Source Job

• Design, execute, and ensure operational excellence of risk adjustment coding and clinical documentation programs.
• Create scalable, physician-centric educational programs for accurate and complete diagnosis documentation.
• Lead a multidisciplinary team of coders, auditors, and analysts to ensure operational excellence and talent development.

Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. They're the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care.

• Review clinical documentation and assign accurate ICD-10-CM, HCPCS, and CPT codes to encounters
• Ensure compliance with CMS, payer, and risk adjustment coding guidelines
• Collaborate with clinicians and billing staff to clarify documentation or coding discrepancies

Main Street Health is the nation's largest provider of value-based care exclusively serving rural America. They partner with rural primary care doctors and reinforce the importance of trust and relationship-driven care in rural communities.

• Ensuring the accuracy, integrity, and quality of coding practices within the HIM department.
• Conducting thorough reviews of clinical documentation, coding, and billing processes to ensure compliance.
• Educating and training coding staff on best practices and updates in coding guidelines.

Cooper University Health Care is committed to providing extraordinary health care. They focus on clinical innovations and access to facilities, equipment, technologies and research protocols, and offer competitive rates, compensation programs, benefits, and career growth.

• Lead advanced coding education for individual providers and large provider groups, utilizing remote methods such as E/M and Medicare Preventive services.
• Design, implement, and lead specialty-specific documentation and coding training programs to address unique needs and challenges.
• Monitor market trends and emerging issues related to documentation and coding, ensuring timely and relevant updates to training programs.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems. They optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. Their platform is led by top industry talent and consists of scalable operations and end-to-end, cloud-based technology.

• Performs claims processing, insurance and charge verification, payment posting, account resolution, customer service and follow up.
• Educates staff and physicians on CPT/HCPCS/ICD-10 codes and appropriate documentation requirements to reduce errors and remain compliant.
• Works directly with staff when needed for insurance authorization assistance, IPA guidance and insurance optimization.

Community is committed to providing the highest standard of care. They value their diverse team members and offer various opportunities for growth and development.

• Conducts audits of clinical documentation reviews to ensure compliance and regulatory requirements.
• Develop and deliver training sessions based on audit findings to support CDI team competency.
• Oversee the accuracy, specificity, and completeness of clinical documentation.

Adventist HealthCare is a faith-based, not-for-profit organization dedicated to improving the health and well-being of people and communities. They employ over 6,000 professionals and are one of the longest serving healthcare systems in the Washington, D.C., area.

• Organizes and prioritizes assigned work to ensure completion within the assigned time frame.
• Reviews charts and medical records, assigning ICD and CPT code combinations to each data element.
• Audits for documentation opportunities and queries clinical staff to fill in any gaps.

Riverside Health System's mission is to care for others as we would care for those we love. We extend that sense of caring to every patient, resident and customer, as well as to each member of our team, offering care at all stages of life, in hundreds of locations.

• Creates and delivers education to the Coding Team, Clinical Documentation Nurses, Physicians, and other licensed providers to improve documentation quality.
• Collaborates with CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.
• Monthly monitoring of the clinical dashboard demonstrating improvement in statistical targets.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system.

• Serve as the authoritative SME on technical CARC/RARC codes, mapping, and workflows.
• Define product requirements for auto-scrub, intelligent resubmission, documentation-request automation, and worklist prioritization for soft denials.
• Design root-cause prevention logic that feeds denial patterns upstream to SmarterPrebill, SmarterUM, and Patient Access.

Smarter Technologies is a healthcare technology company focused on transforming how healthcare services are delivered, managed, and reimbursed. They bring together Access Healthcare, SmarterDx, Thoughtful AI, and Pieces, combining deep healthcare services expertise with advanced data, automation, and AI capabilities.

• Partner with the Product and Engineering teams to bake clinical integrity into the roadmap.
• Serve as the "Clinical Closer" for enterprise sales; act as the primary point of escalation and expertise for prospective clients.
• Design, implement, and oversee robust Clinical Quality Improvement (CQI) programs; define the KPIs that measure success.

Wheel is evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. They offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.

• Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention.
• Partner with provider clients to design and implement best practices for denial prevention and appeal workflows.
• Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments.

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage over 24 years of expertise and their E360 RCM ™ platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers. EnableComp is a multi-year recipient of the Top Workplaces award recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.

• Lead pre-live and post-live athenaOne Collector/billing training to providers, administrative and billing staff in all markets
• Innovate and create new learning experiences for Care Centers for Privia University (LMS).
• Provide excellent customer service through creative problem solving and follow through

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. They are led by top industry talent and exceptional physician leadership.

• Performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record.
• Trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function.
• Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of their team, you'll have the opportunity to join their quest for better health care, no matter where you work within the Northwestern Medicine system.

• Perform chart scrubbing and clinical documentation audits to ensure completeness and accuracy.
• Review records to validate ICD-10 diagnosis coding and supporting clinical documentation.
• Ensure compliance with PDPM (Patient-Driven Payment Model) and CMS guidelines.

Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging their extensive global network, they connect clients with highly qualified professionals, offering tailored services to meet clients' unique business needs.

• 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 with efficient management of records.

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. As an affiliate of Dignity Health, they work hand-in-hand with physicians and providers throughout California to provide comprehensive health care services.

• Develop and implement Freenome’s enterprise-wide revenue cycle strategy.
• Build, coach, and develop a high-performing team and foster a culture of accountability.
• Establish and oversee all processes related to coding, claims submission, reimbursement, and accounts receivable management.

Freenome is an equal-opportunity employer that values diversity. They are committed to building a career with their company and offer future opportunities via email alerts.

• Perform audits to assess the quality of documentation, accuracy of charge code assignment and review financial billing statements.
• Answer any physician and/or clinic questions and concerns regarding current ICD-10 and CPT guidelines.
• Provide coding training and updates for coding staff, physicians and clinics as assigned.

Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. They have an innovative, multifaceted culture that embraces collaboration, excellence, discovery, and compassion.

• Responsible for coding procedures and entering charges to comply with regulations and internal policies.
• Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present.
• Participate in audits to evaluate if all selected codes are accurate and develop methodologies to improved coding issues.

Northside Hospital is an award-winning and state-of-the-art hospital that is continually growing. They are expanding the quality and reach of their care to patients and communities which creates more opportunity for healthcare professionals in Atlanta and beyond.

• Independently own aligning operations for client accounts.
• Translate performance data into narratives that clearly articulate drivers, risks, and opportunities.
• Partner with clients to align operational expectations with internal capabilities.

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM ™ intelligent automation platform to improve financial sustainability. It is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list.

• Review documentation to assign appropriate CPT, HCPCS, and ICD-10 diagnosis codes
• Resolve edits in WQs (charge review, claim edit, and follow up) and review denials for possible corrected claims or appeals
• Work with clinic supervisors and/or providers to resolve coding issues and questions, following applicable payer rules and guidelines

CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.