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.
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 evaluate medical record documentation for completeness, accuracy, and compliance.
Collaborate with physicians, nurses, and coding professionals to ensure appropriate clinical documentation.
Identify opportunities for documentation improvement to support coding accuracy, reimbursement, and clinical outcomes.
We improve the quality and accuracy of clinical documentation through expert CDI consulting. Our collaborative, mission-driven team offers opportunities for continuous learning and professional growth.
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.
Provides onsite and remote clinical documentation integrity support to CDI programs as part of the System Office CDI Float Pool.
Reviews and audits medical records to ensure accurate documentation of medical necessity, severity of illness, and level of services.
Trains end users on CDI software systems and communicates with healthcare teams to improve documentation practices.
Trinity Health is a large not-for-profit, faith-based health care system with 121,000 colleagues and nearly 36,500 physicians and clinicians serving communities across 27 states. The system includes 101 hospitals and invests heavily in community benefit programs.
Analyze data and generate monthly KPI reports for executive leadership.
Collaborate with physicians, coding, and clinical quality 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 delivers more than 20 million patient encounters annually with over 157,000 employees across 24 states.
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.
Lead daily CDI operations, including staffing, workload balancing, and training for clinical documentation improvement.
Conduct real-time clinical reviews for complex cases and analyze data to ensure quality and accuracy.
Collaborate with physicians and staff to enhance documentation quality and compliance with coding guidelines.
Adventist HealthCare is a faith-based, not-for-profit healthcare organization providing comprehensive services including acute-care hospitals, rehabilitation, outpatient centers, and home care. With over 6,000 employees, they are the largest healthcare provider in Montgomery County, Maryland, focused on extending God's care through physical, mental, and spiritual healing.
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.
Provide executive oversight for HIM, coding, and CDI operations, ensuring alignment with strategic priorities and regulatory compliance.
Establish and enforce documentation quality standards and coding accuracy to optimize reimbursement and maintain medical record integrity.
Manage vendor performance for HIM, coding, CDI, transcription, and ROI services, ensuring adherence to quality and regulatory requirements.
CommonSpirit Health is one of the nation's largest nonprofit Catholic healthcare organizations, delivering more than 20 million patient encounters annually through over 2,300 clinics and 158 hospital-based locations across 24 states. With more than 160,000 employees, 45,000 nurses, and 25,000 physicians, they provide over $5 billion in charity care and community benefits each year.
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.
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.
Serve as an expert in coding guidelines and perform audits to ensure compliance.
Develop and deliver role-specific training and educational materials for coding staff.
Analyze billing/coding behavior and recommend improvements.
UW Medicine is Washington’s only health system with a top-rated medical school and an internationally recognized research center. Nearly 29,000 healthcare professionals, researchers, and educators work within its family of organizations.
Assign and sequence ICD-10-CM, ICD-10-PCS, and CPT-4 codes for inpatient, outpatient, ambulatory, and emergency room records.
Review medical records for DRG/APC assignment, verify charge accuracy, and abstract clinical data.
Collaborate with providers and hospital departments to ensure proper documentation and regulatory compliance.
Logan Health is a growing health system in Northwest Montana that provides quality, compassionate care through connection, service, and innovation. As a healthcare organization, they employ a team-oriented staff and value kindness, trust, collaboration, and excellence.
Ensures optimum reimbursement and improves day-to-day operations of the revenue cycle.
Processes and follows up on payer issues with various entities for completion.
Researches and resolves straightforward account activity and maintains accuracy of the revenue cycle system.
Athletico empowers people, inspires hope and transforms lives through exceptional, progressive fitness, performance and rehabilitative services. They are a people-focused company with a strong culture built on core values like one team, recognition, and trust and integrity.