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.
Help hospitals and health systems understand how AI-powered CDI can improve documentation, boost revenue, and drive quality care.
Work closely with Customer Success to refine documentation workflows and help clients maximize their CDI programs.
Help design, implement, and refine comprehensive educational materials, guidelines, and curricula for CDI specialists, ensuring they can accurately review AI-driven query recommendations and maintain compliance standards.
SmarterDx builds clinical AI that is transforming how hospitals translate care into payment. Founded by physicians in 2020, their platform connects clinical context with revenue intelligence, helping health systems recover millions in missed revenue, improve quality scores, and appeal every denial.
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.
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.
Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
Ensure compliance with legal, regulatory, and organizational standards with your expertise and training.
Review patient medical record information via population health tools to identify, assess, monitor and review network coding opportunities.
Dignity Health Management Services Organization (Dignity Health MSO) aims to build a system-wide integrated physician-centric, full-service management service organization structure. They provide management and business services, leveraging economies of scale and leading efforts in developing Medicaid population health care management pathways.
Conduct audits comparing medical record documentation to reported codes.
Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
Provide feedback, education, training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision and coding principles.
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 in both in-person and virtual settings. Their platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
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.
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.
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.
Assigns ICD-10 and CPT Codes and performs charge reconciliation.
Cooper University Health Care is committed to providing extraordinary health care. They are continuously discovering clinical innovations. Cooper offers career growth through professional development and is the employer of choice in South Jersey.
Monitor and interpret CMS, state Medicaid, and industry risk adjustment and quality regulations.
Provide SME guidance to Product, Sales, and Account Management on RA policy and program implications.
Partner with product teams to ensure solutions align with regulatory and audit requirements.
Cotiviti is a company that focuses on healthcare solutions. They offer a competitive benefits package to address a wide range of personal and family needs.
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.
Northeast Georgia Health System (NGHS) is a non-profit organization dedicated to improving community health through various initiatives. With a team of caregivers serving over 1 million people across the region, NGHS consists of five hospitals and numerous outpatient facilities.
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.
Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types.
Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures
Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures.
Northwestern Medicine is committed to a patient-first approach, setting them apart as a leader in healthcare. They pride themselves on providing competitive benefits, from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, aiming to care for their employees.
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.
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.
Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for medical diagnoses and procedures based on clinical documentation.
Ensure coding compliance with CMS guidelines, and state/federal regulations. Ability to write precise, professional, and well structured feedback to providers and team members.
Assist with claim reviews, denials, and coding-related audits to optimize revenue integrity.
Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Their mission is to improve the quality of life throughout Arizona by helping communities “Live Better, Live Longer” through personalized healthcare.
Performs the final reconciliation on clinic or provider visits.
Reviews, abstracts, and codes multiple or sub specialty services and complex or unusual cases, and assigns appropriate coding classifications.
Interacts with coding staff, business office, providers, hospital staff, clinic managers, and other clinical personnel on billing related issues.
University of Utah Health is a patient-focused organization that enhances the health and well-being of people through patient care, research, and education. They are a Level 1 Trauma Center and are nationally ranked and recognized for their academic research and quality standards.