Qureos Mentor

Brown University Health

<div><ul><li>Job ID: JR-108990
</li><li>Entity: Brown University Health
</li><li>Location Name: Corporate Headquarters
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Reporting to the Director, Supply Chain Operations, provides daily purchasing functions for Brown University Health&rsquo;s centralized purchasing and procurement department. Responsible for coordinating activities and functions of the daily tactical and strategic operations.</p>
<h2 class="jobSectionHeader"><b>
RESPONSIBILITIES</b></h2>
<ul><li>Purchasing supplies, materials, equipment, and services according to procurement policies and standards for Brown University Health.</li>
<li>Processing priority purchasing requests for all service lines.</li>
<li>Prepare and issue purchase orders and agreements.</li>
<li>Resolve any supply issues or discrepancies between suppliers and their organization.</li>
<li>Provide customer service to internal stakeholders on new/existing requests.</li>
<li>Maintaining accurate purchasing records in accordance with internal policies.</li>
<li>Increase ordering efficiency with suppliers.</li>
<li>Review purchase requirements with internal stakeholders.</li>
<li>Track and maintain the status of orders and report issues to supervisor.</li>
</ul><h2 class="jobSectionHeader"><b>MINIMUM QUALIFICATIONS</b></h2>
<ul><li>Ability to exercise considerable independent judgement when performing daily tasks.</li>
<li>Represents the organization in a professional manner.</li>
<li>Complies with company policies, procedures, and regulatory standards.</li>
<li>Effectively manages competing priorities in a changing, highly results oriented, deadline driven environment.</li>
<li>Ensures proper protection of organization&rsquo;s confidential information.</li>
<li>A high level of interpersonal skills to effectively represent Brown University Health and Supply Chain in interaction with all levels of personnel within and outside the organization.</li>
</ul><h2 class="jobSectionHeader"><b>EDUCATION</b></h2>
<p>
High School Diploma or equivalent required and a minimum of 2 years of experience in purchasing.</p>
<h2 class="jobSectionHeader"><b>
EXPERIENCE</b></h2>
<ul><li>Proficiency in Microsoft Office Suite required.</li>
<li>Excellent verbal and written communication skills.</li>
<li>Excellent interpersonal and customer service skills.</li>
</ul><h2 class="jobSectionHeader"><b>Pay Range</b></h2>
<p>
$20.96-$34.61</p>
<h2 class="jobSectionHeader"><b>
Location</b></h2>
<p>
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903</p>
<h2 class="jobSectionHeader"><b>
Work Type</b></h2>
<p>
M-F 8:00am-5:00pm</p>
<h2 class="jobSectionHeader"><b>
Work Shift</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
Daily Hours</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
Driving Required</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Supply Chain Purchasing Specialist

<div><ul><li>Job ID: JR-108756
</li><li>Entity: Brown University Health
</li><li>Location Name: Corporate Headquarters
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Reports to PFS Manager of Coding Policy and Education. Assists Manager in providing feedback and education to coders and providers. Assists Manager with coordinating external audits and internal audits.</p>
<p>
Brown University Health employees are expected to successfully role model the organization&rsquo;s values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b>, as these values guide our everyday actions with patients, customers, and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul>
<p>In addition, our leaders will demonstrate an aptitude for:</p>
<ul>
<li>Ensure Accountability and Build Effective Teams</li>
<li>Drive Vision and Purpose and Optimize Work Processes</li>
</ul>
<p>By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.</p>
<h2 class="jobSectionHeader"><b>
RESPONSIBILITIES</b></h2>
<p>
Performs audits of the validation team to assure all validation is consistent with coding guidelines and Brown University Health&rsquo;s billing, coding, and compliance policies. Works with Manager to create annual validation schedule and validator goals. Ensures validators are performing timely and accurate audits and are meeting all goals of the department.</p>
<p>
