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Rehab Liaison (Rn, Therapist Or Healthcare Sales Required)

The Rehab Liaison is responsible for developing census as defined through targeted goals of the business plan and developing refer...

Posted 7 days ago

The Rehab Liaison is responsible for developing census as defined through targeted goals of the business plan and developing referral relationships within the geographic territory with an emphasis on face-to-face contacts. In addition, the liaison will assist with coordination of referral to admission conversion process and represent our company in community-related activities. In addition, the position: * Utilizes market analysis data in individual territory identifying new business and potential opportunities. * Recognizes barriers to admission, responds appropriately and follows up on admissions variables. * Understands healthcare operations, legal guidelines, competitive analysis, and market place trends * Provides in-services and professional presentations for referral sources, community groups and other organizations, regarding our company's services, programs and outcomes. The Rehab Liaison creates an environment and culture that enables the hospital to fulfill its mission by providing patient safety and patient-centered treatment. Benefits To attract and retain the best professionals, we offer a comprehensive and competitive benefits package that includes medical, dental, vision, 401(k), college savings plan, employee assistance program, pre-paid legal plan and much more. For more information on available benefits, please click here. What types of patients will you see? We are an acute rehabilitation hospital setting. Typically our patients spend an average of 2-4 weeks in our hospital and come to us with a wide variety of diagnosis such as: stroke, spinal cord injury, brain injury, various neurological disorders, rheumatoid arthritis, osteoarthritis, amputation, joint replacement, fractures, multiple trauma, cardiac conditions, and pulmonary conditions. 80% of our patients are discharged directly home. We use evidence-based practice guidelines to treat our patients. We utilize our clinical outcomes to assess and improve our treatment interventions and programs. We participate in a national outcomes database, which provides benchmarks and sophisticated outcome reports to help us continually analyze and improve our patient outcomes. Helping you become better is critical to our success - You will be paired with mentors; attend in-house as well as external educational programs. The treatment team is made up of full time therapists, nurses, social workers, pharmacists and medical staff; and we offer educational benefits if you are interested in continuing your education. Job Code: 100147 License or Certification: * Current driver's license in state employed and acceptable driving record according to company policy * Current State Professional License required * Current CPR certification preferred * CRRN preferred. Education, Training and Years of Experience: * Bachelor's Degree preferred or equivalent job experience * Minimum 2 years experience as clinician or tech in healthcare environment preferred * Minimum 1 year experience as nurse liaison or successful sales experience in healthcare environment preferred * Familiarity with acute hospital, rehab hospitals, and local healthcare market preferred Machines, Equipment Used: * General office equipment such as telephone, copy machine, fax machine, calculator, computer. Physical Requirements: * Good visual acuity and ability to communicate. * Ability to lift and push/pull a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements. Compliance: * Adheres to the company's Standards of Business Conduct. * Maintains current licensure and/or certifications, if applicable. Skills and Abilities: * Ability to speak, read, write, and communicate effectively. * Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner. * Ability to work independently without supervision. Environmental Conditions: * Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure. * Exposure or potential exposure to blood and body fluids may be required. * Handicapped accessible. * May work under stressful circumstances at times. Proficiency or Productivity Standards: * Meets established attendance standards. * Adheres to hospital/department dress code including wearing ID badge. * May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines. * May be required to work on religious and/or legal holidays on scheduled days/shifts. * Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster. * May be required to stay after workday to assist after a disaster situation until relief arrives. * May be required to perform other duties as assigned by supervisor. * Must be able to travel overnight to fulfill essential training requirements. Travel is infrequent, but necessary for training purposes. Minimum required travel includes training at Corporate Office in Birmingham, AL. Address: 3800 Ridgeway Drive, Birmingham 35209 Shift: Day Job Job ID: 1825215

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Rehab Liaison (Rn, Therapist Or Healthcare Sales Required)

Healthsouth Corporation Birmingham AL, 35202

The Rehab Liaison is responsible for developing census as defined through targeted goals of the business plan and developing refer...

