claims health postdoctoral fellow - institute for health computing (north bethesda location)

clinical research assistant ii (health, behavior and society)

commercial driver (class b)/warehouse assoc

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claims health postdoctoral fellow - institute for health computing (north bethesda location) Jobs in Baltimore

clinical research assistant ii (health, behavior and society) Jobs in Baltimore

commercial driver (class b)/warehouse assoc Jobs in Baltimore

health educator, grant services specialist ii (ncs) - baltimore city health department Jobs in Baltimore

interviewer (health, behavior and society) Jobs in Baltimore

claims health postdoctoral fellow institute for health computing north bethesda location

University of Maryland, Baltimore

<div></div><div><div>The University of Maryland Institute for Health Computing is recruiting a Postdoctoral Fellow jointly mentored by Dr. Chixiang Chen and Dr. Rozalina McCoy.
About the University of Maryland Institute for Health Computing (UM-IHC):
The UM-IHC is a collaborative initiative of the University of Maryland Baltimore, the University of Maryland College Park, and the University of Maryland Medical System, founded with generous funding from Montgomery County and the State of Maryland&rsquo;s MPower initiative. Based in North Bethesda, MD, the IHC optimizes computational and analytical methods to build a learning health system for improving the health and quality of life of the citizens of Maryland. Key foci of the Institute include population health, clinical trial innovation, health informatics, artificial intelligence, therapeutic target discovery, and immersive visualization.
Essential Functions:<ul><li>
Methodologies in target trial emulation: Developing and Applying advanced causal inference methods to analyze real-world data (e.g., OLDW)</li><li>
Scientific writing: Publishing leading biostatistical and clinical journals</li><li>
Data Management and Learning: Designing, managing, and learning multi-RCT and cohort databases.</li></ul><div> 
</div></div><div>
Qualifications<div></div> 
Education: A Ph.D. degree in a quantitative public health field such as biostatistics/statistics, epidemiology, health informatics, population health sciences, or a closely related area is required.
Experience: Experience in cleaning and analyzing large-scale real-world data, such as Medicare claims and electronic health records is preferred but not required. Candidates should have the ability to conduct independent quantitative public health research developing or using advanced data science methods.
Knowledge, Skills, and Abilities:<ul><li>
 Strong quantitative background in causal inference</li><li>
 Strong programming skills</li><li>
 Strong scientific writing skills</li></ul>
Patience and perseverance in research Stipend for Postdoctoral Fellows is commensurate with qualifications and will be equal to or exceed NIH postdoctoral stipends. Benefits will be in accordance with the University of Maryland's standard postdoctoral benefits.
For immediate consideration, please send a cover letter and a recent CV, including names and contact information of three references to Dr. Chen at chixiang.chen@som.umaryland.edu
The University of Maryland, Baltimore is an Equal Opportunity/Affirmative Action employer and educational institution and does not discriminate on the basis of race, color, religion, age, ancestry, national origin, gender, sexual orientation, gender identity or expression, physical or mental disability, marital status, or protected veteran's status to recruit, hire, compensate, train, and promote employees and applicants for employment in all job levels with regard to their qualifications and without consideration to the aforementioned categories. Exceptions to this policy will be made only as allowed by law; for example, due to bona fide occupational qualifications or lack of reasonable accommodations for disabilities.
The University is committed to equal opportunity in the workplace and affirmative action to identify qualified applicants from many backgrounds and to retaining a diverse workforce. All of us benefit from the opportunity to work in an environment that brings together people from diverse backgrounds, and equal employment opportunity is essential to achieving diversity. The University prepares an annual Affirmative Action Plan aimed at developing and maintaining a broadly representative workforce. Through internal monitoring and reporting systems, the University assesses the effectiveness of its Affirmative Action Plan.
The University is committed to fostering a work environment free of discrimination where respect and civility is valued. To that end, the University condemns incidents of hate crimes, intimidation, and bias. Harassment or acts of violence that are racially, ethnically, and/or otherwise motivated and which infringe on the rights and freedom of others will not be tolerated at the University's institutions or facilities.
 If you need a reasonable accommodation for a disability, for any part of the recruitment process, please contact us at HRJobs@umaryland.edu and let us know the nature of your request and your contact information. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.<div> 
</div></div><div>
Job: Postdoctoral Fellows</div><div>
Organization: School of Medicine - Centers/Programs/ORCs</div><div>
Job Posting: Mar 18, 2026</div></div>

