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.
Review and validate all assigned OASIS assessments for accuracy, completeness, and internal consistency.
Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement.
Provide clear, actionable feedback to field clinicians with a focus on education and process improvement.
Adaptive Home Health builds a higher-acuity, patient-centered home health model across Michigan. The company operates in a tech-forward environment with strong operational support.
Coordinate patient care remotely using phone or video, focusing on assessments, care plans, and resource access.
Identify process improvements through data collection and auditing, while navigating multiple EHR platforms.
Utilize home health expertise to triage patient needs and maintain open communication with patients, caregivers, and providers.
ThedaCare is a community health system consisting of seven hospitals and numerous clinics, serving as the third largest health care employer in Wisconsin. With approximately 6,800 employees, the organization emphasizes innovation, compassion, and a commitment to improving community health.
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.
Supports clinical safety, accuracy, and oversight of integrated AI tools by reviewing AI-assisted outputs and surfacing risks.
Applies nursing judgment to review charts, calls, messages, and other member interactions to assess quality, safety, and member experience.
Assists with data collection and basic analysis for quality and safety work, and participates in cross-functional improvement efforts.
Included Health is a healthcare company delivering integrated virtual care and navigation. They are on a mission to raise the standard of healthcare for everyone, and offer members care guidance, advocacy, and access to personalized virtual and in-person care.
Serve as a clinical subject matter expert supporting product and AI teams to evaluate new features for clinical safety and risk.
Conduct first-line clinical risk assessments across high-impact areas like documentation workflows and medication management.
Partner cross-functionally with product, engineering, regulatory, and clinical teams to guide safe innovation throughout the product lifecycle.
Our partner operates in healthcare technology, and we use an AI-powered matching process to connect candidates with roles. The environment is mission-driven and highly collaborative, focusing on improving outcomes across long-term and post-acute care settings.
Analyze and audit inpatient claims for DRG validation, coding accuracy, and clinical appropriateness without a medical record.
Utilize proprietary auditing systems to make determinations and generate audit letters, meeting productivity and quality standards.
Identify new claim types and suggest process improvements while maintaining expert ICD-10 and DRG coding knowledge.
Cotiviti is a healthcare analytics and auditing company that helps payers and providers improve financial performance and clinical outcomes. It is a large organization with a culture focused on accuracy, compliance, and collaboration.
Coordinate and oversee the MDS process for all residents, ensuring accuracy, completeness, and regulatory compliance.
Collaborate with interdisciplinary teams to maximize reimbursement through accurate documentation and chart review.
Maintain knowledge of Medicare, Medicaid, and regulatory requirements, and educate staff on documentation best practices.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. We leverage our global network to connect clients with qualified professionals and offer tailored services to meet unique business needs.
Provide patient-focused telehealth clinical triage assessments and health education via phone, video, and chat.
Work independently to make clinical decisions, assess needs, and direct patients to appropriate care levels while documenting interactions.
Monitor performance metrics, participate in coaching sessions, and communicate with clients and team members.
Carenet Health is a behind-the-scenes partner for over 250 of the nation's premier health plans and health systems, providing telehealth and virtual care clinical triage assessments and health education. Named one of America's fastest-growing private companies by Inc. Magazine for eight consecutive years, the company is integrity-driven and focused on compassionate, evidence-based care.
Support accurate risk adjustment coding by performing first-pass reviews of member medical records.
Maintain compliance with CMS risk adjustment diagnosis coding guidelines and HCC coding standards.
Collaborate with a remote team and contribute to team success through proactive communication and continuous learning.
BlueCross BlueShield of Tennessee is Tennessee's largest health benefit plan company, helping members since 1945. As a remote-first organization, it fosters a culture of innovation and collaboration with a focus on employee well-being.
Must have at least 5 years' RN experience with current licensure, a bachelor's degree or equivalent, and at least 1 year of leadership with direct reports.
Responsible for overseeing RN denials management specialists, pre-bill utilization reviews, payer calls, workflow optimization, and collaboration with internal RCM teams.
