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.
Conduct thorough patient assessments and create personalized treatment plans via video visits
Collaborate with a multidisciplinary team to deliver high standards of evidence-based care
Maintain accurate records, respond to patient messages, and dedicate 10-20 hours weekly to patient care
Allara is a comprehensive women's health provider offering expert, longitudinal care for hormonal, metabolic, and reproductive conditions. Trusted by over 60,000 women, it is a fast-growing platform with a diverse, inclusive, mission-driven team.
Conduct comprehensive reviews of home health pre-claim review packages for Medicare compliance.
Document review outcomes with clinical rationale and meet a 7-business-day turnaround.
Maintain 98% accuracy and complete required training and quality assurance sessions.
Broadway Ventures is a consulting firm providing program management, technology, and innovative solutions to government and private sector clients. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, it emphasizes integrity, collaboration, and excellence in its culture.
Conduct thorough patient assessments and develop personalized treatment plans via video visits.
Collaborate with a multidisciplinary care team to deliver the highest standards of care.
Educate patients on preventative care and wellness using evidence-based strategies.
Allara is a comprehensive women's health provider specializing in expert, longitudinal care for hormonal, metabolic, and reproductive conditions. As one of the fastest-growing women's health platforms in the U.S., Allara bridges overlooked gaps in healthcare for women.
Oversee medical necessity reviews for home health, acute, post-acute, and outpatient services for Medicare Advantage populations.
Collaborate with treating physicians, nursing teams, and external agencies to promote evidence-based care and appropriate resource utilization.
Apply CMS regulations, coverage determinations, MCG criteria, and medical policies in a fully remote, part-time physician leadership role.
Jobgether is an AI-powered job matching platform that connects candidates with employers. It uses objective screening to share top-fitting applicants with hiring companies, emphasizing data privacy and human oversight throughout the recruitment process.
Conduct video-based appointments for non-emergency issues.
Treat patients in internal medicine and related areas such as urgent care, gynecology, and obesity care.
Design personalized treatment plans and collaborate remotely with other clinicians.
DrHouse is building a new model of virtual healthcare that is fast, accessible, and centered on both patient and provider experience. They are a growing digital health company with a mission-driven community of clinicians committed to equitable healthcare access.
Perform concurrent medical record reviews on nursing units to clarify patient documentation.
Prompt physicians to resolve missing, unclear, or conflicting documentation for appropriate reimbursement.
Provide education to patient care providers on clinical documentation standards and coding requirements.
Virginia Mason Franciscan Health provides a full spectrum of health care services across the Puget Sound region, with a legacy of compassionate care and innovation. With 10 hospitals and nearly 300 care sites, the organization is dedicated to healing the whole person through rigorous research, education, and collaboration.
Deliver high-quality synchronous and asynchronous care, including assessment, diagnosis, prescribing, and medication titration.
Uphold unparalleled clinical patient care by providing prompt, empathetic treatment and adhering to platform guidelines.
Embrace a ground-floor opportunity to shape a new clinical program with a commitment to continuous learning and hands-on engagement.
Hims & Hers is a leading health and wellness platform on a mission to help the world feel great through the power of better health. They are revolutionizing telehealth for providers and patients, offering personalized solutions for weight loss, mental health, sexual health, hair care, and more.
Conduct clinical audits for suspected fraud, waste, and abuse with high autonomy.
Document findings in formal reports, graphs, and audit logs, aligning with unit goals.
Develop and present FWA-related education to Oscar teams, ensuring compliance with regulations.
Oscar is a health insurance company built on a full stack technology platform, focused on serving members like a doctor in the family. Founded in 2012, it is a forward-thinking company that values diversity and innovation, with a culture of fostering belonging and support.
Provide expert nutrition care to women through telehealth, analyzing intake assessments and delivering diet and lifestyle counseling.
Collaborate with APRNs and MDs on complex women's health cases while maintaining accurate patient records.