Claims Health Postdoctoral Fellow - Institute for Health Computing (North Bethesda location)

Global Solutions Network, Inc.

<div>Global Solutions Network (GSN), a federal government contracting firm, presents this full time, long-term position supporting GSN's customer at the National Institutes of Health (NIH). This position provides a competitive salary and comprehensive benefits. 
If interested, please provide an up-to-date resume. 
RESPONSIBILITIES<ul><li>
Serve as coordinator and dispatcher to the drivers providing transportation services for the Bayview Research Center (BRC) Campus/Satellite locations(s) Shuttle Program, and the Clinical Research Branch (CRB) Participant/Patient Shuttle Program.</li><li>
Serve as and schedule self as alternate drive for shuttle programs during downtime periods of two hours or more.</li><li>
Drive specified routes following an established sequence to pick up biological specimens from National Institute on Aging (NIA) facilities.</li><li>
Coordinate collection, transportation and delivery of specimens and results.</li><li>
Transport supplies, medical records, mail, passengers, and staff for the NIA facilities at Harbor Hospital, HANDLS MRV (medical research vehicle) and at NIH, if needed.</li><li>
Transport and sort mail and Fed-Ex packages to be distributed to NIA-CRC Unit at Harbor Hospital, the MRV, Triad and BRC-Buildings at JHBMC and the NIH main campus in Bethesda.</li><li>
Transport linen to and from the MRV.</li><li>
Transport NIH research participants/patients and family members or caretakers, luggage and wheelchairs from a pre-notified location, date and time for arrival at HH and return to the originating or departing location (door to door); services may be provided any day of the week.</li><li>
Treat each passenger with respect and courtesy at all times; maintain the highest levels of customer care while demonstrating a friendly and cooperative attitude.</li><li>
Assist passengers/participants into and out of the government vehicle, provide assistance walking and with loading, unloading, and carrying luggage and medical equipment as needed; escort participants on and off the NIA IRP clinical unit (5th floor of Harbor Hospital) and to and from the vehicle and provide assistance as needed, i.e., walking alongside; and reports any concerns or issues while transporting participants to the NIA IRP clinical unit.</li><li>
Protect the confidentiality of NIH research participants/patients. Driver shall avoid referring to patients by name, but rather address them by &ldquo;sir&rdquo; or &ldquo;ma&rsquo;am&rdquo;. The driver shall not allow any written information (e.g., name lists, etc.) to be viewed by unauthorized individuals.</li><li>
Transport IRB regulatory documents to and from the MedStar Health Investigational Review Board as needed.</li><li>
Access computer to confirm transport schedules.</li><li>
Complete pickup and delivery logs, bar-coding and scanning procedures.</li><li>
Match requisitions with specimens, log appropriately and immediately communicate with the Clinical Nurse Manager or designee any discrepancies.</li><li>
Maintain proper handling of dry ice needed to maintain sample integrity. Formal training required.</li><li>
Identify Routes / Transport Locations. Common locations include Clinical Core Lab, Biorepository (Triad), OSD Office, Mail Room, HANDLS, Medical Records in the BRC, Johns Hopkins, Johns Hopkins Bayview Medical Campus, Franklin Square, NIH, etc.</li><li>
Maintain knowledge of MRV schedule and routes and coordinate work hours for rare weekend openings; coordinate coverage with team for planned time off.</li><li>
Provide for safe packing of materials using guideline issued by national authorities.</li><li>
Complete DOT Training requirements (provided by NIA) related to principal duties and responsibilities.</li><li>
Complete blood borne pathogen training.</li><li>
In coordination with CRB pharmacist, replenish the MRV Emergency boxes.</li><li>
Attend CRB staff meetings.</li><li>
Comply with all traffic laws; maintain knowledge of procedure for handling any accident involving government vehicles.</li><li>
Complete logs for sample &amp; mail pick up.</li><li>
Demonstrate proper lifting techniques.</li><li>
Perform collection and delivery of small vessels containing liquid nitrogen.</li><li>
Maintain knowledge of temperature and storage conditions for blood, urine and tissue samples.</li><li>
Perform daily check of vehicle fluids and mechanical response and report vehicle or maintenance problems to the NIA/IRP Vehicle Fleet Manager.</li><li>
Transport sensitive cognitive data in small locked data bags to and from Harbor Hospital and the BRC building; complete and sign delivery logs during pick-up and drop-off of data bags; secure vehicle during transport.</li></ul> 
REQUIREMENTS
<ul><li>High school diploma.</li><li>
Minimum of four (5) years of general experience in shuttle driver/courier services.</li><li>
License/Certificate: Maryland Driver&rsquo;s License and safe driving record.</li><li>
Successful background check, including driving record.</li><li>
Knowledge of DOT transportation regulations.</li><li>
Excellent verbal communication skills; ability to provide outstanding customer service and respond to client requests courteously and quickly.</li><li>
Ability to handle sealed vessels containing biological specimens.</li></ul> 
BENEFITS<ul><li>
Medical, Dental, &amp; Vision Coverage</li><li>
Paid Time Off and Paid Holidays</li><li>
401K/Profit Sharing Plan</li><li>
Flexible Spending Accounts (Healthcare &amp; Dependent Care)</li><li>
Pretax Parking &amp; Transportation Plan</li><li>
Short-Term &amp; Long-Term Disability Insurance</li><li>
Life &amp; AD&amp;D Insurance</li><li>
Professional Development/Education</li><li>
Employee Referral Bonuses</li><li>
Employee Discount Program</li><li>
Merit Bonuses</li><li>
Employee Assistance Program</li><li>
Travel Assistance Program</li></ul> 
Global Solutions Network, Inc. (GSN) is an Equal Employment Opportunity (EEO) employer. It is the policy of GSN to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.</div>

