Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
Act as a subject matter expert on medical payment policy, analyzing client data and presenting new policy opportunities to health plans.
Collaborate with Client Medical Directors and internal teams to develop and advocate for adoption of medical policies that maximize value.
Prepare presentations, coordinate reviews, and inspire trust as a trusted advisor for the Health Plan's medical payment strategy.
Cotiviti is a healthcare analytics company that partners with health plans to optimize payment accuracy and medical policy through data-driven solutions. The company employs a global workforce and fosters a collaborative, client-focused culture.
Manage and resolve claims rejections and denials, escalating trends as identified.
Verify patient eligibility and benefits, and coordinate with insurance payers.
Maintain compliance with HIPAA regulations and meet productivity standards.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction. They are a growing company with a dedicated team passionate about making judgment-free care accessible.
Develop and maintain audit concepts by researching regulatory, coding, or payer policy changes and updating rule documents and code lists.
Perform QA reviews to ensure audit concepts comply with coding standards, payment methodologies, and payer policies prior to deployment.
Collaborate with cross-functional teams including operations, clinical, and client services to support policy execution and drive concept quality.
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering value and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, we are a digital-first, AI-powered platform that reimagines what's possible in healthcare.
Identify, research, process, and resolve customer inquiries regarding health insurance benefits, claims, and eligibility.
Analyze medical records and apply medical necessity criteria to determine the appropriateness of benefit requests.
Maintain accurate records, meet quality and timeliness standards, and coordinate with internal departments and external organizations.
Blue Cross Blue Shield of Arizona provides health insurance products and services to individuals, families, and businesses, aiming to inspire health and make it easy. The company has been recognized as a Healthiest Employer and has transformed healthcare for over 80 years with teams in Phoenix, Tucson, Chandler, and Flagstaff.
Review and abstract medical records for surgical CPT and ICD10 coding, ensuring accuracy and compliance.
Serve as a mentor for junior coders and handle escalated cases requiring complex coding expertise.
Work with multiple platforms including MD Cloud, Medaxion, and EMRs to manage edits, denials, and charge corrections.
US Anesthesia Partners is a healthcare company specializing in anesthesia services and revenue cycle management. They are a large employer with a focus on coding accuracy and compliance, fostering a collaborative and mentoring culture.
This advanced inpatient coder codes and abstracts medical records for reimbursement, research, and data analysis.
Uses 3M encoder and demonstrates competency in ICD-10, CPT-4, and HCPCS coding systems.
Meets quality and productivity standards while working in a remote, collaborative environment.
CommonSpirit Health operates over 700 care sites across the U.S., including clinics, hospitals, and virtual care services. With a focus on building healthy communities and advocating for the vulnerable, they employ a supportive, team-oriented workforce.
Perform medical claims audit reviews with a focus on the Home Health sector, applying medical review guidelines and documenting findings.
Collaborate with the audit team to identify vulnerabilities, generate audit letters, and support findings during appeals.
Maintain knowledge of coding systems (ICD-10, CPT-4, HCPCS) and regulatory changes to ensure high-quality, deadline-driven work.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients using an AI-powered platform. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company fosters a collaborative, fast-paced remote culture.
Assign and sequence ICD-10-CM, ICD-10-PCS, and CPT-4 codes for inpatient, outpatient, ambulatory, and emergency room records.
Review medical records for DRG/APC assignment, verify charge accuracy, and abstract clinical data.
Collaborate with providers and hospital departments to ensure proper documentation and regulatory compliance.
Logan Health is a growing health system in Northwest Montana that provides quality, compassionate care through connection, service, and innovation. As a healthcare organization, they employ a team-oriented staff and value kindness, trust, collaboration, and excellence.
Assign ICD-10-CM, CPT, and E/M codes for hospital-based encounters with high accuracy.
Review clinical documentation to ensure compliance with coding guidelines and payer requirements.
Collaborate with internal teams and client stakeholders while managing multiple assignments.
The partner company provides medical coding services for hospital-based care, ensuring accurate documentation and revenue cycle management. The team emphasizes compliance, accuracy, and a quality-focused culture.
