field_job_employment_type

job_industry

field_job_occupational_field_parents_all

job_organization_name

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 DRG Revenue Integrity Auditor (DRG - A) performs Diagnostic Related Group (DRG) validation and quality audits on Inpatient charts. The DRG - A will perform chart reviews and will ensure that all reviewed charts capture the patient’s true clinical picture from the codes assigned by the facility’s coders in compliance with federal laws. The DRG - A will utilize International Classification of Diseases - Clinical Modification (CM) and Procedure Coding System (PCS) Terminology to ensure accurate coding. Responsible for validating proper sequencing and accuracy of ICD-10-CM/PCS codes, POA assignments, severity of illness (SOI), risk of mortality (ROM), Hierarchical Condition Category (HCC) capture CMI and other coding factors. Usage of most current Clinical Criteria, MCG, InterQual, payers’ Clinical Policy Bulletins, CMS Guidelines, NCDs and/or LCDs. Adherence to all coding guidelines and CDI best practices, as endorsed by ACDIS and AHIMA, to determine correct coding that is clinically supported and composing and sending queries when necessary. Analyze records for potential query opportunities and appropriate code assignment along with correct code sequencing. Maintain quality of reviews by making sure the true clinical picture is captured timely. Staying up to date with medical and coding guidelines, along with advancements within their field. Support CorroHealth in developing accurate training materials. Provide training and shadowing to new hires. Assist CorroHealth with project data analysis, reporting, and feedback internally and externally to CorroHealth clients. Maintain professional etiquette. Ensures all PHI is appropriately stored and delivered to authorized individuals. Meets or exceeds production and quality metrics. Attend all mandatory meetings and trainings. Additionally, DRG - A may also be required to audit clients’ clinical documentation integrity (CDI) program to include query review, analysis of coding, and overall program accuracy. Responsible to keep up with your company and EMR access log ins and passwords. All other position related duties as delegated by management. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The list below is representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. **Sign on bonus available**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.Important Duties and Responsibilities:<ul><li>Adherence to all coding guidelines and CDI best practices, as endorsed by ACDIS and AHIMA, to determine correct coding that is clinically supported</li><li>Analyze records for potential query opportunities and appropriate code assignment and code sequencing</li><li>Maintain quality of reviews and making sure the true clinical picture is captured, along with ensuring chart review productivity</li><li>Staying up to date with official coding guidelines, coding clinics and clinical criteria</li><li>Available to provide training to other new hires, if required, along with supporting development of training materials, as well as clinical, coding and CDI policies</li><li>Assisting with project data analysis, reporting, and feedback both internally and to clients</li><li>In all situations, protecting the privacy and confidentiality of patient health and client information, and follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices, standards, and procedures</li><li>Conduct chart reviews as assigned, meeting the productivity standards as set forth for each&nbsp;project or record type</li><li>Communicates with coworkers in an open and respectful manner that promotes teamwork and knowledge sharing</li><li>When interacting with clients, always conducts themselves in a professional manner, exhibiting excellent relationship, work performance and communication skill so as to support the company and its business interests</li><li>Maintenance of professional credentials and knowledge of CDI, coding, reimbursement, and compliance issues through continuing education</li><li>Other duties and responsibilities, as assigned</li></ul>Work Experience:<ul><li>Five or more years working in an acute care setting or a third-party&nbsp;vendor as a DRG Auditor or Clinical Documentation Specialist (CDS).</li><li>Prior experience of working as a CDI/Coding auditor is preferred but NOT a requirement.</li></ul>Knowledge, Skills &amp; Abilities:<ul><li>Experience with telecommuting and electronic medical record systems required</li><li>Good computer skills and familiarity with commonly used work apps, such as MS Word, MS Excel, MS Outlook, Teams, etc.</li><li>Strong analytical skills</li><li>Works well with numbers, using basic math skills</li><li>Strong team player</li><li>Ability to work with multiple and diverse clients and projects</li><li>Ability to switch between multiple clients throughout the day and week</li><li>Ability to work with minimal supervision</li><li>Ability to maintain and access multiple files</li></ul>We Offer:<ul><li>Quality of life with a remote predictable, full-time schedule</li><li>Exempt/Salaried positions</li><li>Opportunities for career growth within the organization</li><li>Medical, Dental, Vision coverage, 401K with match</li><li>Long-term disability insurance, life insurance and more</li><li>Holidays Time and ample paid time off</li><li>Allowance for CME and/or license renewal</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