Shuttle Driver/Courier - NIH

Kennedy Krieger Institute

<div>Overview:
<div>
The Psychologist II will provide clinical services in the Child and Family Therapy (CFT) Clinic working with the entire family to address behavioral and emotional problems that impact the positive functioning of the patient&rsquo;s life as well as those of their family. The incumbent will also provide individual therapy, parent training, and various group treatments to complement family therapy.
</div>Responsibilities:
<div>
1. Provide direct clinical services in a hospital outpatient setting.
 
2. Provide supportive clinical services to families of outpatients.
 
3. Participate in research projects involving the assessment and treatment of behavior disorders. 
4. Provide supervision and training for Behavioral Psychology doctoral interns and postdoctoral fellows. 
5. Participate in administrative, clinical, and training meetings as necessary.</div>
Qualifications:
<div>
QUALIFICATIONS: 
<ul><li>Must possess and maintain licensure to practice as a Psychologist in the state of Maryland.</li><li>Must be credentialed through the Kennedy Krieger Medical staff office before beginning the position.</li></ul></div><div></div><div> 
EDUCATION: 
<ul><li>Doctoral degree in clinical, counseling, or school psychology from an American Psychological Association (APA)-accredited college or university required.</li><li>Internship training from an APA-accredited program in clinical child or pediatric psychology.</li></ul></div><div></div><div> 
EXPERIENCE: 
<ul><li>Minimum of two years of experience in a multi-disciplinary setting working with children, adolescents, and family therapy is required. This experience may be satisfied through post-doctoral fellowship training in pediatric psychology.</li><li>Must have completed a minimum of a one-year clinical internship in psychology with specialization in pediatric behavior disorders.</li><li>Experience in conducting research and communicating research findings via professional conferences, peer reviewed journals, seminars, etc. is preferred.</li></ul></div> 
<div></div>
Minimum pay range: USD $72,770.26/Yr. Maximum pay range: USD $129,818.62/Yr.</div>