Provide regular feedback to staff, including praising them for their successes and mentoring/retraining as needed. Identifies coding trends and reports these trends to the Manager. Maintains updated knowledge of all billing, coding, insurance, and compliance guidelines, including but not limited to HiPAA, CPT, ICD-10, HCHPCS, medical terminology, etc. Applies this knowledge daily and serves as a resource to staff.</p>
<p>
Serves as the principal trainer to new staff and a resource to the team, answers questions and provides guidance. Oversees the development and growth of the individual validators. Acts as a resource for healthcare professionals in need of coding/documentation assistance. Assists Manager with human resource issues including hiring, evaluating, implementing improvement/corrective action plans, and terminations, as needed. Prepares payroll as requested.</p>
<p>
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and the American Association of Professional Coders. Monitors validators for violations and reports to PFS Manager or Director when areas of concern are identified. Performs other duties as necessary.</p>
<h2 class="jobSectionHeader"><b>
MINIMUM QUALIFICATIONS</b></h2>
<p><b>
BASIC KNOWLEDGE:</b> Associate Degree or 3 years of experience in a medical coding/validating role. Certification required: CCS, CPC. RHIA or RHIT considered.</p>
<p><b>
EXPERIENCE:</b> Three to five years progressively responsible experience performing outpatient coding. Experience in a large, multispecialty physician group and/or complex academic medical center preferred. One to two years supervisory experience strongly preferred. Experience should demonstrate a high level of knowledge in ICD-10-CM and CPT-4 coding methodologies. Effective written and oral communication skills and effective leadership/management skills required. Experience with Epic preferred.</p>
<p><b>
WORKING CONDITION AND PHYSICAL REQUIREMENTS:</b> This position is Remote in Providence, RI.</p>
<p><b>
INDEPENDENT ACTION:</b> Performs independently within the department&rsquo;s policies and procedures. Refers specific complex problems to the Manager when clarification of the departmental policies and procedures are required.</p>
<p><b>
SUPERVISORY RESPONSIBILITY:</b> Supervisory responsibility for up to 20 FTEs.</p>
<h2 class="jobSectionHeader"><b>
Pay Range</b></h2>
<p>
$71,136.00 - $117,353.60</p>
<h2 class="jobSectionHeader"><b>
Location</b></h2>
<p>
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903</p>
<h2 class="jobSectionHeader"><b>
Work Type</b></h2>
<p>
M-F Days</p>
<h2 class="jobSectionHeader"><b>
Work Shift</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
Daily Hours</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
Driving Required</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Supervisor Coding Validation

<div><ul><li>Job ID: JR-108924
</li><li>Entity: Brown University Health
</li><li>Location Name: Corporate Headquarters
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice.</p>
<p>
Brown University Health employees are expected to successfully role model the organization's values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b> as these values guide our everyday actions with patients, customers, and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul><h2 class="jobSectionHeader"><b>RESPONSIBILITIES</b></h2>
<ul><li>Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax, or via electronic submission.</li>
<li>Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve payer errors.</li>
<li>Continually maintain knowledge of payer specific updates via payer&rsquo;s listservs, provider updates, webinars, meetings, and websites.</li>
<li>Understand and maintain compliance with HIPAA guidelines when handling patient information.</li>
<li>Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials.</li>
<li>Report to supervisor identification of denial trends resulting in revenue delays.</li>
<li>Answer telephone inquiries from 3rd party payers; refer all unusual requests to supervisor.</li>
<li>Retrieve appropriate medical records documentation based on third party requests.</li>
<li>Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal procedures.</li>
<li>Work with management to improve processes, increase accuracy, create efficiencies, and achieve the overall goals of the department.</li>
<li>Maintain quality assurance, safety, environmental, and infection control in accordance with established policies, procedures, and objectives of the system and affiliates.</li>
