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Fabrication Quality Control (QC) Manager
✦ New
Salary not disclosed
Long Beach, MS 1 day ago

Job Title: Fabrication Quality Control (QC) Manager

Location: Long Beach, MS (Open to Relocation)

Employment Type: Direct Hire

Work Environment: 100% Onsite

Travel: 0–5% local travel to fabrication shop, office, or job sites as needed

Compensation

  • Salary: $102,000 – $136,000 annually (based on experience)
  • Bonus: Discretionary annual bonus


Position Summary

Wheeler Staffing Partners is seeking an experienced Fabrication Quality Control (QC) Manager to oversee and manage quality control and assurance processes for fabrication operations supporting industrial and process piping projects. This role provides technical leadership to ensure fabricated products meet industry standards, regulatory requirements, project specifications, and client expectations.

The QC Manager will work closely with estimating, engineering, and fabrication teams to ensure consistent quality, compliance with applicable codes, and continuous improvement in fabrication processes. The ideal candidate has experience within pipe fabrication, process piping, or mechanical subcontractor environments, along with strong knowledge of engineering drawings, fabrication methods, and estimating standards.

Key Responsibilities

Quality Control Leadership

  • Develop, implement, and maintain quality control standards and procedures aligned with industry codes, project specifications, and client requirements
  • Oversee daily inspection of machinery, equipment, fabrication processes, and working conditions to ensure compliance with quality and regulatory standards
  • Prepare daily inspection reports and provide recommendations for corrective actions when quality issues are identified
  • Establish and maintain quality assurance policies, procedures, and quality manuals supporting ISO 9001:2015 and ASME certification standards

Fabrication Quality Oversight

  • Perform and document in-process inspections and verification for piping, plumbing, and sheet metal fabrication
  • Ensure fabricated products meet project design specifications, applicable codes, and client requirements
  • Inspect fabrication documentation and maintain records required for quality compliance and project documentation
  • Prepare project turnover documentation and quality packages for completed work

Welding & NDE Management

  • Test and certify welders and welding procedures according to applicable codes
  • Maintain welder continuity logs in compliance with industry standards
  • Coordinate and schedule contract Non-Destructive Examination (NDE) testing as required

Regulatory Compliance

  • Ensure all quality control activities comply with industry regulations, codes, and project standards
  • Monitor regulatory changes affecting fabrication and piping standards and communicate updates to internal teams

Data Analysis & Continuous Improvement

  • Analyze quality metrics, trends, and performance data to identify opportunities for process improvement and defect reduction
  • Conduct root cause analysis and support corrective and preventative actions
  • Lead or support cross-functional quality improvement initiatives that enhance operational efficiency and product quality

Estimating & Bid Support

  • Review Requests for Quotation (RFQs) and assist estimating teams with quality requirements and bid specifications
  • Support cost estimating efforts related to fabrication processes and project requirements
  • Utilize established KPI metrics to determine performance factors and labor hour calculations during estimate development

Cross-Functional Collaboration

  • Partner with estimating, engineering, project planning, and fabrication teams to resolve quality concerns and implement corrective actions
  • Support development of fabrication strategies for new projects or process improvements

Training & Team Development

  • Provide training, coaching, and mentorship to quality control personnel and fabrication staff on quality standards and best practices
  • Promote a culture of safety, quality, and continuous improvement throughout fabrication operations

Required Qualifications

  • 5+ years of quality control experience within pipe fabrication, industrial/process piping, or mechanical subcontractor environments
  • Experience working in a fabrication shop environment
  • Ability to read and interpret engineering drawings, specifications, and fabrication documentation
  • Experience with cost estimating related to fabrication and piping work
  • Knowledge of pipe fabrication methods, materials, and project specifications
  • Familiarity with process piping unit rates and estimating references such as ’73 Price Book or Page & Nations
  • Strong analytical, documentation, and quality inspection skills
  • Ability to manage multiple projects in a fast-paced fabrication environment

