Conduct coding audits to ensure accuracy and compliance with coding guidelines.
Identify compliance risks and recommend corrective action plans.
Provide education and training to physicians and staff on coding best practices.
Theoria Medical is at the forefront of healthcare innovation and quality, offering a blend of medical excellence and technological advancements, primarily serving the post-acute sector. Their network includes multispecialty physician services across skilled nursing facilities nationwide, fostering a mission-driven culture that values expertise and innovation.
Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for various purposes.
Abide by the Standards of Ethical Coding and official coding guidelines, staying updated on coding changes and interpretations.
Perform detailed reviews of Inpatient records, assign diagnosis and procedure codes, and meet established productivity guidelines with high accuracy.
Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials.
Perform inpatient coding audits and review services remotely.
Identify trends and suggest corrective action plans.
Provide in-service education to clients on coding trends.
UASI has over 40 years of experience and enduring partnerships with its valued clients. The company was recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023 and 2024, with a dedicated team and long-term success.
Perform accurate code assignments for ED records (facility and profee) while working remotely.
Be flexible, detail-oriented and have the ability to work independently.
Meet client productivity targets while maintaining coding quality of 95% or greater.
UASI is a company that values its employees! They have been awarded the Top Workplace award by the Cincinnati Enquirer in 2022 and 2023. Their 40 years in business contributes to the long tenure of their team.
Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
Ensure compliance with legal, regulatory, and organizational standards.
Ensure claims are processed correctly and on time through clear communication and efficient management of records.
Dignity Health Medical Foundation provides comprehensive health care services. They have care centers throughout California and are affiliated with Dignity Health, one of the largest health systems in the nation. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Audit behavioral health documentation and coding (ICD-10-CM and CPT) for accuracy, compliance, and completeness.
Deliver actionable feedback to providers, educating on coding and documentation guidelines.
Serve as a subject matter expert by answering coding-related questions and supporting internal teams.
Headway is building a new mental healthcare system from the ground up—one that’s accessible, effective, and built to scale. They have over 75,000 providers across all 50 states running their practice on their software, serving over 1 million patients.
Works with field staff and Manager, Clinical Services (MCS) to appropriately schedule clinicians for cases in assigned areas of responsibility.
Communicates appropriately regarding changes in schedule or service delivery.
Demonstrates the ability to be efficient and productive by organizing job duties and responsibilities.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and the health of the communities we serve.
Supervise day-to-day operations of assigned Utilization Management staff.
Provide full people management for assigned Utilization Management teams, including hiring and performance management.
Drive team performance against key metrics, including engagement, productivity, and quality scores.
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.
Identifies and applies appropriate ICD-10 and CPT codes.
Ensures accurate entry of insurance benefits and authorizations.
Completes other activities to ensure complete and accurate claims.
Sarasota Memorial Healthcare System is committed to keeping people safe. They require all individuals providing care to vulnerable populations to undergo background screening.
Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams with compassion, creativity, and an unwavering commitment to children with medical complexity.
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.
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep its members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most.
Focuses on ensuring accuracy, compliance, and integrity of medical coding across healthcare records.
Conducts detailed audits, reviews clinical documentation, and identifies discrepancies impacting billing and compliance.
Collaborates with clinicians, revenue cycle teams, and leadership to improve documentation quality and coding consistency.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They process applications and share shortlists with employers, focusing on objective and fair review.
Accurately codes and abstracts outpatient medical records utilizing ICD-10-CM and CPT-4 coding systems.
Assigns modifiers when appropriate.
Must be able to maintain a minimum 95% coding accuracy.
Montefiore St. Luke’s Cornwall (MSLC) has been a cornerstone of high-quality healthcare in Orange County for 150 years. MSLC is a member of the Montefiore Health System and provides care to more than 250,000 patients annually; it strives to be the employer of choice by offering comprehensive benefit packages.
Oversee and/or perform an accurate medical record review for all RISK.
Conduct training related to ,RISK, platform usage, update any training materials, and function as RISK SME.
Manage RISK coding projects when needed- including project status and completing chart reviews for coding projects as needed.
Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. They are trusted by 80+ customer organizations nationwide and work to advance care quality, strengthen documentation integrity, and sustain operational readiness.
Onboard teams to train their entire RCM staff on billing best practices.
Provide reporting training, particularly in the areas of accrual accounting and AR.
Establish and nurture relationships with client stakeholders and billing personnel.
Prompt is revolutionizing healthcare by delivering highly automated and modern software to rehab therapy businesses, teams, and patients. As the fastest growing company in the therapy EMR space, they are looking to bring on a Senior Billing Success Manager.
Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines.
Stay current on coding guidelines appropriate to the position; learn new appeal categories as production needs require.
Professionally communicate finds, errors, and suggestions to facilitate on-going communications and efficient department operations.
Cotiviti focuses on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. They offer a team-oriented environment and a comprehensive benefits package to address various personal and family needs.
Own end-to-end billing operations across the full claims lifecycle.
Lead and manage a team of 4+ offshore support staff setting priorities, assigning workstreams, and reviewing output.
Manage a high volume of billing questions and escalations from vendors and internal teams.
Prosper Health aims to improve the lives of autistic and neurodivergent adults by delivering specialized mental health services covered by insurance. The company is experiencing rapid growth with a team of over 400 clinicians and a focus on high-ownership and mission-driven culture.
Improve key performance metrics for the focused area within the revenue cycle.
Conduct audits of all revenue cycle processes, vendors, and technology.
Determine root cause of issue and appropriateness of actions taken, assist in corrective action plan development.
ATI Physical Therapy partners with business leaders to improve healthcare. They focus on positive change throughout the revenue cycle and offer competitive benefits.
Manage a high volume of patient-facing and internal billing questions.
Work claims end-to-end via our clearinghouse, partnering with stakeholders.
Support efforts to streamline existing RCM processes and ad-hoc RCM projects.
Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition. They have 100s of 1000s of patients and 1000s of dietitians on their platform and have raised $115M from top-tier VCs.