Quorum Health

Solutions Engineer

• Design and implement scalable integration solutions.
• Translate business and system requirements into technical specifications.
• Support Oracle ERH deployment initiatives.
• Partner with internal teams and external vendors.
• Ensure alignment between business needs and technical execution.
• Identify integration risks early and develop mitigation strategies.
• Ensure data integrity and system reliability throughout implementations.

Senior Integration Engineer

Medical Director

• Provide direct leadership for various IT clinical domains.
• Serve as primary IT lead for EMR planning and execution.
• Collaborate closely with implementation partners and QHC leadership.
• Act as key liaison with governance teams ensuring effective EMR implementation.

Director of Ancillary, Clinical Systems

Scheduler

• Accurately schedules procedures consistent with physician orders, maintaining an accuracy rate of 98%.
• Provide patients with exam appropriate preparations.
• Notify the appropriate departments of any schedule changes.
• Accurately assign the correct insurance at the time of scheduling, maintaining an accuracy rate of 98%.
• Maintain policy, productivity and customer service standards set forth by the department.
• Maintain a call abandonment rate of less than 3%.
• Perform medical necessity checks as dictated by payor policies and government regulation.

Financial Planning and Analysis

• This position provides Medicaid enrollment support and financial assistance services for community-based individuals.
• Screen and assist with all steps of the Medicaid and Charity Care/Other Assistance Programs enrollment process.
• Make/take phone calls related to the Medicaid and Charity Process to both patients and Medicaid state representatives.
• Gather, verify, evaluate, and enter necessary social, financial, and medical information into various forms/applications.
• Collaborate with on-site leadership and financial counselors to ensure timely submission of Medicaid or Charity applications based off program guidelines.
• Maintain proper certification and training on federal and state level (if required).
• Maintain a knowledge base of the current Medicaid/Charity/Other Assistance Programs within the state and keep up to date with ongoing changes to any policies and procedures – Federal, State, Organization.
• Meet or exceed daily standards for performance, accuracy, customer service, and quality.
• Performs other duties as assigned.

Financial Assistance Specialist

Operations

• Reporting to the Coding Operations Director, the Coding Operations Manager is responsible for providing operational leadership and oversight of assigned coding functions across the organization.
• Direct management responsibility over assigned coding operations.
• Ensures coding activities comply with organizational productivity, quality, compliance, and turnaround time expectations.
• Collaborates with Revenue Integrity and Patient Financial Services to resolve coding-related billing edits and reduce reimbursement delays.
• Maintains extensive knowledge of National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), National Correct Coding Initiative (NCCI) edits, and applicable federal and state regulatory requirements affecting coding and reimbursement.
• Achieves organizational coding quality and reimbursement accuracy goals through accurate assignments of coding methodologies.
• Schedules staff, manages staffing assignments, and monitors coding productivity.

Manager – Coding Operations

Medical Billing and Coding

• Supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership.
• Provides oversight of coding quality, coding edits, auditing, and staff education.
• Monitors coder productivity and quality and provides timely feedback.
• Ensures encounters processed by the coding team include an appropriate documented claim-hold reason before final billing.
• Develops, implements, and monitors coding policies and procedures that support accurate coding and compliance.
• Tracks and trends post-discharge coding queries and provides education.

Senior Outpatient Coder

Director

• Oversight and responsibility over all quality, risk management and patient safety related activities
• Directs performance improvement initiatives ensuring compliance with regulatory standards
• Works with clinicians and administrators to improve overall patient safety and outcomes
• Responsible for the facilities' quality and risk management programs
• Facilitates alignment between improvement initiatives and the organization’s strategic plan
• Maintains system-wide Quality program including data collection and analysis
• Collaborates with Clinical and Non-Clinical teams to improve key performance indicators
• Serves as an internal consultant in regulatory and process improvement areas
• Manages and reports Core Measures and quality metrics

