Audit outpatient and specialty claims to ensure coding accuracy, clinical validity, and medical necessity.
Utilize advanced coding knowledge and audit tools to identify billing issues and document findings.
Meet productivity and quality standards while recommending process improvements and new claim types.
Cotiviti is a healthcare analytics and auditing company that focuses on improving claims accuracy and reducing costs for clients. They are a mid-to-large sized employer with a culture that emphasizes quality, collaboration, and innovation in healthcare auditing.
Assign ICD-CM/PCS, CPT, and HCPCS codes, modifiers, and MS-DRG/APC classifications.
Interact with medical staff, nursing, and ancillary departments to ensure accurate documentation and coding.
Meet quality standards of 95% correct diagnoses and procedures, and perform follow-up on rejected or denied encounters.
Sarah Bush Lincoln is a healthcare organization providing medical record management and coding services. They emphasize career development through continuing education and on-site training, fostering a culture of professional growth.
Oversee clinical/coding DRG audits to ensure accuracy and compliance with internal policies and industry standards.
Maintain strong client relationships through accurate audits, understanding client needs, and reporting denial trends.
Coach, develop, and mentor clinical staff to achieve quality performance using servant leadership principles.
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve access to healthcare. The company offers a dynamic, innovative environment with a competitive compensation package including health insurance, 401(k) with match, and paid parental leave.
Review and validate medical codes for accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems.
Provide expert coding guidance and support to clinicians and departments, serving as a resource for complex coding questions.
Conduct coding audits, generate productivity reports, and collaborate with IT and billing teams to resolve system issues.
Mission Healthcare is a home health and hospice company serving seven states, the largest of its kind in the western United States. They emphasize a culture of compassion, accountability, respect, excellence, and service (CARES) and are committed to diversity and inclusion.