Use motivational interviewing and evidence-based practice to support hormonal, metabolic, and reproductive health in a fully remote setting.
Allara is a comprehensive women's health provider specializing in expert, longitudinal care for hormonal, metabolic, and reproductive health. Trusted by over 60,000 women nationwide, it is one of the fastest-growing women's health platforms in the U.S. with an inclusive, mission-driven culture.
Provide real-time EHR charting support to physicians during outpatient visits.
Accurately document patient encounters and interpret clinical terminology.
Maintain HIPAA-compliant workflows and complete medical records efficiently.
This company provides virtual medical scribe services, supporting physicians with real-time EHR documentation during patient encounters. It offers a fully remote work environment with a collaborative culture focused on healthcare technology and professional development.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Perform medical assessments, review patient histories, and provide recommendations or prescriptions.
Maintain accurate documentation of patient encounters in the electronic health record system.
9amHealth is an AI-enabled virtual specialty care platform focused on managing high-cost chronic conditions like obesity, diabetes, and hypertension. Founded in 2021 and backed by leading healthcare investors, the company fosters a collaborative learning culture with a small, flexible team spread across the globe.
Review and analyze complete patient medical records to identify all diagnostic and procedural information.\n- Assign accurate diagnostic and procedural codes using encoder software to ensure proper MS-DRG assignment and sequencing.\n- Maintain compliance with coding guidelines and verify medical record completeness for accurate reimbursement.
Henry Ford Health is a leading academic health system providing a comprehensive continuum of care, including primary to complex care, virtual care, and health insurance. With 12 hospitals and hundreds of ambulatory locations across Michigan, it is headquartered in Detroit and committed to innovation and community impact.
Evaluate and treat patients remotely using a variety of digital tools to manage care and oversee technology outputs.
Communicate effectively to drive member engagement and articulate clinical reasoning to support product development.
Manage a large and varied caseload safely and efficiently, utilizing a biopsychosocial model and evidence-informed practice.
Hinge Health uses technology to scale and automate healthcare delivery, starting with musculoskeletal conditions affecting over 1.7 billion people. As a preferred partner to 60+ health plans, it serves over 20 million people across 2,800 employers and has offices in San Francisco, Montreal, and Bangalore.
Review prior authorization cases to ensure clinical and operational standards are met.
Audit AI outputs, third-party reviews, and internal decisions for accuracy and compliance.
Collaborate cross-functionally to refine workflows and improve patient access to treatment.
Generator Health operates a platform that streamlines prior authorization processes for patients and providers. They handle tens of thousands of patients weekly and emphasize collaboration and accuracy in a high-autonomy remote environment.
Assign diagnostic and procedural codes for general surgery and ophthalmology records using ICD-10-CM, CPT, and E&M guidelines.
Maintain high productivity and accuracy while reviewing medical documentation and resolving coding discrepancies.
Participate in coding education, roundtables, and mentoring to support team development and client requirements.
This company provides medical coding services to healthcare clients, ensuring accurate documentation and revenue-cycle operations. It operates as a fully remote, collaborative team focused on quality, compliance, and professional growth.
Review complex inpatient medical records and assign ICD-10-CM, ICD-10-PCS, and DRG codes accurately.
Ensure compliant documentation and billing by applying federal and VHA coding guidelines.
Maintain 95% coding accuracy and meet facility-specific turnaround requirements while working remotely.
This role is with a partner company that supports inpatient coding operations for Veterans Affairs medical centers. The environment is structured and mission-driven, with a focus on accuracy, compliance, and federal healthcare standards.
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.
Conduct clinical audits and risk assessments to identify compliance gaps.
Manage multiple client engagements and deliver accurate project results.
Build strong client relationships and present findings to leadership.
Kodiak Solutions transforms healthcare through technology-driven solutions, specializing in finance, unclaimed property, and risk management. Their innovative platform streamlines operations, allowing providers to focus on patient care.