DRG Revenue Integrity Auditor

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:CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures.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>Conduct clinical documentation tasks, meeting productivity and quality standards as set for each project.&nbsp;</li><li>Adhere to all coding and clinical documentation improvement guidelines as endorsed by AHIMA and ACDIS.&nbsp;</li><li>Perform review on clinical documentation and issue queries when appropriate.</li><li>Review medical records for completeness and accuracy for severity of illness and risk of mortality.&nbsp;</li><li>Accurate and timely record review.&nbsp;</li><li>Demonstrate knowledge of DRG payer issues, documentation opportunities, and clinical documentation requirements.&nbsp;</li><li>Analyze findings and identify potential root causes of produced errors.&nbsp;</li></ul>Qualifications and Requirements:<ul><li>Experience with telecommuting, working with EMRs and other electronic tools.&nbsp;</li><li>Strong analytical skills.&nbsp;</li><li>Strong Microsoft Office skills.&nbsp;</li><li>Works well with numbers.&nbsp;</li><li>Strong team player.&nbsp;</li><li>Ability to work with multiple and diverse clients and projects.&nbsp;</li><li>Ability to work with minimal supervision.&nbsp;</li><li>Ability to maintain and access multiple files.&nbsp;</li><li>Assure that work product is completed with high levels of accuracy and attention to detail.&nbsp;</li></ul>Education &amp; Experience:<ul><li>CCDS or CDIP certification required. **Or be willing to get CCDS certification within 6 months of employment.</li><li>Current RN license.</li><li>Three years CDI experience.</li><li>Two years or more clinical experience in an acute care setting preferred.</li></ul>We Offer:<ul><li>Quality of life with a remote predictable, full-time schedule</li><li>Opportunities for career growth within the organization</li><li>Medical, Dental, Vision coverage, 401K with match</li><li>Long-term disability insurance, life insurance and more</li><li>Holidays Time and ample paid time off</li><li>Allowance for CME and/or license renewal</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.

CDI Specialist, RN/BSN, CCDS (FT/REMOTE) (CDI experience req'd)

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 US OnlyRequired Schedule: Monday - Friday, 8:00 AM - 5:00 PM ESTHourly Pay: $18.27 (firm)Job Summary:Join our team as Coordinator, Appeals Management, where you’ll play a critical role in resolving outstanding hospital claim denials and ensuring timely and accurate appeal submissions. You’ll work closely with insurance payers and internal teams to move appeals forward, document processes, and maintain compliance with healthcare regulations.<ul><li>Perform medical claim 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 skills in Outlook. Should be able to create a meeting invitation, accept a meeting invitation, receive and respond to email and set up folders.</li><li>Must be able to type a minimum of 25 wpm with a 90% accuracy rate.</li></ul>What we offer:<ul><li>Equipment provided</li><li>Medical/Dental/Vision Insurance</li><li>401k matching (up to 2%)</li><li>PTO: 80 hours accrued, annually</li><li>9 paid holidays</li><li>Tuition reimbursement</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.