<li>Perform other related duties as required.</li>
</ul><h2 class="jobSectionHeader"><b>MINIMUM QUALIFICATIONS</b></h2>
<h3 class="jobSectionHeader"><b>BASIC KNOWLEDGE:</b></h3>
<ul><li>Equivalent to a high school graduate.</li>
<li>Knowledge of 3rd party billing to include ICD, CPT, HCPCS, and 1500 claim forms.</li>
<li>Demonstrated skills in critical thinking, diplomacy, and relationship-building.</li>
<li>Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings.</li>
<li>Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies.</li>
</ul><h3 class="jobSectionHeader"><b>EXPERIENCE:</b></h3>
<ul><li>One to three years of relevant experience in professional billing preferred.</li>
<li>Experience with Epic a plus.</li>
</ul><h3 class="jobSectionHeader"><b>INDEPENDENT ACTION:</b></h3>
<p>
Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action.</p>
<h3 class="jobSectionHeader"><b>
SUPERVISORY RESPONSIBILITY:</b></h3>
<p>
None</p>
<h2 class="jobSectionHeader"><b>
PAY RANGE</b></h2>
<p>
$19.97-$32.96</p>
<h2 class="jobSectionHeader"><b>
LOCATION</b></h2>
<p>
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903</p>
<h2 class="jobSectionHeader"><b>
WORK TYPE</b></h2>
<p>
Monday-Friday 7:30-4</p>
<h2 class="jobSectionHeader"><b>
WORK SHIFT</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
DAILY HOURS</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
DRIVING REQUIRED</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Medical Billing Professional Denial Specialist

<div><ul><li>Job ID: JR-108676
</li><li>Entity: Brown University Health
</li><li>Location Name: Corporate Headquarters
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice.</p>
<p>
Brown University Health employees are expected to successfully role model the organization's values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b> as these values guide our everyday actions with patients, customers, and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul><h2 class="jobSectionHeader"><b>RESPONSIBILITIES</b></h2>
<ul><li>Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax, or via electronic submission.</li>
<li>Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve payer errors.</li>
<li>Continually maintain knowledge of payer specific updates via payer&rsquo;s listservs, provider updates, webinars, meetings, and websites.</li>
<li>Understand and maintain compliance with HIPAA guidelines when handling patient information.</li>
<li>Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials.</li>
<li>Report to supervisor identification of denial trends resulting in revenue delays.</li>
<li>Answer telephone inquiries from 3rd party payers; refer all unusual requests to supervisor.</li>
<li>Retrieve appropriate medical records documentation based on third party requests.</li>
<li>Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal procedures.</li>
<li>Work with management to improve processes, increase accuracy, create efficiencies, and achieve the overall goals of the department.</li>
<li>Maintain quality assurance, safety, environmental, and infection control in accordance with established policies, procedures, and objectives of the system and affiliates.</li>
<li>Perform other related duties as required.</li>
</ul><h2 class="jobSectionHeader"><b>MINIMUM QUALIFICATIONS</b></h2>
<h3 class="jobSectionHeader"><b>BASIC KNOWLEDGE</b></h3>
<ul><li>Equivalent to a high school graduate.</li>
<li>Knowledge of 3rd party billing to include ICD, CPT, HCPCS, and 1500 claim forms.</li>
<li>Demonstrated skills in critical thinking, diplomacy, and relationship-building.</li>
<li>Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings.</li>
<li>Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies.</li>
</ul><h3 class="jobSectionHeader"><b>EXPERIENCE</b></h3>
<ul><li>One to three years of relevant experience in professional billing preferred.</li>
<li>Experience with Epic a plus.</li>
</ul><h3 class="jobSectionHeader"><b>INDEPENDENT ACTION</b></h3>
<p>
Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action.</p>
<h3 class="jobSectionHeader"><b>
SUPERVISORY RESPONSIBILITY</b></h3>
<p>
None</p>
<h2 class="jobSectionHeader"><b>
PAY RANGE</b></h2>
<p>
$19.97-$32.96</p>
<h2 class="jobSectionHeader"><b>
LOCATION</b></h2>
<p>
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903</p>
<h2 class="jobSectionHeader"><b>
WORK TYPE</b></h2>
<p>
Monday-Friday 7:30-4</p>
