Manage DRG-related payer denials to protect reimbursement and minimize revenue loss.
Leverage clinical and coding expertise to produce compliant appeal outcomes.
Identify documentation and coding risks pre-claim to strengthen revenue integrity.
Rochester Regional Health is an integrated health services organization serving Western New York and beyond, with nine hospitals and numerous care facilities. It is a large health system focused on leading the evolution of healthcare.
Conduct targeted telephonic outreach to patients and families to educate them on palliative care.
Complete structured eligibility screenings to identify patients with chronic illness and functional decline.
Schedule eligible patients for an initial visit with a nurse practitioner and coordinate logistics.
Vynca provides comprehensive care for individuals with complex needs, aiming for more quality days at home. They are a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity.
Support delivery of evidence-based health communication technical assistance and training for public health clients.
Assist with needs assessments, resource development, and dissemination of tools for nutrition, physical activity, and chronic disease prevention.
Coordinate webinars, workshops, and other learning opportunities while tracking project metrics and quality improvement.
ICF is a global advisory and technology services provider. With approximately 9,000 employees, they combine unmatched expertise with cutting-edge technology to help clients solve complex challenges and shape the future.
Review clinical documentation and assign ICD-10, CPT, and HCPCS codes.
Maintain 95% coding accuracy while meeting production standards.
Collaborate with providers and clients to ensure compliant billing.
This company provides healthcare revenue cycle services, including professional medical coding. It offers a fully remote, collaborative work environment with a focus on quality and continuous learning.
Conduct Annual Wellness Visit questionnaires over the phone with patients.
Make outbound calls to schedule and complete screenings.
Accurately document patient information in EMR systems like NextGen.
Welltality provides healthcare support by conducting Medicare Annual Wellness Visit pre-screenings to help patients stay proactive with their care. The team values accountability, teamwork, and continuous improvement.
Assist with retrospective and concurrent coding for PACE Dual participants.
Conduct pre-visit chart preparations and post-visit chart reviews.
Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustment diagnosis coding guidelines.
WelbeHealth provides seniors with the opportunity to continue living in their homes through its PACE program. The company employs a collaborative interdisciplinary team approach and values diversity and inclusion.
Own first-level reviews of pre-certification requests for medical appropriateness and necessity.
Drive post-service reviews and manage the appeals process for non-certified services.
Coordinate smooth discharges and redirect care in-network to keep patients on track.
Personify Health created the first personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together in one place. Their team serves employers, health plans, and health systems with a mission to empower people to lead healthier lives.