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About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:CorroHealth company, is an innovative, rapidly growing physician-led organization that helps hospitals improve financial performance by benchmarking hospital performance by payer and functional area, identifying sources of lost revenue or risk, creating and implementing operational solutions to address the issues uncovered, and monitoring ongoing results. The company has a vibrant culture that strives to promote a positive work-life balance while allowing professionals to utilize their skills in an environment that positively impacts healthcare.&nbsp; Job Description:&nbsp; We are seeking a full-time Client Analyst to join the Strategic Advisement department. The Client Analyst will work with large healthcare data sets to produce strategic analytics reports that are distributed to clients. This role will assist Strategic Advisors in developing solutions to address client needs. The Client Analyst will assist in market research, provide insight into market trends, and provide meaningful insights into the diagnosis of the client’s problems. This role is central to key functions fundamental to our core offering, and this individual will be immersed in critical, customer-facing operations with an opportunity to take on more responsibilities over time.&nbsp;ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Key Responsibilities:<ul><li>Analyze and validate large datasets to identify trends and produce meaningful insights.</li><li>Assist in developing solutions to address client challenges.</li><li>Conduct market research and provide insights into industry trends.</li><li>Support Strategic Advisors by participating in client calls and meetings (not leading presentations).</li><li>Ensure quality assurance (QA) and validation of data-driven reports.</li></ul>Required Skills and Qualifications:<ul><li>4-year degree in a related field - REQUIRED</li><li>2-3 years' experience in a similar&nbsp;position preferably in a healthcare environment analyzing patient revenue cycle data</li><li>Expertise in Excel and strong analytical abilities - REQUIRED</li><li>Excellent time management and project management skills, capable of handling multiple competing deadlines and deliverables.</li><li>Experience with healthcare data, including insurance, hospital, or billing systems.</li><li>Ability to translate complex data into clear, actionable insights.</li></ul>What we offer:&nbsp;<ul><li>Location: Remote within US Only</li><li>Equipment provided</li><li>Annual Salary Starting at: $65,000 and up depending on experience.</li><li>Comprehensive Medical/Dental/Vision Insurance Plan Options</li><li>401k program matching up to 2%</li><li>PTO: 120 hours annually&nbsp;</li><li>9 paid annual holidays</li><li>Tuition reimbursement program</li><li>Life Insurance</li><li>Short/Long Term Disability options</li><li>Professional growth and more!</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CorroHealth

Client Analyst

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.<ul><li>Resolve complex, higher-dollar unpaid/denied claims by leveraging proprietary software system, making phone calls, generating letters, accessing client systems and insurance carrier web portals in the pursuit of getting a claim resolved.</li><li>Identify and report trends found during the account resolution process such as CPT/HCPCS errors/deletions, duplicate claims, revenue code mapping mismatches, missing charges, no claim on file.</li><li>Perform financial account assessment functions including but not limited to adjustments and NRP to patient. Work within client systems to complete rebill functions.</li><li>Perform administrative functions including but not limited to medical record submissions, billing claims, patient assistance outreach, obtaining documents from client systems and insurance plan code updates, review corrected claim requests and approve for client assistance or correct the bill within client platform, review and submit payment verification assistance requests.</li><li>Maintain familiarity with client preferences and known issues across multiple client accounts.</li><li>Support special projects for clients as needed.</li><li>Other duties as assigned.</li></ul>QUALIFICATIONS<ul><li>High School Diploma or equivalent </li><li>5+ years relevant industry experience in registration, billing, collections, required</li><li>3+ years experience with insurance carrier claims resolution, required</li><li>3+years of Epic, Cerner, Meditech or other EMR experience preferred</li><li>Knowledge of UB04 claim forms, EOB’s and medical records required</li><li>ICD-9, ICD-10, CPT and HCPCS coding knowledge required</li><li>Ability to conduct detailed research to resolve complex claims</li><li>Intermediate mathematics skills (addition, subtraction, ability to identify trends, etc.)</li><li>Advanced knowledge of Excel and Power Point</li><li>Ability to compile and summarize data</li><li>Strong verbal and written communication skills</li><li>Ability to analyze and interpret complex documents, contracts, notes, and other correspondence</li><li>Ability to prioritize and multitask in a fast-paced environment</li><li>Ability to work effectively in a remote environment</li><li>Investigative mind set to identify issues and implement solutions.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Acute Hospital Insurance Specialist 3