<h2 class="jobSectionHeader"><b>
WORK SHIFT</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
DAILY HOURS</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
DRIVING REQUIRED</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Medical Billing Professional Denials Specialist

<div><ul><li>Job ID: JR-109092
</li><li>Entity: 58 AMARAL ST
</li><li>Location Name: 58 AMARAL ST
</li><li>City, State: East Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Reports to the Ambulatory Clinical Manager and/or Practice Manager, or other assigned Supervisory personnel and under general supervision of the attending Licensed Independent Practitioner, and functions in accordance with established policies and procedures in an Ambulatory setting. All essential functions performed in this position reflect the age-specific needs of the geriatric, adult, adolescent, and pediatric patient. Fosters patient and family centered care and nursing services in accordance with the Brown University Health&rsquo;s mission, vision, values, with consideration of the life span, including all developmental stages as well as cultural patterns. Brown University Health employees are expected to successfully role model the organization's values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b> as these values guide our everyday actions with patients, customers and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul><h2 class="jobSectionHeader"><b>RESPONSIBILITIES</b></h2>
<p>
Works effectively and respectfully at his/her highest capabilities and training.</p>
<p>
Follows the practice, clinic or office workflow protocols to maximize quality and efficiency.</p>
<p>
Performs pre-visit planning by reviewing and updating the patient record prior to the appointment with recent test results, consults, correspondence, etc. and determines needed services based on practice protocols. Communicates point of care reminders to providers via the electronic medical record (EMR).</p>
<p>
Prepares patients for examination and treatment in accordance to their clinic specific workflow protocol, by escorting from the waiting area to the exam room. Takes vital signs, weighs patients and records in patient chart. Enters in patient chief complaint, medication reconciliation, histories and other services as outlined in workflow protocol. Notes all patient health concerns into EMR. Records the patient pain score. Completes all questionnaires in the patient&rsquo;s chart.</p>
<p>
Ensures effective patient flow throughout the practice, clinic and office.</p>
<p>
Reviews Health Maintenance and Chronic Illness services and performs/orders according to protocols and standing orders.</p>
<p>
Performs testing procedures such as blood pressure, EKG, pulse oximetry, Hgb A1-C, glucose, urinalysis, urine hcg, rapid strep test, and other point of care tests.</p>
<p>
Records allergy information, medications, medical, surgical, and family histories in the patient chart. Initiates pharmacy benefits verification.</p>
<p>
Assists physician with physical examinations. Performs all procedures using aseptic techniques, following standard procedures.</p>
<p>
Assists provider with all physical examinations. Performs all procedures using aseptic techniques, following standard procedures.</p>
<p>
Administers vaccines and places PPDs as per practice/clinic protocol.</p>
<p>
Completes appropriate follow-up work after visit including, but not limited to, ensuring all blood and specimens are properly labeled, recorded and sent to lab.</p>
<p>
Follows up to ensure all lab results are entered in the medical record. Tracks orders and results. Contacts patients for outreach and reminders for labs/orders. Updates EMR with status. Reports all abnormal lab results to physician or nurse immediately.</p>
<p>
Follows up on referrals for specialty care and/or other services. Tracks consult reports and ensures EMR is updated accordingly. Contacts patients for outreach and/or reminders for referrals.</p>
<p>
Checks for prescription refills pending.</p>
<p>
Ensures examination room is cleaned between each patient and set-up appropriately for next appointment.</p>
<p>
Thoroughly explains programs, procedures and correct preparation for various tests and exams. Provides education to patients regarding the importance of coordination of care and the prudent use of emergency rooms when seeking care. Documents identified barriers.</p>
<p>