Posted 7 days ago

The Rehab Liaison is responsible for developing census as defined through targeted goals of the business plan and developing referral relationships within the geographic territory with an emphasis on face-to-face contacts. In addition, the liaison will assist with coordination of referral to admission conversion process and represent our company in community-related activities. In addition, the position: * Utilizes market analysis data in individual territory identifying new business and potential opportunities. * Recognizes barriers to admission, responds appropriately and follows up on admissions variables. * Understands healthcare operations, legal guidelines, competitive analysis, and market place trends * Provides in-services and professional presentations for referral sources, community groups and other organizations, regarding our company's services, programs and outcomes. The Rehab Liaison creates an environment and culture that enables the hospital to fulfill its mission by providing patient safety and patient-centered treatment. Benefits To attract and retain the best professionals, we offer a comprehensive and competitive benefits package that includes medical, dental, vision, 401(k), college savings plan, employee assistance program, pre-paid legal plan and much more. For more information on available benefits, please click here. What types of patients will you see? We are an acute rehabilitation hospital setting. Typically our patients spend an average of 2-4 weeks in our hospital and come to us with a wide variety of diagnosis such as: stroke, spinal cord injury, brain injury, various neurological disorders, rheumatoid arthritis, osteoarthritis, amputation, joint replacement, fractures, multiple trauma, cardiac conditions, and pulmonary conditions. 80% of our patients are discharged directly home. We use evidence-based practice guidelines to treat our patients. We utilize our clinical outcomes to assess and improve our treatment interventions and programs. We participate in a national outcomes database, which provides benchmarks and sophisticated outcome reports to help us continually analyze and improve our patient outcomes. Helping you become better is critical to our success - You will be paired with mentors; attend in-house as well as external educational programs. The treatment team is made up of full time therapists, nurses, social workers, pharmacists and medical staff; and we offer educational benefits if you are interested in continuing your education. Job Code: 100147 License or Certification: * Current driver's license in state employed and acceptable driving record according to company policy * Current State Professional License required * Current CPR certification preferred * CRRN preferred. Education, Training and Years of Experience: * Bachelor's Degree preferred or equivalent job experience * Minimum 2 years experience as clinician or tech in healthcare environment preferred * Minimum 1 year experience as nurse liaison or successful sales experience in healthcare environment preferred * Familiarity with acute hospital, rehab hospitals, and local healthcare market preferred Machines, Equipment Used: * General office equipment such as telephone, copy machine, fax machine, calculator, computer. Physical Requirements: * Good visual acuity and ability to communicate. * Ability to lift and push/pull a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling are undertaken which exceeds these minimum requirements. Compliance: * Adheres to the company's Standards of Business Conduct. * Maintains current licensure and/or certifications, if applicable. Skills and Abilities: * Ability to speak, read, write, and communicate effectively. * Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner. * Ability to work independently without supervision. Environmental Conditions: * Indoor, temperature controlled, smoke-free environment. Occasional outdoor exposure. * Exposure or potential exposure to blood and body fluids may be required. * Handicapped accessible. * May work under stressful circumstances at times. Proficiency or Productivity Standards: * Meets established attendance standards. * Adheres to hospital/department dress code including wearing ID badge. * May be required to work weekdays and/or weekends, evenings and or night shifts if needed to meet deadlines. * May be required to work on religious and/or legal holidays on scheduled days/shifts. * Will be required to work as necessary during disaster situations, i.e., before, during or after a disaster. * May be required to stay after workday to assist after a disaster situation until relief arrives. * May be required to perform other duties as assigned by supervisor. * Must be able to travel overnight to fulfill essential training requirements. Travel is infrequent, but necessary for training purposes. Minimum required travel includes training at Corporate Office in Birmingham, AL.

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Nurse Healthcare Manager RN

Brookdale Senior Living Birmingham AL, 35202

Full Time Nurse Healthcare Manager RNFull Time Nurse Healthcare Manager RN Brookdale Univ Pk IL/AL/MC(AL) 400 University Par...