Preferred Qualifications

  • Experience with modular estimating
  • Experience utilizing KPI metrics for labor hour build-up and performance factors
  • Certified Welding Inspector (CWI) certification preferred
  • ASNT Level II certification in ASME B31 piping preferred
  • Advanced proficiency in Microsoft Excel and Microsoft Office Suite

Skills & Competencies

  • Strong leadership and quality management capabilities
  • Advanced knowledge of fabrication quality standards and inspection procedures
  • Strong analytical and problem-solving skills
  • Excellent communication and documentation abilities
  • Ability to collaborate across engineering, fabrication, and project teams
  • High attention to detail and commitment to quality standards

Work Environment

This position operates primarily within a fabrication shop and office environment and may include exposure to industrial work settings, including equipment, welding operations, and fabrication processes.


Why Work with Wheeler Staffing Partners

Wheeler Staffing Partners connects skilled professionals with leading organizations across the United States. Our team is dedicated to helping candidates find opportunities that align with their expertise, career goals, and long-term professional growth while providing personalized support throughout the hiring process.

Not Specified
Director of Clinical Documentation Integrity
Salary not disclosed
Baltimore, MD 6 days ago

Job Responsibilities:

The JHHS Clinical Documentation Integrity Director (CDI) is responsible for the oversight of the CDI shared service team that is comprised of assistant directors, managers, Registered Nurses (RN) and/or Health Information Professionals in addition to the JHHS CDI Educator. The director acts as a systems expert on matters related to physician clinical documentation, coding, risk adjustment, education and reimbursement processes in working towards agreed upon quality and productivity targets for the health system. This role identifies opportunities to improve clinical documentation quality through process review, performance/quality, and productivity reporting, and works with VPMAs, Functional Unit Administrators, Directors, and others to implement improved process and enhancements. Works in collaboration with finance and quality staff along with other departments and system hospital staff to design workflow and requirements that meet reporting, coverage, and quality review requirements.


Reports to the Executive Director of Regulatory Finance Informatics & Clinical Analytics of the Johns Hopkins Health System.


Qualifications:

Requires successful completion of an accredited program: requires Baccalaureate degree from an accredited School of Nursing, OR requires successful completion of an AMA approved Physician Assistant program

Master’s degree preferred

10 years of experience in the field of quality improvement, medical record/health information administration, acute care, clinical documentation and/or coding preferred. 2 years of staff management experience required at minimum if past experience is complemented by experience in inpatient, outpatient, compliance, medical necessity, charge master coding quality improvement, or clinical documentation improvement.

  • 7 years in clinical documentation preferred
  • Be familiar with all government health care reimbursement systems
  • Familiarity with Quality Programs
  • Coding experience preferred


Required Licensure/Certification

RN: Must possess current licensure to practice as RN in State of Maryland or another state that participates in the Nurse Licensure Compact. or

PA: Must possess current licensure to practice as a PA by the Maryland Board of Physicians. Board certified by the National Commission on Certification of Physician Assistants (NCCPA) or

MD/DO: an active medical license is required; board certification preferred. Experience in Clinical Documentation Integrity strongly preferred.


Certified Clinical Documentation Specialist (CCDS) obtained through the Association of Clinical Documentation Improvement Specialists (ACDIS) and/or Certified Documentation Improvement Practitioner (CDIP) obtained through the American Health Information Management Association (AHIMA) highly preferred. Must obtain CCDS certification within 6 months of hire, if not currently certified.