Regional Director – Quality

Medical writer

• Provides clinically based, concurrent and retrospective reviews of inpatient medical records.
• Ensures documentation accurately reflects quality of care, severity of illness and risk of mortality to support compliant coding, reimbursement, quality reporting, and denials prevention initiatives.
• Proactively contacts physicians or other clinicians as needed to clarify procedures/diagnoses to ensure proper documentation.
• Performs initial case reviews and follow up reviews.
• Submits compliant provider queries as needed to clarify documentation of relevant diagnoses, procedures, clinical indicators, present-on-admission status, acuity, specificity, and treatment in accordance with ACDIS/AHIMA compliant query guidance and organizational policy.
• Applies knowledge of ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AHA Coding Clinic, MS-DRG/APR-DRG methodology, CC/MCC capture, SOI/ROM, and quality indicators to support an accurate working DRG in collaboration with Coding/HIM.
• Promotes a partnership with Coding/HIM team to ensure the accuracy of principal diagnosis, procedures, and completeness of documentation to determine the working and final DRG, severity of illness and risk of mortality.
• Functions as a liaison between clinical and coding teams.
• Actively engages and participates in delivery of education to providers through extensive interaction one on one.
• Utilizes critical thinking skills and clinical reasoning to identify, clarify, and query accurate representation of documentation to reflect appropriate clinical status of the patient which will translate into quality reporting, physician report cards, reimbursement, public health data, and disease tracking and trending.

Clinical Documentation Specialist

Bookkeeper

• Prepare and process invoices, statements and other payment requests, including sorting and prioritizing incoming documents.
• Reviewing payment request for proper approval and circulating documents as necessary.
• Examining the mathematical accuracy of payment request.
• Allocating invoice amounts to departmental/intercompany and general ledger accounts.
• Organizing accounts payable information into batches for data entry.
• Inputting transactions to the accounts payable system from PO, Non-PO, Wires, & Credit invoices.
• Balancing entered transactions to generated system reports.
• Responsible for running weekly check runs & voids.
• Matching checks to payment documents.
• Sorting and mailing checks.
• Investigating and responding to accounts payable inquiries from AAs.
• Scanning AP Disbursement Documents to ShareDrive & SharePoint.
• Filing of AP Disbursement Documents and Journal Entries.
• Maintaining files and keeping them organized and up to date.
• Other special assignments as requested by Accounts Payable Manager.

Accounts Payable Coordinator

• The Clinical Documentation Integrity Specialist (CDIS) Lead is an advanced level position for the experienced and proficient CDI Specialist consistently meeting or exceeding all criteria for CDIS advanced performance.
• The CDIS Lead provides support to CDI leadership within a defined scope of facilities and CDI team.
• The CDIS Lead serves as a liaison between senior leadership, medical staff, nursing, coding, case management and quality departments.
• Key Responsibilities: May be assigned special projects related to CDI processes, quality, data analysis, or HIM/CDI performance.
• Assumes responsibility for daily workflow process and adjustments for the CDI team.
• May present CDI performance metrics at facility meetings.
• May present CDI education as needed.
• Will assume operational oversight in the absence of the CDI Director.
• Supports CDI team through multidisciplinary approach in support of program goals.
• Facilitates collaborative efforts between CDI, HIM and Medical Staff providers.
• Facilitates collaborative efforts between CDI and clinical teams such as Quality and Case Management.
• Effectively utilizes leadership abilities and critical thinking skills to identify opportunities for team process and engagement optimization.
• Maintains professional competency in documentation and coding practices by keeping up to date with new coding guidelines, policies/procedures, federal and state reimbursement.

Clinical Documentation Integrity Specialist – Lead

• Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations.
• Abides by the Standards of Ethical Coding as set forth by AHIMA.
• The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance.
• Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.).
• Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.
• Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits.
• Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity.
• Research electronic medical record for any additional diagnoses documented to meet medical necessity.