Psychologist II - Child and Family Therapy Clinic

PEMCCO

<div>Do you thrive at the intersection of safety, compliance, and people? Join us as a Workers' Compensation Claims Examiner and help drive a safer, healthier workplace for our employees and contractors. In this role, you&rsquo;ll manage workers&rsquo; compensation, DOT/CDL compliance, and drug and alcohol programs while using data analysis to spot risks before they become incidents. You&rsquo;ll partner closely with HR, operations, and stakeholders to build a proactive safety culture, one where accountability, prevention, and continuous improvement are the standard. 
PEMCCO Inc. is a dynamic and innovative organization dedicated to enhancing urban mobility and transforming transit systems. We are committed to delivering high-quality transit solutions that improve the lives of our communities. Join our team of passionate professionals and be part of a company that values integrity, collaboration, and excellence. 
Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. 
Key Responsibilities: 

Workers Compensation Claims &ndash; Capabilities/Potential Duties:
<ul>
<li>Investigating and managing all workers&rsquo; compensation claims, including those involving operators, mechanics, and CDL-regulated staff.</li>
<li>Ensuring compliance with Maryland Workers Compensations Laws and Regulations; Labor and Employment Laws, and State of Maryland RTW policies and Directives. In conjunctions along with the WC Claim TPA.</li>
<li>Maintaining HIPAA-compliant confidentiality while managing sensitive medical and employment data.</li>
<li>Supporting labor relations by working closely with union representatives to ensure fair, transparent, and contract-compliant processes that are directly related to workers compensations claims and injured employees and return-to-work processes.</li>
<li>Analyze trends in worker injuries, incidents, and claims to identify potential risks before they escalate.</li> 
</ul>
Drug and Alcohol/DOT Compliance &ndash; Capabilities/Potential Duties:
<ul>
<li>Compliance to 49 CFR 655 and 40</li>
<li>Oversight of CDL medical qualifications and DOT driver compliance</li>
<li>Managing return-to-duty and follow-up testing</li>
<li>Administering testing for non&ndash;safety-sensitive positions</li>
<li>Partnering with HR on job classifications and regulatory investigations</li> 
</ul>
Safety Program Development &amp; Data Analysis
<ul>
<li>Collaborate with the Office of Safety to identify workplace risk trends through data analysis and incident tracking.</li>
<li>Assist in designing and implementing new systems and programs to reduce worker injuries, incidents, and resulting claims.</li>
<li>Support development and promotion of safety awareness campaigns based on data trends and areas of elevated risk.</li>
<li>Maintain and report OSHA-mandated records (e.g., 300/301 logs) in compliance with federal requirements.</li>
Participate in corrective action planning and support follow-through to reduce future risk. 
<li>
</li>
</ul><ul><li>Ensure continuous compliance with federal, state, and local laws affecting workforce safety and eligibility.</li>
</ul><ul><li>Reduce operational risk through proactive monitoring and intervention strategies.</li>
</ul><ul><li>Serve as the subject matter expert for workers&rsquo; compensation and DOT compliance.</li>
</ul><ul><li>Strengthen labor-management relationships through consistent and equitable application of policies.</li>
</ul><ul><li>Ability to maintain confidentiality and act with integrity at all times.</li>
</ul><ul><li>Availability to travel locally for site visits, investigations, or field safety visits.</li>
</ul><ul><li>Performs other duties as assigned.</li></ul> 