Not Specified
Clinical Documentation Coordinator
Salary not disclosed
Las Vegas, NV 5 days ago

Clinical Documentation Coordinator

*THIS POSITION IS NOT REMOTE*

****MUST LIVE IN LAS VEGAS*******

Location: Las Vegas, NV

Employment Type: Full-Time

Work Model: Hybrid after 6-month probationary period


Benefits

  • Employer-Paid Pension
  • Health, Dental & Vision Insurance
  • Consolidated Annual Leave
  • Extended Illness (Sick) Bank
  • 457 Deferred Compensation Plan
  • Comprehensive Group Health Insurance
  • No Nevada State Income Tax
  • No Social Security (FICA) deduction


Position Summary

We are seeking a Clinical Documentation Coordinator to support accurate, complete, and compliant clinical documentation within an acute care inpatient setting.

The CDI Specialist will collaborate with physicians, nursing staff, coding professionals, and ancillary departments to ensure documentation reflects the severity of illness, risk of mortality, quality metrics, and reimbursement accuracy.

This position is open to qualified Registered Nurses, International Medical Graduates (Physicians), and Health Information Management professionals with required CDI certification.


Key Responsibilities

  • Conduct concurrent review of inpatient medical records to ensure accurate and complete clinical documentation
  • Identify documentation opportunities and initiate compliant physician queries
  • Ensure documentation supports appropriate MS-DRG, APR-DRG, and risk adjustment capture
  • Collaborate with Coding, Case Management, and Quality teams
  • Educate providers on documentation best practices and regulatory requirements
  • Monitor and improve key CDI metrics (query rate, response rate, agreement rate, CMI impact)
  • Maintain compliance with CMS and payer guidelines


ABSOLUTE MUST HAVE CERTIFICATION

  • Certified Clinical Documentation Specialist (CCDS)


Registered Nurse Pathway

Education & Experience

  • Graduate of an accredited school of nursing
  • Minimum 3 years of clinical nursing experience
  • Minimum 3 years of Clinical Documentation Improvement experience

Licensure

  • Active, unrestricted Nevada Registered Nurse license


Physician (International Medical Graduate) Pathway

Education & Experience

  • International Medical Graduate (MD)
  • Minimum 3 years acute care clinical experience
  • Minimum 3 years CDI experience


HIM / Coding Pathway

Education & Experience

  • Bachelor’s degree in Healthcare or related field (or equivalent experience)
  • Minimum 3 years Health Information Management experience in acute inpatient setting
  • Minimum 3 years CDI experience

Required Coding Certification (one of the following):

  • CCS
  • RHIT
  • RHIA
  • CPC
  • CPC-P


Why Join Us?

  • Collaborative, team-focused CDI environment
  • Opportunity to impact quality metrics and patient outcomes
  • Competitive compensation based on experience and credentials
Not Specified
Clinical Documentation Specialist SR (CDI)
Salary not disclosed
Tampa, FL 3 days ago

Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer.As the only National Cancer Institute-designated Comprehensive Cancer Center based in Fl orida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 10,000 who are shaping the future we envision.

Moffitt has been recognized as a Best and Brightest Company to Work for in the Nation, a Digital Health Most Wired Organization and continually named one of the Tampa Bay Time’s Top Workplaces. A National Cancer Institute (NCI)-designated Comprehensive Cancer Center since 2001.


Summary

Job Summary

Clinical Documentation Specialist SR


Position Highlights:

  • The Clinical Documentation (CDI) Specialist Senior is a responsible for facilitating the improvement in the overall quality and completeness of provider-based clinical documentation in the medical record by working directly with providers. This position is responsible for assisting treating providers to ensure that documentation in the medical record accurately reflects the severity of illness, risk of mortality, complexity of patient care, and hierarchal condition categories of the patient.
  • The Clinical Documentation Specialist Senior assesses clinical documentation through extensive medical record review, deployment of artificial intelligence, and collaborating directly with the providers to clarify the documentation to accurately and completely reflect the patients’ medical conditions. Extensive collaboration with physicians, mid-levels, nursing staff, other patient care givers to include developing and delivering education, which will be accomplished with on-site meetings, zoom meetings, telephonic discussions, rounding and email. This position will collaborate with the Health Information Management (HIM) coding staff and the Educators to ensure that appropriate reimbursement is received for the level of services rendered to patients, clinical information utilized in profiling and reporting outcomes is complete and accurate.
  • Additionally, the Clinical Documentation Specialist Senior is expected to function as a subject matter expert on the team and assist less experience team members in understanding and following operational policies. This role is responsible for training and onboarding new team members and participating in special projects assigned by the Mid Revenue Cycle leadership.


