Conduct audits of medical records for compliance with federal coding regulations and guidelines.
Provide education and training to providers on CPT, ICD-10, and HCPCS codes.
Act as an internal expert to ensure coding compliance with state and federal regulations.
Privia Health is a technology-driven national physician enablement company collaborating with medical groups, health plans, and health systems. It aims to optimize physician practices and improve patient experiences through cloud-based technology and scalable operations.
Supports and strengthens the Compliance program by providing advisory support to business stakeholders.
Conducts compliance investigations and assists with auditing and monitoring activities.
Advances policy governance and development, translating regulations into practical guidance.
Rula is a mental health company dedicated to providing evidence-based, compassionate care to treat the whole person. They are a remote-first organization with a culture that values diversity, equity, and inclusion, hiring in most U.S. states.
Monitor coding prevalence and ensure compliance with CMS audit processes.
Conduct provider and coder level reviews to ensure accurate risk adjustment data submission.
Maintain tracking tools and assist in RADV audits and corrective action plans.
Alignment Health is a healthcare organization dedicated to transforming senior care, focusing on the chronically ill and frail. The company is fast-growing with a passionate team united in the mission to put seniors first.
Build and lead Chamber's first compliance function, spanning regulatory, clinical, government programs, IT/security, and internal audit.
Partner with legal, clinical, security, and business teams to embed compliance into workflows, technology, and market expansion.
Serve as the strategic compliance expert for Medicare/Medicaid, HIPAA, CPOM, and risk-based program development.
Chamber is rebuilding the system for cardiology by partnering with independent cardiologists and equipping them with technology, data, and operational tools. The company is an early-stage, mission-driven team focused on transforming heart health through AI-enabled clinical workflows and human-centered care.
Develops, manages, and monitors corporate compliance programs that promote ethical behavior and mitigate risk.
Leads risk assessments, audits, and regulatory interactions, including preparing reports and responding to inquiries.
Builds relationships with internal and external stakeholders to drive compliant outcomes and manages operational compliance activities.
Omnicare is a leading provider of pharmacy services to long-term care facilities nationwide, supporting skilled nursing, assisted living, and other institutional care settings. The organization fosters a culture of care, innovation, and accountability, with a focus on quality and safety in everything it does.
Oversee CMS and state audit readiness, live audit management, and corrective action plans.
Build internal monitoring, training, and reporting to foster a culture of compliance.
Collaborate with clinical and operations teams to integrate audit findings into improvements.
Habitat Health empowers older adults to experience more good days through the Program of All-Inclusive Care for the Elderly (PACE), delivering coordinated medical and social care in homes and communities. Supported by leading healthcare organizations and investors, the company is expanding its scalable model with a mission-driven culture focused on participant well-being.
Oversee delegated audits related to UM, Credentialing, Claims, Enrollment, and Appeals processes to ensure compliance with payer contracts.
Educate staff, update policies and workflows, and act as a liaison between payers and local market leadership during audits.
Operationalize regulatory communications from governing bodies and document process changes for upstream and downstream teams.
Dignity Health Management Services offers integrated management and business services to healthcare providers, focusing on managed care administrative and clinical services to contain costs and improve quality. It is part of CommonSpirit Health, a large health system with a mission-driven culture centered on community and patient care.
Maintain, organize, and monitor electronic and paper medical records for completeness and regulatory compliance.
Process release of information requests while verifying identities, authorizations, and legal requirements.
Monitor compliance with HIPAA and regulatory standards, support audits, and drive quality improvements.
US Security & IT supports healthcare organizations with information management and compliance solutions. The company offers a supportive, collaborative remote environment with a focus on wellbeing and professional growth.
Own and mature security, privacy, and compliance programs across HIPAA, SOC 2, and HITRUST.
Lead HITRUST certification end to end, including scoping, evidence collection, and assessor coordination.
Partner with Engineering, Product, SRE, and IT to integrate security into architecture, SDLC, and cloud infrastructure.
IntusCare is an end-to-end ecosystem built specifically to help PACE programs deliver exceptional care, strengthen financial performance, and stay compliant. It is a growing healthcare SaaS organization that empowers teams to improve outcomes for dual-eligible seniors.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Respond to patient inquiries through chat, email, and internal messaging with clarity, warmth, and professionalism.