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Appeals Management for Prior Authorization Group.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Job Summary<ul><li>Perform denial research and follow-up work with insurance companies via phone to resolve appeals that have been submitted but remain without a determination</li><li>Compile multiple documents into appeal bundles and submit appeal bundles to payers in a timely manner</li><li>Determine and document appeal timeframes and payer process per facility within CorroHealth proprietary system</li><li>Transcribe information from clients’ EMRs and payer portals into required electronic format; check completed work for accuracy</li><li>Monitor and complete tasks within shared inboxes and internal request dashboards</li><li>Receive and document incoming emails, calls, tickets, or voicemails</li><li>Follow up with the client or internal staff via email or phone for additional information as requested</li><li>Export and upload documents within CorroHealth proprietary system</li><li>Cross-trained on various functions within the department to support other teams as needed</li><li>Other responsibilities as requested by management</li></ul>Minimum Qualifications: <ul><li>Must love communicating with others over the phone</li><li>Computer proficient. Must have intermediate skills with Outlook and Excel.</li><li>Must be able to schedule meetings, log onto Teams for meetings.</li><li>Must be able to open a new excel workbook, use formulas such as; adding and subtracting, copying and pasting.</li><li>Must be able to type a minimum of 25wpm</li><li>Detail oriented</li><li>Shows initiative and responsibility in taking the necessary steps towards problem resolution</li><li>Works independently, but is a team player</li><li>Able to work in a fast-paced environment</li><li>Possess good verbal and written communication skills</li><li>Required to keep all client and sensitive information confidential</li><li>Strict adherence to HIPAA/HITECH compliance</li></ul>Education/Experience Required:<ul><li>High School Diploma or equivalent required</li><li>Bachelor’s degree preferred</li><li>Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines</li><li>Prior experience of accessing hospital EMR’s and Payer Portals preferred</li><li>Proficient in MS Word and Excel. Needs to be able to open a new excel workbook, copy and paste, do basic formulas such as adding, subtracting and copying and pasting.</li><li>Must have basic skils in Outlook. Should be able to create a meeting invitation, accept a meeting invitation, receive and respond ot email and set up folders.</li><li>Must be able to type a minimum of 25 wpm with a 90% accuracy rate.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Coordinator, Appeals Management

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs. We are currently seeking full-time, remote Jr. Denial Coordinators. The Jr. Denial Coordinator role is an entry level role and an excellent way to start your career at a growing company in a fast-paced industry. Learn the ins and outs of healthcare Revenue Cycle Services, with a specialty in Denials Management.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Responsibilities include, but are not limited:<ul><li>Scanning, faxing and filing highly confidential documents</li><li>Downloading and printing medical records</li><li>Generating appeal letter templates</li><li>Packaging certified mail</li><li>Logging events on accounts in workflow system</li><li>Adding notes to accounts in hospital patient accounting systems</li></ul>Minimum Qualification<ul><li>HS diploma required (Healthcare degree or certificate preferred)</li><li>Healthcare experience a plus.</li><li>Strong multi-tasking skills.</li><li>MUST possess strong computer skills.</li><li>Proficiency with MS Office including TEAMS</li><li>Excellent oral and written communication skills.&nbsp;</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Jr Coordinator, Denials Management

