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.
Assist team on a smooth end-to-end billing process
Investigate, document, and follow up on denials and underpayments
Complete recurring work queues on a monthly basis
Omada Health is reverse engineering healthcare delivery, focusing on the space between doctor visits. They offer virtual-first models with human-led care teams, connected devices, and AI to support chronic conditions and have served over two million members across 2,000+ organizations.
Accurately code diagnoses, procedures, and other services to ensure medical records and billing are accurate.
Work with providers to ensure documentation is clear and complete, resulting in accurate coding.
Review all claim edits and correct errors in a timely fashion, coding for practice and hospital charges for all departments supported by the Professional Billing Office.
ProMedica is a mission-driven, not-for-profit health care organization that provides acute and ambulatory care, a dental plan, and academic business lines across nine states. The organization operates 10 hospitals and employs over 1,300 healthcare providers through ProMedica Physicians, with a culture committed to improving health and well-being, earning national recognition for clinical excellence.
Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for various purposes.
Abide by the Standards of Ethical Coding and official coding guidelines, staying updated on coding changes and interpretations.
Perform detailed reviews of Inpatient records, assign diagnosis and procedure codes, and meet established productivity guidelines with high accuracy.
Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials.
Evaluate and present audit results and educational instruction to physicians, coders, and staff.
Review clinical documentation to ensure adherence to billing guidelines and internal coding policies.
Provide instruction on documentation standards and correct use of CPT‑4 and ICD‑10 codes.
Pediatrix Medical Group is a leading provider of specialized healthcare for women, babies, and children. Since 1979, they've grown into a national, multispecialty medical group with a commitment to coordinated and compassionate care, bolstered by investments in research, education, and safety.
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.
Accurately codes and abstracts outpatient medical records utilizing ICD-10-CM and CPT-4 coding systems.
Assigns modifiers when appropriate.
Must be able to maintain a minimum 95% coding accuracy.
Montefiore St. Luke’s Cornwall (MSLC) has been a cornerstone of high-quality healthcare in Orange County for 150 years. MSLC is a member of the Montefiore Health System and provides care to more than 250,000 patients annually; it strives to be the employer of choice by offering comprehensive benefit packages.
Review patient documentation for accuracy and qualification.
Create claim and/or invoice by confirming sales order.
Monitor Patient billing module and update information as needed.
Cala Health is dedicated to freeing people from the burden of chronic disease by creating non-invasive prescription therapies. They currently have thousands of employees and strive to empower people to get back to their lives with confidence and ease.
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.
Resolve aged claims and appeals via payer portals & outbound phone calls.
Identify non-payment trends and escalate groups of claims to the Dispute Resolution teams.
Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
CareDx, Inc. is a precision medicine solutions company focused on healthcare solutions for transplant patients. They offer products, testing services, and digital healthcare solutions. They are the leading provider of genomics-based information for transplant patients.
Manage a high volume of patient-facing and internal billing questions.
Work claims end-to-end via our clearinghouse, partnering with stakeholders.
Support efforts to streamline existing RCM processes and ad-hoc RCM projects.
Nourish is on a mission to improve people’s health by making it easy to eat well. They are building an AI-native, patient-friendly healthcare system centered on nutrition. They have 100s of 1000s of patients and 1000s of dietitians on their platform and have raised $115M from top-tier VCs.
Performs advanced level work related to denial management.
Processes and follows up on all appeal types, at an expert level, to all payers.
Takes actionable steps to resolve open claims, including refiling or appealing claims, or resolving manual tasks.
US Anesthesia Partners is a company that provides anesthesia services. They provide equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, or disability.
Conducting collection activity on appealed claims by contacting government agencies and third party payers.
Requesting additional information from Patients, Medical Records, and others as needed.
Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed.
Sutherland helps strengthen brands by improving customer experiences. They're a global company with nearly 40,000 employees across over 100 countries, focusing on customer care and delivering extraordinary service.
Research and document new payment integrity concepts by analyzing medical policies, billing regulations, and reimbursement logic.
Translate complex billing rules into precise technical specifications for automated claim auditing algorithms.
Conduct hands-on data analysis using Microsoft Excel to explore datasets and quantify savings potential for clients.
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and handle over 12 million prior authorization requests annually. The Coherenauts who succeed here are empathetic teammates who are candid, kind, caring, and embody their core values and principles.
Monitors and verifies insurance information for patient visits.
Communicates with patients about co-pays, benefits, coverage, and care authorization.
Aviary is an organization in the healthcare sector. We value employees who are rigorous analytical thinkers and problem solvers with a strong work ethic.
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep its members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most.
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.
Evaluates medical records to provide clinical and surgical abstraction for complex professional services, ensuring coding accuracy and compliance with national guidelines.
Consults with medical providers to clarify record information and accurately code diagnostic and procedural data using ICD-10-CM and CPT-4.
Works independently in a remote setting, utilizing coding software to maintain productivity and quality standards while supporting department projects and validation edits.
Banner Health is one of the largest nonprofit health care systems in the country, providing hospital services, primary care, research, and more across its network. It is a Great Place To Work® Certified organization with a large, skilled workforce committed to patient care and employee wellbeing.
Develop and maintain standard operating procedures and conduct training for revenue cycle teams to uphold best practices.
Perform audits on payer payments and fee schedules to ensure accurate reimbursement and identify denial trends affecting revenue.
Manage multiple priorities including special projects, Salesforce cases, and process documentation to support key performance goals.
Privia Health is a national physician enablement company that uses technology and scalable operations to help medical groups deliver high-value care in-person and virtually. The company, led by top talent and physician leaders, has a cloud-based platform focused on improving patient outcomes and provider well-being.