The HIE Specialist monitors patient account tracking systems to ensure accurate data capture and resolves missing or incomplete information. They remotely access hospital systems to retrieve chart documents and facilitate record completion for contracted providers.
The Quality Assurance Auditor conducts detailed audits of billing activities, claim follow-ups, and collection efforts to ensure compliance and accuracy. They provide feedback to staff, identify performance trends, and collaborate with leadership to refine billing policies and workflows.
The Compliance Manager oversees the company's compliance program, ensuring adherence to government laws, regulations, and internal policies. They are responsible for conducting internal investigations, managing audits, and providing training to staff regarding billing and coding standards.
Review patient medical records and assign accurate CPT and ICD-10 diagnosis codes for emergency medicine services in accordance with documentation, payer requirements, and applicable regulations. Meet daily productivity and accuracy targets, identify documentation deficiencies, query physicians when needed, and support quality assurance and timely workflow completion.
The Payer Contract Specialist manages the negotiation, implementation, and ongoing maintenance of payer contracts to ensure optimal reimbursement and compliance. They also serve as the subject matter expert for contract modules, monitoring payer performance and communicating policy updates to internal stakeholders.
