Provide subject matter expertise on Payment Integrity claims processing edits, vendor edits, and reimbursement policies.
Respond to internal and external inquiries and disputes while documenting industry standard coding rules and recommending policy changes.
Collaborate with partners to scope, prioritize, and deliver solutions using data insights and process improvements.
Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. Founded in 2012, the company fosters a culture of transparency, collaboration, and authenticity as an Equal Opportunity Employer.
Audit inpatient DRG, outpatient, and professional fee coding for accuracy and compliance.
Review up to 25 diagnoses and procedures per record, classify errors with references.
Deliver facility audit reports and lead training sessions for coding staff and clinicians.
Arrow ARC provides healthcare staffing and program support to Veterans Health Administration facilities across the U.S. It is a certified Service-Disabled, Veteran-Owned Small Business joint venture known for an agile, mission-focused, results-driven approach.
Analyze, research, and resolve issues related to the creation and submission of paper and electronic claims.
Monitor claim errors, identify opportunities for new edits, and collaborate with the Business Systems Department to implement clearinghouse edits.
Validate daily imports, balance hash totals, and report system issues to IS to ensure timely resolution.
Pediatrix Medical Group is one of the nation’s largest providers of prenatal, neonatal and pediatric services, led by physicians. They offer a diverse range of opportunities, competitive salaries, and a commitment to clinical excellence, focusing on a team approach to improve patient lives.
Serve as an expert-level coder for complex inpatient records, ensuring accurate data retrieval and reimbursement.
Resolve billing inquiries, manage DRG denials, conduct audits, and support revenue cycle integrity.
Mentor coding staff and collaborate with management on training, education, and process improvements.
CommonSpirit Health operates more than 700 care sites across the U.S., from clinics and hospitals to home-based and virtual care services. With a mission to build healthy communities and advocate for the poor and vulnerable, they foster a culture of compassion and innovation.
Conduct routine and targeted coding audits for internal and outsourced vendors across ASC, hospital outpatient, and professional fee services.
Review ICD-10, CPT, HCPCS, and payer policies to ensure coding accuracy, compliance, and documentation support.
Prepare audit reports, identify trends, provide coder education, and support performance improvement initiatives.
Surgery Partners is a healthcare services company operating ambulatory surgery centers and related facilities across the United States. With more than 58 facilities, the company prioritizes compliance, quality, and a diverse, inclusive workplace.
Analyze hospital claims to identify discrepancies between expected and actual insurance reimbursements.
Investigate underpayments and payment variances by examining coding errors, billing discrepancies, and payer policies.
Collaborate with insurance carriers and internal stakeholders to resolve billing issues and improve revenue recovery outcomes.
This partner company specializes in healthcare revenue integrity, helping hospitals recover appropriate reimbursement for services. The team fosters a collaborative, inclusive culture focused on continuous improvement and professional development.
Manage accounts receivable, including analysis of aged AR and identification of root cause issues.
Investigate, resolve, and appeal insurance claim denials, contacting payer representatives as needed.
Collaborate with internal teams and care center staff to drive optimal revenue cycle performance.
Privia Health is a technology-driven physician enablement company that partners with medical groups and health systems to optimize practices and improve patient experiences. It is led by top industry talent and physician leadership with a focus on scalable operations and cloud-based technology.
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.
Audit inpatient and outpatient records for coding accuracy, documentation support, and reimbursement impact.
Review ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRG, modifier, and bundling assignments across facilities.
Present findings and provide facility-specific coding education to leadership and stakeholders.
A large regional health network operates multiple medical facilities across the United States, focusing on accurate coding and compliance. The organization maintains a structured, regulated environment with an emphasis on quality improvement, education, and confidentiality.
Conduct detailed audits of medical claims, billing records, coding, and clinical documentation.
Partner with healthcare system clients to resolve billing discrepancies and improve reimbursement.
Serve as a subject matter expert on Medicare, Medicaid, and commercial payer billing requirements.
Jaan Health is an AI-based care management company serving healthcare providers with its Phamily platform to deliver proactive care. It is a fast-growing, early-stage company built on five principles: care, curiosity, clarity, co-creation, and craftsmanship.
Accurately assign and sequence ICD-10-CM, CPT, and HCPCS codes for outpatient medical records and encounters.
