Reimbursement Form Jobs in Usa
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Job Title: Field Reimbursement Manager (FRM) – Remote with Territory Travel
Location: Remote – depends on candidate's location
Travel: Up to 80% (4 days/week) via automobile or air
Position Overview
We are seeking a Field Reimbursement Manager (FRM) to support access and reimbursement services for a specialty pharmaceutical product. In this client-facing, remote-based role, you will work directly with physician offices and manufacturer partners to resolve reimbursement challenges and deliver critical education on payer landscapes and available support services. The FRM acts as a trusted advisor and key liaison between healthcare providers, specialty pharmacies, and internal patient support services. This is a high-visibility, fast-paced role that demands a strong understanding of medical reimbursement, Medicare and commercial payers, and buy-and-bill or specialty pharmacy distribution models.
Key Responsibilities
- Field & Virtual Education (35%) - Deliver on-site or virtual training and education to healthcare providers and staff on reimbursement processes, including lunch-and-learns and scheduled presentations. Log all activity in CRM daily.
- Benefit & Access Education (25%) - Educate providers on benefit verification, prior authorization, payer trends, and support center services. Document and report all interactions as required by the client.
- Reimbursement Support (20%) - Assist offices with claims, billing and coding, appeals, medical benefit interpretation, and co-pay or patient assistance programs. Coordinate closely with case managers for resolution.
- Territory Management (10%) - Manage a schedule of outbound calls, appointment setting, and in-office follow-ups. Collaborate with manufacturer field teams to ensure seamless communication and data sharing.
- Program Performance Monitoring (10%) - Track territory metrics in CRM, analyze trends, and contribute to quarterly reporting and customer satisfaction feedback as needed.
Qualifications:
- Bachelor’s degree or equivalent experience
- 8+ years in healthcare reimbursement (Buy & Bill, Specialty Pharmacy)
- Knowledge of Medicare & commercial insurance
- Strong communication, customer service, and organizational skills
- Proficient with PowerPoint, CRM systems, and virtual meeting tools
- Valid driver’s license; must be able to travel up to 80%
Preferred Qualifications:
- Field reimbursement or specialty pharmacy experience
- Account management or pharmaceutical industry experience
Working Conditions:
- Remote/Work-from-Home (must reside within the assigned territory)
- Travel required up to 80% (valid driver’s license and clean MVR required)
Benefit offerings available for our associates include:
- Medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and a 401K plan
- Flexibility to choose the type of coverage that meets individual needs
- Eligibility for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
- The California Fair Chance Act
- Los Angeles City Fair Chance Ordinance
- Los Angeles County Fair Chance Ordinance for Employers
- San Francisco Fair Chance Ordinance
Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.
What We Offer:
- Competitive pay
- Exceptional benefits
- Generous Paid Time Off - start accruing on day one
- 401k with company match
- Paid maternity and paternity benefits
- Award-winning training and development
- Tuition Reimbursement
- Luxury work environment
- Meaningful and rewarding work
Vi at Bentley Village is located at 2315 Leisure Lane, Naples, FL 34110
Responsibilities:Clinical Reimbursement Manager - MDS RN
Full-Time Onsite Position
Collaborates with the DON, Clinical Reimbursement Specialist (where applicable) and various disciplines to complete the Minimum Data Set (MDS), Resident Assessment Instrument (RAI), and all associated processes. With guidance and oversight from the DON, the CRM ensures completion of the assessment within the timeframe as mandated by federal regulations and company policies. The CRM also manages the overall process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center. Responsibilities also include assisting with the coordination of the resident care planning processes. Performs other duties as assigned. This is a safety sensitive position.
Principal Accountabilities / Essential Job Functions:
• Reviews the clinical records, MD progress notes, therapy and nursing documentation in order to capture all care and services for optimal reimbursement.
• Ensures that participants in the assessment process complete an accurate and comprehensive assessment and collaborates with the Clinical Reimbursement Specialist (where applicable)or DON to address concerns.
• Tracks Medicare/Managed Care beneficiaries to determine continued and appropriate Medicare eligibility and benefit period by determining skilled level of need.
• Performs concurrent and ongoing MDS review to ensure appropriate PDPM category is achieved through the capture of appropriate clinical information.
• Manages the coordination of ICD-10 coding for Medicare and Managed Care billing.
