Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to ensure all necessary documentation is present to support selected procedure codes.
Participate in audits to evaluate coding accuracy and develop methodologies to improve coding issues identified.
Northside Hospital is an award-winning, state-of-the-art healthcare system. It is continuously growing and offers opportunities for healthcare professionals.
Support quality assurance and audit planning for the WTC Health Program
Analyze claims data to identify trends and recommend improvements
Maintain health plan codebook and ensure accurate medical coding standards
Advanced Technologies & Laboratories International, Inc. (ATL) provides expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. The company offers a competitive total compensation package and invests in professional growth through tuition reimbursement and certification programs.
Provides oversight of coding teams, holding them accountable to enterprise established KPIs, including DNFC.
Manages staff to ensure coding team meets productivity and quality standards, developing performance improvement plans as needed.
Acts as a liaison between CDI, physicians, clinical quality, and patient financial services 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 has more than 157,000 employees and operates across 24 states, delivering over 20 million patient encounters annually.
Review medical record documentation to assign diagnoses, procedures, and modifiers for reimbursement and statistical classification.
Meet or exceed productivity and accuracy standards (95% accuracy) while following coding guidelines and maintaining confidentiality.
Participate in coding education, training, and departmental meetings, and assist in updating desk procedures.
Denver Health is an integrated academic healthcare system and Colorado's primary safety-net provider, including a Level I Trauma Center, 555-bed hospital, and 19 school-based health centers. It is a mission-driven organization with a culture of respect, belonging, and accountability, employing over 10,000 people.
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.
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.
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.
Performs clinical quality assurance review of daily clinical validation reviews and communicates differing audit decisions to ensure accuracy.
Integrates healthcare auditing principles and uses industry knowledge to substantiate decisions, reviewing medical records and applying clinical criteria.
Serves as a mentor to other QA auditors and may flex into initial audit or appeals roles as needed.
Cotiviti provides healthcare auditing and recovery solutions to ensure high quality recoverable claims. As a company, it employs a sizable workforce and fosters a culture of compliance, accuracy, and continuous improvement through professional skepticism and mentorship.
Manages a remote team of behavioral health coding auditors, ensuring audit quality and team performance.
Serves as subject matter expert in behavioral health CPT coding, DSM-5 diagnostic coding, and payer requirements.
Drives operational strategy including capacity planning, staffing, and quality standards for behavioral health audit operations.
Machinify is a leading healthcare intelligence company delivering value and efficiency to health plan clients. Deployed by over 85 health plans, including many of the top 20, and representing over 270 million lives, they offer a flexible and trusting remote work environment.
Act as a subject matter expert on medical payment policy, analyzing client data and presenting new policy opportunities to health plans.
Collaborate with Client Medical Directors and internal teams to develop and advocate for adoption of medical policies that maximize value.
Prepare presentations, coordinate reviews, and inspire trust as a trusted advisor for the Health Plan's medical payment strategy.
Cotiviti is a healthcare analytics company that partners with health plans to optimize payment accuracy and medical policy through data-driven solutions. The company employs a global workforce and fosters a collaborative, client-focused culture.
Perform advanced coding for outpatient surgical and observation records with 95% or above accuracy.
Monitor compliance with federal and state coding laws and coordinate billing information.
Serve as a resource and mentor to coding staff on billing policy and procedure issues.
OHSU is Oregon's only public academic health center, providing patient care, leading groundbreaking research, and training healthcare professionals. As Portland's largest employer, OHSU offers opportunities to learn and advance within a system of hospitals and clinics across Oregon and Southwest Washington.
Accurately correct coding-related denials for billing in Epic, including writing appeal letters.
Abstract operative reports in 3M and/or Epic while maintaining 95% accuracy or greater.
Ensure timely completion of patient accounts to meet department standards and goals.
Applied Medical Systems is a trusted partner for medical billing services, helping healthcare providers thrive through expert medical billing, coding, and practice management for over 45 years. The company has a stable, growing organization with a strong future and values a diverse and inclusive workplace.
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.
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.
Apply deep clinical, coding, and reimbursement expertise to enhance AI-enabled claim selection tools.
Partner with data science teams to validate AI outputs and improve model performance.
Serve as a coding subject matter expert to support audit concept development and optimization.
Cotiviti is a healthcare analytics company specializing in payment integrity and data-driven solutions. The company fosters a collaborative culture and emphasizes innovation in healthcare audit and analytics.
Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
This advanced inpatient coder codes and abstracts medical records for reimbursement, research, and data analysis.
Uses 3M encoder and demonstrates competency in ICD-10, CPT-4, and HCPCS coding systems.
Meets quality and productivity standards while working in a remote, collaborative environment.
CommonSpirit Health operates over 700 care sites across the U.S., including clinics, hospitals, and virtual care services. With a focus on building healthy communities and advocating for the vulnerable, they employ a supportive, team-oriented workforce.
CommonSpirit Health is one of the largest nonprofit Catholic healthcare organizations in the US, providing integrated health services across 24 states with over 157,000 employees. It is driven by innovation and faith, committed to creating a just, equitable healthcare system.
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 validate medical codes for accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems.
Provide expert coding guidance and support to clinicians and departments, serving as a resource for complex coding questions.
Conduct coding audits, generate productivity reports, and collaborate with IT and billing teams to resolve system issues.
Mission Healthcare is a home health and hospice company serving seven states, the largest of its kind in the western United States. They emphasize a culture of compassion, accountability, respect, excellence, and service (CARES) and are committed to diversity and inclusion.