Qureos Mentor

UMC Health System

<div>We&rsquo;ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas&reg;.
The HIM Coder/Biller is responsible for the accurate assignment of ICD-10-CM diagnosis codes and resolution of claim edits for outpatient records across the hospital. 
 
Reports to
 
Facility Coding Manager 
 
Job Specific Responsibilities 
1. Assign accurate diagnosis codes for outpatient, ancillary laboratory, and diagnostic services. 
2. Maintain current knowledge of coding guidelines, regulatory requirements, and medical billing processes. 
3. Perform coding quality reviews and audits as assigned. 
4. Troubleshoot and resolve SVC (Simple Visit Coding) errors while identifying process improvement opportunities to prevent billing delays. 
5. Review and resolve claim edits and denials, identifying corrective actions and preventative measures to improve claim accuracy. 
6. Collaborate with internal departments to support efficient revenue cycle operations and issue resolution. 
7. All other duties as assigned by the coding manager. 
 
Education and Experience 
<ul><li>High School Diploma or GED.</li><li>Completion of Medical Record technology program or equivalent job experience.</li><li>Experience with billing and clinical EMR software; Epic strongly preferred.</li><li>Minimum of two (2) years of medical coding and billing experience preferred, including service areas such as Emergency Department, outpatient, ambulatory, surgery, observation, and clinic/series encounters.</li></ul> 
Required Licensures/Certifications/Registrations 
<ul><li>RHIT, RHIA, CCS-P, CPC, or equivalent coding certificate.</li></ul> 
Knowledge, Skills and Abilities 
<ul><li>Strong working knowledge of ICD-10-CM, CPT, HCPCS, and E/M coding guidelines.</li><li>Understanding of medical claims processing and billing functions.</li><li>Strong organizational and time management skills.</li><li>Ability to prioritize tasks and meet deadlines.</li><li>Ability to respond to ever-changing needs and situations.</li><li>Strong attention to detail and commitment to accuracy.</li><li>Ability to maintain strict confidentiality.</li></ul> 
Interaction with Other Departments and Other Relationships 
Works collaboratively with team members across Health Information Management (HIM), Patient Financial Services, Registration, Case Management, Revenue Integrity, and other Revenue Cycle departments. 
 
Physical Capabilities 
Occasionally exerts a small amount of force to lift, carry, push, pull, and move objects. Should be able to lift 10 lbs. Work involves sitting for prolonged periods of time. Hearing acuity is required to be able to accurately transact business dealings. 
 
Environmental/Working Conditions 
This position primarily operates in an indoor office environment with protection from weather conditions; however; occasional temperature variations within the facility may occur. Periodic travel to off-site locations may be required, and travel activities may be affected by weather conditions.
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*</div>

HIM Coder/Biller

<div>We&rsquo;ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas&reg;.
Gives professional nursing care to patients and provides supervision and guidance to the members of the nursing staff at least 50% of the time. Has experience in general nursing and a working knowledge of organizational and nursing policies. 
 
 
 
 
JOB SPECIFIC RESPONSIBILITIES: 
 
I. Clinical Standards 
<ul><li>Quality Patient Care- Provide quality patient care adhering to safety practices and proper
</li></ul>clinical documentation. Quickly adjusts to quality initiatives and change. Contributes to the
 
success of the nursing and unit specific strategic plans. 
<ul><li>Hospital Wide Quality Metrics -</li></ul>
o Inpatient Satisfaction &ldquo;Likelihood to Recommend&quot; (Non-nursing department use house
 
wide score; Nursing units use department specific score) 
o NRC: Ambulatory Surgery - Departments use specific results (OPS, GI, Cath, and IR) 
o NRC: Individual Department results 
<ul><li>Quality Measurement: Did staff wash their hands?</li><li>Stewardship- Cost Center actual expenses in comparison to flex budget</li><li>Delegation - Makes licensed and unlicensed assignments according to the Nurse Practice
</li></ul>Act and UMC Policies 
<ul><li>Identification of Problems, Issues and Trends- Analyzes actual or potential barriers to help
</li></ul>identify problems, issues and trends 
<ul><li>Patient Flow - Manages patient flow for maximum efficiency and notifies internal resources
</li></ul>of changes
 
 
II. Professional Growth &amp; Development 
<ul><li>Leadership/Charge Meeting/Staff Meeting Attendance
</li><li>Committee/Workplace Involvement</li><li>Development of Nursing Profession</li></ul> 
III. Patient Safety and Quality Outcomes (NDNQI quality data &ndash; Units that do not monitor specific indicators will use the hospital wide scoring for the year) 
<ul><li>Performance/Evaluation Criteria: Below 25th percentile, Below the mean, Below the 50th percentile,
</li></ul>above the 75th percentile, or Above the 90th percentile 
<ul><li>Falls with Injury</li><li>Hospital Acquired Pressure Ulcer</li><li>Catheter Associated Urinary Tract Infection (CAUTI)</li><li>Central Line Associated Blood Stream Infection (CLABSI)</li></ul> 
EDUCATION AND EXPERIENCE: 
 
Graduated from an accredited school of nursing.
 