• Directs the interdisciplinary team process to communicate opportunities to ensure capturing of all care, services, and diagnosis.
• Coordinates with rehabilitation services Program Director, Corporate Director of Clinical Reimbursement and Central Billing Office as needed to communicate case mix data required for accurate claim billing at month end.
• Reviews additional document requests by local Medicare Administrative Contractors, insurance carriers or auditors to ensure appropriate documentation is submitted timely for review.
• Encourages staff to report changes in the resident's status and involves the DON in addressing concerns.
• Confirms that residents and their families are actively involved in the information sharing and decision-making process.
• Completes resident assessment protocol documents within scope of practice.
• Assists with the completion of the resident care plan and the care plan conferences per requirements as requested by the DON.
• Provides resident and family education as needed.
• Identifies and reports deviations from safe practice to the DON. Adheres to policies and guidelines of regulatory agencies (i.e. OSHA, CMS).
• Manages emergency situations based on the Company’s safety and disaster policies.
• Communicates and collaborates with other members of the healthcare team to resolve resident care problems and to enhance care delivery.
• Participates in quality assessment/performance improvement activities and audits.
• Maintains minimum data set competencies and attends annual educational programs.
• Attends/participates in care center meetings, in-services and committee meetings.
• May perform CPR, use Automated External Defibrillator (AED), and render first aid in emergency situations.
Physical Requirements:
• Constant: Walking, must have the ability to operate in a constant state of alertness and in a safe manner.
• Frequent: Standing
• Occasional: Handling medical supplies and equipment, pushing up to 120 lbs.
• Seldom: Bending, crouching, pulling, reaching up to 36 in., lifting Residents (70 lbs. to 300 lbs.) with use of assistive device
Sensory Requirements:
• Balance, tactile, hearing, smelling, near, midrange, color and peripheral vision
Working Conditions:
• Regular on-site physical presence is required.
Qualifications:Key Competencies:
• Maintains a courteous and professional manner through interactions with others.
• Uses a resident and customer-focused approach to problem solving and goal setting.
• Uses discretion in handling confidential information, incorporating all Federal, State and local privacy and confidentiality requirements.
• Must possess knowledge of regulatory compliance and Continuing Care Retirement Community operations.
• Excellent knowledge of Case-Mix, and the Federal Medicare PPS process as required.
• Thorough understanding of the Quality Indicator Process, and OBRA regulations.
• Excellent oral and written communication skills and ability to interface and maintain effective relationships with all departments and employees in a team-oriented environment.
• Computer proficiency using Microsoft Office.
• Must be sensitive to the needs of older adults and enjoy working with a senior population.
Education and Experience:
• Education: Graduation from a School for Registered Nurses is required.
• Work Experience: Minimum 3 years of previous experience in an MDS/Clinical Reimbursement Nurse role is required.
• Licensure / Certification, where required: Current State Licensure as a Registered Nurse in the state where practicing is required. Current CPR and Automated External Defibrillator (AED) certifications are required. Current First Aid certification is required or must be willing and able to become First Aid certified. Food handlers certification, where required.
The application window is anticipated to close within 30 days of the date of the posting.
This position requires compliance with Florida’s Care Provider Background Screening process. Please see the Clearinghouse screening information here: Pay Range: USD $82,487.45 - USD $107,228.73 /Yr.
Hospice Reimbursement Group, a division of Medical Services of America Inc., is currently seeking experienced Full-Time Hospice Reimbursement Specialist for our corporate office in Lexington, SC.
MSA offers competitive pay and excellent benefits
- 40 hours paid time off during the first year of employment
- Medical, Vision & Dental Insurance
- Company paid life insurance
- 401(k) retirement with a generous company match
- Opportunities for advancement
- Other great benefits
This person will be responsible for submitting and re-billing claims
- Submits claims for all pay sources and locations as assigned.
- Tracks reasons for unpaid claims and re-bills claims as necessary.
- Files electronic and/or written appeal requests in a timely manner.
- Works with locations to resolve any issues that may affect billing.
Job Requirements
- High School Diploma or General Education Degree (GED) required.
- Previous hospice reimbursement experience preferred.
- Previous medical office billing/collection experience preferred.
