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.
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.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Verify and analyze medical records to assign diagnostic and procedural codes using CMS guidelines.
Ensure accurate charge capture and data entry with a 95% accuracy rate.
Serve as a coding resource, resolve discrepancies, and assist in training new staff.
Munson Healthcare is northern Michigan's largest healthcare system with eight community hospitals serving over half a million residents. With a focus on excellence, teamwork, and community, they offer a supportive culture and a lifestyle in a beautiful region.
Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
Follows established policies and procedures to pay, pend for additional information, or deny claims.
Accountable to meet and maintain established department production and quality standards.
Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
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.
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.
Review and validate all assigned OASIS assessments for accuracy, completeness, and internal consistency.
Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement.
Provide clear, actionable feedback to field clinicians with a focus on education and process improvement.
Adaptive Home Health builds a higher-acuity, patient-centered home health model across Michigan. The company operates in a tech-forward environment with strong operational support.
Perform inpatient coding audits and review services remotely.
Identify trends and suggest corrective action plans.
Provide in-service education to clients on coding trends.
UASI has over 40 years of experience and enduring partnerships with its valued clients. The company was recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023 and 2024, with a dedicated team and long-term success.
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.
Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Troubleshoot product, service, and enrollment issues with sensitivity and urgency while maintaining compliance.
iRhythm is a leading digital healthcare company that creates trusted solutions to detect, predict, and prevent disease. The company combines wearable biosensors and cloud-based data analytics with proprietary algorithms, and is experiencing rapid growth with opportunities across the globe.
Provide clinical leadership and subject-matter expertise to support analysis and configuration of medical policy content within claims processing systems.
Ensure accurate implementation of medical policies, review criteria, and authorization requirements while maintaining system infrastructure integrity.
Serve as an expert resource for medical policy configuration and PGE coding, mentoring Coding Specialists and providing training to operational partners.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota. We are motivated by the well-being of our members, not profits, and we are committed to sustainability and innovation.
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.
Apply correct coding, regulatory and compliance guidelines, including ICD-10-CM, CPT, APC, and E&M codes.
Maintain 95% coding accuracy while meeting department productivity standards.
Participate in staff discussions and provide valuable input to the coding team.
Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, it is the only National Cancer Institute-designated cancer center in Washington, with eight clinical care sites and a reputation as one of the world's leading cancer research centers.
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.
Lead advanced coding education for providers and groups, including E/M and Medicare Preventive services.
Analyze coding performance indicators to identify training needs and improve accuracy.
Develop and refine coding presentations and materials reflecting latest industry standards.
Privia Health is a technology-driven, national physician enablement company that optimizes physician practices and improves patient experiences. The company is led by top industry talent and physician leadership, with scalable operations and cloud-based technology.
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.
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.
Perform Skilled Nursing Facility (SNF) medical claims audit reviews for Government and Commercial Payers.
Document findings referencing medical review guidelines and support audit findings during the appeals process.
Work collaboratively with the audit team to identify vulnerabilities and improve medical policies and workflows.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans and representing more than 270 million lives, the company uses a configurable, AI-powered platform combined with industry expertise to maximize financial outcomes and reduce healthcare costs.