Support medical policy functions by providing medical coding and system configuration support.
Perform coding analyses and utilization reporting to recommend medical policy updates.
Participate in cross-functional meetings to align with enterprise strategic priorities.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. Motivated by the well-being of members, they are committed to service, sustainability and innovation.
Conduct audits of medical coding to ensure compliance with standards.
Develop and deliver education to improve documentation quality and coding accuracy.
Assist with internal and external audit preparation and response.
Sprinter Health reimagines how people access care by bringing it directly into their homes. They have supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS.
Audits clinical documentation and coding for inpatients, emphasizing mortality reviews to identify improvement opportunities and ensure compliance with guidelines.
Collaborates with clinical teams and medical staff as an expert educator to develop strategic plans and teaching tools that improve quality metrics and outcomes.
Manages advanced project work including Risk Adjustment and Quality Abstraction, while partnering with departments like IT and Analytics to design new workflow solutions.
Northwestern Medicine is a leader in the healthcare industry focused on a patient-first approach to cultivate a positive workplace. The organization provides competitive benefits like tuition reimbursement, loan forgiveness, and 401(k) matching to take care of its employees as part of a large health system.
Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
Ensure compliance with legal, regulatory, and organizational standards.
Ensure claims are processed correctly and on time through clear communication and efficient management of records.
Dignity Health Medical Foundation provides comprehensive health care services. They have care centers throughout California and are affiliated with Dignity Health, one of the largest health systems in the nation. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Conduct coding audits to ensure accuracy and compliance with coding guidelines.
Identify compliance risks and recommend corrective action plans.
Provide education and training to physicians and staff on coding best practices.
Theoria Medical is at the forefront of healthcare innovation and quality, offering a blend of medical excellence and technological advancements, primarily serving the post-acute sector. Their network includes multispecialty physician services across skilled nursing facilities nationwide, fostering a mission-driven culture that values expertise and innovation.
Evaluate and present audit results and educational instruction to physicians, coders, and staff.
Review clinical documentation to ensure adherence to billing guidelines and internal coding policies.
Provide instruction on documentation standards and correct use of CPT‑4 and ICD‑10 codes.
Pediatrix Medical Group is a leading provider of specialized healthcare for women, babies, and children. Since 1979, they've grown into a national, multispecialty medical group with a commitment to coordinated and compassionate care, bolstered by investments in research, education, and safety.
Evaluates medical records to provide clinical and surgical abstraction for complex professional services, ensuring coding accuracy and compliance with national guidelines.
Consults with medical providers to clarify record information and accurately code diagnostic and procedural data using ICD-10-CM and CPT-4.
Works independently in a remote setting, utilizing coding software to maintain productivity and quality standards while supporting department projects and validation edits.
Banner Health is one of the largest nonprofit health care systems in the country, providing hospital services, primary care, research, and more across its network. It is a Great Place To Work® Certified organization with a large, skilled workforce committed to patient care and employee wellbeing.