Break down complex topics (billing, CPT codes, coverage, device returns) into simple, patient-friendly explanations.
Document all interactions clearly and accurately, ensuring consistent follow-up until issues are fully resolved.
Salvo Health takes a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions. Backed by leading health care investors, Salvo's team includes board-certified physicians, dietitians, nurses, and therapists who provide evidence-based, continuous care.
Conduct detailed medical record audits to assess coding accuracy, documentation quality, and regulatory compliance.
Interpret CMS and payer guidance to identify compliance gaps and provide actionable recommendations.
Prepare audit reports and deliver provider education to improve billing accuracy and reduce risk.
This role is with a partner company specializing in healthcare compliance and coding audits for diverse healthcare settings. The collaborative, client-focused environment values analytical thinking, professional integrity, and continuous learning.
Conduct clinical audits and risk assessments to identify compliance gaps.
Manage multiple client engagements and deliver accurate project results.
Build strong client relationships and present findings to leadership.
Kodiak Solutions transforms healthcare through technology-driven solutions, specializing in finance, unclaimed property, and risk management. Their innovative platform streamlines operations, allowing providers to focus on patient care.
Perform in-depth compliance audits to ensure adherence to local, state, and federal regulatory guidelines.
Identify potential compliance concerns and opportunities for documentation improvement.
Prepare and share detailed audit reports with physicians, advanced practice providers, and clinical leadership.
Baptist Health is a faith-based, not-for-profit health system in Northeast Florida, providing preventive and specialty care through 200+ locations and six hospitals. As the largest healthcare provider in the region, it fosters a welcoming workplace where every team member's voice is heard.
Provide compliance documentation and knowledge management support to the Contracts Management and Compliance Division.
Maintain the organization-wide risk register, track mitigation actions, and support sub-recipient due diligence workflows.
Coordinate compliance training, monitor U.S. government regulatory updates, and prepare compliance reports for leadership.
Jhpiego is a global health nonprofit affiliated with Johns Hopkins University, dedicated to improving the health of women and families in developing countries. The organization values diversity, equity, and inclusion, and offers a supportive, mission-driven work culture.
Manage and maintain Virta's privacy compliance program, including policies, procedures, PIAs, and records of processing activities.
Act as primary point of contact for privacy inquiries from customers, prospects, and partners, supporting DPAs, BAAs, RFPs, and due diligence.
Drive cross-functional privacy initiatives, training, metrics, and incident response workflows to strengthen Virta's privacy posture.
Virta Health is on a mission to reverse metabolic disease in one billion people through virtual care, personalized nutrition, and technology. Backed by over $350 million from top-tier investors, the remote-first company partners with health plans and employers to help members restore their health.
Process and maintain accurate Medicare enrollment and disenrollment requests, ensuring compliance with CMS regulations.
Reconcile membership reports and resolve enrollment system rejections, building case files for CMS approval.
Mentor junior team members and collaborate on special projects, including process documentation and quality reviews.
HealthEdge provides AI-powered operational infrastructure for health insurance companies, aiming to modernize operations and improve competitiveness. UST HealthProof, a fast-growing company, focuses on reducing administrative costs and improving healthcare experiences, led by seasoned leaders fostering a supportive, growth-oriented environment.
Independently audit professional-fee coding for accuracy, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, E/M services, modifiers, and professional components.
Prepare reports, deliver coding education, and maintain 95% audit accuracy.
A large regional healthcare network providing medical services across multiple facilities. The culture emphasizes independent auditing, high accuracy, and collaborative compliance education.
Complete credentialing and re-credentialing applications for physicians, ancillary providers, and facilities with third-party payers and governmental programs.
Partner with client liaisons and payers to manage enrollment status, follow up on applications, and communicate updates to providers and clients.
BerryDunn is a professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies across the US. The firm is known for its client-centered, people-first culture and commitment to diversity, learning, and well-being.
Process patient payments and manage payment plans with accuracy and compliance.
Educate patients on billing, insurance verification, and claims-related inquiries.
Resolve billing issues by researching account history and coordinating with internal teams.
Five Star Solutions is a customer service and healthcare billing solutions provider, supporting patient payment and insurance processes. The company fosters a remote work culture with a focus on empathy, accuracy, and compliance.