OU Health

Insurance

• Perform pre-registration and insurance verification for inpatient and outpatient services.
• Follow scripted benefits verification and pre-certification format in the EMR and document results.
• Contact patients to confirm or obtain missing demographic information, quote/collect patient cost share, and provide appointment instructions.
• Assign insurance plans accurately and perform electronic eligibility confirmation.
• Complete Medicare Secondary Payor Questionnaire as applicable.
• Calculate patient cost share and arrange payment or collection via phone.
• Research patient visit history to ensure compliance with payor-specific rules (e.g., Medicare 72-hour rule).
• Communicate with physicians and case managers to resolve authorization or referral issues.
• Document benefit and authorization information in the standard EMR screens and notes as needed.
• Implement system downtime procedures when necessary.
• Practice and adhere to the organization’s Code of Conduct and Mission and Value Statement.

Insurance Verifier

Architect

• The individual in this role will lead key vendors, application teams, infrastructure teams, and project/product managers to develop and carry out test plans for a variety of clinical and business applications including but not limited to implementations, optimizations, system upgrades, and pre- and post-patching.
• Defining OU Health ETS testing strategy, develop and mature the OU Health testing methodologies, including identifying and implementing automation tools to improve operational efficiencies.
• Lead a regular review of processes for script development, defect tracking, logistics and resources for all testing efforts and perform general project management of testing activities.

Testing, Quality, Release Management Architect

Account Manager

• Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution.
• May reconcile daily IDX system receivables reports.
• May balance monthly transactions and provide summaries to faculty and department administration.

Senior Patient Account Representative – PB Payment Posting

Human Resources

• Lead efforts to resolve complex technical issues and system errors especially situations that require cross-team collaboration.
• Work closely with operations to develop and coordinate team members to implement issue resolution plans.
• Lead work efforts to perform routine maintenance tasks, such as software updates, patches, and upgrades, to ensure the stability and security of the EHR system.
• Coordinate and lead testing and validation activities for system changes, enhancements, and upgrades, following pre-defined change management processes to ensure that new features and configurations meet functional requirements and do not introduce unintended consequences or disruptions.
• Play a key role in strategic planning initiatives related to EHR systems, collaborating with senior leadership to align technology investments with organizational goals and objectives, and driving initiatives that enhance patient care delivery and organizational efficiency.
• Drive continuous improvement initiatives to enhance the functionality, usability, and interoperability of EHR systems, collaborating with stakeholders to prioritize enhancements and address emerging needs.
• Take on project management responsibilities for EHR implementation projects, system upgrades, and other initiatives, overseeing project planning, execution, and post-implementation support to ensure successful outcomes and stakeholder satisfaction.
• Establish and enforce governance processes and procedures for EHR system management, ensuring compliance with regulatory requirements, industry standards, and organizational policies related to data security, privacy, and confidentiality.
• Provide leadership and mentorship to junior analysts and team members, fostering a culture of collaboration, innovation, and continuous improvement, and promoting the professional growth and development of team members through coaching, feedback, and skill-building opportunities.

EHR Application Analyst – Cupid

Auditor

• Performs internal quality assessment reviews on OUH coders
• ensure compliance with national coding guidelines and OUH coding policies
• Helps to coordinate and direct day-to-day coding educational activities
• Facilitates and provides coding educational classes/presentations to staff
• Communicates outcomes to the coding team to improve accuracy, integrity, and quality of patient data
• Assists Coding Leadership in root cause analysis of coding quality issues
• performing account reviews, and preparing training documents

Inpatient Auditor, Coding Quality/Review Educator

Program Manager

• Facilitate significant quality, process and performance improvement activities using Lean Six Sigma methodologies.
• Lead a team/project and support medical research efforts utilizing DMAIC and Lean Six Sigma methodologies with limited guidance.
• Provide regular project reviews to the Sponsor and/or Executive Leadership, including developing and presenting quality data.
• Coach and mentor process improvement teams following prescribed methodology ensuring timely and successful completion.
• Establish strong team relationships building trust and open communication regarding quality and patient safety issues and results.
• Support strategic goals, which contribute to the success of the organization.

