Job Search Results for clinical

Insight Global is seeking 1 Revenue Integrity Specialist to support a large healthcare system based out of Annapolis, MD. The candidate is responsible for overseeing and maintaining specifically... More assigned system Charge controls, developing enhanced charge reconciliation functions at the department level, CDM maintenance, and governmental updates related to Revenue Integrity and Compliance. Provide all levels of support to Luminis Health facilities to ensure revenue recognition, including issue resolution for assigned areas of responsibility. Responsibilities are to resolve issues and assist others with resolving problems related to Revenue Integrity. Position communicates to internal and external users all corrections, changes and provides education to the facilities and internal customers. Reviews system charge reports and identifies trends, educational needs, workflow problems, and potential system issues. Generates monthly reconciliation reports and facilitates daily/weekly calls to review the data with the department's heads, hospital administrators, and CBOs. Ensures that any reconciliation issues are resolved promptly. The position will require reviewing specific account details to support other employees, CBO staff, or Administration when there are questions regarding the charge reconciliation process. They will analyze revenue cycle systems, including reporting data to maintain acceptable reconciliation performance, compliance, user satisfaction, and help develop greater efficiencies to identify charge enhancement opportunities. This position will determine the need for claims to be adjudicated with no further review, review records, or facilitate an onsite audit at the hospital. Develops and documents hospital claims review and audit policies. Collaborates with Luminis Health facilities to provide clinical policy representation at meetings to ensure that decisions, which affect claim processing, are appropriate and will result in cost-effective, efficient, and accurate claims payment. The analyst will investigate provider aberrant/fraudulent billing practices utilizing paid claim data and review medical records. Provides education to employees and provider offices as needed to understand correct claim coding, use of CPT, ICD9, ICD-10 HCPCS, etc.Essential Job Duties:Pulls weekly performance reports and distributes them to organizational stakeholders. Analyzes the reports and summarizes any significant changes or trending;Generates daily reconciliation reports. Distributes the results and facilitates calls between the departments, CBO, and Administration to resolve any issues;Manages, coordinates, updates, and implements the Charge Description Masters ("CDM");Provides assistance and analysis to all levels of clinical management in support of suggested, requested, and mandated changes to the CDM;Provides education and in-service training to clinical departments concerning the use of proper CPT-4 Codes or charge codes;Performs all other duties as assigned or required, including account research, problem-solving any assigned research requests from the facilities, report writing as needed, etc.;Conducts review of the chargemaster and updates as appropriate to enhance revenue for clinical departments;Conducts audits of Corporate CDM against all individual department CDM systems;Analyzes data within the CDM and assigns CPT/HCPCS and revenue codes to the ChargeMaster;Review revenue cycle systems and clinical systems to maintain charge integrity and develop greater efficiencies for charge recognition;Responsible for making CDM related decisions that require a higher-level analysis and investigation;Identifies billing irregularities on hospital bills and recommends the next level of review, including telephonic discussions with the hospital, referral to the vendor, or onsite audit at the hospital. Recommends solutions to resolve billing inconsistencies.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

MUST SIT IN SOCAL. An employer in the Southern California area is looking for a remote RN Case Manager. This is a contract with high possibility of extensions. Candidate must have a few years of... More experience in a Case Management role, an active CA RN license, and experience managing a heavy case load in a high paced environment. This individual will be responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Candidate must sit in Southern California area. Standard hours M-F.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

In this role we are looking for an IRIS Engineer to work for a lead system integrator. We are seeking a highly skilled IRIS Engineer with proven experience in developing clinical interoperability... More solutions using InterSystems IRIS for Health, HL7, FHIR, and ObjectScript. This role involves designing, building, and supporting scalable data integration pipelines that transform and exchange healthcare data in a HIPAA-compliant environment.In this role you will be responsible for the following:Build, deploy, and maintain integration workflows using IRIS for Health and ObjectScriptProcess HL7 v2/v3 messages (e.g., ADT, ORU, ORM) through IRIS Business ServicesPerform HL7-to-FHIR transformations using DTLs, custom scripts, or ObjectScriptCreate and expose FHIR APIs (R4) for internal and external useValidate and map HL7 segments (PID, PV1, OBX) to FHIR resources (Patient, Encounters, Observations)Develop and maintain routing, transformations, and business rules in IRIS productionsEnsure PHI data is transmitted securely using TLS, OAuth2, and HIPAA-compliant practicesCollaborate with clinical informatics, engineering, and compliance teams to maintain interoperability standardsWe are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