Tools &amp; Systems Used:
<ul>
<li>Drug &amp; Alcohol Testing Platforms</li>
<li>Workers&rsquo; Compensation Case Management Systems</li>
<li>HRIS / Compliance Systems 
</li>
<li>Microsoft Office Suite</li></ul> 


Competencies:
<ul>
<li>Strong analytical and investigative skills.</li>
</ul><ul><li>Excellent verbal and written communication.</li>
</ul><ul><li>Ability to manage sensitive situations with professionalism and discretion.</li>
</ul><ul><li>Detail-oriented with strong organizational and documentation skills.</li>
</ul><ul><li>Adept at cross-functional collaboration and stakeholder engagement.</li></ul> 


Required Qualifications: 
<ul>
<li>Bachelor&rsquo;s degree in Human Resources, Occupational Health &amp; Safety, Public Administration, Business Administration, or a related field.</li>
<li>Relevant certifications preferred (e.g., SHRM-CP, CHRC, CHSP, ASP, or similar).</li>
<li>3 to 5 years of experience managing workforce compliance programs, preferably in a transit, transportation, or unionized environment.</li>
<li>Experience managing workers&rsquo; compensation claims and familiarity with return-to-work programs.</li>
<li>Working knowledge of DOT, FTA, and FMCSA regulations.</li> 
</ul>
Preferred Qualifications:
<ul>
<li>Bachelor&rsquo;s degree in Human Resources, Occupational Health &amp; Safety, Public Administration, Business Administration, or a related field. 
</li>
<li>3-5 years of experience managing workforce compliance programs, preferably in a transit, transportation, or unionized environment.</li></ul> 


Benefits
<ul>
<li>15 days of Paid Time Off</li>
<li>11 Paid Holidays</li>
<li>Medical, Dental, and Vision</li>
<li>Voluntary Short-Term Disability, Life Insurance, Accident, Critical Illness, Hospital Indemnity, Whole Life Plus, Identity Theft, and Law Assure</li>
<li>401(k)</li>
<li>Employee Assistance Program (EAP)</li> 
</ul>
Compensation
<ul>
<li>$31.25 - $37.50 per hour, depending on experience.</li> 
</ul>
PEMCCO, Inc. is an equal opportunity employer. The Company does not discriminate on the basis of race, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, military or veteran status, pregnancy, childbirth, and related medical conditions or any other characteristics protected by applicable federal, state, or local law.</div>

