Review medical records to develop concise clinical reviews supporting authorization and reimbursement.
Facilitate communication with payors to ensure appropriate utilization management decisions.
Collaborate with interdisciplinary team to prevent denials and optimize patient care.
West Virginia University Health System is West Virginia’s largest health system, providing comprehensive healthcare services. With over 35,000 employees and 25 hospitals, it is the state's largest employer and offers a collaborative, patient-centered culture.
Perform clinical reviews for medical necessity, level of care, and authorization compliance.
Prepare and submit high-quality appeals related to DRG downgrades and clinical validation denials.
Apply payer-specific guidelines and document review findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable revenue cycle solutions and clinical expertise. The company builds long-term careers by investing in team members' professional development and personal growth.
Ensure quality and completeness of medical record documentation through concurrent interaction with physicians and staff.
Facilitate modifications to clinical documentation to support accurate reimbursement and severity capture for inpatients.
Educate patient care team members on documentation best practices and support timely, accurate reporting.
Cooper University Health Care is a healthcare organization dedicated to providing extraordinary care through clinical innovation and advanced facilities. It offers a comprehensive benefits program and opportunities for career growth, with a team-oriented culture.
Serves as a subject matter expert in clinical documentation quality, risk adjustment, and HCC coding integrity.
Performs prospective reviews of medical records to validate chronic conditions and ensure documentation accuracy.
Utilizes Epic and OurPractice Advisories to support accurate coding, HCC capture, and compliance.
UASI is a clinical documentation improvement consulting firm dedicated to improving the quality and accuracy of clinical documentation. They offer a collaborative, mission-driven environment with opportunities for professional growth.
Code across specialties, translating clinical documentation into ICD-10-CM, CPT, and HCPCS codes with heavy dermatology and orthopedic focus.
Own documentation quality by validating provider notes against E/M guidelines and directly communicating with practice managers and physicians.
Resolve denials by researching complex coding-related denials, understanding why claims were denied, and using AI tools to draft appeals.
Clarity RCM is a rapidly growing revenue cycle management company on the Inc. 5000 list. They manage billing, credentialing, and account management for private dermatology practices nationwide, expanding into orthopedics.
Manage charge entry, claim submission, and payment posting for assigned clients
Work first-pass denials and resubmit or appeal claims as appropriate
Monitor and report on denial rates and billing performance for your assigned accounts
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company is an equal opportunity employer committed to diversity and inclusion.
Conduct independent clinical research and interpret specialty society guidelines to originate automated payment integrity logic.
Author end-to-end logic from scratch, translating clinical documentation and coding frameworks into precise parameters.
Lead cross-functional policy development and own concept rollouts from discovery through post-launch tracking.
Devoted Health is a healthcare company on a mission to improve the health and well-being of older Americans by providing a seamless care platform. Founded in 2017, it fosters a culture of innovation and collaboration, with a focus on data and AI to deliver exceptional member experiences.
Lead appeals strategy for denials across commercial and governmental payers nationwide.
Develop evidence-based appeal packages including letters of medical necessity and clinical summaries.
Collaborate with physicians, field teams, and revenue cycle to improve reimbursement outcomes and patient access.
Advanced Oxygen Therapy, Inc. (AOTI) transforms wound care through breakthrough technologies like TWO2 therapy and NEXA NPWT system. The company is backed by a world-class international leadership team and a robust global infrastructure, offering a unique opportunity to make a meaningful impact in healthcare.
Manage day-to-day operations for the outpatient clinical documentation improvement program across multiple facilities.
Liaise with physicians and leadership on coding rules, risk adjustment, and reimbursement guidelines.
Ensure compliant and accurate medical record documentation while facilitating standardization.
Henry Ford Health is an academic health system providing comprehensive care across Michigan. With 12 hospitals and hundreds of clinics, it is a large organization focused on collaboration and innovation.
Review inpatient claims to identify missed reimbursement opportunities based on ICD-10 coding accuracy.
Analyze hospital billing files and medical records to optimize DRG reimbursement.
Collaborate with leadership on case prioritization and workflow management.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using intelligent automation. They are a multi-year Top Workplaces award recipient and have been on the Inc. 5000 list of fastest-growing private companies for eleven years.
Verify patient insurance eligibility and benefits prior to services and document findings accurately.
Post insurance and patient payments, research variances, and follow up on outstanding claims.
