Assess complex denial processes, identify root causes, and develop strategies to improve financial performance and prevent revenue loss.
Lead denials-related projects from planning through implementation, coordinating with operational and executive stakeholders.
Analyze denial trends, perform root-cause analysis, and develop actionable recommendations to reduce denials and optimize revenue cycle performance.
This partner company is a healthcare organization seeking a consultant for revenue cycle denials management. The company size and culture are not specified.
Assess clinical documentation for compliance with AMA and CMS coding guidelines.
Provide education and guidance to providers, clinical staff, and coders on documentation standards.
Analyze audit data, report findings, and collaborate with leadership to improve coding practices.
UnityPoint Health is a healthcare system providing medical services across Iowa, Illinois, and Wisconsin. It is recognized as a top workplace, committed to team member support, development, and a culture of belonging.
Execute clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers, and track denials and underpayments.
Review provider documentation and assign codes per ICD-10-CM, CPT, and HEDIS guidelines, escalating gaps as needed.
Collaborate with Data & Analytics and Revenue Cycle teams to track claim trends, documentation compliance, and A/R performance.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs by delivering 24/7 virtual-first and in-home medical, behavioral, and social care. As a growing startup, they foster a values-driven culture focused on children first, earning trust, innovation, empathy, and diverse perspectives.
Review patient medical records to improve the quality and completeness of clinical documentation.
Collaborate with providers, coders, and care team to ensure accurate documentation reflecting severity of illness.
Develop and deliver clinical documentation improvement education and guidance to providers.
Our partner is a healthcare organization seeking a Clinical Documentation Specialist. They offer remote work with flexible scheduling and are dedicated to improving patient care through accurate documentation.
Lead and develop a high-performing team of Clinical Experience Managers to execute clinical engagement strategies.
Oversee priority client engagements, using clinical AI recommendations to improve documentation quality and financial performance.
Partner cross-functionally to ensure client insights drive scalable playbooks, education, and operational improvements.
SmarterDx is transforming how health systems use clinical AI to capture the full value of patient care delivered. As a Smartian, you'll help build technology that makes healthcare more accurate, sustainable, and effective for everyone.
Monitor and maintain assigned referral WorkQueues in Epic EMR, updating referral status, scheduling, and benefit details.
Identify and escalate referrals missing information or requiring additional action to the clinical team.
Conduct ineligibility notification calls and maintain accurate documentation in EHR and Aviary Health systems.
Aviary Health is redesigning heart health by delivering exercise and wellness for older adults with cardiovascular disease via telemedicine. The team is comprised of mission-driven clinicians, engineers, and professionals dedicated to evidence-based cardiovascular rehabilitation.
Conduct detailed assessments and coordinate individualized care plans with healthcare teams.
Educate patients and families on disease processes, treatment options, and self-care strategies.
Advocate for patients' needs within the healthcare system, ensuring timely access to services.
Empowers individuals facing health challenges by providing compassionate, expert-guided care advocacy services. Dedicated to ensuring personalized support and seamless care coordination.
Code across specialties, translating clinical documentation into ICD-10-CM, CPT, and HCPCS codes with heavy dermatology and orthopedic focus.
Own documentation quality by validating provider notes against E/M guidelines and directly communicating with practice managers and physicians.
Resolve denials by researching complex coding-related denials, understanding why claims were denied, and using AI tools to draft appeals.
Clarity RCM is a rapidly growing revenue cycle management company on the Inc. 5000 list. They manage billing, credentialing, and account management for private dermatology practices nationwide, expanding into orthopedics.
Lead professional billing coding and clinical documentation integrity programs across a complex health system, ensuring coding accuracy and regulatory compliance.
Oversee team operations, including staffing, performance monitoring, audit education, and continuous process improvement.
Build strong relationships with executives, physicians, and coding professionals to drive quality and reimbursement integrity.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use technology to review applications and share top-fitting candidates with employers, fostering an inclusive and efficient hiring process.
Review, analyze, and complete pre- and post-payment claim audits and appeals in accordance with client policies, CMS guidelines, and healthcare industry standards.
Apply clinical judgment to evaluate documentation and determine the appropriateness and accuracy of claims.
Analyze healthcare claims, reimbursement information, and supporting documentation to identify discrepancies and potential payment issues.
Our partner company focuses on ensuring healthcare claims are reviewed accurately, consistently, and in accordance with applicable policies and industry standards. It is a collaborative, fast-paced, and evolving environment with opportunities for professional development and career advancement.