MSA is an Equal Opportunity Employer
About Us
At Casago Smoky Mountains, we create exceptional guest experiences across premium short-term rental properties in East Tennessee. We’re professional, proactive, and proudly personal. As one of the fastest-growing vacation rental management companies in East Tennessee, we combine the energy of growth with a strong commitment to structure, service quality, and team support. As part of the national Casago network, we blend cutting-edge technology with deep local knowledge to deliver exceptional guest experiences and strong returns for property owners.
Position Overview
We're seeking a creative, energetic, and results-oriented marketer passionate about short-form video content to join our local team. You'll ideate, shoot, edit, and publish engaging TikToks, Instagram Reels, and YouTube Shorts on a near-daily basis to highlight our stunning Smoky Mountain properties, seasonal adventures, guest stories, and owner benefits. Your content will directly drive traffic and conversions to our websites: boosting direct guest bookings (to reduce reliance on OTAs) and generating leads from potential property owners interested in our management services. This on-site role allows you to film authentically in the mountains, collaborate closely with our team, and respond quickly to trends or opportunities.
Key Responsibilities
- Develop and execute a high-volume short-form video calendar (5–7+ posts/week across TikTok, Instagram Reels, YouTube Shorts)
- Shoot vertical video content on-location at our cabins (interiors, hot tubs, mountain views, fireplaces), local attractions (hiking trails, fall colors, Dollywood, wildlife), guest experiences, and owner testimonials
- Edit videos with trending audio, captions, text overlays, effects, and strong CTAs linking to our booking site and owner inquiry forms
- Optimize posts with Smokies-specific hashtags (#SmokyMountainsCabins #GatlinburgGetaway #PigeonForgeVacation #CasagoSmokies), geotags, and SEO-friendly captions to maximize reach and traffic
- Analyze performance metrics (views, engagement, link clicks, website referrals via Google Analytics) and refine strategies for better ROI
- Support integrated digital efforts: assist with paid social ads (Meta, TikTok), website content updates, email campaigns, and listing optimizations
- Engage with our community: monitor comments/DMs, encourage user-generated content from guests, and run local promotions/contests
- Report weekly on KPIs: follower growth, social engagement, website traffic from social channels, direct booking increases, and owner leads generated
Qualifications & Skills Required:
- Proven track record creating and producing short-form videos (TikTok/Reels/Shorts) with strong engagement or viral potential
- Hands-on video shooting and editing experience (CapCut, InShot, Premiere Rush/Pro, or similar tools); comfortable filming outdoors/in natural settings
- Deep familiarity with social media trends, algorithms, and best practices for travel/hospitality content
- Working knowledge of digital analytics tools (Google Analytics, Meta Business Suite, TikTok Analytics) and link tracking
- Passion for the Smoky Mountains – local knowledge of the area (attractions, seasons, hidden gems) is essential for authentic content
- Experience or understanding of the vacation rental industry (Airbnb, Vrbo, direct bookings, property management) preferred
- Self-motivated with strong organization to meet regular posting deadlines
- Bonus: Experience with paid ads, SEO, email tools (e.g., Klaviyo), graphic design (Canva), or photography
- Must live in or be willing to relocate to the Sevierville/Gatlinburg/Pigeon Forge area (reliable transportation required for on-location shoots)
What Success Looks Like:
- Steady growth in social followers, engagement, and virality
- Measurable increases in website traffic, direct bookings, and owner inquiries from social channels
- Content that strengthens Casago Smoky Mountains' local brand as the go-to for authentic, high-quality Smokies vacations
Why Join Casago Smoky Mountains?
- Be part of a growing, locally-owned team in one of America's top vacation destinations
- Daily inspiration from the mountains – film in real cabins and explore the Smokies for content
- Direct impact on business growth in a competitive, high-demand market
- Competitive salary + performance bonuses tied to traffic/bookings/leads
- Perks like access to properties for inspiration, local experiences, and collaborative team environment
To apply: Send your resume, links to your TikTok/Instagram/YouTube portfolio (short-form video examples), and a brief note on why you're excited to market Smoky Mountains rentals with Casago – on-site in Sevierville! Email to
Schedule & Work Location
- Status: Full-Time (40 hours per week).
- Work Model: Hybrid / Remote.
- Location Requirement: Must live locally within the East Tennessee area.
- Some weekday flexibility may be available based on operational needs and coverage planning; however, core schedule coverage is required.
Benefits
- $45,000 salary
- Paid Time Off (vacation, sick days, holidays).
- Health insurance and retirement savings options.