Responsibilities:

  • Reviews medical records for quality, completeness, and accuracy of documentation. Ensures that coded diagnoses accurately reflect level of patient care and patient status, including severity of illness and risk of mortality. Identifies gaps in documentation as well as conflicting or unspecified diagnoses and clarifies diagnoses with providers to assign the most accurate ICD 10CM/PCS code from the documentation. Must meet and maintain the quality and productivity measures established per polices.
  • Delivers ongoing education to providers through collaboration and communication via on-site meetings, zoom meetings, telephonic discussions, rounding, and email. Provides supplemental educational material and tools relative to documentation improvement practices for individual practitioners and groups of clinicians.
  • Identify and share documentation improvement opportunities with providers to capture the patient's accurate severity of illness and risk of mortality, comorbid conditions, and all other condition categories.
  • Develop clear, concise and compliant written and verbal queries to providers, seeking clarification on unclear, incomplete, or non specified documentation. Utilizes software system and the Natural Language Processor (NLP) to review, compile clinical indicators for provider collaboration, code, collect, track, and report outcomes accurately and timely.
  • Key Performance Indicators and additional significant metrics will be reported and discussed regularly, and as needed to the Medical Executive Committee via presentation to the Medical Records Committee and with other committees as directed
  • The Senior is expected to function as a subject matter expert on the team and assist less experience team members on following operational policies. It is responsible for training and onboarding new team members and participating in special projects assigned by the Mid Revenue Cycle leadership.


Credentials and Experience:

  • Associate’s Degree – field of study: Nursing, HIM or another Healthcare related field
  • A minimum six (6) years acute care clinical documentation experience
  • ICD-10-CM and ICD-10-PCS coding and query process knowledge
  • Ability to recognize opportunities for documentation improvement, and hold collaborative discussions with providers to address the opportunities in documentation.
  • Proficient in computer skills including: MS Office, Optum 360 eCAC, Cerner HER


Certifications:

  • (CCDS) Certified Clinical Documentation Specialists from ACDIS
  • (CDIP) Certified Documentation Integrity Practitioner from AHIMA
  • (CDEI) Certified Documentation Expert Inpatient from AAPC
  • Registered Nurse (RN) *in lieu of a certification listed above, an (active) RN will satisfy the certification requirement
Not Specified
Trainer, Revenue Integrity - Corp Rev Cycle Serv - Full Time (Remote)
🏢 Guthrie
Salary not disclosed
Sayre, PA, Remote 2 days ago
Summary:
The Trainer, Revenue Integrity is responsible for developing and delivering training programs that support accurate and compliant revenue cycle processes. This role ensures that staff across departments understand and adhere to revenue integrity standards, including coding, billing, documentation, and compliance requirements. The trainer collaborates with subject matter experts to create educational materials and evaluates training effectiveness to drive continuous improvement.
Experience:
- Minimum of 3-5 years of experience in healthcare revenue cycle, coding, billing, or compliance
- Experience in developing and delivering training programs
- Familiarity with CMS regulations, payer guidelines, and healthcare compliance standards
- Strong communication, presentation, and instructional design skills
Education:
- Bachelor’s degree in Healthcare Administration, Health Information Management, or related field (required)
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification (preferred)
Key Roles and Responsibilities:
1. Design and deliver training programs on revenue integrity topics including coding, billing, and documentation.
2. Assess training needs through surveys, audits, and performance data.
3. Develop educational materials such as manuals, presentations, and e-learning modules.
4. Conduct onboarding training for new hires and ongoing education for existing staff.
5. Collaborate with compliance and revenue cycle teams to ensure training aligns with current regulations.
6. Monitor and evaluate training effectiveness and make improvements as needed.
7. Maintain training records and documentation for compliance purposes.
8. Serve as a subject matter expert on revenue integrity practices.
9. Provide one-on-one coaching and support to staff as needed.
10. Stay current with industry trends, regulatory changes, and best practices in revenue integrity.
Other Duties:
1. Educating caregivers on functionality or workflow
2. Remaining current with industry standards and events that may significantly impact reimbursement.
Upload 9-22-25
Remote working/work at home options are available for this role.
permanent
Trainer, Revenue Integrity
🏢 Guthrie
Salary not disclosed
Sayre, PA 2 days ago
Summary:
The Trainer, Revenue Integrity is responsible for developing and delivering training programs that support accurate and compliant revenue cycle processes. This role ensures that staff across departments understand and adhere to revenue integrity standards, including coding, billing, documentation, and compliance requirements. The trainer collaborates with subject matter experts to create educational materials and evaluates training effectiveness to drive continuous improvement.
Experience:
- Minimum of 3-5 years of experience in healthcare revenue cycle, coding, billing, or compliance
- Experience in developing and delivering training programs
- Familiarity with CMS regulations, payer guidelines, and healthcare compliance standards
- Strong communication, presentation, and instructional design skills
Education:
- Bachelor’s degree in Healthcare Administration, Health Information Management, or related field (required)
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification (preferred)
Key Roles and Responsibilities:
1. Design and deliver training programs on revenue integrity topics including coding, billing, and documentation.
2. Assess training needs through surveys, audits, and performance data.
3. Develop educational materials such as manuals, presentations, and e-learning modules.
4. Conduct onboarding training for new hires and ongoing education for existing staff.
5. Collaborate with compliance and revenue cycle teams to ensure training aligns with current regulations.
6. Monitor and evaluate training effectiveness and make improvements as needed.
7. Maintain training records and documentation for compliance purposes.
8. Serve as a subject matter expert on revenue integrity practices.
9. Provide one-on-one coaching and support to staff as needed.
10. Stay current with industry trends, regulatory changes, and best practices in revenue integrity.
Other Duties:
1. Educating caregivers on functionality or workflow
2. Remaining current with industry standards and events that may significantly impact reimbursement.
Upload 9-22-25
Not Specified
Medical Assistant
✦ New
Salary not disclosed
Kissimmee, FL 1 day ago

Medical Assistant

Location: Kissimmee, FL

Schedule: Mon – Fri 8:00 AM – 5:00 PM

Pay Rate: $18-$20/hr

Dress Code: Plain blue or grey scrubs

Job Summary

We are seeking a certified Medical Assistant to join our team. You will be the primary point of contact for patients, ensuring they are prepared for examinations while supporting our physicians with accurate documentation and efficient clinical coordination. This role requires a blend of clinical skill, administrative accuracy (specifically with HEDIS and referrals), and exceptional customer service.

Detailed Daily Responsibilities

1. Patient Rooming & Clinical Preparation

  • Intake: Room patients according to established policies; take and record vital signs and prepare the patient for physical examinations or procedures.
  • Screening: Conduct in-person and telephone screenings, focusing on gathering objective data and intake information for the clinical team.
  • Emergency Response: Maintain a calm and effective demeanor during medical emergencies, following protocol to ensure patient safety.

2. Documentation & Administrative Coordination

  • EMR Management: Record all patient care activities in the medical record accurately and in real-time.
  • Referrals & Authorizations: Manage the end-to-end process for patient referral authorizations and Durable Medical Equipment (DME) requests.
  • Quality Reporting: Provide data tracking and reporting on HEDIS Measures to ensure the clinic meets quality-of-care benchmarks.
  • Coding: Utilize knowledge of ICD-10 and CPT coding to ensure accurate documentation and billing support.

