Review documentation to assign appropriate CPT, HCPCS, and ICD-10 diagnosis codes
Resolve edits in WQs (charge review, claim edit, and follow up) and review denials for possible corrected claims or appeals
Work with clinic supervisors and/or providers to resolve coding issues and questions, following applicable payer rules and guidelines
CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record.
Trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function.
Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of their team, you'll have the opportunity to join their quest for better health care, no matter where you work within the Northwestern Medicine system.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure necessary documentation is present.
Participates in audits to evaluate code accuracy and develops methodologies to improve coding issues.
Northside Hospital is an award-winning and state-of-the-art healthcare provider that is continually growing. By constantly expanding the quality and reach of our care we hope to create even more opportunity for the best healthcare professionals in Atlanta and beyond.
Accurate coding of professional services from medical record documentation.
Reviews, codes and assigns correct ICD-10-CM diagnosis codes.
Knowledge of insurance company, third-party and government reimbursement programs.
University Health (UH) is committed to being a leader in providing healthcare. UH is an equal opportunity employer committed to a culturally inclusive workplace that values and celebrates differences.
Codes and abstracts Outpatient records for data retrieval, analysis, reimbursement and research.
Codes and enters diagnostic and procedure codes into the designated coding and abstracting system.
Meets quality and productivity coding standards and demonstrates the ability to navigate an EMR.
CommonSpirit Health has over 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen both inside our hospitals and out in the community.
Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for medical diagnoses and procedures based on clinical documentation.
Ensure coding compliance with CMS guidelines, and state/federal regulations. Ability to write precise, professional, and well structured feedback to providers and team members.
Assist with claim reviews, denials, and coding-related audits to optimize revenue integrity.
Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Their mission is to improve the quality of life throughout Arizona by helping communities “Live Better, Live Longer” through personalized healthcare.
Train all new coders on department policies, procedures and correct coding principles
Analyze coder's workload and make recommendations to assigned supervisor to ensure all work is completed by the specified timeframes
Research and provide guidance to coders and other DHMF/CSH staff on coding-related questions or concerns
Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. As an affiliate of Dignity Health, they work hand-in-hand with physicians and providers throughout California to provide comprehensive health care services. 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 audits comparing medical record documentation to reported codes.
Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
Provide feedback, education, training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision and coding principles.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. Their platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Perform coding audits and reviews on a variety of professional fee record types.
Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
Assist in the design and presentation of educational seminars to clients and staff
UASI is an award-winning company with over 40 years of experience, offering consulting services. We have enduring partnerships with our valued clients, stability, and long-term success of our dedicated team.
Codes and abstracts Inpatient records for data retrieval, analysis, reimbursement and research.
Codes diagnostic and procedure codes into a designated coding and abstracting system utilizing the 3M encoder, as appropriate.
Meets quality and productivity coding standards and demonstrates the ability to navigate an EMR.
CommonSpirit Health is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen both inside our hospitals and out in the community. With more than 700 care sites across the U.S., CommonSpirit is accessible to nearly one out of every four U.S. residents.
Utilizes technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types.
Reviews the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures
Interprets health record documentation using knowledge of anatomy, physiology, pharmacology to report appropriate diagnoses
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of our team, you'll have the opportunity to join our quest for better health care.
Review encounter documentation to confirm reported services.
Resolve pre-bill edits to confirm correct coding (modifier, diagnosis, CPT, and HCPCS review).
Educate providers on correct coding and documentation guidelines.
Northwestern Medicine is committed to prioritizing every patient interaction to cultivate a positive workplace. Because of its patient-first approach, the company stands as a leader in the healthcare industry with competitive benefits that take care of its employees.
Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
Collaborates with a variety of internal and external clients, including health care executives, physicians, provider office personnel, and payer representatives from various health plans to streamline and optimize accurate diagnosis code capture.
Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” and they recognize that work is a part of life, not separate from it, and foster a flexible environment.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Reviewing and resolving missed or miscoded charges.
Ensuring coding and billing practices comply with guidelines.
Following Medicare/Medicaid and other payer requirements.
Marshfield Clinic Health System enriches lives through accessible, affordable, and compassionate healthcare, prioritizing patients' needs. They value connection with colleagues and community recognition, offering affordable living and leisure opportunities.
Follow VitalCaring billing Standard Operating Procedures and regulatory billing guidelines
Collaborate with your supervisor and the billing team to address payor and billing concerns
Ensure documentation accuracy and submit claims in accordance with Medicare and other payor requirements
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 65 locations across the country. They foster a culture of support, growth, and excellence.
Demonstrates knowledge of basic audit skills and adheres to Internal Audit Standards and UPH Internal Audit policies and methodologies.
UnityPoint Health is committed to their team members and has been recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row. They champion a culture of belonging where everyone feels valued and respected, and believe in equipping you with support and development opportunities to deliver an exceptional employment experience.