Conducts baseline, routine, and focused audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes.
Researches, interprets, and communicates federal and state laws and guidelines pertaining to CMS and Medicare.
Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.
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 focuses on scalable operations and cloud-based technology to reduce healthcare costs.
Review and abstract professional medical records to ensure accurate code assignment.
Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers following national and payer-specific guidelines.
Maintain coding quality metrics and participate in coding audits.
We reimagine how people access care by bringing it directly into their homes. We have supported over 2 million patients across 22 states, completed over 130,000 in-home visits, and raised over $125M from top investors.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Apply CMS guidance, coding guidelines, and industry standards during claim review, including hospital bill audits and itemized bill reviews.
Prepare appeal responses using applicable coding guidance and maintain required certifications and continuing education.
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. They are a dynamic growing organization promoting a collaborative and innovative work environment.
Review and assign accurate ICD-10-CM, CPT, and HCPCS codes based on clinical documentation.
Ensure coding compliance with CMS guidelines and state/federal regulations, and assist with claim reviews and audits.
Maintain up-to-date knowledge of coding guidelines and meet productivity and quality standards.
Optima Medical is an Arizona-based medical group with 30 locations and 130+ medical providers, caring for over 200,000 patients statewide. They offer a supportive culture with growth opportunities, a fun work environment, and comprehensive benefits.
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.
Review and validate medical codes for diagnoses, procedures, and services to ensure accuracy and compliance with ICD-10, CPT, and HCPCS coding systems.
Provide expert coding guidance to clinicians and departments, serving as a resource for complex coding questions.
Conduct coding audits and quality reviews, generate productivity reports, and collaborate with IT and billing teams to resolve system issues.
Mission Healthcare is the largest home health and hospice company in the western United States, serving patients across seven states. The company fosters a culture of collaboration, compassion, and commitment, with core values of Compassion, Accountability, Respect, Excellence, and Service.
Review clinical documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes for diagnoses, procedures, and services rendered.
Monitor outpatient coding work queues and unbilled accounts to support timely filing and claims submission, while resolving coding-related edits.
Collaborate with providers and revenue cycle teams to improve documentation, ensure coding accuracy, and maintain compliance with regulations.
Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. We cultivate a caring, fun, honest, and autonomous work environment with a shared mission to create a positive impact.
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.
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.
Review clinical documentation and assign ICD-10, CPT, and HCPCS codes.
Maintain 95% coding accuracy while meeting production standards.
Collaborate with providers and clients to ensure compliant billing.
This company provides healthcare revenue cycle services, including professional medical coding. It offers a fully remote, collaborative work environment with a focus on quality and continuous learning.
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.
Assist with retrospective and concurrent coding for PACE Dual participants.
Conduct pre-visit chart preparations and post-visit chart reviews.
Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustment diagnosis coding guidelines.
WelbeHealth provides seniors with the opportunity to continue living in their homes through its PACE program. The company employs a collaborative interdisciplinary team approach and values diversity and inclusion.
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.
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.
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.
Abstracts and codes physician professional services using CPT and ICD-9 codes.
Provides documentation feedback to physicians and trains staff on billing and coding.
Resolves pre-accounts receivable edits and ensures charge capture through reconciliations.
Northwestern Medicine is a healthcare leader with a patient-first approach. They offer competitive benefits like tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits, supporting a diverse team dedicated to better 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.
Conduct quality assurance and audit planning for the WTC Health Program, reviewing claims and analyzing data to identify trends and issues.
Research federal payer coverage policies and develop program policies and procedures, maintaining the health plan codebook.
Collaborate with clinicians and subject matter experts to support medical management and claims review, ensuring accurate application of medical coding standards.
Advanced Technologies & Laboratories International (ATL) provides expertise in quality assurance, claims processing, medical coding, and audit for the World Trade Center Health Program. The company offers a competitive total compensation package including paid leave, medical, dental, vision, and a 401(k) retirement plan.
Perform medical claims audit reviews with a focus on the Home Health sector, applying medical review guidelines and documenting findings.
Collaborate with the audit team to identify vulnerabilities, generate audit letters, and support findings during appeals.
Maintain knowledge of coding systems (ICD-10, CPT-4, HCPCS) and regulatory changes to ensure high-quality, deadline-driven work.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients using an AI-powered platform. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company fosters a collaborative, fast-paced remote culture.