This position assigns, per coding guidelines, the current version of ICD diagnosis and procedure codes and CPT-4 procedure codes for Observation, Same Day Surgery, Emergency Department, Urgent Care and/or Ancillary medical records. Completes coding for all accounts on a timely basis within the four day bill hold time frame. Follows up on all accounts needing coding queries or documentation completion by clinicians or medical staff. Demonstrates coding competencies with quality of coding and daily output of volume consistent with department productivity standards.
Posting Note: As a manager you will enjoy managing a team, have previous case management experience, and a solid understanding of working with HEDIS measures. The team of 12 includes RN's, Social Workers, and Care Navigators that work remotely, speaking to our families by phone. The position will have to require excellent coaching skills to support the team, collaborate with senior staff to improve Care Coordination processes while supporting contractual obligations with payer partners.
This position will work remotely, however, you will be expected to attend meetings on-site if necessary. You will need to reside in the Phoenix Metro area.
Schedule: M-F 8:00 - 5:00
Location: Remote - the position requires availability to attend meetings on-site if the business requires.
Requirements: Educational: Bachelor's Degree in Nursing or Health Care Related field, or a Master's in Social Work. Previous experience working with HEDIS measures, strong management skills, and proven ability to handle projects, a caseload, and manage a team successfully. Please see detailed requirements in the job requirements section.
Integrated Care coordination is the deliberate organization of patient care activities to facilitate the appropriate delivery of health care services. This position manages the activities of PCCN’s care coordination team who interact with families telephonically. The Integrated Care Coordination Team includes RN Care Managers, Social Workers, and Care Navigators. The Manager of Integrated Care Coordination oversees daily operations for the team and provides guidance, mentoring, and education to support and develop staff. The Manager of Integrated Care Coordination collaborates with PCCN’s clinical leadership to develop programs to meet emerging needs of children, families, and staff while supporting contractual obligations with payer partners. This position works independently and reports to the Director, Business Operations and Clinical Programs.
The Pre Access Specialist I is responsible for accurate and complete insurance verification, authorization, and complete pre-registration of all scheduled clinic visits and office based procedures. The position works within the EMR using an automated insurance verification tool along with payer websites and documents within the EMR.
The Pre Access Specialist II is responsible for accurate and complete insurance verification, authorization, and complete pre-registration of all scheduled Diagnostic, Surgical, Audiology and/or Rehabilitation visits. The position works within the EMR using an automated insurance verification tool along with payer websites and documents within the EMR.
This position is responsible for the coordination and management of the physician schedules for office based procedures, outpatient surgery, laboratory, radiology and inpatient services. The position works with systems, physicians and team members to appropriately schedule complex services. This position can act as a scheduler as back-up and secures authorization for upcoming complex services.
This position performs a variety of diagnostic radiography imaging procedures to provide data for diagnosis of disease and injuries in accordance with all applicable standards, regulations and licensing requirements.