Perform line-by-line review of high-dollar facility itemized bills and claim forms to identify billing errors.
Apply coding and reimbursement expertise to validate accuracy and ensure claims are paid correctly.
Serve as a subject matter expert for complex billing issues and drive payment integrity improvements.
Oscar is a health insurance company built on a full-stack technology platform with a focus on serving members. Founded in 2012, it fosters a culture of transparency and collaboration, working to change health care.
Manage prior authorization requests, reviewing clinical documentation and verifying ICD-10 and CPT codes.
Submit requests via payer portals, monitor pending cases, and follow up with insurers.
Investigate denials, prepare appeals, and coordinate with providers to prevent care delays.
Jobgether is an AI-powered job platform that matches candidates with relevant opportunities through objective review processes. It focuses on efficient recruitment and data privacy, using technology to support hiring decisions.
Assign ICD-10 and CPT/HCPCS codes to patient encounters based on medical documentation.
Analyze medical records to extract pertinent coding information.
Ensure compliance with AMA, CMS, and other regulatory coding guidelines.
Mass General Brigham is a not-for-profit integrated health care system supporting patient care, research, teaching, and community service. We believe high-performing teams drive groundbreaking medical discoveries and foster a welcoming community focused on changing lives.
Assign and verify CPT, ICD-10 CM coding and modifiers based on documentation, ensuring compliance with official coding guidelines.
Resolve claim edits and denials, monitor charge capture volumes, and work with providers and clinic staff to ensure accurate charge capture.
Act as a subject matter expert in one or more specialties, identify trends and educational opportunities, and may train other coders.
Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children, providing a wide range of care from routine visits to life-saving treatments. The organization fosters a diverse and inclusive culture and seeks individuals committed to its vision of the healthiest kids in the country.
Reviews and codes medical records for general surgical specialties using ICD-10, CPT, and HCPCS codes.
Abstracts demographic and coding data, audits orders and claims, and reviews documentation for medical necessity.
Provides technical guidance to physicians and staff and develops stakeholder relationships.
Piedmont Healthcare is a healthcare system providing medical services across Georgia. It fosters a shared purpose and recognition, with wellness programs and comprehensive benefits for employees.
Serve as an expert-level coder for complex inpatient records, ensuring accurate data retrieval and reimbursement.
Resolve billing inquiries, manage DRG denials, conduct audits, and support revenue cycle integrity.
Mentor coding staff and collaborate with management on training, education, and process improvements.
CommonSpirit Health operates more than 700 care sites across the U.S., from clinics and hospitals to home-based and virtual care services. With a mission to build healthy communities and advocate for the poor and vulnerable, they foster a culture of compassion and innovation.
Apply senior-level expertise to code inpatient and outpatient professional fee services across multiple specialties, assigning CPT, HCPCS, and ICD-10 diagnosis codes.
Review documentation to resolve edits in work queues and analyze denials for corrected claims or appeals.
Collaborate with clinic supervisors, providers, and Revenue Management to resolve coding issues and ensure compliance.
CommonSpirit Health is a nonprofit health system with more than 700 care sites across the U.S., serving nearly one out of every four U.S. residents. The organization is committed to building healthy communities and innovating healing both inside hospitals and in the community.
Interpret clinical documentation to accurately assign diagnosis and procedure codes for outpatient encounters.
Maintain current knowledge of ICD-10 and CPT coding systems and ensure documentation supports assigned codes.
Manage daily work queues and perform data and charge entry within patient accounting systems.
This partner company operates within an academic medical environment, providing healthcare services and supporting accurate outpatient coding. Their culture is supportive and collaborative, with a focus on high-quality healthcare operations and continuous learning.
Reviews DRG assignment for Medicare/Medicaid inpatients to ensure compliance with ICD-10 coding and billing regulations.
Analyzes physician documentation for coding accuracy and queries physicians when documentation is inadequate or unclear.
Provides guidance and education to inpatient coders and Clinical Documentation Specialists on coding guidelines.
Hackensack Meridian Health is a health care network that helps patients live better, healthier lives and serves as a leader in transforming healthcare. With a culture rooted in connection and collaboration, their employees are team members supported by competitive benefits and a focus on community.
Create the blueprint for configuration of medical and dental plans from plan documents and standards.
Build, validate and test plan benefits and code mapping logic for accurate claims processing.
Troubleshoot system issues and coordinate with teams to improve efficiency and resolution.
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Backed by leading healthcare and technology investors, the company is headquartered in Buffalo, NY and values resilience, uncommon thinking, and positivity.