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Location: Remote within the United States ONLYSchedule: Monday - Friday, 8:00 AM - 5:00 PMAs a Clinical Review Specialist, you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor. You will perform retrospective clinical case reviews and draft appeals that focus on establishing the Medical Necessity of the services performed, both Inpatient and Outpatient.Essential Duties and Responsibilities:·Performs retrospective medical necessity reviews to determine appeal eligibility of clinical disputes/denials.·Constructs and documents a succinct and fact-based clinical case to support appeal utilizing appropriate medical necessity criteria and other pertinent clinical facts.oPertinent clinical facts include, but are not limited to, documentation preventing a safe transfer/discharge or documentation of medical necessary services denied for no authorization.·Demonstrates ability to critically think, problem solve and make independent decisions supporting the clinical appeal process.Minimum Qualifications &amp; Competencies:·RN License with strong clinical knowledge - Active unrestricted clinical license in at least one state within the United States.·Minimum of 2-3 years of writing appeals letters and clinical auditing.·Minimum of 2-3 years Utilization Review / Case Management experience within the last 5 years.·Must be familiar with the payer guidelines and EMR systems like Epic, Cerner or Meditech.·Managed care payor experience a plus in either Utilization Review, Case Management or Appeals.·Must have excellent attention to detail, written communication skills and be computer proficient.PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Clinical Review Specialist

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.JOB SUMMARY: The Coding Specialist is responsible for accurately coding (ICD-10-CM, CPT, if applicable, Level I &amp; II modifiers, if applicable), and evaluation and management. May also code: outpatient facility ancillary or clinic services.Project work: Professional Clinic or Specialty Coding (E&amp;M)MUST HAVE: • Minimum of one year of experience in evaluation and management, surgery, emergency room, observation, injections and infusions, or denials. This should include hospital and/or physician practice. • Coding Certifications: The following are recognized professional certifications: Certified Professional Coder (CPC); Certified Outpatient Coder (COC); Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P). Coding Specialist II coders are required to possess at least one of the above professional services coding certifications. Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position. • RHIA, RHIT certification accepted equivalent for all coding positions. • Pass a pre-employment coding test that is provided, developed and administered by candidate management instructions.PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Primary Care Clinic Coding Specialist

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:The Senior Client Service Coordinator plays a key role in supporting the Client Services team by leading resolution efforts for complex client issues, mentoring team members, and driving operational improvements. This role serves as a subject matter expert across key service areas, with a particular focus on the Appeals product line, which represents a significant portion of departmental volume. The Senior Coordinator collaborates cross-functionally to ensure timely, accurate, and client-focused service delivery.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Schedule: Monday - Friday, 8:00 AM - 5:00 PM EST or 9:00 AM - 6:00 PM ESTCore Responsibilities:<ul><li>Lead resolution of complex client service issues, acting as the first escalation point and ensuring timely follow-up, especially for high-volume areas such as UM Appeals.</li><li>Serve as a subject matter expert (SME) in UM Appeals and other key operational workflows, with deep understanding of payer-specific requirements, timely filing guidelines, and documentation standards.</li><li>Monitor and analyze operational performance, identifying trends and opportunities for improvement, and delivering actionable insights to enhance service delivery and client satisfaction.</li><li>Develop and maintain training resources, including SOPs and best practices, while mentoring and onboarding new team members.</li><li>Collaborate with Strategic Advisors, technical teams, and operational stakeholders to resolve escalated issues, support strategic initiatives, and improve client outcomes.</li><li>Perform additional duties as assigned that align with departmental and company growth initiatives.</li></ul>Skills &amp; Competencies:<ul><li>Strong interpersonal skills; approachable and effective across diverse teams</li><li>Computer proficient.</li><li>Demonstrates initiative and accountability in resolving issues and driving outcomes</li><li>Works independently while contributing effectively to team goals</li><li>Exceptional organizational and time management abilities</li><li>High attention to detail and accuracy in documentation and task execution</li><li>Ability to manage multiple priorities and track deliverables across projects</li><li>Excellent written and verbal communication skills, with a professional and client-focused tone</li><li>Customer-focused mindset with a commitment to service excellence</li><li>Adaptable in a fast-paced, collaborative environment</li><li>Strong critical thinking and problem-solving skills, especially appeals workflows</li><li>Comfortable collaborating with cross-functional teams, including Strategic Advisors, technical, and operational stakeholders</li><li>Commitment to HIPAA/HITECH compliance and confidentiality in all communications and documentation</li></ul>Education &amp; Experience:<ul><li>High School Diploma or equivalent required</li><li>Bachelor’s degree strongly preferred</li><li>Client Services experience required</li><li>1–2 years in healthcare appeals workflows, including managing appeal submissions, interpreting payer-specific requirements, and an understanding of timely filing guidelines</li><li>Knowledge of healthcare revenue cycle operations, including prior authorization, denials management, and appeals resolution</li><li>Prior experience accessing hospital EMRs and payer portals strongly preferred</li><li>Experience with Salesforce preferred</li><li>Experience as a Business Analyst or Project Management preferred</li><li>Proficiency in MS Outlook, PowerPoint, Word, and Excel.</li><li>Demonstrated ability to communicate clearly and professionally</li><li>Experience collaborating with Strategic Advisors and cross-functional teams (technical, operational, and client-facing) to resolve escalated issues and communicate outcomes</li><li>Familiarity with HIPAA and healthcare compliance standards in client communications and documentation</li></ul>Physical Requirements:This role may require extended periods of sitting and computer use. Occasional standing, walking, and light lifting (up to 20 lbs) may be necessary. Must be able to communicate effectively and perform repetitive hand movements.CorroHealth is an Equal Opportunity Employer and considers applicants without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics, or any other protected status under applicable law.PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Sr. Coordinator, Client Services