The Medical Assistant (Front/Back Swing), under the supervision of the Clinical Lead and Practice Leader, is responsible for assisting in the delivery of healthcare and patient care management. This... More role assists the providers within scope of practice to provide quality patient care. This includes gathering patient information, assessing patient requests, obtaining and monitoring patient vitals, assisting with procedures and re-processing instruments.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

MIDAS: Senior Backend Engineer, Data Overview: looking for an experienced Senior Backend Engineer, DAta to build nad maintain the software systems that power our healthcare data platform. You will be... More building robust, scalable applications and services that enable our teams to process complex clinical data efficiently while empowering data and analytics engineers to do more with higher data quality. Culture:o This group is very supportive of each other, collaborative, and folks are invested in helping you growo The folks that are most successful here are typically those with the ability to learn and adapt quickly, figure out whatevers needed to deliver value, and collaborate well with others Key Responsibilities:o Platform Software Development: end-to-end ownership of software applications, APIs, and services that support our data platformo Service Architecture: develop microservice and serverless-based applications that support end-to-end data lifecycle from ingest through to customer impacto Developer Experience: develop tools, libraries, and frameworks that enable data/analytics engineers and data scientists to work more efficiently and safely with clinical datao Infrastructure and DevOps: develop automation tooling, monitoring, and operational software that ensures platform reliability and observability, as well as compliance and privacy with healthcare datao Technical Leadership: drive best engineering practices across team and org, partner cross-functionally and collaborate to drive adoption of clinical data productso AI-leveraged Engineering: leverage LLMs to accelerate tasks like data modelling, query writing/rewriting, document creation, code review, synthetic/test data generationWe are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

The Project Manager will be responsible for executing a highly effective project delivery process for construction projects including development of project scope and budget, solicitation of... More consultant/ contractor bids, monitoring construction progress, maintaining financial records and turnover of project documentation. The Project Manager will facilitate each project in collaborative process with planners, facilities operations and clinical sponsors. Candidate will provide on-site supervision of construction phases by chairing owner-architect-contractor progress meetings to ensure the project is completed in a manner consistent with the contract documents and intended scope. Candidate will draft proposal requests for vendors, consultants and contractors and manage contract and award process. Provide oversight to all project delivery activities, include support during planning and activation phases. Manage a matrixed organization for successful project delivery. These include resources internal and external to the department within the Medical Center enterprise, such as Plant, IT Services, Clinical Engineering, and other Clinical Leadership. Direct and manage resources external to the enterprise such as contracted designers, builders, skilled trades and other professional service providers or vendors. Continually monitor outside influences such as regulatory agencies, market and technology changes that support or hinder the efficiently accomplishment of department process and procedures. Provide project controls by updating ledger software to monitor invoice and expenses. Manage and updating project schedules within identified software. Develop project charters to for scope identification and documentation. Manage and document project issues and risks. Provide change management by documenting alterations to project plan and maintaining up to date change logs. Manage and report variance according to developed planManage multiple projects simultaneously, understanding interdependencies and constrained resources. Phase projects accordingly to meet client needs as they affect direct patient care. Travel to projects in the Chicagoland Area outside the Hyde Park campus boundaries.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

Insight Global is hiring a Physical Therapy Assistant for their client's Acute Rehab team in Camden, NJ. The PTA will support acute care operations for a 24-bed acute care unit. The patient... More population consists primarily of true acute care patients, as opposed to sub-acute. Patients in the unit are required to do 3 hours of therapy 5x a week. This position involves performing rehabilitative treatments under the supervision of a physical therapist, providing data on patient progress, and assisting with clinical and operational issues. Clinical areas may involve stroke, brain, neuro, orthopedics, transplants, etc. Responsibilities include consulting with medical professionals, delivering physical therapy interventions, maintaining patient records, utilizing support staff, and communicating with patients and their families. The position is Monday-Friday, 40hrs/wk, working 5x8s. There are two rotating weekend days a month required. Team members are required to work both 1 summer and 1 winter holiday per year. The role requires an Associate degree in Physical Therapy Assistance, New Jersey licensure, and CPR certification.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

