Source Job

• 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.

• 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.

• 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.

• 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.

• Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers.
• Proactively identify overpayments to ensure accurate claims payments on inpatient services.
• Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.

Clover Health is reinventing health insurance by combining the power of data with human empathy to keep its members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most.

• Perform accurate code assignments for ED records (facility and profee) while working remotely.
• Be flexible, detail-oriented and have the ability to work independently.
• Meet client productivity targets while maintaining coding quality of 95% or greater.

UASI is a company that values its employees! They have been awarded the Top Workplace award by the Cincinnati Enquirer in 2022 and 2023. Their 40 years in business contributes to the long tenure of their team.

• Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines.
• Stay current on coding guidelines appropriate to the position; learn new appeal categories as production needs require.
• Professionally communicate finds, errors, and suggestions to facilitate on-going communications and efficient department operations.

Cotiviti focuses on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. They offer a team-oriented environment and a comprehensive benefits package to address various personal and family needs.

• Audit behavioral health documentation and coding (ICD-10-CM and CPT) for accuracy, compliance, and completeness.
• Deliver actionable feedback to providers, educating on coding and documentation guidelines.
• Serve as a subject matter expert by answering coding-related questions and supporting internal teams.

Headway is building a new mental healthcare system from the ground up—one that’s accessible, effective, and built to scale. They have over 75,000 providers across all 50 states running their practice on their software, serving over 1 million patients.

• 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.

• Accurately code diagnoses, procedures, and other services to ensure medical records and billing are accurate.
• Work with providers to ensure documentation is clear and complete, resulting in accurate coding.
• Review all claim edits and correct errors in a timely fashion, coding for practice and hospital charges for all departments supported by the Professional Billing Office.

ProMedica is a mission-driven, not-for-profit health care organization that provides acute and ambulatory care, a dental plan, and academic business lines across nine states. The organization operates 10 hospitals and employs over 1,300 healthcare providers through ProMedica Physicians, with a culture committed to improving health and well-being, earning national recognition for clinical excellence.

• Develop and maintain standard operating procedures and conduct training for revenue cycle teams to uphold best practices.
• Perform audits on payer payments and fee schedules to ensure accurate reimbursement and identify denial trends affecting revenue.
• Manage multiple priorities including special projects, Salesforce cases, and process documentation to support key performance goals.

Privia Health is a national physician enablement company that uses technology and scalable operations to help medical groups deliver high-value care in-person and virtually. The company, led by top talent and physician leaders, has a cloud-based platform focused on improving patient outcomes and provider well-being.

• Research and document new payment integrity concepts by analyzing medical policies, billing regulations, and reimbursement logic.
• Translate complex billing rules into precise technical specifications for automated claim auditing algorithms.
• Conduct hands-on data analysis using Microsoft Excel to explore datasets and quantify savings potential for clients.

Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. They work with over 660,000 providers and handle over 12 million prior authorization requests annually. The Coherenauts who succeed here are empathetic teammates who are candid, kind, caring, and embody their core values and principles.

• Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for various purposes.
• Abide by the Standards of Ethical Coding and official coding guidelines, staying updated on coding changes and interpretations.
• Perform detailed reviews of Inpatient records, assign diagnosis and procedure codes, and meet established productivity guidelines with high accuracy.

Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials.

• Accurately codes and abstracts outpatient medical records utilizing ICD-10-CM and CPT-4 coding systems.
• Assigns modifiers when appropriate.
• Must be able to maintain a minimum 95% coding accuracy.

Montefiore St. Luke’s Cornwall (MSLC) has been a cornerstone of high-quality healthcare in Orange County for 150 years. MSLC is a member of the Montefiore Health System and provides care to more than 250,000 patients annually; it strives to be the employer of choice by offering comprehensive benefit packages.

• Improve key performance metrics for the focused area within the revenue cycle.
• Conduct audits of all revenue cycle processes, vendors, and technology.
• Determine root cause of issue and appropriateness of actions taken, assist in corrective action plan development.

ATI Physical Therapy partners with business leaders to improve healthcare. They focus on positive change throughout the revenue cycle and offer competitive benefits.