Provide day-to-day operational leadership and subject matter expertise for a team of CDI specialists, ensuring documentation accuracy and regulatory compliance.
Serve as a clinical and coding resource, assisting with complex cases, DRG validation, and performance oversight.
Foster collaboration across multidisciplinary stakeholders to enhance communication and achieve accurate clinical documentation.
CommonSpirit Health is a nonprofit Catholic healthcare organization delivering integrated health services. With over 157,000 employees and 25,000 physicians across 24 states, the organization fosters a culture of innovation and humankindness.
Audit outpatient and specialty claims to ensure coding accuracy, clinical validity, and medical necessity.
Utilize advanced coding knowledge and audit tools to identify billing issues and document findings.
Meet productivity and quality standards while recommending process improvements and new claim types.
Cotiviti is a healthcare analytics and auditing company that focuses on improving claims accuracy and reducing costs for clients. They are a mid-to-large sized employer with a culture that emphasizes quality, collaboration, and innovation in healthcare auditing.
Review clinical documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes for diagnoses, procedures, and services rendered.
Monitor outpatient coding work queues and unbilled accounts to support timely filing and claims submission, while resolving coding-related edits.
Collaborate with providers and revenue cycle teams to improve documentation, ensure coding accuracy, and maintain compliance with regulations.
Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. We cultivate a caring, fun, honest, and autonomous work environment with a shared mission to create a positive impact.
Facilitate improvement in provider-based clinical documentation accuracy to reflect patient acuity and severity.
Conduct concurrent record reviews and formulate compliant documentation queries to improve accuracy.
Educate clinicians and facility management on documentation opportunities and coding reimbursement issues.
Banner Health is a large nonprofit health care system with hospitals, clinics, and research centers across multiple states. They focus on skilled and compassionate care using advanced technology to improve patient outcomes.
Ensure quality and completeness of medical record documentation through concurrent interaction with physicians and staff.
Facilitate modifications to clinical documentation to support accurate reimbursement and severity capture for inpatients.
Educate patient care team members on documentation best practices and support timely, accurate reporting.
Cooper University Health Care is a healthcare organization dedicated to providing extraordinary care through clinical innovation and advanced facilities. It offers a comprehensive benefits program and opportunities for career growth, with a team-oriented culture.
Provides oversight of CDI teams, ensuring optimal performance and adherence to compliant CDI practices and regulatory requirements.
Develops strategic plans to achieve enterprise KPIs and analyzes data to generate monthly performance reports for executive leadership.
Acts as a liaison between physicians, coding, and clinical quality to ensure accuracy and integrity of the inpatient medical record.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, it has more than 157,000 employees and delivers over 20 million patient encounters annually.
Assist with retrospective and concurrent coding for PACE Dual participants.
Conduct pre-visit chart preparations and post-visit chart reviews.
Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustment diagnosis coding guidelines.
WelbeHealth provides seniors with the opportunity to continue living in their homes through its PACE program. The company employs a collaborative interdisciplinary team approach and values diversity and inclusion.
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.
Define product requirements, audit methodologies, and business logic for scalable DRG audit workflows.
Partner with data science and AI teams to develop clinical entity extraction and validate model outputs.
Represent the voice of the customer in client discovery sessions and product demonstrations.
Abacus Insights transforms healthcare data for health plans, helping them break down silos to create a trusted data foundation for better decisions. Backed by $100M from top investors, they are a bold, curious, and collaborative team that embraces AI and automation.
Oversee clinical/coding DRG audits to ensure accuracy and compliance with internal policies and industry standards.
Maintain strong client relationships through accurate audits, understanding client needs, and reporting denial trends.
Coach, develop, and mentor clinical staff to achieve quality performance using servant leadership principles.
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve access to healthcare. The company offers a dynamic, innovative environment with a competitive compensation package including health insurance, 401(k) with match, and paid parental leave.
Provides oversight of coding teams, holding them accountable to enterprise established KPIs, including DNFC.
Manages staff to ensure coding team meets productivity and quality standards, developing performance improvement plans as needed.
Acts as a liaison between CDI, physicians, clinical quality, and patient financial services to ensure accuracy and integrity of inpatient medical records.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, it has more than 157,000 employees and operates across 24 states, delivering over 20 million patient encounters annually.
Review medical records within 24-48 hours of admission to evaluate documentation for accurate DRG assignment, severity of illness, and risk of mortality.
Conduct follow-up reviews every 2-3 days and formulate compliant provider queries regarding missing or conflicting documentation.
Educate patient care team members on documentation guidelines and collaborate with HIM coding professionals to ensure accuracy and integrity.
CommonSpirit Health is a large nonprofit Catholic healthcare organization delivering integrated health services. It has over 157,000 employees and 45,000 nurses across 24 states.
Coder III demonstrates proficiency in coding high acuity inpatient accounts and/or technical outpatient accounts.
Utilizes ICD-10-CM, PCS, HCPCS, CPT, and other coding references for accurate coding.
Supports Revenue Cycle goals for timely billing.
Cooper University Health Care is committed to providing extraordinary health care. We offer competitive rates, comprehensive benefits, and opportunities for career growth.
Performs clinical quality assurance review of daily clinical validation reviews and communicates differing audit decisions to ensure accuracy.
Integrates healthcare auditing principles and uses industry knowledge to substantiate decisions, reviewing medical records and applying clinical criteria.
Serves as a mentor to other QA auditors and may flex into initial audit or appeals roles as needed.
Cotiviti provides healthcare auditing and recovery solutions to ensure high quality recoverable claims. As a company, it employs a sizable workforce and fosters a culture of compliance, accuracy, and continuous improvement through professional skepticism and mentorship.
Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to ensure all necessary documentation is present to support selected procedure codes.
Participate in audits to evaluate coding accuracy and develop methodologies to improve coding issues identified.
Northside Hospital is an award-winning, state-of-the-art healthcare system. It is continuously growing and offers opportunities for healthcare professionals.
Serves as a mentor for the coding team, assisting with training and escalated cases.
Interacts with clinicians on documentation deficiencies and collaborates with other departments.
Abstracts medical record documentation into surgical CPT codes and crosswalks to ASA codes.
US Anesthesia Partners provides anesthesia and healthcare revenue cycle management services. They employ a large team of coders and clinical staff, with a focus on quality and compliance.
Conduct coder QA, provide educational feedback, and develop performance improvement plans.
Prepare and present coding curricula and regulatory updates to coders and providers.
Utilize revenue cycle knowledge to analyze coding data, support audits, and maintain shared resources.
US Anesthesia Partners is a leading provider of anesthesia services and revenue cycle management. The company operates across the US and emphasizes a collaborative culture focused on compliance and quality.
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.
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.
Conduct telephonic outreach to Medicare members to improve medication adherence and HEDIS diabetes and blood pressure control.
Use motivational interviewing to assess health risks and engage members in behavior change.
Partner with members to identify opportunities for integration into internal/external programs and coordinate care.
CVS Health is building a world of health around every individual, shaping a more connected, convenient and compassionate health experience. They are a large company with passionate colleagues who care deeply, innovate with purpose, and prioritize safety and quality.