Perform detailed medical record reviews to validate DRG assignments and ensure billing accuracy.
Conduct clinical and coding audits to identify discrepancies and support cost containment.
Collaborate with quality teams and medical professionals to ensure compliance with payer regulations.
The company partners with healthcare organizations to ensure accuracy in medical coding and reimbursement. They offer a fully remote, supportive environment with comprehensive benefits and professional growth opportunities.
Assign ICD-10-CM, ICD-10-PCS, and DRG codes for inpatient accounts based on medical record documentation.
Query clinical providers when documentation is unclear and abstract pertinent data.
Maintain minimum quality and productivity standards while working remotely during core hours of 8:00 AM to 5:00 PM.
Saint Luke’s is a faith-based, nonprofit health system with 18 hospitals in Kansas City. It employs 12,000 people and fosters a collaborative, diverse, and inclusive culture focused on exceptional patient care.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Apply CMS guidance, coding guidelines, and industry standards during claim review, including hospital bill audits and itemized bill reviews.
Prepare appeal responses using applicable coding guidance and maintain required certifications and continuing education.
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. They are a dynamic growing organization promoting a collaborative and innovative work environment.
Review and abstract professional medical records to ensure accurate code assignment.
Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers following national and payer-specific guidelines.
Maintain coding quality metrics and participate in coding audits.
We reimagine how people access care by bringing it directly into their homes. We have supported over 2 million patients across 22 states, completed over 130,000 in-home visits, and raised over $125M from top investors.
Review and assign diagnostic and procedural codes from medical records with 95% accuracy.
Serve as a liaison between billing and clinical sites to resolve coding discrepancies.
Train new employees and act as an expert resource for coding compliance questions.
Munson Healthcare is northern Michigan's largest healthcare system with eight award-winning community hospitals serving over half a million residents. They emphasize a culture of excellence, teamness, positivity, and creativity with over 5,000 employees.
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.
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.
Perform medical claims audit reviews with a focus on the Home Health sector, applying medical review guidelines and documenting findings.
Collaborate with the audit team to identify vulnerabilities, generate audit letters, and support findings during appeals.
Maintain knowledge of coding systems (ICD-10, CPT-4, HCPCS) and regulatory changes to ensure high-quality, deadline-driven work.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients using an AI-powered platform. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company fosters a collaborative, fast-paced remote culture.
Assign diagnostic and procedure codes using designated systems and review inpatient records for accuracy.
Identify and resolve coding edits and discrepancies to ensure claim accuracy and compliance.
Communicate effectively and meet productivity metrics to optimize revenue cycle management.
CommonSpirit Health is building a healthier future through integrated health services as one of the nation's largest nonprofit Catholic healthcare organizations. They deliver over 20 million patient encounters annually with more than 157,000 employees across 24 states, contributing over $4.2 billion annually in charity care and community benefits.
Review and abstract medical records for surgical CPT and ICD10 coding, ensuring accuracy and compliance.
Serve as a mentor for junior coders and handle escalated cases requiring complex coding expertise.
Work with multiple platforms including MD Cloud, Medaxion, and EMRs to manage edits, denials, and charge corrections.
US Anesthesia Partners is a healthcare company specializing in anesthesia services and revenue cycle management. They are a large employer with a focus on coding accuracy and compliance, fostering a collaborative and mentoring culture.
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.
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.
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.
Review anesthesia documentation for required elements such as attestations, signatures, and dates.
Abstract and code surgical procedures from CPT and crosswalk to ASA codes.
Meet team KPIs including daily production and quarterly coding audit score requirements.
US Anesthesia Partners provides anesthesia services and coding solutions. The company employs a large team and emphasizes a remote work culture with performance-based bonuses.
Conducts baseline, routine, and focused audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes.
Researches, interprets, and communicates federal and state laws and guidelines pertaining to CMS and Medicare.
Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.
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 focuses on scalable operations and cloud-based technology to reduce healthcare costs.
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.
Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
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.
Abstracts and codes physician professional services using CPT and ICD-9 codes.
Provides documentation feedback to physicians and trains staff on billing and coding.
Resolves pre-accounts receivable edits and ensures charge capture through reconciliations.
Northwestern Medicine is a healthcare leader with a patient-first approach. They offer competitive benefits like tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits, supporting a diverse team dedicated to better healthcare.
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.