Perform provider documentation and coding audits to ensure CPT, ICD-10-CM, and modifier accuracy.
Brightline is a premier national youth mental health provider delivering high quality virtual and in-person care to families. Founded in 2019, Brightline has delivered care to tens of thousands of families and is backed by investors including Google Ventures and KKR.
Strategically coordinate and optimize the flow of coded medical record information to ensure accurate billing and reimbursement.
Review surgical coding submissions and manage denials to maximize revenue capture and compliance.
Design and deliver impactful educational programs that elevate documentation practices and coding quality.
Henry Ford Health is an academic health system providing comprehensive care across Michigan and beyond. With 12 hospitals and hundreds of ambulatory locations, the organization is a large, purpose-driven team committed to innovation and community impact.
Guide a remote team of Billing Associates in day-to-day billing operations, claims submission, and denial management.
Oversee coding accuracy, payer-specific requirements, and AR aging to ensure clean claim rates.
Develop and maintain billing workflows, stay current on regulations, and support audits.
Dreem Health is America's leading digital sleep clinic, offering home-based sleep testing and telehealth visits. They are part of an international team across the US, France, and Belgium, valuing trust, collaboration, and optimism.
Reviews payor denials and audits for potential lost revenue and writes comprehensive appeal arguments using clinical criteria.
Functions as a hospital liaison with external third-party payors and works with Physician advisor team to facilitate appeals.
Monitors and reports payor trends to management, ensuring compliance with regulatory and accrediting requirements.
Jefferson Health is a nationally ranked not-for-profit health care system reimagining health care and higher education to create unparalleled value. With more than 65,000 employees, it serves patients through millions of encounters annually at 32 hospital campuses and over 700 outpatient locations in the greater Philadelphia region, Lehigh Valley, and southern New Jersey.
Serve as the primary client relationship lead, ensuring alignment on goals, scope, deliverables, and outcomes.
Provide OP HCC CDI subject matter expertise and oversee project execution, quality, and client satisfaction.
Monitor project performance, manage risks and scope changes, and ensure successful delivery of contracted services.
UASI improves the quality and accuracy of clinical documentation through expert CDI consulting. We are a growing team with a collaborative, mission-driven environment that values continuous learning and professional growth.
Review inpatient coding (ICD-10-CM/PCS) to ensure accuracy and completeness for multiple clients.
Validate DRG assignments and optimize reimbursement while maintaining compliance with regulatory standards.
Collaborate with service line teams and client departments to improve documentation and meet production goals.
Kodiak Solutions specializes in healthcare finance, unclaimed property, risk management, and revenue cycle management. They use technology-driven solutions to help healthcare organizations streamline operations and improve patient care.
Perform detailed DRG validation and quality audits of inpatient medical records to assess coding accuracy and clinical validity.
Review ICD-10-CM/PCS code assignment, POA indicators, SOI/ROM, HCC capture, and other reimbursement-related elements.
Support clinical documentation improvement initiatives by identifying documentation and physician query opportunities.
The partner company specializes in healthcare revenue integrity and DRG auditing. It operates with a remote team and values accuracy, compliance, and independent work.
Own end-to-end claims and revenue-cycle operations, including claim submission, denials, appeals, and collections across Medicaid and commercial payers.
Build and optimize payer-specific billing workflows, including claim configuration, coding, and credentialing.
Drive cross-functional execution with Operations, Partner Success, and Finance to improve processes and achieve over $1M in monthly claims.
Jukebox Health partners with health plans to make homes safer and more accessible for older adults and high-needs populations, combining technology with networks of clinicians, suppliers, and installers. Founded by experienced entrepreneurs, Jukebox Health is a fast-growing healthcare services company backed by top venture capital firms like Valtruis and The Home Depot, with a high-trust, collaborative, remote-first culture.
Develop and coordinate individualized treatment plans and discharge services for patients.
Perform medical record reviews to assess admission appropriateness and ensure compliance with standards.
Support denials management and appeals for insurance claims to ensure quality care.
Northwestern Medicine is a healthcare system focused on patient-first care. We offer a supportive workplace with competitive benefits and a culture of growth.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Review medical records and supporting documentation to confirm appropriate billing and apply CMS guidance, coding guidelines, and MUE/NCCI edits.
Prepare appeal responses using applicable coding guidance and assist with new concept development and claim selection criteria.
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. It is a dynamic growing organization with a collaborative and innovative work environment.