- Opportunities for career growth and professional development.
How to Apply
If you’re passionate about delivering excellent guest experiences while understanding the importance of operational performance and business results, we’d love to hear from you. Submit your application and resume to
Equal Opportunity & Employment Disclosures
Casago Smoky Mountains is an Equal Opportunity Employer. Employment is at-will in accordance with Tennessee law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.
Pay: From $45,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- Work Location: Hybrid remote in Sevierville, TN 37862
The Salaried Home Health Weekend Registered Nurse is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries.
Full-time hours Friday - Monday visits Madison, WI Metro and the surrounding communities
Salaried opportunities up to $105,000 base plus mileage, on-call pay, and a $10,000 sign on bonus
Essential Job Functions:
- Develop a plan of care through physician orders, client input, and nursing assessment to include medical interventions and measurable goals and outcomes.
- Educate clients and their family members based on client’s specific needs.
- Properly orient and train primary caregivers to ensure the most optimal functioning level for each client.
- Coordinate the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.
Aveanna Healthcare Offers:
- 401(k) with match
- Health, Dental and Vision Benefits
- Tuition Discounts and Reimbursement
- PTO, Sick Time, and Paid Holidays
Requirements:
- An active RN License in the state of application'
- Valid CPR
Preferred:
- Medicare Skilled Nursing experience
- Basic understanding of Oasis
- 1-year RN experience in a health care setting
HHH
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
Notice for Job Applicants Residing in California
Notice for Job Applicants Residing in Florida
At MercyOne, we care deeply about your well-being—both physical and mental. That’s why we offer a comprehensive benefits package designed to support you in every stage of life. Here’s an overview of what you can expect:
Health and Wellness
Personalized Health Insurance Plans: Including dental and vision coverage, available to you from Day 1.
Wellness Programs: Designed to help you maintain a healthy lifestyle.
Life Insurance Coverage: Providing peace of mind for you and your loved ones.
Financial Security
Education Reimbursement: Supporting your professional growth and development.
403b Retirement Plan with Company Match: Helping you plan for a secure future.
Time Off and Flexibility
Paid Time Off (PTO) Accrual: Begin earning PTO from Day 1.
Six Paid Holidays: Enjoy time to rest and recharge.
Long- and Short-Term Leave Options: Supporting you during life’s unexpected events.
We’re committed to providing benefits that meet your needs and enhance your quality of life. Join us and experience a workplace that truly values you!
**This position is eligible for relocation depending on location**
Shift: Days with Call
Essential Functions:
Administers nursing care to patients; included assessment, planning, implementing, and evaluating the patient’s care plan in coordination with the physician during imaging procedures. Transports patients and gives appropriate reports to ancillary areas.
Provides care to neonate, pediatric, adolescent, adult, and geriatric patients.
Interacts with patients, both pre and post invasive procedures for history, instructions/teaching, and post procedure follow-up. Provides patient/family or caregiver education and counseling in recognition and solution of physical, emotional, and environmental health problems.
Responsible for all medical supplies/equipment being available and in proper working condition in the department including EKG monitors, crash cart, medications (routine, emergency, narcotics), suction, O2 , Ambu bags, airways, E.T. tray and other related supplies in the Medical Imaging Department.
Minimum Qualifications:
Possession of a current or compact state licensure as a registered nurse issued/defined by the State of Iowa
Proof of completion of Mandatory Reporter
Child and/or Dependent Adult Abuse training within three (3) months of hire
American Heart Association Basic Life Support (BLS) for Healthcare Providers certified within six (6) weeks of hire
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Position Details
Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.
Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.
Active - Benefit Eligible and Accrues Time Off
Work Hours per Biweekly Pay Period: 80.00
Shift: Flexible Hours and/or Flexible Schedule
Location: 210 South Florida Avenue Lakeland, FL
Pay Rate: Min $19.37 Mid $24.22
Position Summary
Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.
Position Responsibilities
People At The Heart Of All That We Do
- Fosters an inclusive and engaged environment through teamwork and collaboration.
- Ensures patients and families have the best possible experiences across the continuum of care.
- Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
Safety And Performance Improvement
- Behaves in a mindful manner focused on self, patient, visitor, and team safety.
- Demonstrates accountability and commitment to quality work.
- Participates actively in process improvement and adoption of standard work.
Stewardship
- Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
- Knows and adheres to organizational and department policies and procedures.
