Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Conduct audits of medical records for compliance with federal coding regulations and guidelines.
Provide education and training to providers on CPT, ICD-10, and HCPCS codes.
Act as an internal expert to ensure coding compliance with state and federal regulations.
Privia Health is a technology-driven national physician enablement company collaborating with medical groups, health plans, and health systems. It aims to optimize physician practices and improve patient experiences through cloud-based technology and scalable operations.
Conduct outbound calls with patients in English and Spanish to gather detailed medical and injury histories.
Document information accurately using structured templates and review medical records for completeness and consistency.
Organize and standardize medical information and partner with operations to improve processes and quality.
Indigo builds the best care experience in healthcare, helping physicians achieve independence by making it easier to start, operate, and grow their practices. The company is about 30 people and growing rapidly, with a culture that values deep thinking, speed, craftsmanship, and putting customers first.
Collaborate with health plan leaders to develop quality data strategies and reporting on HEDIS and CAHPS performance.
Oversee data ingestion, validation, and documentation to improve accuracy across EHR, HIE, and supplemental data.
Support regulatory compliance and HEDIS audit readiness while monitoring quality programs and reporting risks.
This organization is a healthcare quality partner focused on national performance initiatives, including HEDIS, CAHPS, and data analytics. It provides a highly collaborative, matrixed environment with opportunities for cross-functional exposure and remote work.
Serve as the first point of contact, greeting patients and handling inbound calls.
Verify insurance, update demographics, and register patients in EMR (EPIC).
Document patient concerns, triage messages, and escalate emergent issues promptly.
U.S. Urology Partners provides urology and specialty services, including surgery and cancer treatment. It has over 50 offices across the East Coast and Midwest, with values of compassion, collaboration, respect, and accountability.
Code inpatient services with 95% or above accuracy following ICD-10 guidelines.
Abstract medical records and assign accurate diagnosis and procedure codes using Epic and 3M 360.
Collaborate with coding leadership and CDI reviewers to resolve coding issues and support compliance.
Oregon Health & Science University (OHSU) is Oregon's only public academic health center, providing patient care, leading research, and training healthcare professionals. As Portland's largest employer, OHSU offers opportunities to learn and advance across hospitals and clinics in Oregon and Southwest Washington.
Independently audit professional-fee coding for accuracy, compliance, and reimbursement impact.
Evaluate ICD-10-CM, CPT, HCPCS Level II, E/M services, modifiers, and professional components.
Prepare reports, deliver coding education, and maintain 95% audit accuracy.
A large regional healthcare network providing medical services across multiple facilities. The culture emphasizes independent auditing, high accuracy, and collaborative compliance education.
Maintain, organize, and monitor electronic and paper medical records for completeness and regulatory compliance.
Process release of information requests while verifying identities, authorizations, and legal requirements.
Monitor compliance with HIPAA and regulatory standards, support audits, and drive quality improvements.
US Security & IT supports healthcare organizations with information management and compliance solutions. The company offers a supportive, collaborative remote environment with a focus on wellbeing and professional growth.
Review inpatient and outpatient records and assign accurate ICD-10, CPT, and HCPCS codes.
Maintain a minimum coding accuracy of 95% while meeting turnaround and quality standards.
Work fully remotely within the US supporting multiple medical facilities.
This position is listed on behalf of a partner company within a large healthcare network. They focus on health information management and clinical coding accuracy, offering a fully remote environment.
Provide expert-level guidance and analysis to the Veterans Health Administration on optimizing business and clinical processes.
Assess current and future state operations, redesign workflows, and implement new business processes to enhance efficiency and compliance.
Collaborate with VHA leadership and stakeholders to align process improvements with operational, clinical, and strategic goals.
Aptive partners with federal agencies to improve performance, streamline operations, and enhance service delivery. Founded in 2012, the company has 300+ employees nationwide and applies technology, creativity, and human-centered services to optimize mission delivery.