Coordinator, Appeals Managment

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 Account Manager Assistant plays a crucial role in supporting the Operations Team by providing administrative, operations and clerical assistance to (AE) Account Executive(s) and Price Transparency (PTT)/No Surprises Act (NSA) Team. This position requires a proactive, organized, and detail-oriented individual capable of multitasking in a fast-paced environmentESSENTIAL 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 US onlyJob Summary:The Account Manager Assistant plays a crucial role in supporting the Operations Team by providing administrative, operations and clerical assistance to (AE) Account Executive(s) and Price Transparency (PTT)/No Surprises Act (NSA) Team. This position requires a proactive, organized, and detail-oriented individual capable of multitasking in a fast-paced environment. Knowledge, Skills &amp; Abilities:<ul><li>Contribute to troubleshooting and create solutions for PTT/NSA tools.</li><li>Assist in the management of calendars by scheduling and coordinating internal and client meetings to ensure optimal use of time as needed.</li><li>Upon request, address calls, emails, and correspondence on behalf of the AE and PTT/NSA Team. Respond to routine inquiries and prioritize/escalate issues by forwarding messages to appropriate leadership and teams.</li><li>Aid in the preparation of meeting agendas, presentations, and materials as needed. Take meeting minutes, distribute agendas, and follow up on action items as requested.</li><li>Support in updating and maintaining the PARA Data Editor (PDE) Customer Relationship Management (CRM) and Client Access with accurate and up-to-date client information. Assist in data entry and report generation if requested. Help with client password resets and guidance.</li><li>Become proficient with Price Transparency and NSA regulations and tools and apply knowledge as CMS makes changes.</li><li>Assist in external client PTT audits.</li><li>Contribute to a culture that values knowledge sharing, improving, best practices, quality results, client services, and team efforts.</li></ul>Qualifications and Requirements:<ul><li>Strong technical skills and experience with Microsoft Suite (e.g., PowerPoint, Excel, Word, Outlook, etc.)</li><li>Minimum of 3 years of experience with healthcare providers or in the healthcare segment</li><li>Minimum of 3 years of experience working in customer support or in an administrative assistant role including MS Outlook calendar management</li><li>General knowledge of HCPCS, CPT®, and Revenue Codes</li><li>Basic knowledge of CMS regulations regarding Price Transparency and the CMS No Surprise Act.</li><li>Must have achieved a High School Diploma or GED</li></ul>Competencies:&nbsp;<ul><li>Detail-oriented and organized.</li><li>Strong written and verbal communication.</li><li>Must be capable of working independently while thriving in a team environment, demonstrating both collaboration and confidence in a balanced manner.</li></ul>Physical Requirements and 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 are 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, incumbents are subject to sitting for prolonged periods. Infrequently, the incumbent must be able to lift and move material weighing up to 20 lbs. Incumbents 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 employee’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.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.

Account Manager Assistant

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:Inpatient Coder/Auditor for internal coders. Must be strong in IP coding and have experience auditing. Will also be a part of production coding for 10hrs a week. This position will work with multiple clients across multiple states. Working with coders to educate them on audit findings.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.Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant. Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices. Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements Protects the privacy and confidentiality of patient health and client information. Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices. Suggests physician query opportunities query Physicians based upon documentation and clinical needs. Prepare deliverables for the coders as required Report work time and work productions in a timely and accurate manner Communicates with coworkers in an open and respectful a manner which promotes teamwork and knowledge sharing. Provide schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff. Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education Monitor the on-going progress and success of each coder Maintain QA percentages within two internal quality goals; 1) overall minimum coder accuracy of 95% and 2) QA review percentages as close to 10% as possible Identify and resolve coding quality problems or issues in a timely manner Maintain a continual knowledge of problems or issues that could affect coding quality levels Assist in design of systems to help improve coder productivity and assist in improving accuracy of coding Provide monthly reports Participate in corporate training and meetings Provide status reports to senior manager as requested Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program Interpret coding guidelines for accurate code assignment Identify the importance of documentation on code assignment and the subsequent reimbursement impact Comply with all internal policies and procedures Actively participate in Company provided training and education Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health InformationQualifications and Requirements: Regular, predictable and punctual attendance is required Strong verbal and written communication skills are required Ability to prioritize workload, meet deadlines and maintain a high level of quality and accuracy Recognized coding credential from AHIMA or AAPC; and RHIA or RHIT may also be consideredExperience with telecommuting and electronic medical records systems strongly preferredStrong analytical skillsExcellent written communication skillsStrong team playerAbility to work with multiple and diverse clients and projectsAbility to work with minimal supervision5-7 years’ experience coding and/or auditing in an acute care facility or clinic, of patient types listed in the Job Summary of this document&nbsp;Initiative, resourcefulness and attention to detail Customer service support -- minimum one (1) year experience Familiarity with hospital outpatient billing processes Understand hospital APC assignment and associated coding and documentation Coding Certification -- preferred (CPC or CCS) Strong communication skills, proficient in Microsoft Office applications including Word and Excel Ability to navigate in a variety of EMR environments and review hand-written chartsPHYSICAL 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.

