Monitor coding prevalence and ensure compliance with CMS audit processes.
Conduct provider and coder level reviews to ensure accurate risk adjustment data submission.
Maintain tracking tools and assist in RADV audits and corrective action plans.
Alignment Health is a healthcare organization dedicated to transforming senior care, focusing on the chronically ill and frail. The company is fast-growing with a passionate team united in the mission to put seniors first.
Audit inpatient and outpatient records for coding accuracy, documentation support, and reimbursement impact.
Review ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRG, modifier, and bundling assignments across facilities.
Present findings and provide facility-specific coding education to leadership and stakeholders.
A large regional health network operates multiple medical facilities across the United States, focusing on accurate coding and compliance. The organization maintains a structured, regulated environment with an emphasis on quality improvement, education, and confidentiality.
Provide strategic leadership and operational oversight for CMS-mandated RADV audits across Medicare Advantage and Commercial lines of business.
Lead development of audit strategies, workflows, and performance objectives to support regulatory compliance and organizational goals.
Direct departmental operations including staff development, performance management, and cross-functional coordination to ensure successful execution of priorities.
HealthEdge provides AI-powered operational infrastructure for health insurance companies. The company is experiencing strong market momentum and investing in its people to shape the future of healthcare technology.
Conduct routine and focused audits of medical coding to ensure compliance with CMS, payer, and organizational standards.
Develop and deliver education and feedback to coders and providers to improve documentation quality and coding accuracy.
Assist with internal and external audit preparation and response, including documentation requests and validation reviews.
Sprinter Health reimagines healthcare by delivering care directly to patients' homes using marketplace and last-mile technologies. They have supported over 2 million patients across 22 states, completed 130,000 in-home visits, and raised over $125M from investors like a16z and General Catalyst, with a team of clinicians, technologists, and operators.
Independently audit professional-fee coding for accuracy, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, E/M services, modifiers, and professional components.
Prepare reports, deliver coding education, and maintain 95% audit accuracy.
A large regional healthcare network providing medical services across multiple facilities. The culture emphasizes independent auditing, high accuracy, and collaborative compliance education.
Assess clinical documentation for compliance with AMA and CMS coding guidelines.
Provide education and guidance to providers, clinical staff, and coders on documentation standards.
Analyze audit data, report findings, and collaborate with leadership to improve coding practices.
UnityPoint Health is a healthcare system providing medical services across Iowa, Illinois, and Wisconsin. It is recognized as a top workplace, committed to team member support, development, and a culture of belonging.
Audit medical records to ensure documentation supports level of service and compliance with coverage determinations.
Develop and implement educational programs for coding and documentation improvement.
Orient and audit newly on-boarded providers and programs.
Southcoast Health is a not-for-profit health system providing comprehensive healthcare across Southeastern Massachusetts and Rhode Island. With multiple facilities, they have been voted 'Best Place to Work' for 7 years in a row.
Assigns appropriate ICD-10-CM and CPT-4 codes to outpatient visit types with high accuracy.
Reviews medical records thoroughly and interprets documentation to select diagnoses and procedures.
Meets established coding productivity and quality standards (90% productivity, 95% accuracy).
Northwestern Medicine is a healthcare system focused on a patient-first approach to deliver better healthcare. They are a large organization that values employee well-being and offers competitive benefits like tuition reimbursement and 401(k) matching.
Lead day-to-day operations of prospective and concurrent CDI review processes, ensuring quality and productivity standards.
Oversee team performance, coaching, and development while partnering with physicians and clinical teams.
Use data and metrics to drive process improvements, reduce documentation gaps, and support compliance and risk adjustment.
Our partner is a healthcare organization focused on clinical documentation integrity and risk adjustment for Medicare Advantage populations. They are a growing company with a collaborative, mission-driven culture that values heart, excellence, accountability, resilience, and teamwork.
Audit surgical and procedural coding for accuracy, documentation support, and compliance with ICD-10-CM, CPT, and HCPCS guidelines.
Document findings with authoritative guidance, assess financial impact, and recommend corrective actions.
Deliver facility-specific coding education and collaborate with health information management leadership and facility stakeholders.
A healthcare organization is seeking a Surgery Coding Auditor to ensure accurate surgical coding and compliance. The company operates across multiple healthcare facilities in the US and emphasizes quality assurance, education, and process improvement.
Conduct facility inpatient coding audits using MS-DRG and APR-DRG methodologies, providing evidence-based recommendations.
Identify coding quality and compliance opportunities while delivering coder education through the audit process.
Manage multiple cases concurrently, maintain accuracy, and uphold professional ethics and confidentiality.
