Jobs at WVU Medicine

Manage a team delivering financial and compliance analyses for outpatient/provider-based clinics across WVU Medicine. Train staff, maintain CMS provider-based compliance (42 CFR 413.65), evaluate new clinic setups, produce reimbursement and ad-hoc financial reports, monitor Epic billing designations, and lead cross-functional initiatives to optimize reimbursement and regulatory adherence.

Manage patient account balances by submitting accurate claims, resolving edits and denials, following payer rules and timelines, using payer portals for status checks, reconciling transactions, maintaining productivity metrics, and providing excellent customer service while complying with HIPAA and billing regulations.

Manage patient account balances and submit accurate claims to third-party payers. Resolve claim edits and denials, follow up with payers via portals, reconcile billing transactions, maintain productivity targets, support reporting and clerical tasks, ensure HIPAA compliance, and provide customer service to patients and staff.

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

Lead and coordinate provider-based clinic projects to ensure compliance with CMS regulations, optimize reimbursement, manage stakeholders, develop reports/presentations, perform gap assessments, and drive process standardization and improvements across ambulatory operations.

Designs, implements, and optimizes Workday architecture and enterprise solutions. Provides strategic consultation, specifies complex system designs, oversees integration and change management, mentors teams, leads impact analysis, and supports implementations including travel and on-call responsibilities.

Lead design and implementation of process and system improvements, perform data analysis and queries, produce BI reports, gather requirements, coordinate projects, and provide analytical insights to support healthcare business decisions. Work with databases, reporting tools, EPIC, Tableau and SAP, and communicate across organizational levels.

Manage patient account balances by submitting accurate claims, resolving denials and edits, following payer procedures and timelines, using payer portals, reconciling transactions, and supporting revenue cycle performance while maintaining HIPAA compliance and excellent customer service.

Designs and delivers training across clinical revenue cycle functions (CDI, coding, denials, UR). Develops curricula, tip sheets, and audits; provides case-based support, monitors denial trends, and partners with leaders to improve documentation, compliance, and financial performance using Epic and revenue cycle analytics.

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.

Manage patient account balances by submitting accurate claims, resolving denials and claim edits, following up with payers, reconciling transactions, using payer portals, maintaining compliance with HIPAA and billing regulations, producing reports, and providing patient customer service to maximize revenue cycle performance.

Manage patient account balances by submitting accurate claims, resolving claim edits and denials, following up with third-party payers, reconciling billing transactions, using payer portals, maintaining HIPAA compliance, and supporting revenue cycle reporting and productivity goals.

Manage hospital patient account balances and insurance claims: submit accurate claims, resolve denials and edits, follow up with third-party payers, use payer portals and billing systems, support revenue cycle reporting, maintain compliance with federal/state regulations and HIPAA, and serve as a resource and super user for billing applications.

Obtain prior authorizations for outpatient elective infusions and injections, verify payer requirements and coding (ICD-10/CPT), submit and follow up on authorizations and appeals, liaise between clinics, pharmacists, and Patient Financial Services, and maintain documentation/work queues in Epic and Outlook to ensure reimbursement.

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

Lead and manage mid-to-low risk IT projects affecting multiple departments. Develop and maintain project plans, scope, schedules, budgets, risk and issue logs. Coordinate resources, vendors, and stakeholders; ensure communication, change control, transitions to support, and project delivery within PMO standards.

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.

Lead mid- to low-risk IT projects across departments: develop and maintain project plans, manage scope, schedule, risks, vendors, budgets, communications, and transitions to support. Serve as liaison between IT and business units, facilitate meetings, track issues, and ensure project delivery meets customer needs.

Design and build BI solutions and dashboards, perform data analysis and SQL development, apply data governance and security, and lead requirements gathering and project coordination to drive process improvement and reporting accuracy across the health system.

Manage patient account balances by submitting accurate claims, resolving claim edits and denials, following up with third-party payers, reconciling billing transactions, maintaining productivity, ensuring HIPAA compliance, and providing customer service to maximize cash collections.