Coding Quality Specialist - IP Auditor/Coder

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 Coding Specialist II is responsible for accurately coding (ICD-10-CM, CPT, if applicable, Level I &amp; II modifiers, if applicable) evaluation and management, surgery, emergency room, observation, injections and infusions, or coding edit and denials resolution. May also code: outpatient facility ancillary or clinic services. Will be working with multiple facility specific, state billing and coding guidelines as well as various Medicare Administrative Contractors nation-wide. *This role will be focused on Primary Care Coding - experience with professional fee, Annual Wellness Visits, Office Procedures, Multi-specialty, etc.* *Cerner and/or Meditech ExperienceESSENTIAL 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>ESSENTIAL JOB FUNCTIONS:Project WorkRecord KeepingAnalysis/ReportingCustomer Service<ul><li>Outpatient Facility Coding (Ancillary &amp; Clinic, etc.)</li><li>Professional Clinic or Specialty Coding (E&amp;M)</li><li>Coding edits and denials resolution</li><li>Completion of Masterlog of accounts coded daily</li><li>Completion of Time Allocation reports daily</li><li>Identifies trends and reports to Coding manager</li><li>Identifies potential issues or errors</li><li>Client liaison to communicate account inquiries</li><li>Identifies daily work queues</li></ul></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.

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 Manager, Clinical Operations will support the Senior Director in overseeing the Clinical Documentation team's workflow operations and participating in reviews of organizational and functional activities. They will assist in managing a comprehensive and practical schedule of daily production coverage, financial expectations, and client success. Additionally, they will collaborate with the Senior Director to ensure that all client expectations are met to the highest degree of quality. The Manager, Clinical Operations will contribute to producing and presenting reports to leadership to trend and track the success and gaps of the division. Furthermore, they will play a role in achieving operational excellence by assisting in the construction of plans and strategies to overcome challenges.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.Essential Functions:Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.Role &amp; Responsibilities:<ul><li>Report directly to the Senior Director of Clinical Documentation.</li><li>Assist the Senior Director in overseeing the Clinical Documentation team's workflow operations and contribute to reviews of organizational and functional activities.</li><li>Manage a comprehensive and practical schedule of daily production coverage, financial expectations, and client success in alignment with the company directives.</li><li>Ensure that all client expectations are met to the highest degree of quality.</li><li>Produce and present reports to the Clinical Documentation team and other leadership members to trend and track the success and gaps of the division.</li><li>Collaborate with the Clinical Documentation team to achieve operational excellence by implementing plans and strategies to overcome challenges.</li><li>Organize, prioritize, and delegate workload within the Clinical Documentation team in line with the company's vision and objectives.</li><li>Implement Performance Improvement Programs to drive continuous quality and productivity improvements.</li><li>Assist in the preparation and documentation of policies and procedures.</li><li>Identify opportunities for process and product improvements to enhance the department's competitive market position and outcomes for clients.</li><li>Participate in cross-functional projects and process improvement initiatives.</li><li>Facilitate departmental and client meetings, ensuring effective communication and collaboration.</li><li>Produce and facilitate monthly or quarterly executive report outs to clients.</li><li>Provide timely and accurate reporting regarding department performance, financial goals, and objectives.</li><li>Collaborate with stakeholders to address operational risks and mitigate their impact on cost, schedule, and quality factors.</li><li>Develop and maintain manuals and training aids&nbsp;to support ongoing staff training and development initiatives.</li><li>Accumulates data, maintains records, and prepares reports on the administration of production projects and other assigned activities.</li><li>Works with client management coding, CDI and technical support services to ensure client expectations are met.</li></ul>Knowledge, Skills &amp; Abilities:<ul><li>AHIMA or AAPC accreditation preferred.</li><li>Minimum of three years' experience in Revenue Cycle Management.</li><li>Six Sigma or related LEAN/OPEX/Process Excellence experience desirable.</li><li>Proficient in Microsoft Word, Excel, and PowerBI.</li><li>Strong verbal and written communication skills.</li><li>Ability to work independently, exercise good judgment, and make confident decisions.</li><li>Proficiency in generating, interpreting, and analyzing reports.</li><li>Effective team player with the ability to collaborate and communicate effectively across departments.</li></ul>Physical Requirements and 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, incumbents are subject to sitting for prolonged periods. Infrequently, incumbent must be able to lift and move material weighing up to 20 lbs. Incumbent 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 employee’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.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.

