... Medicaid billing changes. Assists in performing computer system upgrades and conversions and ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
... Medicaid billing changes. Assists in performing computer system upgrades and conversions and ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
... Medicaid billing changes. Assists in performing computer system upgrades and conversions and ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
... Medicaid billing changes. Assists in performing computer system upgrades and conversions and ... Integrity. Compassion. * SERVICE GOALS: Personally connect. Keep everyone informed. Be on their ...
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Minimum ...
Quick apply
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Minimum ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist
Columbus, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist
Columbus, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist - Recovery Center
Muncie, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist - Recovery Center
Muncie, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist - Recovery Center
Mishawaka, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
Therapist - Recovery Center
Mishawaka, IN · On-site
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... programs that deliver exceptional, person-centered care and restore hope for individuals, families ... Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ...
... program that promotes ethical conduct, regulatory adherence, operational integrity, and ... Ensure compliance with Medicare, Medicaid, HIPAA, 42 CFR Part 2, and other applicable federal and ...
... program that promotes ethical conduct, regulatory adherence, operational integrity, and ... Ensure compliance with Medicare, Medicaid, HIPAA, 42 CFR Part 2, and other applicable federal and ...
... program that promotes ethical conduct, regulatory adherence, operational integrity, and ... Ensure compliance with Medicare, Medicaid, HIPAA, 42 CFR Part 2, and other applicable federal and ...
... program that promotes ethical conduct, regulatory adherence, operational integrity, and ... Ensure compliance with Medicare, Medicaid, HIPAA, 42 CFR Part 2, and other applicable federal and ...
Business Office Specialist
$21 - $24/hr
Integrity: We are honest and professional. * Trust: We count on each other. * Excellence: We strive ... Advanced training programs * Passionate company culture committed to the highest standard of care ...
Business Office Specialist
$21 - $24/hr
Integrity: We are honest and professional. * Trust: We count on each other. * Excellence: We strive ... Advanced training programs * Passionate company culture committed to the highest standard of care ...
Clinical Director
$74K - $101K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Clinical Director
$74K - $101K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Therapist - Recovery Center
Mishawaka, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Quick apply
Therapist - Recovery Center
Mishawaka, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Therapist - Recovery Center
Muncie, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Quick apply
Therapist - Recovery Center
Muncie, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Clinical Director
Muncie, IN · On-site
$74K - $101K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Clinical Director
Muncie, IN · On-site
$74K - $101K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Therapist
Columbus, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Quick apply
Therapist
Columbus, IN · On-site
Our work is grounded in trauma-informed care, compassion, and integrity, and every team member ... Participate in program improvement initiatives and clinical projects as assigned. Required ...
Clinical Director
$68K - $93K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Clinical Director
$68K - $93K/yr
... programs that prioritize safety, integrity, and long-term recovery outcomes. Why Join Indiana ... Familiarity with Joint Commission standards, Medicaid requirements, and clinical documentation ...
Medicaid Program Integrity information
What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?
| Aspect | Medicaid Program Integrity | Medicaid Claims Examiner |
|---|---|---|
| Primary Focus | Detecting and preventing fraud, waste, and abuse in Medicaid programs | Reviewing and processing Medicaid claims for accuracy and compliance |
| Required Credentials | Typically healthcare or compliance certifications, knowledge of Medicaid policies | Healthcare or claims processing certifications, attention to detail |
| Work Environment | Regulatory agencies, government offices, compliance departments | Insurance companies, healthcare providers, government Medicaid offices |
Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.

Full-time
Posted 28 days ago
Beacon Health System rating
6.6
Based on 137 frontline employees who took The Breakroom Quiz
556th of 870 rated healthcare providers
Job description
Reports to the VP Patient Access. Responsibilities include providing training and support to team members and physicians on BMG computer applications/systems. This includes project planning, analysis, implementation, troubleshooting, conducting quality assurance and maintaining computer system security. Performs general consulting and serves as a liaison with BMG departments/physician offices as required. Provides educational classes to team members on commercial (contracted & non-contracted) insurance updates and Medicare and Medicaid billing changes. Assists in performing computer system upgrades and conversions and providing feedback to the Director of Finance to improve the revenue cycle.
MISSION, VALUES and SERVICE GOALS
- MISSION: We deliver outstanding care, inspire health, and connect with heart.
- VALUES: Trust. Respect. Integrity. Compassion.
- SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.
Provides training to team members and physicians at BMG sites on new and existing computer applications/systems (primarily the Allscripts ProPM and Allscripts Pro EHR Electronic Health Records) and provides overall support of these systems by:
- Planning and implementing computer applications/systems in accordance with established BMG policies and procedures.
- Coordinating and developing training session content; utilizing outside vendors and consultants as needed.
- Developing and maintaining training manuals and related documentation.
- Developing new programs and reports, maintaining existing programs, and modifying reports.
- Conducting new team member orientation to BMG performance standards, policies, and procedures, as it relates to system software.
- Monitoring all projects and providing periodic status reports, in accordance with established BMG procedures, to the Director of Finance.
- Meeting with Directors/Practice Managers to teach them proper utilization and review of revenue cycle practice reports (i.e. error report, untracked encounter report, exception report, etc.).