Posted 1 week ago

Full Time Nurse Healthcare Manager RNFull Time Nurse Healthcare Manager RN Brookdale Univ Pk IL/AL/MC(AL) 400 University Park Drive Birmingham, AL 35209 Job #:NHMSCbirmAL7245877 Brookdale. Bringing new life to senior living. Job Summary: Manages the day-to-day clinical services of the community to ensure resident's healthcare needs are met. Ensures residents are treated with respect and dignity and ensures quality care as resident's healthcare needs change. Supervises and provides leadership as well as coaching to licensed nurses and other direct care staff within the community. Your responsibilities: * Responsible for the direct supervision of community-based licensed, certified and non-certified clinical associates. * Assigns and directs work of subordinates; appraising performance; rewarding and disciplining associates; addressing complaints and resolving problems * Provides training and education to resident care associates on an ongoing basis with classroom in-services, and situation-specific training * Supervises the maintenance of resident charts and reviews documentation performed by care giving staff * As described and allowed in the Nurse Practice Act, assesses health, oversee medication administration, functional and psycho-social status of residents, initiates individualized service plans, proactively manages care and services for each resident, evaluates effectiveness and maximizes the resident's opportunity to remain in their environment * Manages the health care of residents, including the dissemination of information to families and associates. Ensures that family members are aware of resident's need for scheduled appointments * Participates in pre-admission screening of prospective new residents. Assures that required documentation is completed prior to or upon resident admission, including nursing assessments, service plans, and other assigned forms. Updates assessments as required by policy and as described/allowed in Nurse Practice Actor state regulation * Performs on-site evaluations of residents admitted to alternate care environments for treatment, and maintains contact with resident families with the intent of returning resident to Brookdale * Evaluates residents; documents changes in condition, and notifies executive director, physician, and resident's legally responsible party/family of resident's condition and reactions * Communicates with physicians regarding residents' status and condition changes. Ensures residents are prepared for physician appointments, and visits * Facilitates continuity of care for those residents receiving home health care, hospice services, and other third party healthcare- related services * Participates in or leads meetings relevant to resident care issues, such as Service Plan meetings, involving appropriate parties as needed * Ensures in-house ancillary medical services such as podiatrist, doctor visits, dental visits, psych visits, lab, X-ray, ambulance, etc. are scheduled and followed through * Participates in department quality improvement activities * Assists in keeping the environment safe for associates to reduce the occurrence of Workers' Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated * Shares on-call and manager on duty responsibilities/shifts as required Required skills and qualifications: * Education as required to obtain state nursing license (RN). * Preferred a minimum of 3 years clinical leadership experience. * Working knowledge of basic technology and electronic documentation * RN license required Brookdale is the largest senior living solutions company in the country, with 1,000+ communities in 46 states serving 110,000 residents around the country. That translates to lots of career opportunities for you! We offer independent living, assisted living, Memory Care, skilled nursing, continuing care retirement, in-house therapy, hospice, home health, and personalized living. If you're a Brookdale associate, please consider referring someone through the Good People Program! Brookdale is an EOE-(Equal Opportunity Employer) and drug-free workplace. Brookdale offers a number of benefits to full-time associates including, but not limited to: medical, dental, vision, disability, life, paid time off, educational reimbursement. All associates, age 21 and older, are eligible to participate in the 401(k) retirement savings plan.

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Project Architect - Healthcare Market

Gresham, Smith And Partners Birmingham AL, 35202

Our healthcare team specializes in architectural design and planning to deliver research-based, value-added solutions for health s...

Posted 1 week ago

Our healthcare team specializes in architectural design and planning to deliver research-based, value-added solutions for health systems, care providers and patients alike. Responsibilities: * Perform work on all phases of various architectural projects including design development, preparation of presentation drawings and specifications, design review, coordination and correlation of construction drawings. * Prepare schematics, design development and construction documents. Develop, modify and review production drawings and edit project narratives and specifications. * Research materials to determine appropriate selection for project. * Plan, coordinate and administer projects from the initial programming stages all the way through to construction administration. * Review construction submittals and assist project manager in construction administration. * Analyze client problems and develop architectural solutions to those problems. Minimum Qualifications * 5 year Bachelor's/Master's degree in Architecture. * Minimum of 8-10 years of job-related experience. * Licensed with Healthcare experience required. * Demonstrated experience using AutoCAD, REVIT Sketchup, PhotoShop software. * Ability to interact professionally and comfortably with a variety personalities and communication styles and build and maintain excellent interpersonal relationships. * LEED certification is preferred. * Proficient in Microsoft Office applications, particularly Word and Excel. * Time management skills. * You must include a portfolio of work samples along with a resume/CV in your online application. Gresham Smith is committed to fostering a diverse workforce and is proud to be an Affirmative Action/Equal Opportunity Employer of Minorities/Women/Protected Veterans/Individuals with Disabilities. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, age, national origin, veteran status, disability, or any other classification protected by law. Gresham Smith will not accept unsolicited resumes from recruiters, headhunters, contract recruiters, search firms or employment agencies. An executed GRESHAM PLACEMENT SERVICES AGREEMENT (PSA) is required prior to any payment obligation for either a referral or recruiter fee. In the event a recruiter or agency submits a resume or candidate without a previously executed PSA, GRESHAM SMITH explicitly reserves the right to recruit and hire those candidate(s) at its discretion, and without any financial obligation whatsoever to the recruiter or agency. Any such unsolicited resume or candidate contact information, including those submitted directly to GRESHAM SMITH'S hiring managers or any other employee, shall become the property of GRESHAM SMITH upon receipt.

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Bi-Lingual Healthcare Customer Service Representative

DST Systems, Inc. Birmingham AL, 35202

The speed of technology. The influx of data. Shifting regulations. Increased customer expectations. That's where you'll find DS...

