e4health

Medical Billing and Coding

• responsible for accurately abstracting data into appropriate client electronic medical record systems
• following the Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding
• Performs data entry of required abstracted patient information into the client’s information system
• Queries physicians when appropriate and interact with Clinical Documentation staff as per account requirements
• Maintains consistent coding accuracy rate of 95% or better while also meeting productivity standards
• Assigns appropriate ICD-10-CM, E/M, CPT, HCPCS codes and modifiers to professional fee accounts as per designated workflow
• Abstracts and enters coded data and/or charges for physician statistical and reporting requirements
• May assign/validate professional fee level of service based upon either 95 or 97 Evaluation and Management Guidelines
• Queries physicians to clarify conflicting, imprecise, incomplete, ambiguous, and/or inconsistent clinical information when appropriate
• Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution
• Communicates with Clinical Documentation Improvement and/or Revenue Cycle teams for follow up and reconciliation of accounts
• Maintains required productivity and quality requirements
• Maintains coding credential requirements

Professional Fee Coder

Analyst

• Support critical Epic MRT testing activities
• Lead testing, validation, and troubleshooting of laboratory medical device integrations supporting Epic Beaker and Epic MRT initiatives
• Configure, support, and optimize Data Innovations Instrument Manager (DI) interfaces
• Collaborate with laboratory operations, Epic Beaker teams, application analysts, and technical teams
• Execute and support integration, workflow, and end-to-end testing activities
• Analyze, troubleshoot, and resolve connectivity, mapping, and result transmission issues

CP and DI Analyst

Systems Engineer

• Lead the implementation, optimization, and management of financial application systems
• Drive improvements in revenue cycle management
• Develop and execute strategic initiatives to enhance revenue cycle workflows and systems
• Collaborate with management to align IT strategies with goals
• Lead implementation of new revenue cycle technologies and initiatives
• Ensure systems meet regulatory requirements and data security standards
• Analyze current patient access processes and identify opportunities for improvement

Financial Systems Analyst – Senior

• Plan and control clinical system analysis and development for assigned area
• Serve as Project Leader on major projects
• Provide technical support, assistance and information to users

Clinical Analyst II

Consultant

• Provides routine support and maintenance support to current production, and non-production, applications as assigned
• Identifies, analyzes, and resolves data and system issues of advanced complexity
• Gathers requirements, develops specifications, prepares, and reviews documentation
• Develops, validates, and executes comprehensive test plans
• Communicates effectively, negotiates changes, and assists in prioritization of tasks with client
• May be considered the Subject Matter Expert in their area of application or domain
• Provide knowledge transfer and mentoring to team members as necessary
• Understands and complies with all enterprise and IS departmental information security policies, procedures, and standards
• Works with key project team members to define requirements, design the functional solution, identify and resolve project issues, and ensure the IT solution meets requirements
• Builds positive relationships with business operations, IT&S leadership, and vendors
• Documents requirements defines scope and objectives, and formulates systems to parallel overall business strategies

Epic Certified Consultant

Auditor

• The Outpatient Auditor is responsible for completing quality assurance reviews on internal and/or external outpatient coding specialists or external providers
• This role involves validating the coding specialist is accurately abstracting data into appropriate client electronic medical record systems
• Responsible for reporting quality results, tracking educational opportunities, and providing educational support and training

Outpatient Auditor – SMART Reviewer

• The Inpatient Coder is responsible for accurately abstracting data into appropriate client electronic medical record systems
• Follows the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding
• Performs data entry of required abstracted patient information into the client’s information system
• Assigns Present on Admission (POA) indicators according to AHA POA guidelines
• Queries physicians when appropriate and interacts with Clinical Documentation staff as per account requirements
• Maintains consistent coding accuracy rate of 95% or better while also meeting productivity standards

Inpatient Coder

• Reviews medical records as assigned for appeal writing
• Adheres to guidelines as set forth by ACDIS, AAPC, and AHIMA
• Maintains strict confidentiality of all patient information in accordance with HIPAA
• Works closely with the client, co-workers and management to meet the specific needs of each assignment in alignment with e4health core values
• Effectively utilizes computer software based on the specific client requirements

CDI Appeal Consultant

Program Manager

• Direct enterprise-wide Cerner Millennium implementation and optimization programs
• Develop and manage program governance structures, roadmaps, and strategic objectives
• Lead cross-functional delivery teams including clinical informatics, technical analysts, architects, trainers, and project managers
• Ensure alignment between organizational goals and EHR transformation initiatives
• Oversee multiple concurrent workstreams and interdependencies
• Collaborate with executive leadership, physicians, nurses, operational leaders, and IT leadership
• Facilitate steering committees, governance meetings, and executive reporting
• Manage vendor and consulting partner relationships
• Provide subject matter expertise across Cerner Millennium modules including, clinical and revenue cycle applications
• Lead workflow redesign and clinical transformation efforts
• Oversee application build, integration, testing, cutover, and go-live activities
• Support system optimization and post-implementation stabilization
• Manage program budgets, forecasting, contracts, and resource allocation
• Monitor KPIs, project health metrics, and implementation milestones
• Ensure compliance with healthcare regulations, security, and data governance requirements
• Develop risk mitigation and contingency plans
• Drive organizational readiness and adoption strategies
• Oversee training, communication, and end-user engagement initiatives
• Lead process improvement and workflow standardization activities
• Support long-term operational sustainability and continuous improvement

