Jobs at WVU Medicine

Lead a team supporting Epic analytics and clinical/operational systems. Oversee daily operations, project coordination, testing, reporting, data governance, staffing, training, and vendor interactions. Design scalable data models and pipelines (Microsoft Fabric, SQL Server, Power BI), ensure data quality, and present findings to executive stakeholders while maintaining system availability and compliance.

Design, implement, and optimize enterprise data architecture and management for healthcare analytics. Lead data solutions using Microsoft Fabric and Power BI, ensure data governance, integrate imaging and EMR systems, troubleshoot ETL/SSIS, manage projects, mentor staff, and ensure HIPAA-compliant data practices.

Obtain prior authorizations for elective procedures, verify eligibility/benefits, review clinical documentation and coding (ICD-10/CPT), manage denials and appeals, collaborate with schedulers, physicians, and financial services to secure reimbursements and minimize write-offs.

The Insurance Claims Specialist manages patient accounts, ensuring accurate claim submissions, compliance with regulations, follow-up on unpaid claims, and provides excellent customer service for revenue cycle operations.

Manage denied claims and accounts receivable by investigating denials, communicating with payers and clinics, composing non-clinical appeals, posting adjustments, maintaining compliance with billing regulations, and supporting revenue cycle workflow and reporting.

Obtain prior authorizations for elective procedures, verify eligibility and benefits, code cases, review clinical documentation, follow up on requests/appeals, communicate with insurers and care teams to secure reimbursements and minimize write-offs.

Manage patient account balances through accurate claim submission, payer follow-up, denial management, and reconciliation. Use payer portals and billing systems to resolve unpaid or rejected claims, maintain productivity targets, produce reports, comply with HIPAA, and provide customer service while supporting revenue cycle operations.

Manage patient account balances by submitting accurate claims, following federal/state and payer regulations, resolving denials and claim edits, using payer portals, performing account follow-up and reconciliation, supporting denial investigations, maintaining HIPAA compliance, and providing excellent patient/customer service to optimize revenue cycle performance.

Obtain prior authorizations for elective procedures, verify insurance eligibility and benefits, code cases, review clinical documentation, follow up on authorizations and denials, assist denial management and retro-authorizations, and communicate with providers, schedulers, and financial clearance teams to minimize delays and revenue loss.

Provide clinical information to third-party payors and manage utilization review tasks to secure authorizations, process denials, document authorizations/covered days, maintain insurer forms, support clinical teams, perform reception and administrative duties, and rotate weekends/holidays as assigned.

Manage patient account balances by submitting accurate claims, resolving edits and denials, following up with third-party payers, reconciling billing transactions, using payer portals, maintaining HIPAA compliance, producing reports, and providing excellent customer service to maximize collections.

The Insurance Claims Specialist manages patient account balances, submits claims, resolves errors, and provides customer service regarding claims and billing.

Manage patient account balances by submitting accurate claims, following federal/state and third-party billing rules, resolving denials and claim edits, verifying claim status via payer portals, reconciling transactions, and providing customer service while maintaining HIPAA compliance and departmental productivity goals.

Provide user support, troubleshoot and maintain clinical software systems, assist with implementations, testing, data import/export and basic reporting, deliver end-user training, and coordinate project tasks under senior staff guidance.

Supports design, implementation, maintenance, and troubleshooting of clinical and business software systems. Provides end-user training and support, assists with system testing, data import/export, basic reporting, and project coordination. Works with senior analysts to optimize workflows, manage user security, document requirements, and contribute to system enhancements and training materials.

Responsible for resolving credit balances and refunds, conducting research on refund requests, and providing excellent customer service in a healthcare setting.

The Associate Systems Analyst supports software system design, implementation, and maintenance while assisting in troubleshooting, training, and project coordination to enhance operational efficiency in healthcare settings.

The Insurance Claims Specialist manages patient account balances, submits claims, resolves errors, ensures compliance with regulations, and provides customer service.