Workers' Compensation Claims Examiner

Nexus Family Healing

<div>Description: 
Nexus Family Healing - Woodbourne is looking to hire a HR Coordinator to our join our Human Resources team!
At Nexus-Woodbourne, we provide children and youth (ages 0-21) that have a mental health diagnosis involving severe emotional and behavioral problems, safe, specially equipped foster homes that have the skills and resources to meet their complex needs.
At Nexus Family Healing, we embrace diversity, promote equity, and foster inclusion. As a national mental health organization, we serve a diverse group of youth and families, and we strive for our workforce to support and represent that diversity.
Schedule/Location/Pay:<ul><li>
Full time onsite opportunity - 1301 Woodbourne Ave, Baltimore, MD</li><li>
Starting Pay range: $24-26 per hour</li></ul>
Nexus&rsquo; Comprehensive Benefits Include:<ul><li>
Four weeks paid time off (PTO) in the first year of employment</li><li>
Multiple options for health insurance coverage</li><li>
No-cost life insurance</li><li>
Short/long-term disability insurance</li><li>
401k match</li><li>
NEW - Talkspace Therapy Benefit for the whole family</li><li>
NEW - Hinge Health Benefit for the whole family</li><li>
NEW &ndash; Carrot Fertility Benefit</li><li>
Tuition assistance and training opportunities</li><li>
 Advancement and internal promotion pathways available</li><li>
And much more!</li></ul>
Position Summary: Our Human Resources Coordinator services in the following functional areas: benefits administration, employee relations, performance management, onboarding, policy implementation and interpretation, recruitment, affirmative action, and employment law compliance. 
Primary responsibilities:<h3 class="jobSectionHeader">
New Employee Onboarding</h3><ul><li>
Coordinate and conduct New Employee Orientation, ensuring timely completion and submission of all required new hire documents (PCR, I-9, tax forms, direct deposit, Vets form, etc.).</li><li>
Set up employee files and maintain a follow-up system to collect outstanding documents.</li><li>
Present and review required policies and procedures, including site-specific materials, Employee Handbook, job descriptions, HIPAA, Drug &amp; Alcohol Policy, Conflict of Interest, and automated timekeeping processes.</li><li>
Conduct benefits presentations, track eligibility dates, and obtain completed benefit election/waiver forms for submission to the Benefits Specialist.</li></ul><h3 class="jobSectionHeader">
Payroll &amp; Timekeeping</h3><ul><li>
Coordinate timekeeping and payroll activities, ensuring accuracy and compliance.</li><li>
Train employees and support supervisors in using the automated timekeeping system.</li><li>
Review, correct, and submit payroll data to corporate.</li><li>
Collaborate with corporate to ensure accurate handling of timekeeping exceptions (FMLA, LOA, disability, workers&rsquo; compensation, PTO, etc.).</li></ul><h3 class="jobSectionHeader">
Recruiting &amp; Staffing</h3><ul><li>
Coordinate full-cycle recruiting in compliance with corporate policy and AAP guidelines.</li><li>
Create internal/external job postings, place ads, collect applicant profiles, and support candidate screening.</li><li>
Schedule interviews, extend approved offers, and issue offer letters.</li><li>
Process background checks, driving records, physicals, and other pre-employment requirements.</li><li>
Attend job fairs, manage multiple recruiting activities, and maintain AAP/EEO records.</li></ul><h3 class="jobSectionHeader">
HR Administration</h3><ul><li>
Support HR functions including documenting work injuries, leaves of absence, disability claims, work accommodations, and other assigned activities.</li><li>
Maintain HR forms, materials, and departmental correspondence with professionalism and strong customer service.</li><li>
Ensure compliance with company policies, privacy regulations, and state/federal requirements.</li></ul><h3 class="jobSectionHeader">
Workers&rsquo; Compensation &amp; Leave Management</h3><ul><li>
Generate and submit First Report of Injury forms and forward provider bills and physician notes to the insurance carrier.</li><li>
Record injuries on the OSHA log and ensure annual posting compliance.</li><li>
Serve as liaison between injured employees and insurance representatives.</li><li>
Assist in case management for W/C, disability, life, and leave of absence claims to ensure timely and accurate documentation, pay, benefits, and communication.</li></ul><h3 class="jobSectionHeader">
HRIS, Reporting &amp; Records Maintenance</h3><ul><li>
Maintain personnel files, medical/LOA files, and training records in compliance with corporate guidance and regulatory requirements.</li><li>
Process employee changes (address, marital status, dependents, tax withholding, benefit eligibility, etc.).</li><li>
Generate HRIS reports including performance evaluation notices, benefit eligibility, employment dates, employee rosters, census data, and other required reporting.</li></ul>
Requirements:

 Required Education/Experience<ul><li>
Bachelor&rsquo;s degree in Human Resources or related field. OR some post-secondary education with 5+ years experience in HR or related field may be considered.
</li><li>Minimum of 2 years general HR experience required.</li><li>
Valid driver&rsquo;s license required. Must meet state regulating agency and Home Office driving requirements.</li></ul>
At Nexus Family Healing, our voices and actions are focused on recognizing, affirming and respecting people of every race, ethnic background, socio-economic status, sexual orientation, gender expression and faith.
Our ICARE Values:<ul><li>
Innovation: Leading the way and implementing creative, cutting-edge ideas and approaches</li><li>
Compassion: Listening, honoring differences, and showing respect, kindness, empathy care, and concern</li><li>
Agility: Exhibiting flexibility and adapting quickly</li><li>
Responsiveness: Being quick, positive, and accurate</li><li>
Excellence: Demonstrating quality results that surpass ordinary standards</li></ul>
APPLY TODAY TO BE CONTACTED BY OUR RECRUITING TEAM! When you work at Nexus, you have the opportunity to change lives &mdash; including your own!</div>