- Conducting classroom training and simulation sessions for core competencies in system utilization. Consulting and providing support for initiatives on staff's educational needs and training assessments.
- Facilitating and assisting in implementation of changes in software and billing protocols, as approved.
- Maintaining competence and keeping abreast of changes in software applications and current standards for physician office operations, to serve as a resource for BMG.
Works directly with physicians and other providers on ProEHR system by:
- Assisting providers on customization of ProEHR based on physician/provider specialty/needs.
- Creating ProEHR protocols/short lists to maximize efficiency of system.
- Working with physicians to ensure quality of documentation supports billed services.
- Training new physicians/providers as well as re-training physicians/providers during system upgrades.
Serves as a liaison and facilitator with BMG departments/physician offices who utilize software programs by:
- Meeting with Directors/Practice Managers, team members and physicians as necessary to adequately define their requirements and business needs.
- Acting as a liaison with and advocate for the BMG department/physician office.
- Facilitating the timely delivery of solutions which meet the need of the BMG department/physician office.
- Providing feedback to Directors/Practice Managers on training progress/achievements of team members.
- Communicating, as needed, with management to facilitate the overall satisfaction, perceptions, and improvement of team member education.
- Performing troubleshooting activities to avoid potential problems. Communicating verbally (by phone and in person) and in writing and visually observing CRT, keyboard, and printed representations.
- Performing system tests and analyzing test results.
Provides educational classes to BMG team members on commercial (contracted and non-contracted) insurance updates and Medicare and Medicaid billing changes and stays current and abreast of insurance/billing changes by:
- Attending and participating in professional seminars and continuing education as approved.
- Reading monthly Medicare/Medicaid/CHA bulletins and working with the staff at various sites to ensure information is clearly understood.
- Working closely with Managed Care Department to assist in managed care educational efforts.
Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:
- always Providing excellent customer services. Also communicating with team members and physicians in a courteous, responsive, and helpful manner.
- Establishing and maintaining effective working relationships with team members and physicians.
- Assisting Information Systems Department and the Director of Finance with Medical Information System upgrades and conversions.
- Identifying and communicating to the Director of Finance (and others as appropriate) regarding areas of improvement as it relates to the billing process and the electronic medical records system.
- Participating in group meetings and problem-solving groups as requested by the Director of Finance.
- Taking a leadership role in moving forward and implementing Lean Management concepts as well as leading and participating on Kaizen events.
- Completing other job-related duties and projects as directed.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
- Attends and participates in department meetings and is accountable for all information shared.
- Completes mandatory education, annual competencies, and department specific education within established timeframes.
- Completes annual employee health requirements within established timeframes.
- Maintains license/certification, registration in good standing throughout fiscal year.
- Direct patient care providers are required to maintain current BCLS (CPR), and other certifications as required by position/department.
- Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
- Adheres to regulatory agency requirements, survey process and compliance.
- Complies with established organization and department policies.
- Available to work overtime in addition to working additional or other shifts and schedules when required.
Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
- Leverage innovation everywhere.
- Cultivate human talent.
- Embrace performance improvement.
- Build greatness through accountability.
- Use information to improve and advance.
- Communicate clearly and continuously.
Education and Experience
- The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a bachelor's degree in business administration, Healthcare Administration, or another appropriate field or equivalent experience.
- A minimum of three years progressively responsible medical practice experience is preferred.
- Preference will be given to candidates with training and experience with those software and hardware products regularly used by BMG.
- Experience with third party insurances, Medicare, Medicaid, CPT and ICD-9-CM coding and physician office practices is strongly desired.
Knowledge & Skills
- Requires the technical skills and knowledge necessary to effectively use and support various software and hardware. Also requires the skills to perform systems analysis activities.
- Demonstrates knowledge of networking concepts, servers, databases, reporting tools and programming languages.
- Within two (2) years of employment, acquires and maintains certification as a Certified Professional Coder.
- Requires the ability to pay close attention to details.
- Demonstrates the interpersonal and communication skills (both verbal and written) necessary to make clear and effective presentations and to effectively interact with BMG management, team members, physicians, and vendor representatives. Also requires effective training skills.
- Demonstrates the ability to analyze, design, organize, write, communicate, and evaluate training materials.
- Requires accurate knowledge of medical billing procedures, office procedures, third party insurance, Medicare, Medicaid, worker's compensation, and CPT and ICD-9-CM coding.
- Requires advanced knowledge of the Allscripts ProPM and Electronic Medical Records systems and the ability to operate PCs, computer terminals, printers, audio visual equipment, etc.
- Requires a knowledge of and competency in communicating BMG policies and procedures to BMG team members.
Working Conditions
- Works in an office environment.
- Work hours may vary based on work schedule/training sessions.
- Travel is required to various BMG sites.
Physical Demands
- Requires the physical ability and stamina (i.e., to sit, stand and/or walk for prolonged periods of time, lift, hold and carry objects weighing up to 30 pounds, etc.) to perform the essential functions of this position.
What Beacon Health System employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Beacon Health System
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
South Bend, IN, US
Year founded
2012