Posted 1 week ago

The speed of technology. The influx of data. Shifting regulations. Increased customer expectations. That's where you'll find DST, helping clients find opportunity in ever-changing and complex customer, business, and regulatory requirements. Mastering complexity is a constantly changing and evolving challenge – one that only a few people can embrace and thrive upon. If you see your opportunity in complexity, then we are the right fit for you. Job Description: Organizational Overview As an Associate with DST Pharmacy Solutions, you will be part of an organization that promotes better health outcomes for consumers through clinical and technological innovations. We accomplish this by leveraging the robust technology foundation and powerful analytic resources that are the core of DST, with industry leading clinical expertise and strategic pharmacy and healthcare solutions. You will join a team that is redefining the value of pharmacy in healthcare through the integration of advanced analytics, clinical insights and transformative digital capabilities. Role Overview In your role as a Bi-lingual Health Care Call Center Representative l, you are the front line to our clients and our clients' clients. They have choices about who to work with, and they evaluate us on every call. Every single day you come in, you put yourself in the clients' shoes, anticipate their concerns and help them solve complex problems. In order to ensure our clients receive award-winning service, we know the importance of looking after our associates. We are committed to the development of our people at every level and will give you the training you need to excel in your job. Responsibilities * Provide world class customer service to customers by answering questions, resolving issues and assisting with pharmaceutical and/or medical health transactions. * Provide pharmacies, medical facilities, insurance providers and members with routine information regarding effective dates of coverage, claims history, deductible and coinsurance amounts, and general plan benefit information. * Address claims related issues, concerns and escalations from insurance providers and/or members. * Review, prepare and process pharmaceutical and medical claims, including potential grievance, appeals and coverage determination. * Quote and provide information on benefits, medical, prescription, dental and vision member deductibles, maximum out-of-pocket limits, co-pays, co-insurance details and accumulations. * Research complex issues for customers, supporting their requests, making outbound calls to provide customers with updates or to gain additional information. * Perform special project assignments from time to time, such as research work, obtaining special authorizations, outbound calls and data entry. * Cross train in different areas to expand knowledge base and develop new skills. Qualifications * High School degree and up to 1 year of related experience * Spanish Bi-lingual speaking skills required * At least one year of previous customer service related experience preferred * You will receive strong preference if you have experience working with Medicare, Medicaid, Affordable Act, Commercial, Small/Large Group and/or Pharmaceutical Benefits Management * Excellent communication skills – verbal and written * Intermediate computer proficiency, including keyboarding skills and the ability to navigate through multiple computer systems * Real passion for excellence in service and attention to detail * The shift for this position will be 11am-8pm. Location: Birmingham Alabama DST is an equal opportunity employer and values a diverse and inclusive workplace. All qualified candidates will receive consideration for employment without regard to age, race, color, religion, genetic information, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. For more information about Equal Opportunity in the Workplace please click here and here. DST is committed to working with and providing reasonable accommodation to job applicants with disabilities. If you are a qualified individual with a disability and need an accommodation or accessibility assistance to complete the online application, please contact us at PeopleCenter@dstsystems.com for assistance.

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Healthcare Operations Manager (RN Required)

Davita Bessemer AL, 35021

DaVita is a dynamic, growing and entrepreneurial Fortune 500® Company . We are seeking an ambitious, operationally-focused and res...

Posted 3 weeks ago

DaVita is a dynamic, growing and entrepreneurial Fortune 500® Company . We are seeking an ambitious, operationally-focused and results-driven leader. If you haven't considered Healthcare before, read on as we think you should. Healthcare Experience is NOT required. For the past 10 years, DaVita has demonstrably improved clinical outcomes, continuously improving year after year. As a Healthcare Operations Manager (aka Facility Administrator or "FA" internally) you will directly impact patient care as the trusted front-line leader in an outpatient clinic. As a Healthcare Operations Manager, you can expect: * Patients come first. You have an opportunity to build on your relationship with your patients, while also continuously improving their health through clinical goal setting and quality improvement initiatives. * Meaningful Workday - EVERY Day. You'll go home every day knowing you are making a difference in patients' lives and that you are developing your team to reach their full potential. * Nights, Weekends & Holidays OFF. That means time for you and your family. * Lead a Team. Develop, mentor and inspire a cross-functional clinical team (on average staff of 15-20) to deliver the best for our patients, teammates and community. * Financial Management. Manage complete operation and performance of the clinic: adhere to budget, forecast expenses, manage vendor relationships, order supplies, and monitor compliance. * Autonomy. It's your clinic to run. You aren't alone though. You will have the support and guidance of your director, regional peers and the greater company to help you manage your facility. We foster entrepreneurs and those who seek to continuously improve. * Culture & Growth. Our values are not just written in a book somewhere, but are an intentional part of everything we do. As leaders, you are able to reward others for demonstrating those shared beliefs and behaviors, and in turn, we intend to do the same for you. The shining star for our Healthcare Operations Manager should have: * Passion for making a difference in people's lives. * Minimum of 2 years experience required in leading and inspiring others to great results. Experience supervising direct reports preferred. * We hire leaders from all industries: corporate businesses, retail, military, consulting, healthcare, we could go on... the point is we hire from diverse backgrounds and leadership/management is key. * Proven ability to adeptly manage multiple priorities; a person who "gets the right stuff done". * Demonstrated ability to adapt, innovate and lead in an environment that moves at a rapid pace, where change is common. * Capacity to develop effective relationships at all levels of the organization and to influence positive outcomes. * Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required. * Associate's degree required: Bachelor's degree in related area strongly preferred. Are you ready to take ownership, drive results and experience the rewards? Take the first step at careers.davita.com. DaVita is proud to be an Equal Opportunity Employer - M/F/Veteran/Disability