An employer is seeking a Medical Assistant located in Bethel, CT. This role requires a patient-centric approach to care as you are supporting internal medicine. Provide patient care, clinical... More summary and direction on next steps or follow up Perform phlebotomy for patients as needed Act as a member of the care team, including preparing patients to be seen by collecting and recording clinical information as per protocol Manage patients according to approved protocols and consistent with appointment and scheduling guidelines Carry out standing orders consistent with practice policies and procedures Document all patient interactions and other clinical activities accurately and in a timely manner in the electronic health record (EHR) Schedule tests, treatments and follow up visits on behalf of patients; assist patients with identifying suitable outside resources for disease management and other services; refer patients when appropriate Answer and document patient phone calls; take complete messages and route to providers as needed using the EHR Monitor task buckets in order to respond to tasks in a timely manner, follow up on overdue orders/worklists and monitor status of critical referrals In coordination with Regional Nurse Managers, maintain oversight of temperature monitoring Assist care team to assure smooth office operation and delivery of excellent service through teamwork Provide attention to patients in a manner that builds confidence, trust and loyalty Demonstrate respect for patients and ProHealth staff by presenting a friendly, courteous manner at all times and maintaining patient confidentiality Maintain open lines of communications with care team and Regional Management team Maintain knowledge of current coding, OSHA and CLIA regulations and company policies Adhere to all patient safety initiatives and infection control regulations Perform other duties as assignedWe are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

Insight Global is looking for a float certified medical assistant to join a major health system in the Beaufort/Bluffton, SC area. This person reports to the Outpatient Clinic Manager. They will be... More floating between several clinics in the area, pediatrics, vascular surgery, primary care and sleep. This person interviews patients, measures vital signs (i.e., pulse rate, temperature, blood pressure, weight, and height), and records or inputs information to patients' medical record. Prepares treatment rooms for examination of patients. Basic computer skills required. Annual competencies are required to be maintained. Possess ability to understand and implement a variety of detailed instructions in the execution of therapeutic procedures and ability to make accurate physical observation of patients. Must communicate effectively both verbally and in writing. This role requires minimum high school diploma or equivalent. A national CMA certification through the American Medical Technologist (AMT) or American Association of Medical Assistants (AAMA) or National Health career Association (NHA) or MedCA as a Certified Clinical Medical Assistant (CCMA) or Certified Medical Assistant (CMA) or National Association for Health Professionals (NAHP). Current Basic Life Support (BLS) required, either a certification from an American Heart Association (AHA) BLS for Healthcare Providers (or AHA recognized equivalent) or an American Red Cross CPR/AED for Professional Rescuer and Healthcare Provider.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it may require onsite reviews at provider offices... More based on needs of the area. Schedule is flexible. Remote aspects include contacting/scheduling provider onsite reviews, requesting records from providers via fax, abstraction & entry of medical records assigned by a Clinical Quality Lead nurse. Miles will be reimbursed for any travel. Computer equipment, encrypted zip drives and mobile phones are provided for uploading, transferring and scanning files to our secure file transfer site. 2 weeks of virtual training will be provided and required. RESPONSIBILITIES will include (but not limited to):Contacting/scheduling provider offices & traveling to onsite medical record reviews (mileage, tolls, parking reimbursed)Communicate effectively and professionally with office managers, health systems and any other facility or care providersScan/Upload/Download medical records from onsite reviews dailyMedical record abstraction into database from onsite visit, assigned remote chartsHighlighting member demographics & HEDIS evidence using Adobe Acrobat ReaderReviewing Overreads for any corrections and addressing each dailyAbide by all Code of Conduct, HIPAA, and patient confidentiality requirementsAttend & successfully complete remote training for first two weeks of project. Training includes attending HEDIS measure training via MS TEAMS, testing for proficiency, computer-based company training. Training is paid.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less