Review inpatient and outpatient medical records to ensure accurate and compliant clinical documentation.
Collaborate with physicians and clinical teams to clarify diagnoses and support proper coding.
Maintain productivity targets and contribute to provider education initiatives to improve documentation quality.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. It processes applications using AI to ensure fair review and shares top candidates with employers.
Provides onsite and remote clinical documentation integrity support to CDI programs as part of the System Office CDI Float Pool.
Reviews and audits medical records to ensure accurate documentation of medical necessity, severity of illness, and level of services.
Trains end users on CDI software systems and communicates with healthcare teams to improve documentation practices.
Trinity Health is a large not-for-profit, faith-based health care system with 121,000 colleagues and nearly 36,500 physicians and clinicians serving communities across 27 states. The system includes 101 hospitals and invests heavily in community benefit programs.
Responsible for conducting remote training for the CDIS team.
Aids in development and education of healthcare providers on documentation principles.
Works collaboratively with CDI Leadership to maintain system-wide orientation tools and processes.
Piedmont Healthcare is a healthcare organization focused on providing comprehensive care. They are a large employer with a culture that supports employee wellness and professional growth.
Support payer audits and medical record reviews, ensuring timely submission of documentation.
Manage medical review requests and appeals associated with CMS contractors and regulatory agencies.
Review clinical documentation using audit checklists and partner with teams to gather required records.
VitalCaring is a provider of home health and hospice services founded in 2021. They are a growing company focused on quality and compliance, with a mission to deliver exceptional patient care.
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.
Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams with compassion, creativity, and an unwavering commitment to children with medical complexity.
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.
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.
Conduct clinical reviews of medical records to determine medical necessity and payer compliance.
Evaluate denial cases including appeals, audits, and no-authorization determinations.
Develop evidence-based clinical rationales aligned with payer and regulatory guidelines.
This partner company provides clinical review and healthcare reimbursement support services. The team is remote and operates in a fast-paced, performance-driven environment.