Our partner provides healthcare organizations with high-quality, compliant coding practices through inpatient coding audits. They offer a collaborative, service-oriented environment focused on coding excellence and continuous professional development.
Lead a high-performing team of QA Specialists at the intersection of clinical precision and operational excellence.
Drive coding accuracy, build robust SOPs, and ensure full audit readiness for internal and external partners.
Translate QA findings into actionable insights and mentor team members to elevate compliance standards.
Aledade PBC empowers independent primary care through value-based care. Founded in 2014, it is the largest network of independent primary care in the country with a remote-first, inclusive culture.
Review and abstract professional medical records and assign accurate ICD-10-CM, CPT, and HCPCS codes.
Maintain coding quality metrics, participate in audits, and stay current with coding guidelines.
Ensure confidentiality and adhere to HIPAA and compliance standards while working independently.
Sprinter Health reimagines how people access care by bringing it directly into their homes, using technology to deliver care where people are. Backed by over $125M from top investors like a16z, General Catalyst, GV, and Accel, the team of clinicians, technologists, and operators has supported 2 million patients across 22 states with a 92 NPS.
Reviews, analyzes, and validates diagnostic and procedural codes for reimbursement and billing purposes.
Abstracts accurate information from the electronic health record to support patient care evaluation and administrative decision making.
Ensures compliance with established coding guidelines, third-party reimbursement policies, and regulatory requirements.
Henry Ford Health is a leading academic health system providing a comprehensive continuum of care, from primary and specialty care to virtual care, pharmacy, and health insurance, across Michigan and around the world. With 12 hospitals and hundreds of ambulatory care locations, the organization is grounded in purpose, collaboration, and belonging, empowering team members to grow their careers and make a meaningful difference.
Reviews inpatient and outpatient medical records for documentation, abstracting, and assigning codes to the highest level of specificity.
Assigns procedural and diagnosis codes following ICD-10-CM, CPT, HCPCS guidelines, and payer regulations.
Collaborates with Clinical Auditors to improve coding quality and resolves coding-related denials per payer policies.
UnityPoint Health is a healthcare system providing patient services and medical care. It is recognized as a Top 150 Place to Work in Healthcare, with a culture that champions belonging and offers competitive benefits.
Perform thorough review of medical records for identification of relevant diagnoses and procedures.
Assign appropriate ICD-CM and ICD-10 PCS codes to ensure accurate MS-DRG and APR-DRG assignment.
Abstract required data elements and adhere to compliant provider query practices and coding guidelines.
University of Utah Health is a patient-focused organization that enhances health through patient care, research, and education. It is a Level 1 Trauma Center with five hospitals and eleven clinics, nationally ranked for academic research and quality standards, and values collaboration, excellence, and integrity.
Assess clinical documentation for compliance with AMA and CMS coding guidelines.
Validate clinical documentation and evaluate accuracy and timeliness of the billing process.
Investigate and identify opportunities for improvement and provide education to providers and staff.
UnityPoint Health is a healthcare organization providing services across Iowa, Illinois, and Wisconsin. It is recognized as a top place to work in healthcare and fosters a culture of belonging, development, and total rewards.
Complete final review of medical records and select appropriate ICD-10 and CPT codes within 4 days of patient discharge.
Review documentation to match codes with medical necessity and assign working diagnoses and DRGs.
Collaborate with Clinical Documentation Specialists to identify and address documentation deficiencies.
UAMS is Arkansas' only comprehensive academic health sciences center, combining education, research, and clinical programs. It fosters a collaborative culture focused on improving patient care and supporting teamwork and diversity.
Review and analyze medical record documentation to assign diagnoses and procedure codes for inpatient, outpatient, and professional services.
Ensure compliance with official coding guidelines and ethical standards set by AHIMA.
Work remotely in a full-time, days shift position using ICD-10-CM and CPT/HCPCS coding systems.
Mercy is a Catholic health system founded by the Sisters of Mercy, providing care across hospitals and clinics in the Midwest. It is a large, collaborative organization focused on innovation, technology, and compassion, with a heritage spanning over 195 years.
Review and analyze Medicare claims sampled by the Department of Justice to determine correct coding and payment based on coverage and utilization.
Conduct in-depth claims analysis to detect fraudulent or abusive billing practices using ICD-10, CPT-4, and CMS guidelines.
Complete summary reports and communicate findings internally while maintaining confidentiality and compliance with DOJ and CMS regulations.
Empower AI provides AI-powered solutions for federal government agencies, helping them transform their workforce and operations. Headquartered in Reston, Va., the company has three decades of experience in Health, Defense, and Civilian missions and is recognized as a 2024 Military Friendly Employer.