the patient’s records. The coder will ensure proper completion of Electronic Health Records and proper assignment of ICD-9, HCPCS, CPT and all other relevant codes.

Job Duties and Responsibilities:

• Audits submitted records to ensure proper billing of pre-determined charges
• Receives hospital information to properly bill provider services for hospital patients
• Supplies correct ICD-9 codes on all diagnoses provided
• Supplies correct HCPCS and CPT code on all procedures and services performed
• Train care providers on updated and correct coding information
• Audits medical records to ensure proper coding and compliance with federal and state laws
• Ensures the final diagnoses and procedures used by health care providers are valid and complete

Skills and Qualifications:

• High School Diploma
• Medical Coding Certificate – CPC certification is required
• One year experience using ICD-9-CM, CPT, HCPCs or equivalent
• Excellent interpersonal skills
• In depth computer knowledge
• Advanced verbal, written communication, and organization skills

The billing clerk is responsible for compiling the amounts owed to medical providers. The clerk will use data provided by medical coders and submit claims to the insurance companies prior to billing patients. The billing clerk will also record journal entries, communicate any billing adjustment to patients, and more.

Job Duties and Responsibilities:

• Work with insurance companies, healthcare providers and patients to accurately process claims
• Submit claims to insurance companies using coded data
• Appeal and review denied or unpaid claims with insurance companies
• Verify patients’ insurance coverage and answer any subsequent billing concerns
• Attempt to collect outstanding debt on delinquent accounts
• Manage receivables and Medicare bad-debt reports

Skills and Qualifications:

• High school diploma or GED required
• One year experience in handling billing and account receivables reports in a similar or related field
• Some knowledge of CPT and ICD 9 codes preferred
• Advanced verbal, written communication, and organization skills
• Ability to work in high pressure, fast paced environment
• Ability to navigate computers and other office machines
• Basic bookkeeping and accounting knowledge preferred

The Medical Social Worker is responsible for preparing social histories of patients, and assessing their needs. They also provide casework to patients and their families that are having difficulty with social functioning as it affects their health, and aids in other processes in regards to social agencies.

Job Duties and Responsibilities

• Provides casework to patients and their families in accordance with the physician’s care plan
• Works to assist the physician and other health care providers in understanding any social or emotional factors related to the patient’s health in order to create a plan of care
• Assesses the patient and their family to prepare a social history to modify existing service, or to serve as a guide for changing the level of service
• Considers the patient’s financial situation as it relates to their medical needs, and seeks out financial assistance when deemed necessary to facilitate the most efficient recovery

Education and Experience

• Generally, a minimum of a Master’s degree in social work accredited by the Council on Social Work Education is required, though experience may take the place of some education in certain situations
• At least a year of experience in the health care setting is required
• A current license in the state of practice is required
• Some experience in home health care is preferred, though not required