Schedules tests and follow-up appointments. Pre-registers patient for next visit. Verifies patient demographic and insurance information. Obtains prior authorizations as needed.</p>
<p>
Monitors and orders supplies and keeps room stocked. Cleans medical equipment. Reports broken or missing equipment to manager immediately. Ensures exam rooms are prepared for each patient. Checks expiration dates on medications and supplies, removes and reports expired medication to Practice or Clinic Management.</p>
<p>
Assists with administrative office duties. Mails reminders and other letters to patients.</p>
<p>
Manages time effectively. Fills slow periods with activities to prepare for future needs. Minimizes non-productive time.</p>
<p>
Maintains quality assurance, safety, environmental, and infection control in accordance with established hospital department policies, procedures, and objectives.</p>
<p>
Protects and preserves the patient&rsquo;s right to privacy and confidentiality.</p>
<p>
Maintains a positive attitude and actively engages in the team approach of caring for patients.</p>
<p>
Supports the goals and concepts of the patient centered medical home by demonstrating flexibility and willingness to change.</p>
<p>
Performs other related duties as required.</p>
<h2 class="jobSectionHeader"><b>
MINIMUM QUALIFICATIONS</b></h2>
<p><b>
BASIC KNOWLEDGE:</b></p>
<ul>
<li>High School graduate or equivalent required.</li>
<li>Able to read, write and speak English.</li>
<li>Basic Life Support Certification required.</li>
<li>Completion of a medical assistant certification preferred.</li>
</ul><h2 class="jobSectionHeader"><b>Pay Range</b></h2>
<p>
$18.13-$29.90</p>
<h2 class="jobSectionHeader"><b>
Location</b></h2>
<p>
58 AMARAL ST - 58 Amaral Street East Providence, Rhode Island 02915</p>
<h2 class="jobSectionHeader"><b>
Work Type</b></h2>
<p>
M-F 8:30-5p</p>
<h2 class="jobSectionHeader"><b>
Work Shift</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
Daily Hours</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
Driving Required</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Medical Assistant Ambulatory GI

<div><ul><li>Job ID: JR-108808
</li><li>Entity: Brown University Health
</li><li>Location Name: Corporate Headquarters
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Day
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
The Denials Specialist reports to the Manager of PFS Denials Management. Under general direction and within established Brown University Health policies and procedures, maximizes reimbursement from contracted payers through analysis, tracking, and trending of denials using available metric denial reports. Responsible for actively supporting the execution of strategic initiatives, process re-design, root cause analysis, metric/report development, and special projects as it relates to denials management. Executes the appeal process by receiving, assessing, documenting, tracking, analyzing, responding to, and/or resolving appeals with third-party payers.</p>
<p>
Brown University Health employees are expected to successfully role model the organization&rsquo;s values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b> as these values guide our everyday actions with patients, customers, and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul><h2 class="jobSectionHeader"><b>RESPONSIBILITIES</b></h2>
<h3 class="jobSectionHeader"><b>ESSENTIAL FUNCTIONS</b></h3>
<p>
Consistently applies the corporate values of respect, honesty, and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible, and high-value services within the environment of a comprehensive integrated academic health system. Is responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct.</p>
<ul>
<li>Evaluates denied accounts sent to the Denials Management Department for review.</li>
<li>Assigns denied accounts to appropriate department work queues for resolution.</li>
<li>Identifies repetitive issues with the goal of identifying preventative solutions.</li>
<li>Runs reports and/or uses work queues to identify accounts not worked in a timely manner and follows up with departments when this occurs.</li>
</ul>
<p>Reviews denial database report when denials are posted to correctly categorize provider liable denials, their root cause, and resolution. Performs end of month reviews of the denial database to identify and report on trends, new issues, areas of opportunity, and any other issues/changes related to the denial report that may be appropriate. Responds to departmental concerns about data on their monthly denial reports.</p>