Human Resources Coordinator

Johns Hopkins University

<div>Plastic Surgery &amp; Reconstructive Surgery are seeking a Sr. Medical Office Coordinator to coordinate the day-to-day activities of a multi-faceted surgical practice to ensure a smoothly functioning office and good patient relations. Adapt to changes in technology and software to ensure efficient office practice. Support surgeons in efficient use of operating room and clinic time. Provide administrative support for medical matters on behalf of physicians, as well as general academic/general administrative support. 
Specific Duties &amp; Responsibilities<ul><li>
Coordinate with patient and hospital, complex procedure scheduling including dates for surgery and office visits, preparation and dissemination of pre-operative and hospital admission information.
</li><li>Collect insurance information and complete surgery scheduling and registration in EPIC.
</li><li>Support the physician with insurance preauthorization and single case agreement processes by submitting necessary clinical information as instructed by the physician.</li><li>
Coordinate follow-up office visits by providing information about treatment and testing locations.
</li><li>Schedule lab test and other procedures and/or coordinate with other areas to complete scheduling process.
</li><li>When clinic is cancelled, coordinate with Access Services and Patient Service Coordinators to reschedule physician and/or testing appointments.
</li><li>Coordinate with patient and/or referring physician to obtain outside medical records. Refer patient to appropriate resources.
</li><li>Review clinic schedules and adjust as appropriate.</li><li>
Act as a liaison for patients, coordinating future consultations, diagnostics tests, or procedures.</li><li>
Professionally and efficiently manage incoming calls and requests from patients, surgeons and fellow staff members to ensure that issues are resolved both promptly and thoroughly.
</li><li>Provide quality service and support to patients in a variety of areas which may include, but not limited to scheduling, registration and care coordination.
</li><li>May require travel to multiple work sites.
</li><li>Perform other duties as required.</li></ul> 
Special Knowledge, Skills, and Abilities<ul><li>
Intermediate computer and proofreading skills.
</li><li>Able to work independently.</li><li>
Support fellow staff members and promote team success.</li></ul> 
 
 
Minimum Qualifications 
<ul><li>
High School Diploma or graduation equivalent</li><li>
Three years progressively responsible medical office experience.
</li><li>Medical Terminology</li><li>
Additional education may substitute for required experience, and additional related experience may substitute for required education beyond a high school diploma/graduation equivalent, to the extent permitted by the JHU equivalency formula.</li></ul> 

Preferred Qualifications 
<ul><li>
Two years&rsquo; college or equivalent work experience.</li><li>
Knowledge of patient registration and scheduling in Epic and experience in the Johns Hopkins system strongly preferred.</li></ul> 
Classified Title: Sr. Medical Office Coordinator 
Role/Level/Range: ATO 40/E/02/OE
 
Starting Salary Range: $18.20 - $33.90 HRLY (Commensurate w/exp.) 
Employee group: Full Time 
Schedule: Mon-Fri/40 hrs 
FLSA Status: Non-Exempt 
Location: Hybrid/School of Medicine Campus 
Department name: SOM Plastic Surgery 
Personnel area: School of Medicine</div>

Sr. Medical Office Coordinator (Plastic & Reconstructive Surgery)

CareFirst BlueCross BlueShield

<div>
 
 Resp &amp; Qualifications
 
 
 
 
 PURPOSE:
 
 
 
 The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that govern the appeal process for Commercial and lines of business in order to formulate a professional response to the appeal request. We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.
 