• Review medical records as assigned for complete and accurate documentation of all relevant diagnoses and procedures
• Providing ad-hoc support to Customer leadership regarding current CDI processes and practice not limited to attending customer meetings and sharing insights via CDI metrics
• Identify missed documentation opportunities within medical records as previously reviewed or not reviewed by other Clinical Documentation Integrity Specialist
• Evaluate queries from a compliance perspective to determine if there are any areas of risk, using ACDIS/AHIMA Practice Brief as the standard
• Assess adherence to Customer specific CDI processes/procedures
• Adhere to guidelines as set forth by ACDIS, AAPC, and AHIMA
• Demonstrate understanding of the business of healthcare: MS and APR DRG payer issues, audit risks, documentation opportunities, POA, quality metrics, hierarchical condition categories, and various risk adjustment methodologies
• Work closely with the Customer, co-workers, and management to meet the specific needs of each assignment in alignment with core values
• Effectively utilize computer software based on the specific Customer requirements
• Provide constructive feedback to other CDI Auditors
• Maintain strict confidentiality of all patient information in accordance with HIPAA

Senior Consultant

Project Manager

• Oracle ERP Project Management experience is required along with familiarity with finance and supply chain management
• Knowledge and experience in overall Project Methodology in the creation of the project plans, defining schedules and managing budget limitations
• Defines required roles and tasks, as well as standard PMI PMBOK project management activities
• Develops weekly status reports and modifies schedules
• Work with client team to manage and achieve program and project level goals
• Explore and summarize health system data to provide insight for strategic decisions
• Plans, manages, and coordinates project activities to ensure goals and objectives of multiple and large projects are accomplished within prescribed time-frame and funding parameters
• Establishes timelines and ensures project deadlines are met
• Maintains integrity and cost containment of projects
• Plans, manages, and coordinates projects and ensures project initiatives and timelines are met
• Liaise with service lines and technical teams to translate complex business and technology specifications into relatable concepts to expedite communications and project execution
• Develops project initiation process by defining project scope, determining action items, assigning ownership, creating project timetables, and tracking execution and workflow; prepares, presents and distributes project status reports
• Evaluates, plans, and monitors project implementation for clinical systems; manages project and project delivery teams, ensures deadlines are met, escalates issues for appropriate, timely resolution and adheres to standardized project management methodologies
• Develops interdisciplinary project teams in coordination with clinical community to ensure deployment of systems; serves as liaison to project sponsors, project teams and stakeholders; works with internal, external groups to optimize success of project deployment
• Communicates with user departments and project teams on project activities; confers with project staff and vendors to provide support and resolve problems; collaborates with clinical, financial and quality teams to define and develop metric goals
• Partners with management to develop tools and metrics to evaluate performance of target initiatives; assists with planning monitoring criteria and methodology
• Ensures availability of performance measurement data for review and analysis; evaluates and drives risk management process improvements, efficiencies and workflow enhancements
• Partners with management, identifies end user education, training program and services; assists in the development and maintains department policies and procedures
• Provides subject matter expert support in the development of clinical information systems and integration to improve the timely completion of projects
• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action
• Recommends innovative ideas, processes, and/or procedures for enhancements, additions, and modifications to improve existing systems
• Work with other members of the team to implement solutions to meet business operation needs

Oracle ERP Project Manager

• Guide clients through current workflows, upgrades, system changes and enhancements and ongoing system maintenance
• Act as primary consultant for the client's solution troubleshooting, consultation and knowledge transfer
• Cultivate and sustain relationships with clients to provide appropriate escalation of issues, solution knowledge and engagement support
• Resolve escalated problems and issues using solution knowledge and expertise
• Collaborate with business owners and key stakeholders to define requirements and solutions
• Works with key project team members to define requirements, design the functional solution, identify and resolve project issues, and ensure the IT solution meets requirements
• Builds positive relationships with business operations, ITS leadership, and vendors
• Provide routine support and maintenance support to current production, and non-production, applications as assigned
• Documents requirements defines scope and objectives, and formulates systems to parallel overall business strategies
• Provide knowledge transfer and mentoring to team members as necessary

Senior HIM Consultant

Manager

• Lead coding quality and education teams of hospital, professional fee and global coding auditors
• Evaluate and revise policies and procedures as needed to ensure quality coding
• Develop and provide education to internal coders and providers as needed.
• Ensure team members are educated on coding concepts and coding software
• Review, evaluate and educate coding team members and providers on updated rules and regulations related to coding
• Collaborate with coding and CDI operation managers on coding topics and guidelines
• Track, rend and advise on outcomes of coding audits and needs for coder or provider specific education.
• Research denial trends related to coding

Manager – Coding Education, Quality

• The Outpatient Coder is responsible for accurately abstracting data into appropriate client electronic medical record systems
• Following the Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding, AMA CPT Guidelines, and CMS directives
• Performs data entry of required abstracted patient information into the client’s information system
• Queries physicians when appropriate and interacts with Clinical Documentation staff as per account requirements
• Maintains consistent coding accuracy rate of 95% or better while also meeting productivity standards

ED Coder – Single Path

• Accurately abstracting data into appropriate client electronic medical record systems
• Assigning appropriate ICD-10-CM, E/M, CPT, HCPCS codes and modifiers to professional fee accounts
• Performing data entry of required abstracted patient information into the client’s information system
• Maintaining consistent coding accuracy rate of 95% or better while also meeting productivity standards