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.
Assists in development and maintenance of an efficient UM program to meet the needs of health plan members commensurate with company values.
Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer discussions.
Provide appropriate mentoring and leadership to clinical teams as well as develop relationships to support growth and fiscal responsibility.
Devoted Health is dedicated to improving the health and well-being of older Americans by providing all-in-one healthcare solutions. Founded in 2017, they've rapidly expanded across the United States, fostering a diverse and collaborative work environment where employees are valued for their unique perspectives.
Oversight of site level tasks associated with efficient site activation.
Support the CRA team in preparing for site initiation visits (SIVs).
Perform initial contract and budget negotiations with the sites, as well as amended where applicable
Fortrea helps to turn the impossible into I'm possible. They deliver exceptional service to their patients, fueled by a shared commitment to teamwork and excellence.
Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention.
Partner with provider clients to design and implement best practices for denial prevention and appeal workflows.
Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage over 24 years of expertise and their E360 RCM ™ platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers. EnableComp is a multi-year recipient of the Top Workplaces award recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.
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.
Develop and execute a comprehensive market access roadmap for Ceribell’s product portfolio.
Lead long-term strategy for new and existing reimbursement pathways.
Build and sustain relationships with Medicare Administrative Contractors (MACs), national and regional commercial payers, Medicaid plans, and integrated delivery networks (IDNs).
Ceribell is a medical technology company focused on transforming the diagnosis and management of patients with serious neurological conditions. The Ceribell System is being used in hundreds of community hospitals, large academic facilities and major IDN's across the country. Our entire team is driven by a shared commitment to transforming the landscape of critical care through our rapid seizure detection technology, come join the movement!
Embed behavioral health expertise into the design, governance, and evolution of our digital platform.
Translate complex behavioral health workflows into scalable digital solutions that empower over 70,000 clinicians and millions of patients.
Define how responsible AI and clinical quality are operationalized at a national scale for a mission that truly matters.
Headway is building a new mental healthcare system that everyone can access by making it easy for therapists to accept insurance and scale their practice. Since 2019, Headway has grown into a national network of over 60,000 mental healthcare providers across all 50 states and has served over 1 million patients.
Provide operational leadership and oversight for Privia Health’s telephonic triage and after-hours care coordination platform.
Responsible for data-driven performance management, workflow optimization, staff scheduling, and resource planning to support safe, scalable, and cost-effective service delivery.
Oversee Health Advisors and operational support staff, ensuring adherence to protocols, communication standards, and service-level expectations.
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. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology.
Educate HCPs on Patient Support Programs, providing tailored education to healthcare providers and their staff.
Provide Reimbursement Expertise, educating HCPs on the local payer landscape through education engagements.
Address Access Barriers, providing assistance to HCPs to compliantly troubleshoot claims at retail pharmacies.
Valeris is a fully integrated life sciences commercialization partner providing comprehensive solutions across the healthcare value chain. Formed by the merger of PharmaCord and Mercalis, they work on behalf of life sciences companies to improve the patient experience. They provide commercialization solutions to more than 500 life sciences customers and have provided access and affordability support to millions of patients.
Contribute to the development and implementation of the project's technical activities and strategy including supporting the development and introduction of innovative technical approaches in quality of care, demand generation and adaptive implementation.
Oversee specific project deliverables to ensure they are completed on time and in accordance with PSI quality standards.
Contribute to regular reporting on program activities, including documenting key learnings, adaptations and guidelines.
Population Services International (PSI) is a network of locally rooted, globally connected organizations working to advance the achievement of people-centered health systems that ensure quality, affordable care wherever and whenever it is needed. They work with the public and private sectors as well as local communities, prioritizing people’s voice and choice and developing solutions to meet their essential health needs.