BSN Required 
Minimum of 2 years of OR Experience Required 
 
REQUIRED LICENSURES/CERTIFICATIONS/REGISTRATIONS: 
 
Current license from Texas State Board of Nursing or holds a recognized compact state licensure 
 
SKILLS AND ABILITIES: 
 
Knows clinical and nursing standards and practices in accordance with the nursing scope and standards of practice (ANA, 2010). Special interest in scientific and technical activities for understanding and responding to nursing problems and concepts. All nurses will be required to show current knowledge and clinical competence of the special skills required to give quality care to patients on their unit. Age specific knowledge is required when needed for appropriate patients&rsquo; care. 
 
 
 
INTERACTION WITH OTHER DEPARTMENTS AND OTHER RELATIONSHIPS: 
 
This position requires close interaction with other ancillary departments in order to facilitate a quality multidisciplinary approach to patient care. 
 
 
 
PHYSICAL CAPABILITIES: 
 
Work is of medium demand; walking, sitting and standing most of the time while on duty. Occasional lifting of patients with assistance is required. Adequate hand/eye coordination and fine motor skills required. Talking and hearing is essential for communication. Near visual acuity required to work with charts and observe patients. 
 
 
 
ENVIRONMENTAL/WORKING CONDITIONS: 
 
Works in a well-lighted, heated and ventilated building. Hours may vary to accommodate needs in the department as prescribed by the philosophy of the hospital. May work in units other than the assigned one with orientation. Exposure to blood borne pathogens is high risk.
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*</div>

Registered Nurse (RN) Supervisor OR (FT Weekends Various Shifts)

<div>We&rsquo;ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas&reg;.
Registered Nurse (RN) 
Day Surgery 
 
Departmental Description: 
 
Outpatient Surgery has identified its scope of care to include pre-anesthesia and post-anesthesia care and post procedural care; specifically to prepare the patient for surgery/procedure by assessing and evaluating the patients physical status via nursing assessment, by providing pre-operative or pre-procedure teaching/education, to assist the patient in returning to a safe physiological level after local, or local with sedation anesthesia, regional anesthesia, or completion of Phase I (PACU) care following general anesthesia, and to prepare the patient for discharge home. The American Society of Peri-Anesthesia Nurses, Peri-Anesthesia Nursing Standards, Practice Recommendations, and Interpretive Statements provide the guidelines for patient care. 
The Department of Anesthesiology provides medical direction and coverage with full time attending and resident physician staff and Certified Registered Nurse Anesthetists (CRNAs) on a 24-hours a day, 7 days a week basis. A multi-disciplinary approach to nursing care is utilized in all OPS areas. 
Therapies include pre-operative preparation specific to the individual patient, diagnosis, and operative procedure; post-operative observation and evaluation of hemodynamic stability, administration of oxygen and pulse oximetry; arterial/venous sheath monitoring and removal, and written discharge instructions for home care and follow-up care. Anesthetic agents are not administered in the Outpatient Surgery Department. 
Outpatient Surgery is open Monday through Friday 0530-2200 and is closed on holidays and weekends. A standby team exists for coverage of unexpected Saturday/holiday cases. 
 
Job Summary: 
 
Registered professional nurse who assesses, implements or delegates, plans, and evaluates total nursing care and functions in accordance with established philosophy, providing and directing patient care for a group of patients. Relates effectively with other shifts/departments for optimal continuity of care. Duties also include filling in for clinical liaison.
 
 
Qualifications: 
 
Graduation from an accredited School of Nursing 
Valid Texas RN License/Eligible Compact License 
Must maintain a current BLS certification from American Heart Association 
Minimum of 1 year of acute care experience
 
BSN
 
CPAN/CAPA certification preferred
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*</div>

Registered Nurse (RN) Day Surgery (FT M-F 4 10 HR Shifts) Plus late stay call.

<div>We&rsquo;ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas&reg;.
Job Summary 
 
The Medical Coder is responsible for ICD-10 coding of diagnoses and procedures of inpatient/outpatient discharged patient records. 
 
