Shriners Children's

Medical Billing and Coding

• Interpret health record documentation using knowledge of anatomy, physiology, clinical disease processes, pharmacology and medical terminology to identify diagnoses and procedures.
• Assign and sequence all ICD-10; CPT 4; Healthcare Common Procedure Coding (HCPC) and modifier codes for services rendered accurately and completely.
• Reconcile correct coding edits and discrepancies prior to final coding.
• Maintain coding quality of 95% or higher while meeting established productivity requirements based on encounter type.
• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Identify trends in documentation deficiencies and communicates areas of improvement opportunities to leadership and/or providers.
• Acts as a key liaison for the physicians and clinical staff as it relates to coding and compliance.
• Interacts with physicians and other professional staff of documentation issues relating to coding data.
• Must be able to work independently with minimal supervision.

Professional Coder II

Pharmacist

• Provide clinical pharmacy services on all hospital units
• Manage the pharmacy inventory control program and ordering of pharmaceuticals
• Assist in all pharmacy operations as appropriate, including supervision of the pharmacy technician staff
• Review physician's drug orders and provide quality and timely advice
• Oversee preparation of medications and compounded sterile products
• Oversee inventory management in the pharmacy and medication storage areas
• Recommend, monitor, and evaluate patient-specific pharmacotherapy
• Assist the Director with precepting pharmacy technicians and students
• Review controlled substance records
• Promote medication event management and tracking
• Assume Operational aspects of the Pharmacy Department in the Director's absence

Clinical Pharmacist, PRN

Analyst

• Reports to the Revenue Cycle Manager and supports regional revenue cycle operations for California locations through advanced data analysis, denial trending, performance reporting, and targeted resolution of complex pre-bill edits.
• Identifying root causes of claim barriers, quantifying financial impact, and delivering actionable insights that improve clean claim rates, reduce denials, and optimize net revenue performance.
• Operating with a high degree of independence under the strategic direction of the Revenue Cycle Manager.
• Partners closely with Patient Access, Practice Managers, Contact Center leadership, clinical departments, and external vendors to support data-driven process improvements and enterprise-wide denial prevention strategies.
• Serves as a key analytical resource, translating performance data into operational recommendations that align with regional and system revenue cycle goals.
• Lead advanced analysis of denials, pre-bill edits, and payer trends to identify systemic issues and quantify financial impact.
• Partner with Revenue Cycle Manager to prioritize initiatives based on risk exposure, revenue opportunity, and operational performance gaps.
• Conduct comprehensive root cause analysis and lead the development and monitoring of corrective action plans to prevent recurring denials and claim edits.
• Present findings and strategic recommendations to leadership, translating complex analytics into clear operational direction.
• Drive data-informed process redesign and denial prevention strategies.

Senior Revenue Cycle Analyst

Manager

• Provides assessments, planning, interventions and follow-up for patients and family members
• Coordinates the plan of care to achieve desired outcomes and integrates the work of the health care team
• Ensures the development of a safe and effective plan of care through early identification and assessment of the patient's needs
• Collaborates with patients, families, caregivers, and the health care team for optimal outcomes
• Arranges services among community agencies, physicians, patients, family, caregivers, and others involved in the plan of care
• Ensures prudent utilization of all resources by evaluation of the resources available to the patient

RN Care Manager

• Assessing, planning, coordinating, and following up on care for patients and their families
• Enhance the patient experience by ensuring continuity of care
• Support positive outcomes within a family-centered environment
• Strong assessment skills to identify social and medical inequities
• Proactive critical thinking to anticipate needs
• Ensure compliance with regulations and transitional care

Director

• Creating and nourishing a qualified portfolio of 125-150 donor relationships through regular contact, communication, strategy and solicitation planning
• Creating and overseeing a quarterly appeal schedule in collaboration with the Philanthropy Team
• Plan and manage major donor cultivation and recognition events
• Tracking progress and results using prospect management guidelines and Blackbaud CRM fundraising database

Director, Philanthropy

Clinical Research

• Ensures oversight and compliance of both system-wide and local SHC clinical research activities.
• Reports to the Clinical Research Program Manager and provides support in accordance with SHC’s policies and procedures, and regulations.
• Works closely with the Chief of Staff, SHC scientific and medical staff and other research personnel.
• Ethically recruits and consents SHC’s vulnerable pediatric subjects.
• Collects and safeguards data to ensure proper study conduct, subject safety, and the quality of data.

