Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types
Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans
Perform necessary research to provide to the client to support findings.
UASI is recognized as a Top Workplace. With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we’ve built and the long-term success of our dedicated team.
Ensuring the accuracy, integrity, and quality of coding practices within the HIM department.
Conducting thorough reviews of clinical documentation, coding, and billing processes to ensure compliance.
Educating and training coding staff on best practices and updates in coding guidelines.
Cooper University Health Care is committed to providing extraordinary health care. They focus on clinical innovations and access to facilities, equipment, technologies and research protocols, and offer competitive rates, compensation programs, benefits, and career growth.
Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.
Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.
Collaborate with team leaders to ensure thorough review of DRG denials.
Machinify is a healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They deploy a configurable, AI-powered platform and best-in-class expertise, serving over 85 health plans representing more than 270 million lives.
Review and analyze medical records to ensure coding accuracy in a timely fashion
Identify opportunities for improvement in coding models
Understand and apply coding guidelines to assign appropriate codes to diagnoses and procedures as supported by clinical documentation
SmarterDx builds clinical AI that is transforming how hospitals translate care into payment. Founded by physicians in 2020, their platform connects clinical context with revenue intelligence, helping health systems recover millions in missed revenue, improve quality scores, and appeal every denial.
Perform audits to assess the quality of documentation, accuracy of charge code assignment and review financial billing statements.
Answer any physician and/or clinic questions and concerns regarding current ICD-10 and CPT guidelines.
Provide coding training and updates for coding staff, physicians and clinics as assigned.
Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. They have an innovative, multifaceted culture that embraces collaboration, excellence, discovery, and compassion.
Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition.
Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. Reviews non-CC/MCC records to determine if record was miscoded or if additional documentation is needed.
Works with Coders and CDSs to draft and initiate physician queries.
Emory Healthcare is a healthcare system in Atlanta, GA. We fuel professional journeys with benefits, resources, mentorship, and leadership programs, fostering a supportive environment.
Creates and delivers education to the Coding Team, Clinical Documentation Nurses, Physicians, and other licensed providers to improve documentation quality.
Collaborates with CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.
Monthly monitoring of the clinical dashboard demonstrating improvement in statistical targets.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system.
Supports coding and documentation quality assurance.
Performs internal audits to assess compliance and quality.
Researches coding, billing, and charging compliance issues.
Presbyterian Healthcare Services is dedicated to improving the health of patients, members, and communities. They are a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group, employing nearly 14,000 individuals.
Northeast Georgia Health System (NGHS) is a non-profit organization dedicated to improving community health through various initiatives. With a team of caregivers serving over 1 million people across the region, NGHS consists of five hospitals and numerous outpatient facilities.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present.
Participate in audits to evaluate if all selected codes are accurate and develop methodologies to improved coding issues.
Northside Hospital is an award-winning and state-of-the-art hospital that is continually growing. They are expanding the quality and reach of their care to patients and communities which creates more opportunity for healthcare professionals in Atlanta and beyond.
Organizes and prioritizes assigned work to ensure completion within the assigned time frame.
Reviews charts and medical records, assigning ICD and CPT code combinations to each data element.
Audits for documentation opportunities and queries clinical staff to fill in any gaps.
Riverside Health System's mission is to care for others as we would care for those we love. We extend that sense of caring to every patient, resident and customer, as well as to each member of our team, offering care at all stages of life, in hundreds of locations.
Lead prospective claim review audits related to clinical DRG coding compliance and readmissions programs.
Act as Subject Matter Expert to counsel other team members across Clover on clinical coding guidelines.
Collaborate with teams across Clover to ensure provider understanding of Payment Integrity recommendations.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep their members healthier. They've created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most; they are passionate and mission-driven individuals.
Review clinical information for appropriateness, congruency, and accuracy.
Review and communicate OASIS edit recommendations to each clinician.
Provide customer service/education and act as a resource to Medicare Certified Offices.
BAYADA Home Health Care delivers home health care with compassion, excellence, and reliability. As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates, with 50 years of experience.
Responsible for managing and overseeing activities for multiple value streams within the revenue cycle.
Provide ongoing input in the strategic planning of business requirements and corporate objectives for the Revenue Cycle.
Ensure compliance with all federal, state, and local statutes and regulations, as well as all third-party payer policies.
Virginia Mason Franciscan Health brings together two award-winning health systems in Washington state - CHI Franciscan and Virginia Mason. As one integrated health system, our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.
Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs).
Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions.
Identify potential deficiencies in processes via analysis and trends.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Assigns ICD-10-CM/PCS codes and assigns DRGs for inpatient medical records accounts; assigns ICD-10-CM/PCS codes and CPT codes for outpatient medical record accounts
Abstracts key data elements required for billing
Interacts with providers for clarification of documentation/education
UChicago Medicine has been at the forefront of medicine since 1899 and provides superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, they need employees with passion, talent and commitment… with patients and with each other.