Manager, CDI 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 Coding Quality Specialist responsible for Auditing global team end-to-end coding engagement. Requires the following experience: Certified coder/auditor - RHIT, RHIA, CCS, CPMA, or other coding certification from AHIMA or AAPC* 1+ years Auditing and prior coding experience in the following: -Inpatient -Outpatient -Profee -Facility -E/M leveling -Surgical coding experience -Epic experience requiredESSENTIAL 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.Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant. Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices. Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements Protects the privacy and confidentiality of patient health and client information. Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices. Suggests physician query opportunities query Physicians based upon documentation and clinical needs. Prepare deliverables for the coders as required Report work time and work productions in a timely and accurate manner Communicates with coworkers in an open and respectful a manner which promotes teamwork and knowledge sharing. Provide schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff. Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education Monitor the on-going progress and success of each coder Maintain QA percentages within two internal quality goals; 1) overall minimum coder accuracy of 95% and 2) QA review percentages as close to 10% as possible Identify and resolve coding quality problems or issues in a timely manner Maintain a continual knowledge of problems or issues that could affect coding quality levels Assist in design of systems to help improve coder productivity and assist in improving accuracy of coding Provide monthly reports Participate in corporate training and meetings Provide status reports to senior manager as requested Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program Interpret coding guidelines for accurate code assignment Identify the importance of documentation on code assignment and the subsequent reimbursement impact Comply with all internal policies and procedures Actively participate in Company provided training and education Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health InformationQualifications and Requirements: Regular, predictable and punctual attendance is required Strong verbal and written communication skills are required Ability to prioritize workload, meet deadlines and maintain a high level of quality and accuracy Recognized coding credential from AHIMA or AAPC; and RHIA or RHIT may also be consideredExperience with telecommuting and electronic medical records systems strongly preferredStrong analytical skillsExcellent written communication skillsStrong team playerAbility to work with multiple and diverse clients and projectsAbility to work with minimal supervision5-7 years’ experience coding and/or auditing in an acute care facility or clinic, of patient types listed in the Job Summary of this document&nbsp;Initiative, resourcefulness and attention to detail Customer service support -- minimum one (1) year experience Familiarity with hospital outpatient billing processes Understand hospital APC assignment and associated coding and documentation Coding Certification -- preferred (CPC or CCS) Strong communication skills, proficient in Microsoft Office applications including Word and Excel Ability to navigate in a variety of EMR environments and review hand-written chartsPHYSICAL 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.

Coding Quality 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:Senior Coding Quality Specialist responsible for Auditing global team end-to-end coding engagement. Requires the following experience: Certified coder/auditor - RHIT, RHIA, CCS, CPMA, etc. 3+ years Auditing and prior coding experience in the following: -Inpatient -Outpatient -Profee -Facility -E/M leveling -Surgical coding experience -Epic experience requiredESSENTIAL 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.Performs complex retrospective analysis of medical record documentation to identify coding and billing errors and inconsistencies according to guidelines of the AHA, CMS, AMA, Clinic Coding Clinic and CPT Assistant. Analyzes audit findings to identify potential root causes of coding errors and prevent their reoccurrence Provides second –level review of diagnosis, procedure and billing codes to ensure compliance with legal and procedural policies that ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices. Research, analyze and respond to inquiries regarding compliance, inappropriate coding, denials and billable services Provides technical support and feedback training to internal coding staff regarding coding compliance, documentation, regulatory provisions, third part payer requirements, medical necessity requirements Protects the privacy and confidentiality of patient health and client information. Follows the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines and compliance practices. Suggests physician query opportunities query Physicians based upon documentation and clinical needs. Prepare deliverables for the coders as required Report work time and work productions in a timely and accurate manner Communicates with coworkers in an open and respectful a manner which promotes teamwork and knowledge sharing. Provide schedule of planned work activities, events and sites, and any changes to same to management and appropriate staff. Maintenance of professional coding credentials and knowledge of coding, reimbursement methodologies and compliance issues through education Monitor the on-going progress and success of each coder Maintain QA percentages within two internal quality goals; 1) overall minimum coder accuracy of 95% and 2) QA review percentages as close to 10% as possible Identify and resolve coding quality problems or issues in a timely manner Maintain a continual knowledge of problems or issues that could affect coding quality levels Assist in design of systems to help improve coder productivity and assist in improving accuracy of coding Provide monthly reports Participate in corporate training and meetings Provide status reports to senior manager as requested Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program Interpret coding guidelines for accurate code assignment Identify the importance of documentation on code assignment and the subsequent reimbursement impact Comply with all internal policies and procedures Actively participate in Company provided training and education Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health InformationQualifications and Requirements: Regular, predictable and punctual attendance is required Strong verbal and written communication skills are required Ability to prioritize workload, meet deadlines and maintain a high level of quality and accuracy Recognized coding credential from AHIMA or AAPC; and RHIA or RHIT may also be considered Experience with telecommuting and electronic medical records systems strongly preferred Strong analytical skills Excellent written communication skills Strong team player Ability to work with multiple and diverse clients and projects Ability to work with minimal supervision 5-7 years’ experience coding and/or auditing in an acute care facility or clinic, of patient types listed in the Job Summary of this document&nbsp; Initiative, resourcefulness and attention to detail Customer service support -- minimum one (1) year experience Familiarity with hospital outpatient billing processes Understand hospital APC assignment and associated coding and documentation Coding Certification -- preferred (CPC or CCS) Strong communication skills, proficient in Microsoft Office applications including Word and Excel Ability to navigate in a variety of EMR environments and review hand-written chartsPHYSICAL 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.

