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 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.
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.
Support ongoing documentation quality monitoring by reviewing provider notes for clinical completeness, risk, and payor compliance.
Serve as a clinical point of contact for providers, conducting outreach on documentation best practices and supporting a culture of quality.
Support complaint, grievance, and payor quality review workflows, including intake, clinical review, and resolution documentation.
Grow Therapy is a three-sided marketplace that empowers therapists, augments insurance payors, and serves patients, addressing the need for accessible mental healthcare. Since launching in February 2021, they have empowered over ten thousand therapists and hundreds of thousands of clients, raising over $328 million in funding at a $3 billion valuation from top investors.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Conduct training and education on risk adjustment documentation and coding guidelines for providers.
Perform comprehensive medical record chart audits to validate ICD-10-CM coding and HCC assignments.
Analyze claims data and audit error rates to identify trends and recapture opportunities for chronic conditions.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and exceptional physician leadership, with scalable operations and cloud-based technology.
Review medical records and clinical documentation to ensure accurate, compliant coding per CMS, federal, state, and payer policies.
Conduct routine and focused coding audits, collaborate with clinical leadership and revenue cycle teams, and provide actionable recommendations.
Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, interpreting state-specific billing requirements.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home medical, behavioral, and social care, and are a remote-first, high-growth environment.
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.
Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.
Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.
Cohere Health provides an AI-powered clinical intelligence platform that streamlines access to quality care by improving payer-provider collaboration and cost containment. The company works with over 660,000 providers, handles over 12 million prior authorization requests annually, and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup for 2023 and 2024.
Deliver comprehensive, customer-focused training on the Reveleer platform across clinical coding, data retrieval, and analytics features.
Partner with Learning and Development to create and maintain training materials, including facilitator guides and job aids.
Gather feedback from training sessions and use performance data to refine content and delivery methods.
Reveleer delivers a unified platform for risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations in value-based care. Trusted by 80+ customer organizations nationwide, the company integrates data, analytics, and workflow automation with human-in-the-loop AI.
Responsible for accurate and timely assignment of ICD-10-CM/PCS and HCPCS/CPT codes for various record types.
Performs coding and abstracting to support billing, data quality, and severity-of-illness reporting.
Serves as a mentor to newer coders and works within service line structures as needed.
ChristianaCare is one of the largest health care providers in the Mid-Atlantic Region, operating hospitals in Delaware and Maryland. With over 1,100 beds and ANCC Magnet Recognition across its facilities, it is committed to delivering health through values of love and excellence.
Perform clinical validation and medical record abstraction to ensure accuracy and compliance with CMS quality measures.
Identify and resolve data discrepancies in collaboration with internal teams and external vendors like Oracle Health.
Support timely regulatory submissions and cross-train across validation and abstraction functions for workload flexibility.
Banner Health is a large, nonprofit health care system in the US, providing hospital services, primary care, and research across multiple communities. With a network of hospitals and clinics, they employ skilled professionals using advanced technology to improve patient care.
Lead advanced coding education for providers and groups, including E/M and Medicare Preventive services.
Analyze coding performance indicators to identify training needs and improve accuracy.
Develop and refine coding presentations and materials reflecting latest industry standards.
Privia Health is a technology-driven, national physician enablement company that optimizes physician practices and improves patient experiences. The company is led by top industry talent and physician leadership, with scalable operations and cloud-based technology.
Provide clinical and operational leadership to support timely, evidence-based coverage determinations in Utilization Management.
Coach reviewers on consistent application of medical-necessity criteria, medical policy, and benefit plan language.
Monitor daily workflow health, coordinate coverage plans, and communicate barriers and risks to the UM Manager.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. The company serves employers, health plans, and health systems with data-driven solutions and is on a mission to empower people to lead healthier lives.