3. Room Maintenance & Infection Control

  • Sterilization: Clean and sterilize medical instruments according to safety standards.
  • Stocking: Organize, clean, and restock exam and treatment rooms throughout the shift to ensure a seamless flow for physicians.
  • Infection Control: Strictly adhere to standard infection control precautions and HIPAA regulations regarding patient confidentiality.

Qualifications & Requirements

  • Education: High school graduate or GED equivalent.
  • Certification: Current Medical Assistant Certification (Required).
  • Experience: 1–2 years of customer service experience.
  • Technical Skills: Computer literacy is essential, including intermediate Excel skills for data tracking.
  • Medical Knowledge: Proficiency in medical terminology and a solid understanding of ICD-10 and CPT coding.
Not Specified
Clinical Research Associate
✦ New
Salary not disclosed
San Antonio, TX 1 day ago

Job Summary: Clinical Research Associates works under the direction of physician experts performing data research and document production activities on medical-legal cases. Duties include researching medical billing codes, conducting scientific literature reviews, sourcing cost data, analyzing medical cost/vendor surveys, and performing extensive quality control and proofreading.


About This Opportunity

The Clinical Research Associates begins by working within a designated pod alongside more tenured and experienced team members in higher roles. During this initial phase, the Apprentice provides research assistance on cases managed by senior staff members who carry higher caseloads. As the Apprentice gains experience and proficiency, they gradually transition to independently managing their own caseload of 7-10 active cases.


The Clinical Research Associates receives hands-on training in the company's proprietary Workflow and Information Management System (WIMS) while developing specialized knowledge in medical coding, cost analysis, and document production. As a downstream operations department, this role requires collaboration and communication with various departments across the organization to ensure the highest quality deliverables are completed.


This position requires the ability to work effectively in a fast-paced environment with strong multitasking skills and the ability to maintain composure and organizational clarity during high-pressure situations. Advanced Microsoft Office Suite proficiency, excellent proofreading abilities, critical thinking and problem-solving skills, attention to detail, and a firm commitment to meeting deadlines are essential. The role involves seven to eight hours per day of computer-based work, which may include prolonged sitting.


Essential Job Functions


Research & Analysis

  • Research medical billing codes (CPT, CDT, HCPCS, Anesthesia and MS-DRG) and assign them to medical procedures and services
  • Conduct scientific literature reviews and source healthcare cost data
  • Contact vendors to gather location-specific pricing information
  • Analyze medical cost surveys and perform cost calculations
  • Knowledge of CPT, CDT, HCPCS, Anesthesia and MS-DRG medical codes
  • Intermediate to Advanced knowledge of medical terminology, anatomy, physiology, and pharmacology


Case Management

  • Coordinate communication between internal staff and physician experts
  • Track case progress and keep management informed of project status
  • Ensure all work meets strict deadlines and quality standards
  • Critical thinking and problem-solving skills
  • Ability to thrive in a fast-paced, deadline-driven environment


Quality & Production

  • Perform quality control and proofread medical-legal documents
  • Master our proprietary Workflow and Information Management System
  • Apply methodological processes under physician direction
  • Maintain HIPAA compliance and patient confidentiality
  • Intermediate to advanced proficiency in Microsoft Office Suite (especially Word)
  • Strong grammatical and proofreading abilities
  • Excellent written and verbal communication skills
  • Typing speed of 40+ wpm


Education and Experience

  • Bachelor of Science in Biology and/or Chemistry, OR
  • Medical Billing and Coding Certification with 2+ years of professional medical office experience, OR
  • 2+ years of professional experience in a medical office or medically-related field


Preferred Qualification

  • Active CBCS certification (or willingness to obtain within first year)
  • Strong memory recall abilities
  • Team-first attitude and collaborative spirit
  • Ability to manage multiple priorities with efficiency


Work Schedule

  • 5 day/40-hour work week: Mon - Fri 8:30am - 5:30pm.
  • Overtime may be required and will be based on business needs.