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Healthcare Security Site Supervisor

G4S Security Solutions USA Alabaster AL, 35007

PLEASE CLICK APPLY OR TEXT "JOBS" TO 561-660-9797 FROM YOUR SMARTPHONE! The world's leading private security organization, G4S,...

Posted 4 weeks ago

PLEASE CLICK APPLY OR TEXT "JOBS" TO 561-660-9797 FROM YOUR SMARTPHONE! The world's leading private security organization, G4S, has an immediate job opportunity for a Healthcare Security Site Supervisor. As a Healthcare Security Site Supervisor, you will be responsible for the supervision of security officers, shift supervisors, and the physical security of the client's hospital campus and its surrounding grounds. This individual will be directly accountable for the success, performance, compliance, and client perception of the healthcare security program. This position will act as G4S liaison with the client, law enforcement agencies, healthcare professionals, vendors, patients and guests. You will also perform general security duties in the protection of persons and property and the enforcement of all applicable policies, rules and regulations of the client. G4S is a security provider for the United States government, fortune 500 companies, nuclear power plants, oil and gas companies, airport, ports, banks, hospitals, factories, warehouses, commercial facilities, residential communities and much more. G4S offers job security, excellent pay and benefits, and career opportunities. We offer entry level careers, management careers, sales careers and executive careers across the United States and internationally. Role Responsibility: Specific Duties and Essential Functions * Provide supervision to Shift Supervisors, as well as overseeing the staffing, scheduling and on-site training for security officers * Ensure quality of service and contract compliance by regularly inspecting security personnel and their job performance when assigned to his/her shift * Maintain overtime to a minimal or preset requirement designated by G4S * Perform other operations and related functions (e.g., payroll, review and maintain incident reports, assist in preparation of security surveys and post orders) * Make recommendations for positive and negative personnel actions for those under his/her direct supervision. * Perform security patrols of designated areas on foot or in vehicle * Watch for irregular or unusual conditions that may create security concerns or safety hazards * Communicate by use of Secure Trax ™, 2-way radios, telephones and computers * Sound alarms or call police or fire department in case of fire or presence of unauthorized persons * Warn violators of rule infractions, such as loitering, smoking or carrying forbidden articles * Permit authorized persons to enter property and monitors entrances and exits * Observe departing personnel to protect against theft of company property and ensure that authorized removal of property is conducted within appropriate client requirements * Investigate and prepare reports on accidents, incidents, and suspicious activities * Provide assistance to customers, employees and visitors in a courteous and professional manner, providing exceptional customer service The Ideal Candidate: Education, Licenses and Certifications Required * Must possess a high school diploma or equivalent * Pass any State-required training or other qualifications for licensing * Must possess a current and valid driver's license Type and Length of Specific Experience Required * Must possess one or more of the following: * Service in Military Occupational Specialty related to law enforcement, security (such as Military Police, Elite Military Forces, combat arms) or any support role in a Combat Zone * Graduate of a Certified Public Safety Academy (military or civilian) in the law enforcement, adult corrections or firefighter field * Bachelor's degree in law enforcement or criminal justice related studies * A minimum of 8 or more years of active service in any military branch * Associate's degree (or 60 credits) or higher in law enforcement or criminal justice with current or prior active military service Skills Required * Proficient computer skills including Microsoft Office * Effective oral and written communication skills * Active listening skills * Ability to assess and evaluate situations effectively * Ability to identify critical issues quickly and accurately * Attention to detail Other * Must be at least 21 years old or the minimum age required by the state, if higher * Must be a U.S. citizen or a foreign citizen authorized to legally work in the United States * Subject to a drug screen to the extent permitted by law * Must be able to work flexible schedules * Must have access to reliable transportation * Must be able to operate radio or telephone equipment and/or console monitors * Must have demonstrated ability to interact cordially and communicate with the public Physical Requirements and Environment Environment: Indoor and outdoor, temperature ranges from moderate to extreme cold and heat Major activity: Walking, standing, speaking, listening, observing Physical efforts to carry out job duties: Standing, walking, and sitting. Minimal to no stooping or kneeling. About the Company: EOE Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity G4S is an Equal Opportunity/Affirmative Action Employer and an Alcohol- and Drug-Free Workplace If you have any questions regarding Equal Employment Opportunity, Affirmative Action or Diversity and Inclusion, or have difficulty using the online system and require an alternate method to apply, please contact our Corporate Human Resources Department at (800) 506-6265. To receive an update on your application status, please contact our local office by following this link: http://g4s.us/en/Contact-Us/Local-Offices