Standard Work Duties: Coder II - Outpatient
- Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding
- Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment.
- Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement.
- Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers.
- Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
- Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
- Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
- Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily.
- Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
- Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
Competencies & Skills
Essential:
- Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
- Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision.
- Knowledge of anatomy and physiology, pharmacology, and medical terminology.
Qualifications & Experience
Essential:
- High School or Equivalent
Nonessential:
- Associate Degree
Essential:
- High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.
Other information:
Certifications Essential: CCS
Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Experience Essential:
2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.
Position Details
Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.
Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.
Active - Benefit Eligible and Accrues Time Off
Work Hours per Biweekly Pay Period: 80.00
Shift: Flexible Hours and/or Flexible Schedule
Location: 210 South Florida Avenue Lakeland, FL
Pay Rate: Min $24.73 Mid $30.92
Position Summary
Under the direction of the Coding and Clinical Documentation Improvement Manger , reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, physician advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract, Participates in ongoing continued education to assure knowledge and compliance with annual changes.
Position Responsibilities
People At The Heart Of All That We Do
- Fosters an inclusive and engaged environment through teamwork and collaboration.
- Ensures patients and families have the best possible experiences across the continuum of care.
- Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
Safety And Performance Improvement
- Behaves in a mindful manner focused on self, patient, visitor, and team safety.
- Demonstrates accountability and commitment to quality work.
- Participates actively in process improvement and adoption of standard work.
Stewardship
- Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
- Knows and adheres to organizational and department policies and procedures.
Standard Work Duties
- Determines whether the coding assigned was properly assigned based upon clinical indicators and review of the medical documentation and application of coding guidelines.
- Develop and apply appeal arguments to defend the coding and clinical decisions while being able to address and refute the coding determination made by the carrier/payer.
- Drafts appeal letters, including the coding argument with clinical and coding references, to support the coding decision. This may include providing additional medical record documentation.
- Identifies areas for education to improve complete and accurate coding and billing and provide feedback to management regarding trends or patterns noticed in the coding for discussion.
- Continued follow-up on denials as payers may continue to deny. Collaboration with Physician Advisor as required to continue appeal process.
- Continuously reviews changes in coding rules and regulations including in Coding Clinic, CMS, and other payer guidelines.
- Complete denials/appeals reports for leadership.
- Documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.
- Assigns and sequence documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.s diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines.
- Performs special projects and/or other duties as assigned.
Competencies & Skills
Nonessential:
- Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
- Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision
- MS-DRG and APR-DRG methodology expertise required. Strong knowledge of ICD-10-CM, ICD-10-PCS, POAs, HACs, PSIs, SOIs, ROMs and mortality rates as well as physician queries.
Qualifications & Experience
Nonessential:
- Associate Degree
Essential:
- High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.
Other information:
Certifications Essential: CCS
Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Experience Essential: 2-5 years acute care hospital inpatient coding experience within the past five years.
Glassman Media is seeking a senior-level producer to oversee a premium short-form cooking + wellness project rooted in mindful, plant-based cuisine and a calm, intentional approach to eating and daily ritual. The series is designed as a channel ecosystem (not a single show) made up of multiple recurring episode formats (4–6 minutes each), blending food, lifestyle, and wellness storytelling.
This role is ideal for a producer with strong creative instincts, an elevated doc sensibility, and the ability to oversee dynamic, cinematic food storytelling — beautiful, tactile cooking sequences, visually rich ingredient moments, and a premium look and feel — while still executing efficiently with lean crews and fast turnarounds.
RESPONSIBILITIES
- Oversee the project from development through production and delivery
- Help shape the creative direction and break the series into multiple short-form episode types, including:
- Guided “reset” episodes with real people looking to improve everyday habits
- Recipe-driven cooking episodes featuring simple, accessible techniques
- Mindfulness segments centered on breath, stillness, and conscious eating
- Ingredient + sourcing features (seasonal, local, nature-forward storytelling)
- Oversee the cinematographer on set to ensure the cooking, gardening/ingredient, and meditation segments are shot with a rich, elevated, premium look and feel
- Lead story development with the talent and families already cast and vetted, shaping emotional + practical arcs across episodes
- Bring exceptional skill guiding real people through a meaningful on-camera journey — capturing authenticity while keeping scenes focused, elevated, and story-driven
- Run production logistics, including schedules, crew planning, field coordination, and on-set leadership
- Manage post workflow with strong editorial notes to ensure pacing, tone, and consistency across formats
- Work in-office 5 days a week when not filming to support development, planning, and post-production collaboration
- Bring strong taste level and editorial instincts (premium doc/food sensibility a major plus)
Kelly® Science & Clinical is seeking a Process Engineering Manager for a direct hire opportunity with one of our clients, a leading small molecule CDMO at their Colorado Springs, CO facility. If you’re passionate about bringing the latest scientific discoveries to life and are ready to take the next step in your career, trust The Experts at Hiring Experts.
