The Home Health and Hospice Coder & Auditor is responsible for reviewing, coding, and auditing clinical documentation to ensure accuracy, compliance, and optimal reimbursement. This role combines expert knowledge of ICD-10 coding guidelines, OASIS data set requirements, and CMS regulations to support quality patient care and organizational compliance. The Coder & Auditor works closely with clinicians, compliance, and leadership teams to ensure documentation integrity, accurate coding, and identification of training opportunities.
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Shape the implementation and customer success of FDA-cleared digital treatments in the US health system. The Client Implementation Lead drives revenue growth and patient impact by ensuring health systems, provider groups, and other healthcare organizations are engaged with, understand, and have a smooth experience supporting their patients to use Big Healthβs FDA-cleared treatments.
Lead platform strategy and delivery across Authorizations, Medical Necessity, and Notice of Admission (NOA). Shape our FHIR interoperability roadmap, driving product modernization, and aligning with CMS mandates and TEFCA plans. Modernize legacy infrastructure into scalable, API-driven services. Play a critical role in business development, identifying and pursuing strategic partnerships, supporting M&A evaluations, and representing the product vision.
The Utilization Management Representative will process clinicals to send to payers while the patient is in house, enter authorizations and enter concurrent denials for the RNs. During your 8hr shift you will work with your team to manage the phone queue. A separate workspace, separate from noise between 8:30am-5pm AZ time will be required.
Leads and collaborates with care management operations across various settings, ensuring alignment with system-level strategies. Oversees multiple disciplines, working with medical staff, nursing, clinical, and revenue cycle leaders to optimize patient care and financial performance. Responsible for managing departmental services, including social work, complex care planning, transitions of care, and utilization management.
As the Manager, Provider Engagement, East you will lead the Provider Engagement team to drive network growth, strengthen provider relationships, and ensure Imagine Pediatrics meets enrollment and performance goals. This role requires a balance of team leadership, hands-on process improvement, and relationship management.
Seeking a proactive and detail-oriented team member to help keep our clinician payer enrollment process moving smoothly. You will submit payer enrollments, track statuses, follow up with payers to resolve blockers, and request fee schedules to support operational planning, ensuring clinicians are paneled quickly, especially in NY, NJ, CA, TX, FL, PA, and CO.
Provide clinical insight and strategic partnership for the development, delivery, and implementation of Medical Education for our AWM (Advanced Wound Management) business in Germany, Switzerland and Austria (GSA). Focus on driving Medical Education activities, online and offline, related to AWM across GSA.
Our client, a national healthcare organization, is seeking an experienced Senior Clinical Coding Auditor & Trainer to support its inpatient-coding audit and training initiatives. This role combines coding precision, clinical expertise, and the ability to teach and mentor. The right candidate will develop audit tools, deliver training, and ensure compliance standards are met across a multi-state managed-care operation.
The ECM Clinical Manager handles clinical oversight and management of ECM Lead Care Managers in addressing client's medical, behavioral health, and social determinants of health needs. This role involves communication with ECM Lead Care Managers and occasionally with patients to discuss medication management and ensure follow-up with healthcare providers. The ECM Clinical Manager will be required to travel to Los Angeles, CA, on a monthly basis for up to one week.