Benefits

At Physician Life Care Planning, our employees enjoy benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), life insurance, paid time off program with paid holidays and various wellness programs. Additionally, our career path planning assists employees with their professional goals.


Work Environment

Physician Life Care Planning is a professional office setting. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.


Physician Life Care Planning’s Core Values

Commitment to Excellence, Superlative Expertise, Integrity, Ownership, Professionalism, Problem-Solving and Customer Centricity.


Physician Life Care Planning is an equal opportunity employer.


Confidentiality

Clinical Research Associates must adhere to Federal HIPAA Regulations and willing to sign a Confidentiality Agreement.

Not Specified
Hospital Revenue Recovery Analyst
✦ New
Salary not disclosed
Pittsburgh, PA 1 day ago

Company Description

Audley Law Offices, Partnered with Audley Recovery Solutions LLC, represents hospitals and health systems in complex reimbursement and revenue recovery matters. We specialize in resolving high-dollar, high-complexity claims involving payer denials, coordination of benefits (COB), delayed payments, and legally escalated recovery efforts. Our work sits at the intersection of hospital revenue cycle management and legal advocacy, requiring strong investigative and analytical skills to identify root causes of non-payment, interpret payer policy, and partner closely with providers to protect earned revenue through a patient-centered, professional, and compliance-driven approach. 


Role Description

The Revenue Cycle Analyst is responsible for independently managing and resolving complex hospital claims that require advanced analysis, payer engagement, and strategic follow-up. This role is designed for professionals with 3–5 years of hospital billing or revenue cycle experience who are comfortable working denials, appeals, COB issues, and escalations with minimal supervision.   This candidate will be groomed to be a liaison with leadership at health systems and Audley Revenue Solutions. 


Key Responsibilities 

Claim Resolution & Appeals

  • Manage a caseload of complex, high-value hospital claims involving denials, COB, and delayed reimbursement. 
  • Analyze EOBs, denial codes, payer correspondence, and hospital billing records to identify root causes of non-payment. 
  • Execute resolution strategies including appeals, resubmissions, escalations, and legal referrals. 
  • Communicate directly with payers, TPAs, patients, and legal representatives as needed. 
  • Track claim status and document all activity in internal systems and payer portals. 


Correspondence & Documentation 

  • Draft customized appeal letters, billing inquiries, and escalation correspondence. 
  • Prepare claim summaries and supporting documentation for attorney review. 
  • Maintain clear, accurate case notes and documentation in compliance with HIPAA and PHI standards. 


Client & Internal Coordination 

  • Provide claim updates and issue escalation support to hospital clients and internal leadership. 
  • Participate in reporting, reconciliations, and account reviews. 
  • Flag trends, recurring denials, or outlier claims requiring additional attention. 


Analysis & Process Improvement 

  • Identify coding, billing, or payer policy issues impacting reimbursement. 
  • Conduct cross-system reviews (EMR, payer records, patient information) to support appeal strategy. 
  • Contribute to workflow refinement, templates, and best practices. 
  • Support mentoring or knowledge-sharing with junior staff as needed. 


Required Qualifications

  • 3–5 years of experience in hospital billing, revenue cycle, or claims resolution. 
  • Proven experience handling denials, appeals, and payer follow-up beyond basic claim submission. 
  • Strong understanding of EOBs, denial codes, COB rules, and reimbursement processes. 
  • Excellent written and verbal communication skills. 
  • Strong organizational skills and attention to detail. 
  • Proficiency with Microsoft Word, Excel, Outlook, and PDF tools. 
  • Understanding of HIPAA and secure data handling practices. 