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Fraud Investigator-Birmingham, Alabama

New Directions Behavioral Health Birmingham AL, 35202

Responsible for the analysis of provider and member claims data, and non-clinical review of medical records pertaining to claims a...

Posted 4 days ago

Responsible for the analysis of provider and member claims data, and non-clinical review of medical records pertaining to claims audits and fraud, waste and abuse investigations. Assignments are generally of low to moderate complexity and focused primarily on documentation supporting code billed and documentation requirements, but may also involve other areas such as: compliance with applicable laws and regulations, accreditation standards, and contracts. Works under supervision of the Claims Integrity, Manager with moderate latitude for initiative and independent judgment. ESSENTIAL FUNCTIONS * Reviews and analyzes provider and facility behavioral health claims (including inpatient, residential, partial hospitalization, intensive outpatient and outpatient), associated medical records and processes related to the appropriateness of coding, documentation requirements, and health care regulations. * Conduct background research on provider and associated partners. * Collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy. * Compare to information submitted on the claims in order to determine amount and nature of billable services. * Identifies trends and possible concerns related to potential inappropriate submission of claims by providers or facilities. * Reviews and analyzes claims and medical records submitted by the provider or facility to determine appropriateness of billing and documentation. * Documents findings for each claim line with appropriate claims payment calculation in a findings spreadsheet. * Summarize findings in a written report which will be provided to management, Plan, and in certain circumstances court proceedings. * Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations. * Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings. * Responsible for interfacing with providers regarding compliance with all federal, state, and contractual regulations and obligations. Provide clear, concise and professional provider education in verbal and written format. * Coordinates with various internal customers including Compliance, Legal, Clinical, Quality, Credentialing, Analytics and Network Operations to gather documentation pertinent to the investigation. * Maintains documentation in appropriately organized files, databases, and systems to support audit work performed, detailed conclusions, and support any resulting recommendations. * Participates in selected trainings and webinars to maintain a thorough understanding industry trends and changes. * Assists in communicating the results of audit and consulting projects via written reports and oral presentations containing descriptive, analytical, and evaluative content to management, clients, and Providers. * Maintains strict confidentiality of all provider, member, regulatory, and law enforcement sensitive information reviewed during the audit and/or investigation process. * Completes audits or other assigned work within clearly specified time frames. * Participates in on-going continuing education as required by professional licensure, certification, or as requested by New Directions. * Adheres to New Directions Behavioral Health Mission Statement, Core Values, Code of Business Conduct, and Compliance Program. * Complies with all Federal and applicable State laws and New Directions Behavioral Health Policies regarding, privacy, confidentiality, and security of health information, and other designated information. MARGINAL (NON-ESSENTIAL) FUNCTIONS None This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities as deemed necessary. JOB SPECIFICATIONS: EDUCATION & EXPERIENCE REQUIRED * Bachelor's degree in Healthcare, Business, Computer Science, Mathematics a related field or equivalent experience. * Certified Professional Coder (CPC) or equivalent. * Medical records review and claims analysis experience. * Strong analytical & investigative skills. * Ability to comprehend medical policy and criteria to clearly articulate health information. * Experience with all healthcare coding (CPT, HCPCS, DRG, ICD-10, & Revenue Codes). * Excellent oral and written communication skills and an ability to communicate effectively with all levels of the organization. * Intuitive nature to identify investigational leads regarding fraud, waste or abuse. * Ability to work independently & as part of a productive team. * Ability to handle multiple and conflicting priorities. * Working knowledge of medical review and medical record chart audits. * Proficient in Microsoft products, specifically Excel. PREFERRED * Master's degree in Healthcare, Business, Computer Science, Mathematics a related field or equivalent experience. * 2+ years healthcare claims/reimbursement experience. * 2+ years related experience in healthcare, fraud investigations, managed care, or a related field. * Experience in working with outpatient and/or facility behavioral health providers. * Proficient with all healthcare coding (CPT, HCPCS, DRG, ICD-10, & Revenue Codes). * Familiar with healthcare claim adjudication standards & procedures. * Experience with SQL, Tableau or fraud analytics software. * Accredited Healthcare Fraud Investigator, Certified Fraud Examiner, Certified Insurance Fraud Investigator, Certified Public Accountant, Certified Internal Auditor, Certified Compliance Professional, or other similar licensure/certification

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Patient Registration Representative - Birmingham

R1 Revenue Cycle Management Birmingham AL, 35202

Patient Registration Representative - Birmingham Birmingham, AL USA Shift Days: M-F 2:30p – 11p Set your sights on a role...