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:The Supervisor, DRG Integrity Reviews/Audits, is responsible for overseeing the execution, quality, and delivery of complex, concurrent, and retrospective coding audits. This role ensures compliance with AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, CPT Assistant, and official coding guidelines, while supervising a team of auditors. The Supervisor provides second-level review, client deliverables, coding education, and quality assurance to support both client and organizational goals.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Team Supervision &amp; Leadership<ul><li>Coordinate scheduling of team and client deliverables with leadership.</li><li>Assign new clients to auditors, send weekly assignments, and ensure access to client information.</li><li>Provide auditors with timely updates/changes to coding guidelines and department processes.</li><li>Serve as a Subject Matter Expert (SME) for auditors across assigned audits.</li><li>Conduct training for new and existing auditors to maintain team competency.</li><li>Provide insight to auditor performance; productivity, quality and opportunity find rates</li><li>Conduct QA of at least 25% of departmental work products, ensuring a minimum 95% accuracy threshold.</li><li>Promote teamwork, knowledge sharing, and respectful communication across the team.</li></ul>Productivity &amp; Quality Standards<ul><li>Meet productivity standards set by record type for each audit.</li><li>Maintain billable productive hours at or above 80% when client work is available.</li><li>Monitor and report time, work products, and schedules in an accurate and timely manner.</li><li>Recommend process improvements to streamline workflows and enhance efficiency.</li></ul>Education &amp; Professional Development<ul><li>Participate in development and delivery of coding education for clients.</li><li>Stay current on coding, reimbursement, and compliance issues through continuing education.</li><li>Maintain active professional credentials as required.</li></ul>Audit &amp; Compliance<ul><li>Perform complex concurrent and/or retrospective analysis of medical record documentation to validate coded data.</li><li>Ensure compliance with legal and procedural policies, official coding guidelines, and AHIMA Standards of Ethical Coding.</li><li>Conduct independent QA on assigned Reviews/Audits results with a minimum accuracy expectation of 95%.</li><li>Protect the privacy and confidentiality of patient and client health information at all times.</li></ul>Reporting &amp; Client Deliverables<ul><li>Analyze Reviews/Audits findings and identify root causes of coding errors.</li><li>Prepare detailed summary reports of findings, citing official references.</li><li>Ensure deliverables are accurate, timely, and aligned with client expectations.</li><li>Act as client liaison/expert in organizational policies, maintaining an audit playbook for each assigned client.</li><li>Provide back-up leadership support for client interactions when needed.</li></ul>Special Projects<ul><li>Lead or participate in special projects requiring coding and auditing expertise across the organization.</li><li>Support leadership in implementing new initiatives and process improvements.</li></ul>Qualifications and Requirements:<ul><li>RHIA, RHIT, CCS, or CPC credential required.</li><li>Minimum 5 years’ experience in DRG auditing, coding, or HIM consulting.</li><li>Previous supervisory or lead auditor experience preferred.</li><li>Strong knowledge of ICD-10-CM/PCS, CPT, MS-DRG, APR-DRG, and reimbursement methodologies.</li><li>Excellent analytical, communication, and report-writing skills.</li><li>Ability to manage multiple projects and priorities in a fast-paced consulting environment.</li></ul>Performance Expectations<ul><li>Audit QA accuracy threshold: 95% minimum.</li><li>Billable productivity threshold: 50% minimum (when client work is available).</li><li>Demonstrated ability to apply coding principles consistently to evolving scenarios.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Supervisor, DRG Revenue Integrity

