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.
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.
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.
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.
Focuses on ensuring accuracy, compliance, and integrity of medical coding across healthcare records.
Conducts detailed audits, reviews clinical documentation, and identifies discrepancies impacting billing and compliance.
Collaborates with clinicians, revenue cycle teams, and leadership to improve documentation quality and coding consistency.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They process applications and share shortlists with employers, focusing on objective and fair review.
Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types.
Reviews medical records thoroughly using all available documentation to code appropriate diagnoses and procedures.
Sends appropriate physician queries when required for documentation clarification with focus on complex outpatient encounters.
Northwestern Medicine is a leader in the healthcare industry with a patient-first approach. The organization provides competitive benefits including tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits, striving to take care of its employees.
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.
Responsible for coding procedures and entering charges to comply with federal/state regulations.
Coordinate with Practice Coordinator and Revenue Integrity to ensure documentation supports procedure codes.
Participate in audits to evaluate code accuracy and develop methodologies to improve coding issues.
Northside Hospital is an award-winning, state-of-the-art healthcare provider in Atlanta, Georgia. It is continually growing, offering opportunities for healthcare professionals in a supportive environment.
Piedmont Healthcare is a healthcare organization providing medical services across multiple hospitals in the US. They offer comprehensive benefits and wellness programs, and emphasize a supportive culture where leaders invest in employee success.
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.
Review medical records and clinical documentation to ensure accurate, compliant coding per CMS, federal, state, and payer policies.
Conduct routine and focused coding audits, collaborate with clinical leadership and revenue cycle teams, and provide actionable recommendations.
Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, interpreting state-specific billing requirements.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home medical, behavioral, and social care, and are a remote-first, high-growth environment.
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.
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.
Provide local oversight of the 340B program and ensure compliance with federal regulations.
Manage split-billing software maintenance and conduct self-audits to maintain audit readiness.
Serve as the primary liaison for all 340B-related matters and coordinate external audits.
Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves. It employs more than 24,000 people across Kentucky and surrounding states, with 10 hospitals and numerous points of care.
Codes and abstracts patient encounters for diagnostic and procedural information, analyzing data for reimbursement needs.
Completes final checks on charts ensuring all reports are signed and NCCI edits, CMS, and Joint Commission rules are followed.
Participates in continuing education and communicates with the Manager on training needs.
Plumas District Hospital provides essential health care services to the Quincy, California area and surrounding mountain community. With a population of 5,000 residents, PDH offers an inclusive work environment, competitive compensation, and perks like shift differentials and holiday pay.