Senior Coding Quality 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:Healthcare Auditors develop contract models for analysis and identify potential insurance reimbursement issues through extensive reviews of hospital claim data and related documents. Auditors also contribute to our knowledge base by conducting research on reimbursement risk areas, reviewing data and processes for quality control, and providing feedback for areas of improvement.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>Create and update audit plans, including outlining potential risk areas of a hospital-payer contract based on reimbursement structure and how to manually identify within the data.</li><li>Model and create/update pricing documents based on hospital contracts to calculate expected payments, including percentage of charge, per diems, MSDRG, outlier and/or stoploss, implants, drugs, Medicare, Medicaid, some outpatient, and other reimbursement models.</li><li>Review insurance payments, research applicable sources (contracts, state and federal legislation, insurance payer policies, medical records, etc.) to determine if payment is correct and make recommendations on appropriate next steps.</li><li>Identify contractual and clinical risk areas from commercial and government payors (e.g., Medicare, Medicaid) as well as other specialized audits (such as coordination of benefits and workers’ compensation).</li><li>Develop specifications and procedures to identify and troubleshoot contractual, coding, and administrative areas of underpayment risk using Access, SQL, Excel, and other programs.</li><li>Conduct review of zero-balance hospital accounts to identify underpaid inpatient and outpatient claims.</li><li>Present clear documentation of process, findings, and results of audits.</li><li>Make recommendations to improve internal processes and external client contracts/processes.</li><li>Work with data analyst team to build and validate pricing models.</li><li>Work across project teams to research and outline next steps on identified underpayment trends.</li><li>Other duties as assigned.</li></ul>MINIMUM QUALIFICATIONS &amp; REQUIREMENTS:<ul><li>High School Diploma or equivalent required</li><li>Minimum of 3 years of experience working with large sets of (healthcare) data</li><li>Minimum of 2 years of experience in areas of research and analysis</li><li>Minimum of 2 years of experience with managed care contracts (government and commercial) and hospital reimbursement</li><li>Minimum of 2 years of experience working with inpatient claims</li><li>Minimum of 1 year of experience working with Medicare, Medicaid, outpatient facility claims</li><li>Minimum of 1 year of experience with contract modeling</li><li>Ability to translate complex contract language and healthcare data into actionable information and insights</li><li>Ability to work independently to solve problems and recommend technical solutions (ex. provide calculation/formula to price in Alteryx)</li><li>Intermediate Excel skills, including knowledge of complex formulas and functions (CONCATENATE, IF, pivot tables)</li><li>Basic knowledge of Access (link tables, select/update query, manipulate data in tables) and SQL preferred</li><li>Strong verbal and written communication skills</li><li>Strong organization skills and attention to detail</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.

26 CorroHealth Jobs