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Job Description Summary The Manager will support the overall success of the CDI Staffing Division by managing and assisting the Director and SVP of CDI ServicesESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.<ul><li>Effectively communicates with Director, other Managers, Leads and staff on schedule needs and assignments</li><li>Facilitates initial onboarding process of all concurrent review CDIS to ensure proper understanding of overall workflow process, expectations, and established access</li><li>Reviews the productivity report weekly with each Project Lead; responsible for discussing the CDI’s productivity, monitoring and developing remediation plans for CDIS with Director as needed</li><li>Reviews timecards weekly</li><li>Notifies Director or Assistant Director of CDI Services of errors found, specifically trending by CDIS/Auditor, concerns reported by Project Leads</li><li>Report project status updates to Director&nbsp; weekly and additionally as needed</li><li>Participates in report writing, education development and/or delivery</li><li>&nbsp;Assists in new hire orientation</li><li>&nbsp;Collaborates with CDI Director on Education topics</li><li>&nbsp;Monitors for maintenance of Share Point folders for all staffing projects, discussing needs with Project Leads</li><li>Rounds with each CDI Project lead weekly for updates and needs of individual projects</li><li>Billable 50% per month</li><li>Important Duties and Responsibilities</li><li>Report work time and work products in a timely and accurate manner</li><li>Communicates with coworkers in an open and respectful manner that promotes teamwork and knowledge sharing</li><li>Interacts with clients in a professional manner, that at all times exhibits excellent relationship, work performance and communication skill so as to support the company and its business interests</li><li>Provide schedule of planned work activities, events and sites and any changes to same, to Management and appropriate coworkers</li><li>Maintenance of professional credentials and knowledge of coding, reimbursement and compliance issues through continuing education</li><li>Periodic travel as required</li><li>Preforms other duties as assigned</li><li>Desired Minimum Qualifications</li><li>Recognized credential from ACDIS (CCDS) or AHIMA (CDIP).</li><li>Experience with telecommuting and electronic medical record systems required.</li><li>Current license as a registered nurse (RN)</li><li>BSN or MSN preferred</li><li>Possess sound judgment and strong analytical skills.</li><li>Proficient computer skills, specifically Microsoft Office products.</li><li>Proficient skills utilizing a management system.</li><li>Strong team player with ability to train and mentor others.</li><li>Ability to work with multiple and diverse clients and projects.</li><li>Ability to work with minimal supervision.</li><li>Ability to maintain and access multiple files.</li><li>Assure that work product is completed with high levels of accuracy and attention to detail.</li><li>Possess extensive knowledge of medical and health care policies and processes.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

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