<p>
Develops and maintains a strong working relationship with hospital departments and referring physician offices to collaborate in obtaining information needed for successful appeal/reversal of a denial.</p>
<p>
Maintains current knowledge of state and federal regulations, accreditation and compliance requirements, Brown University Health policies, as well as payer specific policies including LCDs and NCDs, and payer contracts with Brown University Health to identify cause of denials.</p>
<p>
Researches payer issues resulting in payment delays, denials, underpayments, and processing deficiencies and recommends changes as appropriate. Reviews monthly payer updates, prepares a report of the monthly payer updates to present during the monthly Appeal/Denial meeting.</p>
<p>
Tracks the status of appeals by maintaining well-organized records to ensure established timelines are met.</p>
<p>
Maintains a strong working relationship with payers to assure claims appeals are processed appropriately.</p>
<p>
Processes necessary LifeChart online adjustments or changes related to appeals as needed, within the scope of job function.</p>
<p>
Continually evaluates workflow and identifies opportunities to improve process for full and complete payment for all hospital services rendered to patients.</p>
<p>
Creates, generates, and maintains ad hoc reports as requested by Manager to assist in the daily operation of the department.</p>
<p>
Participates in staff meetings, councils, quality improvement teams, and other such meetings and committees as required.</p>
<p>
Develops and maintains working relationship with Brown University Health affiliate departments as needed to ensure fully data exchange.</p>
<p>
Performs other duties as necessary.</p>
<h2 class="jobSectionHeader"><b>
WORK LOCATIONS/EXPECTATIONS</b></h2>
<p>
After orientation at the corporate facilities, work is performed based on the following options approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote Access Policy and Procedure.</p>
<ul>
<li>Full time schedule worked in office</li>
<li>Full time schedule worked in a dedicated space in the home</li>
<li>Part time schedule in office and in a dedicated space within the home</li>
</ul>
<p>Schedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish all job functions within the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into Microsoft Teams during their entire shift and communicate with Supervisor as directed.</p>
<h2 class="jobSectionHeader"><b>
MINIMUM QUALIFICATIONS</b></h2>
<h3 class="jobSectionHeader"><b>BASIC KNOWLEDGE</b></h3>
<ul><li>Associate&rsquo;s degree in accounting, business office practices, computer science, or other related area or equivalent experience.</li>
</ul><h3 class="jobSectionHeader"><b>EXPERIENCE</b></h3>
<ul><li>Three to five years&rsquo; experience in hospital patient accounting.</li>
<li>Experience should demonstrate thorough knowledge of claims administration in similarly complex healthcare organizations.</li>
<li>Must be familiar with ICD-9/10, CPT-4 coding, UB04, and HCFA 1500 claims administration.</li>
<li>Ability to perform financial analysis.</li>
<li>Comprehensive knowledge of patient accounting activities in an automated, networked, multiple hospital environment.</li>
<li>Detailed knowledge of regulatory requirements.</li>
</ul><h3 class="jobSectionHeader"><b>INDEPENDENT ACTION</b></h3>
<p>
Incumbent functions independently within the scope of department policies and practices; refers specific problems to supervisor only when clarification of departmental policies and procedures may be required.</p>
<h2 class="jobSectionHeader"><b>
SUPERVISORY RESPONSIBILITIES</b></h2>
<p>
None.</p>
<h2 class="jobSectionHeader"><b>
PAY RANGE</b></h2>
<p>
$23.11 - $38.16</p>
<h2 class="jobSectionHeader"><b>
LOCATION</b></h2>
<p>
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903</p>
<h2 class="jobSectionHeader"><b>
WORK TYPE</b></h2>
<p>
M-F 7:00am - 3:30pm</p>
<h2 class="jobSectionHeader"><b>
WORK SHIFT</b></h2>
<p>
Day</p>
<h2 class="jobSectionHeader"><b>
DAILY HOURS</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
DRIVING REQUIRED</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Denials Specialist

<div><ul><li>Job ID: JR-108483
</li><li>Entity: Remote