Workplace: Onsite in Colorado Springs, CO
Position Title: Process Engineering Manager, Oral Dosage Forms
Position Type: Direct hire
Salary: $125,000-140,000
Are you ready to drive innovation and success in pharmaceutical manufacturing? We are seeking a dynamic Principal Investigator to serve as a technical authority in process development, scale-up, and technology transfer. If you thrive in collaborative, fast-paced environments and are passionate about advancing life-changing therapies, this is your opportunity to make a significant impact.
Responsibilities
Strategic Process Development & Scale-Up
- Spearhead the development and scale-up of robust, scalable manufacturing processes across a wide spectrum of drug products
- Design and lead process characterization and optimization studies, defining critical process parameters and proven acceptable ranges
- Champion Quality by Design (QbD) strategies and advanced statistical methodologies, ensuring seamless progression from laboratory concepts to pilot-scale execution
Technology Transfer Leadership
- Serve as the technical lead for all technology transfer activities, bridging R&D, global manufacturing sites, and client partners
- Develop and implement comprehensive transfer protocols and process equivalence strategies to ensure flawless execution
- Lead high-performing, cross-functional teams through knowledge transfer, process mapping, and documentation best practices
Pilot Plant & cGMP Operations Management
- Oversee cGMP-compliant pilot plant operations, supporting clinical and commercial production, validation, and process improvement
- Drive continuous improvement projects—maximizing efficiency, quality, and yield
- Provide expert troubleshooting and manage deviations, ensuring on-time project delivery
Capital Projects & Facility Optimization
- Lead equipment qualification and validation for cutting-edge process installations
- Direct facility expansion and modification projects to support innovation and new technology implementation
- Optimize facility workflows to enhance operational excellence and scalability
Quality Assurance & Regulatory Compliance
- Ensure strict adherence to cGMP (21 CFR 210/211) and data integrity (21 CFR 11) regulations
- Develop and execute robust process validation strategies in accordance with global regulatory standards
- Lead investigations, implement corrective/preventive actions, and maintain perpetual audit readiness
Project Management & Client Engagement
- Manage multiple, high-profile client technology transfer programs—delivering on time and within budget
- Serve as the primary technical liaison for clients, providing strategic insight and technical guidance
- Develop detailed project plans, risk assessments, and contingency strategies to de-risk tech transfer activities
- Mentor cross-functional teams, fostering a culture of excellence and innovation
Qualifications
Education:
- Bachelor’s degree in Engineering, Pharmaceutical Sciences, or related field; advanced degree (MS/PhD) preferred
Experience:
- 8+ years’ experience (Bachelor’s), 5+ years (MS), or 3+ years (PhD) in pharmaceutical process development, technology transfer, and scale-up within a CDMO or CRO environment
- Demonstrated success managing complex, cross-functional projects in a regulated setting
Technical Mastery
- Deep expertise in pharmaceutical process engineering, manufacturing technologies, process validation, and equipment qualification
- Comprehensive understanding of cGMP, quality systems, and regulatory compliance
- Proven skills in process automation, risk management, and project execution
Leadership & Collaboration
- Recognized leadership in guiding technical teams and cross-functional project groups
- Outstanding client relationship management and communication abilities
- Strategic thinker with a results-driven mentality, adept at navigating complex challenges and inspiring teams
Why Join Us?
- Work alongside industry leaders and innovators
- Participate in high-impact projects accelerating life-saving therapies to market
- Competitive salary, comprehensive benefits, and opportunities for continued professional growth
What happens next:
Once you apply, you’ll proceed to the next steps if your skills and experience look like a good fit. But don’t worry – even if this position doesn’t work out, you’re still in our network. That means our team of expert Science & Clinical recruiters will have access to your profile, making your opportunities limitless.