Quality Improvement Program Manager

Engineer

• Responsible for implementing, maintaining, and optimizing IAM solutions
• Participate in advanced IAM projects
• Assist in implementation of critical IAM functions such as SSO, MFA, and PAM
• Provide guidance to junior engineers
• Provide 24x7 on-call support with other members of the IAM staff
• Implement and maintain IAM solutions to manage user lifecycle, access, and entitlements
• Deploy privileged access management solutions
• Conduct regular reviews and audits of privileged access
• Resolve complex IAM-related tickets in ticketing queues
• Develop and maintain comprehensive process documentation
• Collaborate with IT teams and business units to ensure proper access controls and integration with other systems

Identity Access Management Engineer

Operations

• Drive the optimization of clinical workflows and operational processes
• Collaborate with healthcare providers, administrators, and staff to identify inefficiencies
• Implement evidence-based improvements and support the center’s goals
• Coach and mentor process improvement efforts that are of moderate difficulty
• Lead multi-departmental or cross functional process improvement initiatives
• Analyze workflows, data, and KPIs to pinpoint inefficiencies
• Facilitate workshops and training sessions
• Develop process maps and documentation
• Partner with leadership to align efforts with strategic goals

Process Improvement Consultant II

• Develop long-term strategies for EHR system architecture and implementation
• Align EHR initiatives with organizational goals and regulatory requirements
• Provide high-level leadership and vision for EHR projects, driving innovation and continuous improvement
• Lead EHR implementation of large-scale optimization efforts from inception to completion
• Design and optimize complex EHR systems for scalability, reliability, and performance
• Create and maintain comprehensive technical documentation and system specifications
• Collaborate with senior management, clinical leaders, ETS teams, and external vendors to gather requirements and align on objectives
• Manage stakeholder expectations and ensure successful delivery of EHR solutions

Revenue Cycle Architect

Medical Billing and Coding

• Reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) codes.
• Performs coding and/or code validation across OUH.
• Applies all appropriate coding guidelines and criteria for code selections.
• Using, ICD-10-CM and/or HCPCS/CPT, primarily assigns, validates, and/or edits codes the following patient types: Same day surgery (SDC), Observation (OBV), Wound Care, Outpatient, Cardiac Cath.
• As needed, may also assign, validate, and/or edit codes for the following patient types: Emergency department (ED), Recurring (RCR), Clinical (CLI) records, and/or Provider Office Visit (POV).
• Assigns, validates, and/or edits procedure categories, modifiers (when applicable).
• Maintains or exceeds established productivity standards.
• Maintains or exceeds established accuracy standards.
• Initiates, validates, and/or edits physician queries in compliance with Company policy where appropriate.
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.
• Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes.
• Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes.
• Meets all educational requirements as stated in current Company policy.

Coding Specialist II, Radiology

• Participate in patient processing and accounts receivable functions such as billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting, and credit balance resolution
• Reconcile daily IDX system receivables reports
• Balance monthly transactions and provide summaries to faculty and department administration

Senior Patient Account Representative – Payment Posting

• Deploy, implement, document, and maintain security solutions.
• Resolve security engineering-related tickets in ServiceNow, ensuring timely resolution and adherence to SLAs.
• Develop and maintain comprehensive process documentation.
• Provide knowledge, coordination, and communication for security engineering projects.
• Identify and implement opportunities for process improvement and automation within the security engineering framework.
• Collaborate with IT teams and business units to ensure proper access controls and integration with other systems.
• Provide vendor management, service level definition, and management for security engineering technologies.
• Support strategic contingency planning from a security perspective.
• Participate in regular business meetings and workshops to ensure knowledge transfer.