Job Specific Responsibilities 
 
Daily assignments may include but are not limited to: 
 
<ul><li>Apply diagnoses codes to in-patient, out-patient, and emergency services</li><li>Maintain knowledge of current laws and regulations related to insurance, Medicare, Medicaid, and DRG coding, sequencing, and CPT coding</li><li>Perform quality improvement reviews as assigned</li><li>All other assigned duties related to Health Information Management</li></ul> 
Inpatient Coder Duties:
 
 
<ul><li>Review and analyze inpatient medical records to assign ICD-10-CM/PCS codes.
</li><li>Ensure completeness of the record to assign the accurate DRG (Diagnosis Related Group) assignment for reimbursement.
</li><li>Maintain knowledge of current coding guidelines, Coding Clinics and facility-specific coding policies.
</li><li>Collaborate with clinical documentation specialists as needed for unclear or inconsistent documentation requiring queries.
</li><li>Maintains knowledge of coding updates through provided or self- learning to ensure compliance with all changes.
</li><li>Maintain productivity and accuracy standards as defined by the department.
</li></ul> 
Outpatient Coder Duties:
 
 
<ul><li>Review outpatient encounters including same-day surgery and observation.
</li><li>Assign appropriate ICD-10-CM, CPT, and HCPCS codes based on documentation.
</li><li>Ensure accurate coding for billing and regulatory compliance.
</li><li>Apply NCCI edits and modifier usage where applicable.
</li><li>Communicate with supervisor to clarify documentation when necessary.
</li><li>Meet department standards for productivity and accuracy.
</li></ul> 
Education and Experience 
 
<ul><li>High School Diploma or GED</li><li>Completion of Medical Record Technology program</li><li>+ 2 years of experience in Health Information Management Coding</li></ul> 
Required Licensures/Certifications/Registrations 
 
<ul><li>RHIT, RHIA, CCS, or coding certificate</li></ul> 
Skills and Abilities 
 
<ul><li>Demonstrated skill in using 3M Encoder computer software for ICD-10-CM and CPT</li><li>Demonstrated knowledge and understanding of diseases and their treatments and operative procedures</li><li>Experience (or ability to learn) using Solventum 360 Encompass computer assisted coding.
</li><li>Experience (or ability to learn) using Cerner or Epic electronic health records system.
</li><li>Strong knowledge of medical terminology, anatomy and physiology.
</li><li>High attention to detail and coding accuracy.
</li><li>Ability to work independently and meet productivity deadlines.
</li><li>Excellent written and verbal communication skills.
</li><li>Ability to maintain patient confidentiality and comply with HIPAA and organizational policies.</li></ul> 
Interaction with Other Departments and Other Relationships 
 
This position will interact with medical staff and physicians throughout the hospital including Clinical Documentation Improvement (CDI) and Patient Financial Services (PFS).
 
 
Physical Capabilities 
 
Position requires prolonged time periods of sitting at a desk, talking on a phone, and working on a computer. Essential hearing and near vision acuity required. Should be able to lift up to 10 pounds 
 
Environmental/Working Conditions 
 
Work area is well lighted, and subject to varying indoor temperature changes.
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*</div>

Coder - Inpatient (Local or Remote with Experience)

<div>We&rsquo;ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas&reg;.
Urgent Care Health and Wellness
 
 
Provides practical care to patients. Works in compliance and in accordance with clinical and nursing standards. In addition to the skills required of all Registered Nurse, special skills related to nursing in the clinic environment are required.
 
 
Essential Functions: Desires to be part of a health care team dedicated to providing patients optimal care. Must be compassionate, conscientious and meticulous. Direct patient care including but not limited to: assess, treat medical conditions of/for patients. Takes and records histories and physical examinations; communicates with physicians regarding patient care and follow-up. Participates with physician in a review of the patient health records. Assures that adequate patient records are maintained, completed and accurately documented; readily accessible and systemically organized. Performs services in accordance with company policy. Participates in appropriate Quality Improvement (QI) for the clinic. Adjusts work house/schedules to meet the needs and demands of the clinic. Aware of Emergency Disaster Plans and how to respond in the event of a disaster. Works effectively with others, demonstrates leadership and teaching ability and the ability to work under pressure.
 
 
Knowledge/Skills/Abilities: Knowledge of clinical nursing standards and practices. Excellent patient care skills. Excellent communication and teamwork skills. Ability to build positive relationships within department
 
<ul><li>CNAs are responsible for providing basic patient care under the supervision of a nurse. The duties generally include observing patients, recording vital signs, performing EKGs, and reporting changes in patient conditions.
</li></ul> 
Qualifications
 
<ul><li>Applicant has completed Nurse Aide course and presents Nurse Aide Certification. PCA or PCT certification also acceptable
</li><li>Must maintain a current BLS certification from American Heart Association
</li></ul> 
OR for Nurse Assistant
 
NAs are responsible for providing basic patient care under the supervision of a nurse. The duties generally include observing patients, recording vital signs, performing EKGs, and reporting changes in patient conditions.
 
 
Qualifications
 
<ul><li>Nursing student who has completed approximately one quarter of their nursing curriculum (LVN or RN) and clinical experience Or applicant has at least one year of previous/recent hospital Nurse Aide experience.
</li><li>Must maintain a current BLS certification from American Heart Association
</li></ul> 
Questions? Contact Lori Garcia, Nursing Administrative Assistant
 
Email: lori.garcia@umchealthsystem.com
 
Call: 806-775-8912
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*</div>

Certified Nurse Assistant/Nurse Assistant-Health & Wellness Urgent Care-(Part Time 7p-7a- 2 Twelve hour shifts a week requirement)