Posted 4 days ago

Patient Registration Representative - Birmingham Birmingham, AL USA Shift Days: M-F 2:30p – 11p Set your sights on a role making a real difference in the healthcare system. We're looking for a self-motivated Patient Registration Representative to join our team. We have a relentless focus on driving results for our customers and enabling them to invest more into patient care; in turn, this allows us to continue to grow our company and your career. The Patient Registration Representative will be responsible for accurate and timely patient registration utilizing medical systems. This person will assign ICD-10 and CPT codes relative to patient registration. The Patient Registration Representative will utilize facility medical necessity tool to verify appropriate diagnosis and coverage criteria. This work will need to be performed according to established policies and procedures. The associate will provide exceptional customer service to physicians, patients, family members and all other medical professionals. In addition to the day to day responsibilities, this person will actively participate in quality improvement and innovative change processes as well as departmental meetings and educational offerings. The successful candidate must have demonstrated experience handling patients with efficiency and accuracy to broad customer base. Your day to day role may include: * Perform registration and basic insurance verification, ensuring collection of 7 critical data elements necessary for proper patient identification and billing. * Identify and update patient demographic information on ADT system as defined by departmental policy and procedures. * Interpret physician orders for appropriate testing or admission criteria. * Coordinate patient admission needs and beds assignment to facilitate timely patient placement. * Identify non-participating Insurances or Out of Networks plans; takes necessary steps to inform patients and physicians regarding options, including but not limited to canceling appointment. * Obtain Insurance Card copies or validate insurance information via electronic medical record, transfer information, or insurance eligibility tool. * Provide courteous and accurate patient and hospital information with way finding instructions for patients, families, visitors, and ancillary areas. * Prepare documents for imaging/scanning into electronic patient record. * Explains processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required. * Assemble and disassemble patient charts or departmental documents according to department policy. * Copying and or faxing documents to ancillary areas or physician offices. * Maintain inventory control of forms and paper supplies needed in area. * Assist with all possible account resolutions pertaining to patient balances. * Perform all other duties and projects as assigned. You Have: * High school diploma or GED required * Experience with customer service * Computer savvy with experience navigating between multiple systems simultaneously * Must have MS Office Experience and excellent typing skills * Must have a high degree of customer service skills in order to communicate effectively with patients, visitors, physicians and care teams * Must demonstrate problem-solving abilities and high attention to detail * Must be able to stand, walk, sit and move freely for extended periods of time * Must be able to work in a patient care environment with exposure to infection or contagious disease It would be great if you also have: * Experience working in a healthcare environment * Completed a Medical Terminology class * Certification in healthcare access preferred We offer: R1 is changing healthcare by infusing operational discipline and proprietary technology in hospital financial processes. We are an industry leader; we are the only independent organization with a comprehensive service and technology offering for hospital revenue cycle management, and we have achieved leading outcomes for our customers. * A strong financial performing, growing organization that will keep you on your toes with new ideas, changes and opportunities to learn and grow in abundance. * A culture of excellence, driving customer success so they can focus on improving patient care and on giving back to the community. * A Total Rewards package which may include such things as: competitive compensation package, the ability to choose from a comprehensive benefit program mostly funded by R1 that includes medical, dental, vision, flexible spending accounts, commuter benefits, life and disability insurance, along with work life balance programs including paid time off for personal time, illness and volunteering, and we offer a retirement savings plan and continuing training and development and so much more! Sound like you? Let's talk! About R1: R1 is a leading provider of revenue cycle management services and Physician Advisory Services to healthcare providers. We are the largest independent end-to-end revenue cycle provider and have the longest operating history in the revenue cycle industry. R1's objective is to be the one trusted partner to manage revenue so providers and patients can focus on what matters most. Our distinctive operating model and values includes people, processes, and sophisticated integrated technology/analytics that help customers realize sustainable improvements in their operating margins and improve the satisfaction of their patients, physicians, and staff. We are dedicated to transforming the commercial infrastructure and patient experience in healthcare. req8736 Category: Operations-Ascension-Birmingham

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Pharmaceutical Sales Representative

Inventive Health, Inc. Birmingham AL, 35202

Do you have a noticeable passion for results? You're bold, empathetic, and very resourceful, especially when results are at stake....