Blends clinical expertise with revenue cycle management to protect the organization's bottom line, decrease A/R, and ensure compliance.
Banner Health is one of the largest nonprofit health care systems in the country, providing hospital services, primary care, research, and physician practices across multiple states. With 31 facilities and a focus on innovation, they recently earned Great Place To Work certification, reflecting their investment in employee happiness and fulfillment.
Review and evaluate medical record documentation for completeness, accuracy, and compliance.
Collaborate with physicians, nurses, and coding professionals to ensure appropriate clinical documentation.
Identify opportunities for documentation improvement to support coding accuracy, reimbursement, and clinical outcomes.
We improve the quality and accuracy of clinical documentation through expert CDI consulting. Our collaborative, mission-driven team offers opportunities for continuous learning and professional growth.
Lead daily CDI operations, including staffing, workload balancing, and training for clinical documentation improvement.
Conduct real-time clinical reviews for complex cases and analyze data to ensure quality and accuracy.
Collaborate with physicians and staff to enhance documentation quality and compliance with coding guidelines.
Adventist HealthCare is a faith-based, not-for-profit healthcare organization providing comprehensive services including acute-care hospitals, rehabilitation, outpatient centers, and home care. With over 6,000 employees, they are the largest healthcare provider in Montgomery County, Maryland, focused on extending God's care through physical, mental, and spiritual healing.
Assign accurate medical codes for inpatient/outpatient professional fee records with 95% or greater quality.
Work independently from a remote home office while meeting client productivity targets.
Maintain technical proficiency with VPN, multi-factor authentication, and office software.
UASI is a medical coding and auditing company with over 40 years of experience in the healthcare information management industry. They have been recognized as a Top Workplace for three consecutive years and emphasize professional growth and a supportive team culture.
Build meaningful relationships with patients and families to understand their goals and barriers.
Create personalized care plans addressing medical, behavioral, and social needs.
Coordinate care across providers and settings, ensuring safety, quality, and continuity.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to making great healthcare affordable and improving patient health. As a physician-led organization with a high degree of agility, it employs a remote team and fosters a collaborative, mission-driven culture focused on continuous learning.
Provide clinical review and correspondence for utilization management, including medical necessity reviews and member communications.
Collaborate with Medical Directors to ensure evidence-based decisions that meet NCQA and CMS standards.
Maintain productivity and quality while working 100% remotely in a fast-paced environment.
Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With over 250 employees, the company fosters a supportive, growth-oriented environment and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup.
Manage patient physiological markers and provide clinical triage.
Conduct wellness calls and collaborate with care teams to set health goals.
Drive patient engagement and ensure adherence to RPM program standards.
Vivo Care is building a platform to make healthcare continuous, personal, and truly connected. It is a fast-growing startup with a culture of inclusion, collaboration, and innovation.
Perform clinical reviews for medical necessity, level of care, and authorization-related denials.
Apply payer-specific guidelines and internal policies to support clear, defensible clinical narratives.
Meet assigned turnaround times and document findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable reimbursement solutions and clinical expertise, leveraging technology and analytics. The company builds long-term careers by investing in professional development and personal growth, fostering a culture of accountability and success.
Focuses on ensuring accuracy, compliance, and integrity of medical coding across healthcare records.
Conducts detailed audits, reviews clinical documentation, and identifies discrepancies impacting billing and compliance.
Collaborates with clinicians, revenue cycle teams, and leadership to improve documentation quality and coding consistency.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They process applications and share shortlists with employers, focusing on objective and fair review.
Perform concurrent and retrospective reviews on all facility and appropriate home health services.
Monitor level and quality of care and proactively manage acutely and chronically ill patients.
Act as liaison to Plan Medical Director and coordinate interdisciplinary approach.
Curana Health is a national leader in value-based care for senior living communities and skilled nursing facilities. Founded in 2021, they serve 200,000+ seniors in 1,500+ communities across 32 states with a team of over 1,000 clinicians.