Franciscan Health

Solutions Engineer

• Responsible for designing and implementing enterprise-grade platform solutions
• Ensure reliable technical execution within Agile delivery
• Provide direction to engineering team members
• Lead solution design, implement complex workflows, integrations, and AI capabilities
• Monitor platform health and performance
• Provide technical leadership within Agile processes
• Align platform practices with governance and total cost of ownership goals
• Design complex, cross-functional automation solutions

Enterprise Solution Engineer

Auditor

• Collaborates with coding leadership and peers in the development and/or implementation of audit/monitoring plans.
• Evaluates prebill hospital inpatient coding compliance edits to ensure compliance with payer reimbursement methodologies and official coding guidelines.
• Summarizes quality review results for Coding Managers, Supervisors, Coding Educator, and coding staff.
• Participates in team meetings with coding personnel when necessary to discuss coding findings.
• Act as a subject matter expert regarding payer reimbursement methodologies and official coding guidelines.
• Provides details specific to audit trends to the Coding Educator for preparation of ongoing education.
• Notifies coding leadership of trends and topics for education and feedback to coders, physicians, and departments.

Coding Auditor – Hospital Inpatient Compliance Edits

Systems Engineer

• Design and implement CI/CD pipelines using Azure DevOps and GitHub Actions, including automated build, test, and deployment processes
• Collaborate with data and analytics teams to enable scalable CI/CD practices across Microsoft Fabric and Databricks environments
• Document and communicate CI/CD standards and practices; build adoption across engineering and analytics teams
• Maintain and continuously improve CI/CD pipelines and deployment processes across the data platform ecosystem

Data System Engineer III

Business Analyst

• Provide on-call support, including after-hours support, for team and customers following the Franciscan Alliance support model
• Collect information regarding potential system enhancement needs
• Troubleshoot and repair customer-reported application problems
• Work with vendors in implementing, upgrading, supporting and troubleshooting applications
• Follow organizational practices for incident, change and requests management
• Act as a Franciscan Alliance applications expert to assist with the creation of training programs
• Research, analyze, and present information regarding potential system enhancement needs
• Document and build workflow, standards, and business processes to facilitate knowledge sharing within and across teams
• Facilitate business user discussions to identify the requirements for Franciscan Alliance applications functionality and workflow
• Maintain and configure the application parameters to ensure Franciscan Alliance applications function according to customers’ specifications

Application Business Analyst II

Collections

• Ensure follow-up of claims on a timely basis and adhere to contractually binding conditions.
• Daily review denials and payment discrepancies identified on EOB, RA, or Payer Correspondence.
• Identify trends of denials, provide documentation and data and offer suggestions for process improvement to resolve issues.
• Review system work-list, report on a daily basis to resolve accounts, which have not been paid within 30 days of claim submission.
• Document activity in an accurate and timely manner on the patient account.
• Maintain follow up procedures and working relationships with departments such as HIM and/or Patient Access.
• Verify newly received status information and update the patient account.
• Ensure compliance with all state and federal billing regulations and report suspicious activities to the appropriate person.
• Work with the department on process improvements to create efficiencies and achieve overall goals.

Collections Specialist

Administration

• Administer the daily administration of 401(k), 403(b), 457(b), 457(f) and defined benefit plans
• Request benefit calculations from the plan actuary and prepare appropriate paperwork
• Inform prospective retirees about their Defined Benefit (DB) options
• Research plan overpayments, requests stop payment/reissues ACH reversals and follows up with participants or participant's survivor
• Research, communicate and complete cases in electronic case management system consistently within the Service Level Agreement assigned
• Educate active and inactive coworkers and beneficiaries on vesting, plan participation, payment options and other retirement details
• Provide support to business HR team members, coworkers, and retirees

Retirement Administration Specialist

Therapist

• Work across multiple Franciscan locations, supporting our hospitals and patients where your skills are needed most.

Travel Respiratory Therapist

Analyst

• Responsible for addressing coding related denials across Franciscan Alliance
• Monitors denial results and notifies Coding Leadership of any identified trends
• Develops and submits well-supported appeal letters related to coding denials utilizing excellent written and communication skills
• Reviews, researches, and responds to inquiries, denial management, and follow-up questions
• Reviews and processes claims and edits for accuracy and insurance and coding compliance
• Utilizes official coding guidelines and follows established policies and procedures
• Acts as a subject matter expert for coding, billing and payer edits and denials
• Assesses and ranks denials priority to align with Rev Cycle goals
• Collaborates with coding leadership, to improve key performance indicators through trending denials
• Coordinates timely response to denials

