Conduct training and education on risk adjustment documentation and coding guidelines for providers.
Perform comprehensive medical record chart audits to validate ICD-10-CM coding and HCC assignments.
Analyze claims data and audit error rates to identify trends and recapture opportunities for chronic conditions.
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 exceptional physician leadership, with scalable operations and cloud-based technology.
Provide medical coding, system configuration, and administrative support for medical policy functions.
Perform coding analyses and utilization reporting to recommend updates to medical policies and system configuration.
Participate in cross-functional meetings to align with enterprise strategic priorities and support team operations.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. We prioritize member well-being over profits, with a focus on sustainability and innovation.
Assign accurate medical codes for inpatient/outpatient professional fee records with 95% or greater quality.
Work independently from a remote home office while meeting client productivity targets.
Maintain technical proficiency with VPN, multi-factor authentication, and office software.
UASI is a medical coding and auditing company with over 40 years of experience in the healthcare information management industry. They have been recognized as a Top Workplace for three consecutive years and emphasize professional growth and a supportive team culture.
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.
Review and accurately code E/M cases for IP/OP/ER services to maximize reimbursement.
Meet daily production goals and maintain a 95% accuracy rate on a consistent basis.
Stay current on coding guidelines and maintain professional credentials, with flexibility to expand into other specialties.
Alteva RCM helps healthcare providers thrive through expert revenue cycle management and innovative solutions. The company fosters a collaborative culture focused on excellence and professional growth.
Verify and analyze medical records to assign diagnostic and procedural codes using CMS guidelines.
Ensure accurate charge capture and data entry with a 95% accuracy rate.
Serve as a coding resource, resolve discrepancies, and assist in training new staff.
Munson Healthcare is northern Michigan's largest healthcare system with eight community hospitals serving over half a million residents. With a focus on excellence, teamwork, and community, they offer a supportive culture and a lifestyle in a beautiful region.
Review inpatient and outpatient medical records to ensure accurate and compliant clinical documentation.
Collaborate with physicians and clinical teams to clarify diagnoses and support proper coding.
Maintain productivity targets and contribute to provider education initiatives to improve documentation quality.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. It processes applications using AI to ensure fair review and shares top candidates with employers.
Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.
Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.
Cohere Health provides an AI-powered clinical intelligence platform that streamlines access to quality care by improving payer-provider collaboration and cost containment. The company works with over 660,000 providers, handles over 12 million prior authorization requests annually, and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup for 2023 and 2024.
Analyze and audit inpatient claims for DRG validation, coding accuracy, and clinical appropriateness without a medical record.
Utilize proprietary auditing systems to make determinations and generate audit letters, meeting productivity and quality standards.
Identify new claim types and suggest process improvements while maintaining expert ICD-10 and DRG coding knowledge.
Cotiviti is a healthcare analytics and auditing company that helps payers and providers improve financial performance and clinical outcomes. It is a large organization with a culture focused on accuracy, compliance, and collaboration.
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.
Review and validate all assigned OASIS assessments for accuracy, completeness, and internal consistency.
Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement.
Provide clear, actionable feedback to field clinicians with a focus on education and process improvement.
Adaptive Home Health builds a higher-acuity, patient-centered home health model across Michigan. The company operates in a tech-forward environment with strong operational support.
Responsible for accurate and timely assignment of ICD-10-CM/PCS and HCPCS/CPT codes for various record types.
Performs coding and abstracting to support billing, data quality, and severity-of-illness reporting.
Serves as a mentor to newer coders and works within service line structures as needed.
ChristianaCare is one of the largest health care providers in the Mid-Atlantic Region, operating hospitals in Delaware and Maryland. With over 1,100 beds and ANCC Magnet Recognition across its facilities, it is committed to delivering health through values of love and excellence.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Lead advanced coding education for providers and groups, including E/M and Medicare Preventive services.
Analyze coding performance indicators to identify training needs and improve accuracy.
Develop and refine coding presentations and materials reflecting latest industry standards.
Privia Health is a technology-driven, national physician enablement company that optimizes physician practices and improves patient experiences. The company is led by top industry talent and physician leadership, with scalable operations and cloud-based technology.
Perform accurate inpatient facility coding using ICD-10-CM/PCS, CPT/HCPCS, and DRG for the VA Portland Health Care System.
Review medical records in VA systems (VistA/CPRS) and ensure compliance with HIPAA and AHIMA standards.
Work remotely and complete coding assignments within specified timeframes.
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Founded in 2012, they have over 300 employees nationwide.
Oversee inpatient coding teams to ensure adherence to enterprise KPIs and compliance standards.
Act as liaison between CDI, physicians, and other departments to maintain accuracy of medical records.
Monitor daily DNFC and coding work queues, developing action plans for sustained improvements.
CommonSpirit Health is a nonprofit Catholic healthcare organization providing integrated health services. With over 157,000 employees and 45,000 nurses, it operates across 24 states, delivering more than 20 million patient encounters annually.
Abstracts and codes physician professional services and diagnosis codes (inpatient admissions, outpatient procedures, diagnostic services).
Assigns appropriate CPT and ICD9 codes and completes coding and billing worksheets.
Trains physicians and other staff regarding documentation, billing and coding, and resolves pre-accounts receivable edits.
Northwestern Medicine is a healthcare organization dedicated to providing patient-first care and advancing better health. As a large healthcare system, it offers competitive benefits including tuition reimbursement, loan forgiveness, and 401(k) matching, fostering a supportive culture focused on employee well-being.
Code inpatient services with 95% or above accuracy.
Abstract information from medical records to assign ICD-10 codes and identify query opportunities.
Collaborate with coding leads, billing, and CDI to resolve issues and ensure compliance with federal and state laws.
OHSU is Oregon's only public academic health center, providing patient care and leading groundbreaking research. As Portland's largest employer, it offers opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Auditing claims for medically appropriate services in inpatient and outpatient settings using medical review guidelines.
Documenting findings with reference to appropriate policies and rules.
Generating letters articulating audit findings.
Machinify is a healthcare intelligence company delivering value and efficiency to health plan clients across the US. Deployed by over 85 health plans representing over 270 million lives, the company uses an AI-powered platform and best-in-class expertise to reimagine healthcare cost reduction.
Review medical records and clinical documentation to ensure accurate, compliant coding per CMS, federal, state, and payer policies.
Conduct routine and focused coding audits, collaborate with clinical leadership and revenue cycle teams, and provide actionable recommendations.
Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, interpreting state-specific billing requirements.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home medical, behavioral, and social care, and are a remote-first, high-growth environment.