Review inpatient claims to identify missed reimbursement opportunities based on ICD-10 coding accuracy.
Analyze hospital billing files and medical records to optimize DRG reimbursement.
Collaborate with leadership on case prioritization and workflow management.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using intelligent automation. They are a multi-year Top Workplaces award recipient and have been on the Inc. 5000 list of fastest-growing private companies for eleven years.
Review inpatient coding (ICD-10-CM/PCS) to ensure accuracy and completeness for multiple clients.
Validate DRG assignments and optimize reimbursement while maintaining compliance with regulatory standards.
Collaborate with service line teams and client departments to improve documentation and meet production goals.
Kodiak Solutions specializes in healthcare finance, unclaimed property, risk management, and revenue cycle management. They use technology-driven solutions to help healthcare organizations streamline operations and improve patient care.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Review medical records and supporting documentation to confirm appropriate billing and apply CMS guidance, coding guidelines, and MUE/NCCI edits.
Prepare appeal responses using applicable coding guidance and assist with new concept development and claim selection criteria.
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. It is a dynamic growing organization with a collaborative and innovative work environment.
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 coding audits to ensure accuracy and compliance with ICD-10, CPT, and HCPCS guidelines.
Document findings with authoritative references and support corrective actions and education.
Stay current on payer rules and flag compliance risks to senior leadership.
Alteva RCM provides expert revenue cycle management and strategic solutions for healthcare providers. They foster a collaborative team culture committed to excellence, seeking passionate professionals to grow their careers.
Review, analyze, and complete pre- and post-payment claim audits and appeals in accordance with client policies, CMS guidelines, and healthcare industry standards.
Apply clinical judgment to evaluate documentation and determine the appropriateness and accuracy of claims.
Analyze healthcare claims, reimbursement information, and supporting documentation to identify discrepancies and potential payment issues.
Our partner company focuses on ensuring healthcare claims are reviewed accurately, consistently, and in accordance with applicable policies and industry standards. It is a collaborative, fast-paced, and evolving environment with opportunities for professional development and career advancement.
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.
Analyze medical records to validate ICD-10-CM, ICD-10-PCS, CPT-4, HCPCS II coding and MS-DRG assignment on acute inpatient and outpatient claims.
Conduct in-depth claims analysis using coding principles and electronic health information systems to ensure assigned codes are supported by documentation.
Meet quality and production standards and ensure compliance with quality management systems and ISO requirements.
Empower AI provides AI for government, helping federal agencies transform their workforce. With three decades of experience in Health, Defense, and Civilian missions, it is headquartered in Reston, VA and recognized as a 2024 Military Friendly Employer.
Conduct Skilled Nursing Facility medical claims audit reviews applying medical review guidelines.
Document findings and generate articulation letters for audit results.
Collaborate with audit team and clients to improve medical policies and workflows.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, the company uses an AI-powered platform and best-in-class expertise to reimagine healthcare.
Review and interpret medical records to assign accurate ICD-10, CPT, and modifier codes for inpatient and outpatient encounters.
Collaborate with physicians and providers to resolve documentation gaps and strengthen coding accuracy.
Support audits, provider education, and revenue cycle performance through quality reviews and consistent productivity.
Jobgether uses AI-powered matching to connect candidates with hiring companies. They operate globally and focus on efficient recruitment through technology.
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.
Provide professional fee coding services across one or more medical specialties, accurately assigning codes.
Review clinical documentation and assign diagnosis and procedure codes to the highest level of specificity.
Work independently in a remote environment while maintaining required productivity and accuracy standards.
The company provides professional fee coding services across medical specialties. They seek a detail-oriented coding specialist to work independently in a remote environment.
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.
Conduct prospective chart reviews to validate ICD-10-CM and CPT coding accuracy.
Provide clinical documentation improvement feedback to providers on documentation gaps.
Ensure compliance with risk adjustment and regulatory coding guidelines.
Thyme Care is a cancer care navigation company transforming the cancer care experience through value-based care. They are building a diverse, mission-driven team to reshape the future of healthcare.
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.
Code outpatient E/M services, procedures, and diagnoses based on clinical documentation
Review medical records and assign appropriate CPT, HCPCS, and ICD-10 codes
Query providers when documentation is incomplete or requires clarification
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. It is a small to mid-sized organization focused on accuracy and compliance in a remote work environment.
Perform daily audits of RCM accounts to ensure accuracy and compliance with policies.
Review documentation, billing records, and account activity to identify errors and process gaps.
Communicate quality issues and provide constructive feedback to staff and department leaders.
Our partner focuses on revenue cycle management services for healthcare organizations. They foster a remote culture centered on accuracy, accountability, and continuous improvement, with a team dedicated to quality and compliance.