 
 
 Essential Functions
 
 
 
 <ul>
 <li>
 Investigates, interprets, and analyzes written appeals and reconsideration requests from multiple sources including applicants, subscribers, attorneys, group administrators, internal stake holders and any other initiators. Responds to such requests with original letters, complex and technical in nature, upholding corporate policies and decisions while meeting all State and Federal regulations and mandates.
 </li>
 <li>
 Organizes the appeal case for physician review by compiling clinical, contractual, medical policy and claims information along with corporate and appellant correspondence. Formulates recommendations for disposition. Prepares the written case for review and, following the physician review, communicates the final decision to the member and providers including an explanation of the final decision and all External appeal rights.
 </li>
 <li>
 Investigates, interprets, analyzes and prioritizes appeal requests using nursing expert knowledge and all available clinical information for both medical and behavioral health conditions, as well as medical policies, to determine if the adverse coverage and adverse decisions are appropriate. Interpret and apply, as appropriate Regulatory and accreditation requirements. Collaborates with Independent Review Organizations and contracted Panel Physicians in obtaining clinical opinions from physician specialists, to determine if adverse decisions are appropriate. Interacts and responds to complaints from Regulatory Agencies and CMS.
 </li>
 <li>
 Maintains a ready command of a continuously expanding knowledge base of current medical practices and procedures, including current medical, mental health and substance abuse/addiction procedural terminology, surgical procedures, dental procedures, diagnostic entities and their complications.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Education Level:
 
 High School Diploma or GED.
 
 
 
 Licenses/Certifications
 
 
 
 <ul>
 <li>
 RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire Required
 </li>
 <li>
 CCM - Certified Case Manager Upon Hire Preferred
 </li>
 <li>
 LNCC - Legal Nurse Consultant Certified Upon Hire Preferred
 
 
 </li>
 </ul>
 
 Experience
 
 
 
 <ul>
 <li>
 2 years medical-surgical or similar clinical experience OR
 </li>
 <li>
 3 years experience in mental health, psychiatric setting
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 2 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, and/or previous experience in a healthcare payor organization working with clinical appeals and grievances.
 </li>
 <li>
 BSN/MSN Degree
 
 
 </li>
 </ul>
 
 Knowledge, Skills And Abilities (KSAs)
 
 
 
 <ul>
 <li>
 Knowledge and understanding of medical terminology.
 </li>
 <li>
 Demonstrated knowledge of regulatory and accreditation requirements, understanding of appeals process and utilization management, and systems software used in processing appeals.
 </li>
 <li>
 Excellent verbal and written communication skills, strong listening skills, critical thinking and analytical skills, problem solving skills, ability to set priorities and multi-task.
 </li>
 <li>
 Ability to effectively communicate and provide positive customer service to every internal and external customer.
 </li>
 <li>
 Knowledge of Microsoft Office programs.
 </li>
 <li>
 Excellent analytical and problem-solving skills to assess the medical necessity and appropriateness of patient care and treatment on a case-by-case basis, including issues pertaining to members with mental health treatment needs or those with substance disorders and addictions.
 </li>
 <li>
 Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
 
 
 </li>
 </ul>
 
 Salary Range:
 
 $67,320 - $133,705
 
 
 
 Salary Range Disclaimer
 
 
 
 The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
 
 
 
 Department
 
 
 
 Clinical Appeals and Analysis
 
 
 
 Equal Employment Opportunity
 
 
 
 CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
 
 
 
 Where To Apply
 
 
 
 Please visit our website to apply: www.carefirst.com/careers
 
 
 
 Federal Disc/Physical Demand
 
 
 
 Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
 
 
 
 Physical Demands
 
 
 
 The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
 
 
 
 Sponsorship in US
 
 
 
 Must be eligible to work in the U.S. without Sponsorship
 
 
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Clinical Appeals Nurse (Remote)

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