Preferred Qualifications 

  • Experience with hospital billing systems EPIC. 
  • Familiarity with payer portals (e.g., Availity, NaviNet, Medicare DDE). 
  • Working knowledge of ICD-10, CPT, and HCPCS coding. 
  • Experience supporting legally escalated claims or working with attorneys. 
  • Power BI or other metric platform knowledge a plus.  
  • PowerPoint presentation skills 

 


Why Join Us 

  • Work on challenging, non-routine claims that require critical thinking and strategy. 
  • Collaborate with attorneys, senior analysts, and hospital leadership. 
  • Be part of a team that values accuracy, professionalism, and accountability. 
  • Contribute directly to protecting hospital revenue and resolving complex payer issues. 


Not Specified
Senior Software Engineer
✦ New
Salary not disclosed

Job Summary:

The Senior Software Engineer is responsible for leading a team of software engineers in the design, development, and delivery of scalable, secure, and high-performance solutions across our core platforms including the Provider Portal, Staff Portal, Pharmacy Portal, and third-party integrations. This role combines hands-on technical leadership with people management responsibilities. The Team Lead oversees feature planning, estimation, and execution, ensures adherence to architectural standards and best practices, and mentors engineers to support professional growth and technical excellence. This position plays a critical role in driving delivery quality, fostering team collaboration, and aligning engineering initiatives with business objectives. This position reports to the Director of Engineering Operations (or equivalent engineering leadership role).


Job Responsibilities

• Lead, mentor, and manage a team of software engineers, providing clear direction, coaching, and performance feedback.

• Manage the successful completion of feature-level and release-level initiatives assigned to the team.

• Oversee sprint planning, estimation, and delivery to ensure commitments are met with high quality and predictability.

• Collaborate with Product, QA, Architecture, and Operations to translate business requirements into technical solutions.

• Contribute hands-on to the design, development, and review of full-stack features using .NET, Angular, Node.js, TypeScript, and SQL.

• Ensure adherence to development standards, coding best practices, and secure software development principles.

• Review code, provide constructive feedback, and maintain accountability for code quality and system performance.

• Partner with technical architects to establish scalable architectural patterns and implementation standards.

• Identify risks, remove blockers, and proactively address technical challenges.

• Support release planning and contribute to engineering roadmap discussions.

• Promote continuous improvement through process optimization, knowledge sharing, and adoption of emerging technologies.

• Foster a collaborative, accountable, and high-performing team culture.


Education

• Bachelor’s degree in Computer Science, Engineering, or related technical field preferred.

• Equivalent experience will be considered.


Experience

• 7+ years of experience in .NET and C# development

• 5+ years of experience with Angular, Node.js, and TypeScript

• 3+ years of experience in a technical leadership or team lead role

• Strong knowledge of SQL and relational database design

• Proficiency with ORMs such as Entity Framework

• Experience with Azure Kubernetes, Azure App Services, and Azure SQL or equivalent cloud platforms

• Experience with Agile and Scrum methodologies, including sprint planning and estimation

• Demonstrated full-stack development expertise

• Experience leading code reviews and enforcing development standards

• Experience contributing to system architecture and cloud-based application design


Skills

• Strong leadership and team development capabilities

• Advanced analytical and problem-solving skills

• Excellent written and verbal communication abilities

• Ability to balance hands-on development with leadership responsibilities

• Ability to manage multiple priorities in a fast-paced environment

• Strong understanding of secure coding practices and defensive programming techniques

• Ability to drive accountability and meet strict deadlines

• Commitment to delivering high-quality, maintainable software solutions

• Prior experience in the healthcare or health tech industry preferred

• Familiarity with HIPAA, SOC II, and healthcare data security standards preferred

• Experience with containerization, microservices, and RESTful API design preferred

• Experience with test-driven development (TDD) preferred


Physical & Technical Environment

• Ability to work at a desk in the office for long periods of time.

• The noise level in the work environment is moderate.

• Specific vision abilities required by this job include close vision and color vision.

• Ability to maintain focus under high levels of pressure/multiple priorities.

Not Specified
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