</li><li>Location Name: Remote-Rhode Island
</li><li>City, State: Providence, RI
</li><li>Work Type: FULL TIME
</li><li>Hours Per Week: 40
</li><li>Shift: Variable
</li><li>Posted Date: 4/28/2026
</li></ul><div><h2 class="jobSectionHeader"><b>SUMMARY</b></h2>
<p>
Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assigns appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes 3M 360 Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.). Confers with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards. Brown University Health employees are expected to successfully role model the organization's values of <b>Compassion</b>, <b>Accountability</b>, <b>Respect</b>, and <b>Excellence</b> as these values guide our everyday actions with patients, customers, and one another.</p>
<p>
In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:</p>
<ul>
<li>Instill Trust and Value Differences</li>
<li>Patient and Community Focus and Collaborate</li>
</ul><h2 class="jobSectionHeader"><b>RESPONSIBILITIES</b></h2>
<p>
Enters coded abstracted information into 3M 360 Finder assigning accurate APC and reviewing all coding edits appearing in 3M. Understands and follows all National Correct Code Initiative Edits (NCCI) and follows pertinent medical necessity requirements. Resolves accounts on the claims edit database. Assigns injections and infusion codes for observation patients. Meets the minimum productivity standard maintaining an average accuracy rating of 95%. Assigns E/M, ICD-10-CM, CPT, or chargemaster codes to clinic visits ensuring medical record documentation supports the code. Should physicians have entered in diagnosis, ICD, or CPT codes, ensures they are accurate and supported by documentation in the medical record. Utilizes 3M to identify and resolve NCCI edits before final billing. Reports documentation insufficiencies to the responsible physician. Follows Rhode Island Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients less than 18 years of age. Monitors and resolves rejected accounts on the Claims Edit Report and eClinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity, and various other coding and billing issues. Refers complex coding issues to the coding validator or supervisor. Reviews pertinent outpatient uncoded reports researching and resolving old uncoded accounts and any accounts posted on report for which the charges are inappropriate. Updates patient financial accounts in the Patient Management and Patient Accounting billing system as required. Follows established procedures for rebilling accounts. Performs related clerical duties as required. Maintains level of knowledge and expertise pertinent to the position.</p>
<h2 class="jobSectionHeader"><b>
MINIMUM QUALIFICATIONS</b></h2>
<p><b>
BASIC KNOWLEDGE:</b> High school diploma or equivalent. Successful completion of formal coding educational program. Ability to read and understand outpatient clinic medical record documentation for reporting of outpatient clinic, ancillary, and endoscopies. Coding certification required from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC).</p>
<p><b>
EXPERIENCE:</b> One to two years experience in outpatient coding or billing. Ability to meet and maintain established quality and productivity standards.</p>
<p><b>
WORKING CONDITIONS:</b> Requires long periods of sitting to review medical records. Ability to lift a minimum of 25 pounds, bend, stoop, stretch, use step-stools to file records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.</p>
<p><b>
INDEPENDENT ACTION:</b> Performs independently within the department&rsquo;s policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.</p>
<p><b>
SUPERVISORY RESPONSIBILITY:</b> None</p>
<h2 class="jobSectionHeader"><b>
Pay Range</b></h2>
<p>
$24.29-$40.07</p>
<h2 class="jobSectionHeader"><b>
Location</b></h2>
<p>
Remote-Rhode Island - N/A Providence, Rhode Island 02901</p>
<h2 class="jobSectionHeader"><b>
Work Type</b></h2>
<p>
8:00am-4:30pm</p>
<h2 class="jobSectionHeader"><b>
Work Shift</b></h2>
<p>
Variable</p>
<h2 class="jobSectionHeader"><b>
Daily Hours</b></h2>
<p>
8 hours</p>
<h2 class="jobSectionHeader"><b>
Driving Required</b></h2>
<p>
No</p>
<p><i>
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.</i></p></div></div>

Coding Specialist Outpatient Telecommute-Surgical Coder

Join Brown University Health and explore 22   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.