Coding Denial Analyst – Hospital Inpatient

Manager

• Develops and implements coding strategies and provides operational leadership to manage coding processes
• Supervises staff, prepares budgets and strategic plans
• Oversees quality assurance programs and ensures regulatory compliance
• Provides oversight and leadership to Coding Supervisors
• Manages performance of coworkers through coaching, feedback, and development
• Oversees auditing and education programs for coding practices
• Aligns coding operations with corporate initiatives and standards
• Participates in problem identification and develops solutions
• Creates an environment that maintains coworker satisfaction
• Acts as a nosologist for accurate translation of healthcare data
• Maintains expert knowledge of coding software tools and process improvements
• Manages departmental budgets and expenditures

Coding Manager

Billing Specialist

• Timely and accurate submission of insurance claims to third-party payers
• Document billing activity in the patient accounting system
• Review daily edit reports and make necessary corrections for submission
• Process re-bills as requested by collectors

• Plan, manage and direct the coordination of radiation oncology care with the knowledge, quality applicable under the standards and policies of Cancer Center
• Provide accurate radiation treatment to patients as prescribed by the radiation oncologist while also developing positive, trusting, caring and professional relationships with patients
• Prepare and set up equipment to ensure immobilization, protection and precise treatment
• Observe the patient’s progress throughout the course of radiation treatment

Radiation Therapist – Registry, Days

• Act as the liaison between clinic managers and Epic Cadence and Ambulatory teams to ensure communication is accurate related to the requested change or provider build requests.
• Act as the liaison between the Contact Center and clinic staff to ensure communication is standardized regarding scheduling changes and new scheduling guidelines.
• Arranges for new provider schedule builds and termination of providers to assist with scheduling accuracy, decrease scheduling errors, and data accuracy.
• Work with Epic Cadence/Radiant/Other teams to ensure providers or resources are assigned the correct visit types for their practice so reports and dashboards show accurate data.
• Optimize the automation of provider changes form to clinic managers to increase ease of communication and accessibility.

Access Optimization Analyst

Medical Billing and Coding

• Reviews and codes patient records in hospitalist rounds and office visits
• Determines when documentation should be utilized for appropriate assignment of ICD diagnosis codes
• Validates accurate representation of patient's clinical picture, treatment, and diagnoses
• Identifies when documentation relevant to the coding process is missing
• Meets defined coding accuracy standards and productivity standards
• Remains current with coding and industry changes through participation in educational opportunities

Hospital Outpatient Coder V – Surgery Observation

Claims Specialist

• Serves as point of contact for vendors and participants for concerns related to claims or billing.
• Performs customer service activities including, but not limited to, support and education to vendors during onboarding phase of partnership, communicating claim statuses to vendors, investigating vendor inquiries, and gathering information related to vendor claim appeals.
• Performs duties related to the timely and accurate adjudication of PACE participant medical claims. This includes data entry, processing manual and electronic claims, verifying proper authorizations, and processing claim denials.
• Ensures claims adhere to CMS rules, Medicare guidelines, and PACE-specific policies.
• Collaborates with the interdisciplinary team (IDT) to resolve discrepancies in authorizations or documentation.
• Conducts any necessary follow up with internal and external stakeholders.
• Assists with maintaining the vendor and provider network within the claims adjudication software. Builds and modifies vendor profiles as program’s vendor network changes. Ensures accuracy of vendor profiles in relation to reimbursement structure in vendor contracts, provider lists, W-9s, etc.
• Enters paper claims into claim adjudication software upon receipt.
• Supports Claim Specialist II in monthly EDPS reporting and error clearance. This includes, but is not limited to, reporting to regulatory agencies, clearing errors for resubmission of codes, and monthly auditing of EDPS return/output data.
• Prepares routine claim reports for review by leadership.
• Collaborates with PACE intake and eligibility team members to maintain accurate participant eligibility record in claim adjudication software, driving accurate and compliant claim payments.
• Assists with tracking vendor 1099s and gathering claims data for reinsurance reporting.
• Performs administrative tasks related to claims processing such as mailing vendor checks and remittance advice, mailing vendor notification letters, etc.
• Works closely with internal stakeholders, including finance, compliance, and clinical teams, to facilitate claims processing workflows. Partners with external stakeholders, such as CMS or third-party vendors, to ensure seamless claims operations.

Claims Specialist – PACE

• Completes appropriate goal re-assessment and discharge planning.
• Performs comprehensive physical therapy evaluations, treatment, and related follow-up services including discharge planning.
• Develops a treatment plan with measurable goals based on patient assessment.
• Collaborates with patient and other healthcare personnel or outside agencies regarding coordination of care.
• Documents patient assessments and pertinent information in a timely manner.
• Provides services and treatments requiring physical therapy skills according to the written plan of care and the signed plan of treatment.
• Supervises Physical Therapist Assistants and Home Health Aides.
• Provides physical therapy according to standards of care defined by the state practice act and other professional and governing agencies.
• Trains and educates patients and family members or others support and documents understanding of treatment plan and goals.