Provide clinical leadership and subject-matter expertise to support analysis and configuration of medical policy content within claims processing systems.
Ensure accurate implementation of medical policies, review criteria, and authorization requirements while maintaining system infrastructure integrity.
Serve as an expert resource for medical policy configuration and PGE coding, mentoring Coding Specialists and providing training to operational partners.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota. We are motivated by the well-being of our members, not profits, and we are committed to sustainability and innovation.
Lead analysis and delivery of coding, billing, and policy solutions from requirements to implementation.
Translate complex medical coding concepts into clear documentation and actionable deliverables.
Act as a key liaison between operations, technical teams, and client stakeholders to ensure alignment.
Partner company focused on healthcare operations, medical coding, and policy. They offer a fully remote environment with comprehensive benefits and professional development opportunities.
Assign accurate medical codes for inpatient/outpatient professional fee records with 95% or greater quality.
Work independently from a remote home office while meeting client productivity targets.
Maintain technical proficiency with VPN, multi-factor authentication, and office software.
UASI is a medical coding and auditing company with over 40 years of experience in the healthcare information management industry. They have been recognized as a Top Workplace for three consecutive years and emphasize professional growth and a supportive team culture.
Support accurate risk adjustment coding by performing first-pass reviews of member medical records.
Maintain compliance with CMS risk adjustment diagnosis coding guidelines and HCC coding standards.
Collaborate with a remote team and contribute to team success through proactive communication and continuous learning.
BlueCross BlueShield of Tennessee is Tennessee's largest health benefit plan company, helping members since 1945. As a remote-first organization, it fosters a culture of innovation and collaboration with a focus on employee well-being.
Verify and analyze medical records to assign diagnostic and procedural codes using CMS guidelines.
Ensure accurate charge capture and data entry with a 95% accuracy rate.
Serve as a coding resource, resolve discrepancies, and assist in training new staff.
Munson Healthcare is northern Michigan's largest healthcare system with eight community hospitals serving over half a million residents. With a focus on excellence, teamwork, and community, they offer a supportive culture and a lifestyle in a beautiful region.
Lead advanced coding education for providers and groups, including E/M and Medicare Preventive services.
Analyze coding performance indicators to identify training needs and improve accuracy.
Develop and refine coding presentations and materials reflecting latest industry standards.
Privia Health is a technology-driven, national physician enablement company that optimizes physician practices and improves patient experiences. The company is led by top industry talent and physician leadership, with scalable operations and cloud-based technology.
Review and accurately code E/M cases for IP/OP/ER services to maximize reimbursement.
Meet daily production goals and maintain a 95% accuracy rate on a consistent basis.
Stay current on coding guidelines and maintain professional credentials, with flexibility to expand into other specialties.
Alteva RCM helps healthcare providers thrive through expert revenue cycle management and innovative solutions. The company fosters a collaborative culture focused on excellence and professional growth.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Abstracts and codes physician professional services and diagnosis codes (inpatient admissions, outpatient procedures, diagnostic services).
Assigns appropriate CPT and ICD9 codes and completes coding and billing worksheets.
Trains physicians and other staff regarding documentation, billing and coding, and resolves pre-accounts receivable edits.
Northwestern Medicine is a healthcare organization dedicated to providing patient-first care and advancing better health. As a large healthcare system, it offers competitive benefits including tuition reimbursement, loan forgiveness, and 401(k) matching, fostering a supportive culture focused on employee well-being.
Responsible for accurate and timely assignment of ICD-10-CM/PCS and HCPCS/CPT codes for various record types.
Performs coding and abstracting to support billing, data quality, and severity-of-illness reporting.
Serves as a mentor to newer coders and works within service line structures as needed.
ChristianaCare is one of the largest health care providers in the Mid-Atlantic Region, operating hospitals in Delaware and Maryland. With over 1,100 beds and ANCC Magnet Recognition across its facilities, it is committed to delivering health through values of love and excellence.
Conduct training and education on risk adjustment documentation and coding guidelines for providers.
Perform comprehensive medical record chart audits to validate ICD-10-CM coding and HCC assignments.
Analyze claims data and audit error rates to identify trends and recapture opportunities for chronic conditions.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and exceptional physician leadership, with scalable operations and cloud-based technology.
Review medical records and clinical documentation to ensure accurate, compliant coding per CMS, federal, state, and payer policies.
Conduct routine and focused coding audits, collaborate with clinical leadership and revenue cycle teams, and provide actionable recommendations.
Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, interpreting state-specific billing requirements.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home medical, behavioral, and social care, and are a remote-first, high-growth environment.
Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Codes and abstracts patient encounters for diagnostic and procedural information, analyzing data for reimbursement needs.
Completes final checks on charts ensuring all reports are signed and NCCI edits, CMS, and Joint Commission rules are followed.
Participates in continuing education and communicates with the Manager on training needs.
Plumas District Hospital provides essential health care services to the Quincy, California area and surrounding mountain community. With a population of 5,000 residents, PDH offers an inclusive work environment, competitive compensation, and perks like shift differentials and holiday pay.
Interpret health record documentation using ICD-10 and CPT 4 coding systems for diagnoses and procedures.
Assign and sequence codes accurately, reconcile edits, and maintain 95% coding quality.
Act as a key liaison for physicians on coding compliance and documentation improvement.
Shriners Children’s is an organization that provides excellence in pediatric specialty care, multi-disciplinary education, and research with global impact. Named the 2025 best mid-sized employer by Forbes, they foster a learning environment that values evidence-based practice and critical thinking.
Code inpatient services with 95% or above accuracy.
Abstract information from medical records to assign ICD-10 codes and identify query opportunities.
Collaborate with coding leads, billing, and CDI to resolve issues and ensure compliance with federal and state laws.
OHSU is Oregon's only public academic health center, providing patient care and leading groundbreaking research. As Portland's largest employer, it offers opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Monitor and interpret CMS guidance for Medicare, Medicaid, and other healthcare programs.
Partner with internal teams to ensure compliance with regulations and contract obligations.
Maintain regulatory tracking documentation and support development of training materials.
HealthEdge provides healthcare software and services to payers and providers. It is a growing company with a focus on compliance and innovation, fostering a collaborative and remote-friendly culture.
Process assigned claims based on client-specified guidelines.
Meet productivity targets and procedural accuracy standards.
Mentor junior team members and collaborate on special projects.
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. With a global presence and over 4000 employees, they are dedicated to simplicity, honesty, and leadership.
Manage the full lifecycle of edit and audit development, converting complex medical policy and coding regulations into actionable logic specifications.
Partner with PI Directors, internal auditors, and claims operations to ensure coding and billing appropriateness and regulatory compliance.
Use data queries to prove financial validity of coding hypotheses and author technical specification documents.
Devoted Health is an all-in-one healthcare company combining health insurance, clinical care, service, and technology to improve the health and well-being of older Americans. Founded in 2017, we've grown fast and now serve members across the United States, with a diverse and big-hearted team.
Conduct research and quality assurance for drug and biological policies.
Write business logic and translate industry references into Cotiviti policy.
Mentor new team members and assist with customer inquiries regarding clinical rules.
Cotiviti is a healthcare analytics company that provides clinical coding and policy solutions for health plans. They focus on maintaining accurate medical policy libraries and employ a global team, offering benefits like PTO and paid family leave.