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.
Review medically complex claims, pre-authorization requests, appeals, and fraud and abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business, we empower clients with tailored solutions, operating with integrity and collaboration.
Investigate and analyze Motor Vehicle Accident accounts to coordinate insurance benefits and resolve outstanding balances for clients.
Conduct online medical research, review medical records, and manage claim life cycles using proprietary systems and tools.
Communicate with payers, attorneys, and clients to resolve claims, handle denials, and identify trends for prevention.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its E360 RCM intelligent automation platform. The company is a multi-year recipient of the Top Workplaces award, ranked #1 by Black Book in 2024, and has been on the Inc. 5000 fastest-growing companies list for eleven years, fostering a culture centered on professional growth and employee investment.
Own end-to-end claims and revenue-cycle operations, including claim submission, denials, appeals, and collections across Medicaid and commercial payers.
Build and optimize payer-specific billing workflows, including claim configuration, coding, and credentialing.
Drive cross-functional execution with Operations, Partner Success, and Finance to improve processes and achieve over $1M in monthly claims.
Jukebox Health partners with health plans to make homes safer and more accessible for older adults and high-needs populations, combining technology with networks of clinicians, suppliers, and installers. Founded by experienced entrepreneurs, Jukebox Health is a fast-growing healthcare services company backed by top venture capital firms like Valtruis and The Home Depot, with a high-trust, collaborative, remote-first culture.
Lead, coach, and develop a team of coders, ensuring daily accuracy, productivity, and compliance.
Serve as the primary escalation point for complex coding issues, partnering with billing and clinical teams.
Monitor KPIs, manage audits, and drive revenue integrity through cross-functional collaboration.
Alteva RCM helps healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. They are a dedicated, collaborative team committed to excellence, always seeking passionate professionals to grow their careers and make a meaningful impact.
Performs clinical evaluations on disability claims to substantiate medical necessity for absence.
Communicates with employees and providers to discuss clinical status and provides follow-up recommendations.
Acts as a clinical resource to claims examiners, ensuring accurate medical terminology and claim decisions.
Sedgwick is the world's leading risk and claims administration partner, helping clients navigate the unexpected with AI-enabled technology and expertise. With over 33,000 colleagues and 10,000 clients across 80 countries, they've been recognized as a Great Place to Work and offer a caring culture.