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.
Audit behavioral health documentation and coding (ICD-10-CM and CPT) for accuracy, compliance, and completeness.
Deliver actionable feedback to providers, educating on coding and documentation guidelines.
Serve as a subject matter expert by answering coding-related questions and supporting internal teams.
Headway is building a new mental healthcare system from the ground up—one that’s accessible, effective, and built to scale. They have over 75,000 providers across all 50 states running their practice on their software, serving over 1 million patients.
Process timely and accurate billing of medical claims in multiple states.
Monitor accounts daily to maximize reimbursement and identify potential billing compliance issues.
Utilize EHR and billing systems to manage claims, denials, and payer communications.
Indigenous Pact PBC, Inc. is a certified B-Corporation established in 2017 with a mission to create health equity for American Indians and Alaskan Natives. The dedicated team has decades of experience working in Indian Country, specializing in customized solutions for sustainable revenue and improved health outcomes.
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.
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.
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.
Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams with compassion, creativity, and an unwavering commitment to children with medical complexity.
Conduct coding audits to ensure accuracy and compliance with coding guidelines.
Identify compliance risks and recommend corrective action plans.
Provide education and training to physicians and staff on coding best practices.
Theoria Medical is at the forefront of healthcare innovation and quality, offering a blend of medical excellence and technological advancements, primarily serving the post-acute sector. Their network includes multispecialty physician services across skilled nursing facilities nationwide, fostering a mission-driven culture that values expertise and innovation.
Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
Follows established policies and procedures to pay, pend for additional information, or deny claims.
Accountable to meet and maintain established department production and quality standards.
Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Investigate and resolve insurance claim denials, handling 50 to 100 denials daily with speed and accuracy.
Partner with payers to secure timely reimbursement and interpret LCD/NCD requirements for CPT/HCPCS-related denials.
Provide top-tier phone support to patients, insurance companies, and internal teams while using payer portals and clearinghouses.
IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions like rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. We foster a culture of respect, empowerment, and shared purpose, with a team committed to patient-centered outcomes and values such as Be Kind and Do What’s Right.
Own end-to-end revenue cycle operations across Medicaid (in-network and out-of-network) within behavioral health programs.
Lead and manage performance of third-party billing vendors and/or internal billing staff, driving improvements in A/R days, denial rates, collections, and first-pass claim acceptance.
Ensure accurate charge capture, documentation alignment, and coding integrity in collaboration with clinical and administrative teams.
We are a mission-driven outpatient behavioral health organization focused on helping individuals and families recover from substance use disorders and co-occurring mental health conditions. Headquartered in North Carolina and expanding across multiple states, we are in a strong growth phase and focused on operational excellence, clinical integrity, and sustainable revenue cycle performance.
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.
Perform accurate code assignments for ED records (facility and profee) while working remotely.
Be flexible, detail-oriented and have the ability to work independently.
Meet client productivity targets while maintaining coding quality of 95% or greater.
UASI is a company that values its employees! They have been awarded the Top Workplace award by the Cincinnati Enquirer in 2022 and 2023. Their 40 years in business contributes to the long tenure of their team.
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 through clear communication and efficient management of records.
Dignity Health Medical Foundation provides comprehensive health care services. They have care centers throughout California and are affiliated with Dignity Health, one of the largest health systems in the nation. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Ensures accuracy and timeliness of patient financial records, including payment posting, insurance follow-up, and revenue integrity.
Monitors work queues, resolves payer discrepancies, and supports provider enrollment and revalidation activities.
Assists with charge review and correction using Epic workflows to improve reimbursement accuracy and cash flow.
This position is listed on behalf of a partner company that manages all applications and next steps for a healthcare revenue cycle environment. The role supports multiple Patient Financial Services functions within a large, process-driven healthcare organization.
Lead client onboarding and coding integration programs, ensuring smooth transitions and long-term operational success.
Oversee outpatient and physician coding operations, ensuring accuracy, compliance, and productivity.
Partner with teams to align coding practices with revenue cycle objectives and drive performance improvements.
Jobgether uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate evaluation and data privacy compliance.
Investigate and resolve health plan denials for coding-related issues, including rejections, down codes, bundling, modifiers, and level of service.
Generate appeals based on dispute reasons and contract terms specific to payors, including online reconsiderations and following payer guidelines.
Maintain working knowledge of workflows, systems, and tools used in the department, adhering to production and quality standards.
Ventra is a leading business solutions provider for facility-based physicians, focusing on Revenue Cycle Management. The company partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver data-driven solutions.
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.
Own the full AR cycle: payment posting, cash reconciliation, aging management, and payer follow-up across district, health plan, and member inquiries.
Investigate and resolve complex claim denials and rejections, submit corrected claims and appeals, and drive systemic fixes to improve clean claim rates.
Serve as internal subject matter expert on payer requirements, billing regulations, and compliance standards, fielding escalations from clinical and operations teams.
Cartwheel is building a new kind of mental health program for kids that puts schools at the center. Backed by top investors, it has grown to serve more than fifty school districts across six states and is driven by a mission to help millions of students experience joy.
Maintains practice management systems, processes insurance claims, and reconciles patient accounts.
Investigates rejected claims, corrects denials, and facilitates payment through collections and billing reminders.
Ensures HIPAA compliance, resolves patient billing issues, and provides professional customer service.
US Anesthesia Partners provides anesthesia services and revenue cycle management. It is a large US-based healthcare organization focused on billing and insurance operations, emphasizing accuracy and compliance.