Manages a remote team of behavioral health coding auditors, ensuring audit quality and team performance.
Serves as subject matter expert in behavioral health CPT coding, DSM-5 diagnostic coding, and payer requirements.
Drives operational strategy including capacity planning, staffing, and quality standards for behavioral health audit operations.
Machinify is a leading healthcare intelligence company delivering value and efficiency to health plan clients. Deployed by over 85 health plans, including many of the top 20, and representing over 270 million lives, they offer a flexible and trusting remote work environment.
Review and abstract professional medical records to ensure accurate code assignment.
Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers following national and payer-specific guidelines.
Maintain coding quality metrics and participate in coding audits.
We reimagine how people access care by bringing it directly into their homes. We have supported over 2 million patients across 22 states, completed over 130,000 in-home visits, and raised over $125M from top investors.
Serve as a critical gateway to patient care by ensuring timely and accurate processing of medical referrals.
Collaborate with providers and clinical teams to review, prioritize, and route referrals in a fully remote setting.
Apply administrative expertise and medical knowledge to support patient safety and operational excellence.
The company is a leading academic healthcare organization dedicated to patient care, research, and education. It offers a fully remote, inclusive work environment with opportunities for career growth.
Provide administrative support to clinical staff in a healthcare office environment, primarily via video conference.
Handle incoming calls, patient records, correspondence with providers, and scheduling of home visits.
Ensure coordination of care and smooth day-to-day office operations, including insurance authorizations and supply ordering.
Vynca provides comprehensive care for individuals with complex needs to have more quality days at home. The company is a close-knit community with core values of Excellence, Compassion, Curiosity, and Integrity.
Contribute directly to improving Provider experience through timely credentialing and enrollment.
Collaborate with cross-functional teams to support new payer launches and share operational insights.
Help educate credentialing associates as new processes and payers are introduced.
Rula is a remote-first company that makes mental health care more accessible by streamlining provider onboarding. The team values diversity, equity, and inclusion, fostering a culture of belonging.
Submit provider and organizational contract requests to commercial, Medicare, Medicaid, and managed care payers.
Monitor contract application status and maintain detailed tracking of all submissions and negotiations.
Coordinate with internal teams to facilitate successful implementation of newly executed agreements.
Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and maintain a fully remote culture focused on collaboration and personal connection.
Review Home Health prior authorization requests for medical necessity using CMS regulations and Clover clinical guidelines.
Perform initial and concurrent clinical reviews, ensuring appropriate care in the least restrictive setting.
Collaborate with providers and internal teams to support timely decision-making and positive member outcomes.
Clover Health is a healthcare company that uses data and technology to provide affordable, high-quality insurance plans for seniors. The company fosters a remote-first culture with a diverse and mission-driven team focused on improving member outcomes.
Review anesthesia documentation for required elements such as attestations, signatures, and dates.
Abstract and code surgical procedures from CPT and crosswalk to ASA codes.
Meet team KPIs including daily production and quarterly coding audit score requirements.
US Anesthesia Partners provides anesthesia services and coding solutions. The company employs a large team and emphasizes a remote work culture with performance-based bonuses.
Create and maintain credentialing and renewal information for Workit providers, ensuring accuracy in payor directories and online systems.
Work closely with the Credentialing Manager and billing staff to resolve denials or authorization issues related to provider credentialing.
Complete revalidation requests issued by payers and maintain up-to-date data for each provider in the credentialing database.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction, offering FDA-approved medication and online recovery groups. The company has a vibrant, democratized culture with multiple ERG groups and opportunities for internal mobility, committed to closing health disparity gaps.
Partner with senior client service managers to support client accounts throughout implementation and ongoing service delivery.
Assist with project coordination, tracking timelines, deliverables, and client requirements.
Serve as a key point of contact between internal teams and client stakeholders to facilitate effective communication.
The company specializes in client service and support solutions for the healthcare sector. It offers a remote-first culture with a focus on collaboration, innovation, and professional growth.