Clinical Research Coordinator II – Per Diem

Insurance

• performs insurance verification functions for assigned SHC facilities
• updates encounters in SHCIS with the appropriate eligibility and COB status
• documents all actions taken on the account related to insurance verification
• updates health plan as needed based on feedback from the insurance company
• maintains knowledge of all payors’ authorization/referral guidelines and updates all appropriate fields in SHCIS
• maintains daily productivity log
• performs bill hold review for assigned facilities
• reviews assigned bill hold worklists
• coordinates and prioritizes assigned activities to achieve maximum productivity
• makes recommendations for quality and efficiency improvements
• identifies system issues and assists in identifying root causes

Patient Access Insurance Coordinator

• Oversees daily clinic workflows to ensure efficiency and patient-centered care
• Supervises and coaches administrative and clinical support staff
• Ensures adherence to pediatric-specific health regulations
• Monitors revenue cycle with attention to subspecialty billing opportunities
• Identifies gaps in authorizations, referrals and documentation
• Fosters a child-friendly and family-centered environment
• Designs and implements strategies to improve patient/family satisfaction
• Handles escalated patient/family concerns
• Uses data and root cause analysis to identify and solve workflow inefficiencies
• Acts as a liaison across care teams, leadership and external partners
• Recruits and retains staff experienced in pediatric care

Practice Manager

Therapist

• Provide evaluation and therapy services including direct patient care and education
• Work with patients in an efficient, age-appropriate, and culturally sensitive manner
• Collaborate with interdisciplinary teams including surgeons and other healthcare providers
• Evaluate pediatric patients for mobility equipment and assistive technology
• Adapt orthopedic rehabilitation principles for children and adolescents
• Engage effectively with patients and their caregivers using developmentally appropriate strategies

Physical Therapist

• Provides evaluation and therapy services, including direct patient care, patient/family education and transition of care.
• Implements a systematic patient examination and evaluation utilizing comprehensive compliant and safe clinical care demonstrating the philosophy of family centered care.
• Collaborates with medical staff and the multidisciplinary team to design and implement individualized plans of care.
• Makes appropriate discharge plans by collaborating with patients, families, and the interdisciplinary team.
• Functions as a team member and develops leadership skills through activities such as mentoring and providing education to students and other professionals.
• Supports risk management and compliance initiatives through accurate, thorough documentation.

• Provides evaluation and therapy services, including direct patient care, patient/family education and transition of care
• Works in an efficient, age-appropriate, and culturally sensitive manner upon licensed independent practitioner referral
• Enjoys working with both orthopedic and developmental populations in a collaborative, specialty care environment
• Experienced in managing post-operative pediatric patients
• Comfortable practicing in an outpatient setting
• Enjoys treating a diverse caseload
• Comfortable working alongside prosthetists and orthotists
• Engages patients and caregivers effectively

Physical Therapist, Part Time

• Analyzing denials data, creating metrics, tracking and trending denials and results for the Central Auth Unit
• Performing appeals, correcting bill hold edits, identifying and trending root causes
• Reporting out findings, assisting in mapping out process improvement opportunities
• Coordinating payor denials and audit activities for timely response
• Communicating and coordinating with various individuals/distributions related to CAU claims denials and edits
• Participating in internal and SHC system-wide revenue cycle meetings to improve processes
• Analyzing KPI data and coordinating revenue cycle analytics for the CAU

Revenue Analyst – Rehab & Therapy Services

• Provide distributive, clinical, consultative, and research pharmaceutical services in a pediatric burn, orthopedic, and rehabilitation hospital
• Function as a member of an interdisciplinary team
• Ensure appropriate techniques are used to prepare medications for patient administration
• Accept, verify, and transmit prescription orders from prescribers
• Screen all prescriptions for appropriateness
• Compound or fill and dispense medications in compliance with standards and laws
• Independently calculate or evaluate dose and check the accuracy of contents
• Assist in the supervision and instruction of volunteers and technicians
• Participate in Quality Assurance and Pharmacy committees

Pharmacist – Per Diem

Administrative Assistant

• Support key administrative functions in research operations
• Coordinates office services such as purchasing, payroll, records control, credentialing
• Coordinates and implements office services such as purchasing lab and office supplies
• Works closely with finance management in monthly fiscal balances
• Collects, verifies and processes credentialing applications
• Conducts orientation of new employees as needed
• Handles ID badge approval for MGH employees working in Shriners research spaces
• Assists with research grant activities and manages submissions

Professional Coder II

Clinical Pharmacist, PRN

Senior Revenue Cycle Analyst

RN Care Manager

RN Care Manager

Director, Philanthropy

Clinical Research Coordinator II – Per Diem

Patient Access Insurance Coordinator

Practice Manager

Physical Therapist

Physical Therapist

Physical Therapist, Part Time

Revenue Analyst – Rehab & Therapy Services

Pharmacist – Per Diem

Administrative Assistant – Part Time