Posted 3 days ago

Do you have a noticeable passion for results? You're bold, empathetic, and very resourceful, especially when results are at stake. You have what it takes: a competitive drive coupled with the exceptional ability to communicate the science behind our client's products and build lasting business relationships. Such talent and passion make you the right fit for this unique sales role with Syneos Health. Why Syneos Health? Join a game-changing global company that is reinventing the way therapies are developed and commercialized. Created through the merger of two industry leading companies - INC Research and inVentiv Health - we bring together more than 23,000 clinical and commercial minds to create better, smarter, faster ways to get biopharmaceutical therapies to patients. Teaming with some of the most talented professionals in the industry, you'll gain exposure and work in a dynamic environment where you'll be supported with comprehensive resources including emerging technologies, data, science and knowledge sharing. Grow your career with a global company committed to shortening the distance from lab to life. Syneos Health has launched more than 120 sales teams in the last 5 years across all major Therapeutic Areas – more than the top 25 pharma companies combined. We offer you more than just one job. The diversification and breadth of Syneos Health creates a multitude of career paths and employment opportunities. Our client roster consists of more than 550 organizations including all 50 of the largest global biopharmaceutical companies. Along with a results-oriented mindset, self-assurance and an engaging manner, the ideal candidate has: * 2+ years recent successful pharmaceutical sales experience, preferably in Cardiovascular or Diabetes therapeutic categories or relevant specialty product * Documented proven and consistent track record of achieving sales results in recent years, demonstrated by national and/or regional rankings, awards and goal achievement * Recent experience in the geography (local market knowledge and existing relationships with target prescribers) preferred * Ability to travel and possess a valid driver's license to drive to assigned healthcare accounts, unless otherwise specified * The drive for self-development, the ability to collaborate, and an action-oriented work ethic Full Syneos Health Selling Solutions benefits which include: * It is the company's policy to provide employees with flexible paid time off (PTO) from work that can be used for vacation, sick days, floating holidays and personal time * Domestic Partner Coverage for: medical, dental, vision, and voluntary life insurance * Medical – Cigna; Dental – Delta Dental; Vision - EyeMed * Company Match 401K - $0.50 per dollar up to 9% of salary * Fleet Vehicle * Eligible to participate in Employee Stock Purchase Plan * Flexible Spending Accounts: Health Care and Dependent Care * Company-paid Basic Term Life Insurance at 2x base salary * Optional Supplemental Term Life Insurance (100% employee paid): for employee, spouse/domestic partner, and children. * Company-paid Short and Long Term Disability * Optional Supplemental Short and Long Term Disability (100% employee paid): employee only * Employee Assistance Program * Tuition reimbursement * Referral bonuses * Dedicated training and support Make your work matter everywhere. Be a driving force in the evolution of healthcare sales. Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Vets/Disabled) Along with a results-oriented mindset, self-assurance and an engaging manner, the ideal candidate has: * 2+ years recent successful pharmaceutical sales experience, preferably in Cardiovascular or Diabetes therapeutic categories or relevant specialty product * Documented proven and consistent track record of achieving sales results in recent years, demonstrated by national and/or regional rankings, awards and goal achievement * Recent experience in the geography (local market knowledge and existing relationships with target prescribers) preferred * Ability to travel and possess a valid driver's license to drive to assigned healthcare accounts, unless otherwise specified * The drive for self-development, the ability to collaborate, and an action-oriented work ethic Full Syneos Health Selling Solutions benefits which include: * It is the company's policy to provide employees with flexible paid time off (PTO) from work that can be used for vacation, sick days, floating holidays and personal time * Domestic Partner Coverage for: medical, dental, vision, and voluntary life insurance * Medical – Cigna; Dental – Delta Dental; Vision - EyeMed * Company Match 401K - $0.50 per dollar up to 9% of salary * Fleet Vehicle * Eligible to participate in Employee Stock Purchase Plan * Flexible Spending Accounts: Health Care and Dependent Care * Company-paid Basic Term Life Insurance at 2x base salary * Optional Supplemental Term Life Insurance (100% employee paid): for employee, spouse/domestic partner, and children. * Company-paid Short and Long Term Disability * Optional Supplemental Short and Long Term Disability (100% employee paid): employee only * Employee Assistance Program * Tuition reimbursement * Referral bonuses * Dedicated training and support Make your work matter everywhere. Be a driving force in the evolution of healthcare sales. Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Vets/Disabled)

Rehab Liaison (Rn, Therapist Or Healthcare Sales Required)

Rehab Liaison (Rn, Therapist Or Healthcare Sales Required)