Ensure coding compliance with legal, regulatory, and organizational standards while initiating physician queries for documentation clarity.
Maintain productivity, quality, and confidentiality standards while supporting team collaboration and professional development.
CommonSpirit Health is a nonprofit Catholic healthcare organization delivering integrated health services. With more than 157,000 employees, 45,000 nurses, and 25,000 physicians across 24 states, it fosters a culture of compassion, innovation, and community service.
Resolve disputed claims by gathering, verifying, and providing additional information.
Resolve discrepancies by examining and evaluating data and selecting corrective steps.
Maintain work operations by following policies and procedures and reporting compliance issues.
Surgery Partners is a healthcare services organization providing surgical care. It is committed to equal employment opportunity and workforce diversity.
Process billing data entry with 10-key skills and compare data with source documents.
Research and update billing demographic data to ensure prompt payment from insurance.
Communicate via phone with clients and patients to resolve billing defects and verify insurance information.
Labcorp is a global leader in laboratory services, providing diagnostic testing and drug development solutions that help healthcare providers, researchers, and patients make informed decisions. With nearly 70,000 employees serving clients in more than 100 countries, Labcorp fosters a collaborative culture focused on improving health and improving lives.
Review clinical documentation and ensure accurate charge entry in the billing system.
Submit insurance claims, monitor status, and resolve denials to maintain a clean billing cycle.
Support families with billing questions and assist with accounts receivable monitoring.
InStride Health delivers specialty anxiety and OCD care for kids, teens, young adults, and families through evidence-based clinical care and technology. The company is a mission-driven startup focused on expanding access to insurance-based care, with a collaborative culture grounded in values like heart, humility, and community.
Review and verify healthcare claims for accuracy, coding, eligibility, and coverage.
Approve or deny claims according to policy terms and regulations, and resolve discrepancies.
Process claims efficiently, meet performance targets, and maintain accurate records.
Blue Cross and Blue Shield of Kansas is a health insurance company providing coverage to Kansans. With over 80 years in the community, it fosters an inclusive, family-first culture and supports professional growth.
Prepare, review, and process accurate customer invoices and billing records.
Research billing discrepancies, resolve routine issues, and escalate complex concerns.
Collaborate with Finance, Operations, Support, and Sales to answer billing questions and improve processes.
Roadie is a logistics and delivery platform that helps businesses manage modern retail delivery with unmatched coverage and flexibility. As a UPS company, it operates a network of more than 310,000 independent drivers across the U.S., reaching 97% of households.
Monitor clearinghouse portals and resolve rejected medical claims daily.
Investigate rejection causes including coding errors and eligibility issues.
Correct claim information and resubmit to insurance payers for reimbursement.
Our partner is a healthcare revenue cycle management company focused on optimizing medical claims processing for providers. They offer a collaborative, inclusive work culture with opportunities for professional growth in a remote environment.
Conduct internal and external quality audits for ICD-10 code abstraction and identify clinical documentation improvement opportunities.
Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data and reviewing Risk Adjustment coding performance.
Maintain compliance with national coding standards and support CMS and Risk Adjustment Data Validation audits.
Oscar is a health insurance company built around a full-stack technology platform and a relentless focus on serving its members. Founded in 2012, it cultivates an inclusive environment where employees can be their authentic selves.
Apply senior-level expertise to code inpatient and outpatient professional fee services across multiple specialties, assigning CPT, HCPCS, and ICD-10 diagnosis codes.
Review documentation to resolve edits in work queues and analyze denials for corrected claims or appeals.
Collaborate with clinic supervisors, providers, and Revenue Management to resolve coding issues and ensure compliance.
CommonSpirit Health is a nonprofit health system with more than 700 care sites across the U.S., serving nearly one out of every four U.S. residents. The organization is committed to building healthy communities and innovating healing both inside hospitals and in the community.
Reviews and codes medical records for general surgical specialties using ICD-10, CPT, and HCPCS codes.
Abstracts demographic and coding data, audits orders and claims, and reviews documentation for medical necessity.
Provides technical guidance to physicians and staff and develops stakeholder relationships.
Piedmont Healthcare is a healthcare system providing medical services across Georgia. It fosters a shared purpose and recognition, with wellness programs and comprehensive benefits for employees.