The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for various specialties including professional fee and facility charts. They are responsible for maintaining high accuracy and quality standards while adhering to ethical coding guidelines and privacy regulations.
The Coding Specialist is responsible for accurately assigning CPT, HCPCS, and ICD-10-CM codes across various medical specialties. They must maintain high productivity and quality standards while ensuring compliance with ethical coding guidelines and privacy regulations.
The specialist performs complex concurrent and retrospective medical record audits to validate coded data against official guidelines. They also develop and deliver educational content to clients based on audit findings to improve coding accuracy and compliance.
The Data Analyst is responsible for loading client chargemaster data into databases using SQL and Excel while validating results for accuracy. The role also involves answering client inquiries, managing project tasks, and collaborating with the Financial Analytics team to support pricing projects.
The Price Transparency Coordinator provides administrative and operational support to the Account Executive and Price Transparency teams. Responsibilities include managing calendars, handling client correspondence, maintaining CRM data, and assisting with regulatory compliance and audits.
The Medical Reimbursement Specialist is responsible for resolving outstanding insurance balances through research, follow-ups, and appeals. They must also perform maintenance on Medicare claims and ensure patient accounts are accurate and compliant with regulations.
The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for various specialties including Outpatient Cath/IVR. They are responsible for maintaining high productivity and quality standards while ensuring compliance with ethical coding guidelines and privacy regulations.
The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for cardiothoracic surgery and other specialties. They are responsible for maintaining high productivity and quality standards while ensuring compliance with ethical coding guidelines.
The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for various specialties including ED and surgical procedures. They are responsible for interpreting coding guidelines to ensure accurate code assignment and maintaining high productivity and quality standards.
The Senior Client Service Coordinator leads the resolution of complex client issues and serves as a subject matter expert for the Appeals product line. They also mentor team members, monitor operational performance, and collaborate cross-functionally to drive service improvements.
The Production Support Specialist maintains the operational integrity of internal business applications by troubleshooting issues and managing service requests. They are also responsible for system configuration, user access management, and monitoring automated processes to ensure system stability.
The Product Owner leads the strategic and operational direction of the Linx Retrieval platform by managing the product backlog and defining requirements. They collaborate with cross-functional teams, including developers and business analysts, to deliver market-driven enhancements and ensure product quality.
The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for various medical specialties including primary care, trauma, neuro, and ortho. They are responsible for calculating ProFee levels, identifying critical care cases, and ensuring compliance with ethical coding standards.
The Insurance Specialist is responsible for reviewing and resolving outstanding insurance balances on Hospital Billing patient accounts. They must ensure cash recovery goals are met while maintaining accurate documentation and compliance with federal and state regulations.
The Coding Specialist will provide accurate CPT, HCPCS, and ICD-10-CM coding for various specialties while maintaining high productivity and quality standards. They are responsible for interpreting coding guidelines, identifying documentation needs for reimbursement, and ensuring compliance with privacy and ethical standards.
The Coding Specialist provides accurate CPT, HCPCS, and ICD-10-CM coding for various specialties to support client reimbursement cycles. They must ensure documentation meets coding guidelines while maintaining high accuracy and productivity standards.
Review, analyze, and code patient medical records to accurately capture diagnoses for HCC, RxHCC, and ESRD models. Maintain high quality and productivity standards while adhering to ICD-10-CM guidelines and privacy regulations.
The Senior Business Systems Analyst acts as a liaison between business stakeholders and the technical team to manage project lifecycles and enhancement requests. They are responsible for gathering requirements, creating technical specifications, and overseeing testing processes to ensure effective system performance.
The Insurance Specialist is responsible for identifying and resolving insurance claims denials and processing errors. They will leverage proprietary software and medical documentation to follow up on unpaid claims while maintaining compliance with HIPAA regulations.
The auditor is responsible for reviewing the accuracy of HCC and RxHCC coded records to ensure compliance with Medicare and ICD-10-CM guidelines. They will also provide feedback to coding team members and assist in the creation of training materials.
Manage the end-to-end authorization process, including notification, submission, and follow-up with payers to ensure timely determinations. Act as a liaison between hospital staff and health payers while maintaining accurate documentation in EMR and internal systems.
The Coding Specialist will provide professional fee, facility, or HCC coding services across various medical specialties. They are responsible for accurately assigning diagnosis and procedure codes while maintaining high productivity and quality standards.
The Clinical Quality Reviewer performs comprehensive clinical reviews of prior authorization requests to ensure medical necessity and regulatory compliance. They also validate documentation accuracy, support physician determination activities, and collaborate with cross-functional teams to optimize review workflows.
Perform complex concurrent and retrospective medical record audits to validate coded data against official guidelines. Develop and deliver educational content to clients based on audit findings to improve coding accuracy and compliance.
Healthcare auditors review hospital claim data and insurance contracts to identify reimbursement issues and underpayment risks. They develop audit plans, model reimbursement methodologies, and provide actionable recommendations to improve financial recovery.
Perform concurrent clinical case reviews to establish appropriate admission status and provide recommendations to client hospitals. Identify process improvements and inefficiencies while interacting with attending physicians to ensure compliance and appropriate payment.
The HCC Coding Quality Specialist is responsible for auditing HCC coded records to ensure accuracy and compliance with Medicare and ICD-10-CM guidelines. They also provide feedback to coders, assist with training materials, and maintain high quality and productivity standards.
The Patient Services Representative is responsible for completing patient registration, verifying health plan coverage, and obtaining necessary authorizations. They must maintain accurate documentation in hospital systems while ensuring compliance with federal and state regulations.
Resolve complex unpaid or denied claims for long-term care and skilled nursing facilities while ensuring compliance with federal and state billing regulations. Coordinate with clinical and finance teams to optimize reimbursement through accurate coding and timely claim submission.
The Medical Director reviews clinical records and case files to ensure Medicare services comply with CMS regulations and clinical guidelines. They also lead peer-to-peer discussions with providers regarding prior authorization requests and drive quality improvement initiatives.
Review and analyze patient medical records to abstract ICD-10 codes specifically mapping to HCC, RxHCC, and ESRD models. Ensure compliance with Medicare guidelines, client-specific requirements, and privacy regulations.
Responsible for reviewing and resolving outstanding insurance balances on hospital or physician patient accounts to meet cash recovery goals. This includes performing account research, preparing payment appeals, and ensuring compliance with federal and client guidelines.
Resolve complex unpaid or denied claims for long-term care and skilled nursing facilities while ensuring compliance with federal and state regulations. Coordinate with clinical and finance teams to optimize reimbursement through accurate coding and timely claim submission.
The role focuses on auditing medical documentation for coding accuracy and performing root-cause analysis on insurance denials to maximize reimbursement. It involves collaborating with physicians to improve documentation specificity and ensuring compliance with medical coding guidelines.
Performs complex retrospective analysis of medical records to identify coding and billing errors while ensuring compliance with legal and procedural policies. Provides technical support, training, and quality assurance monitoring for internal coding staff to optimize reimbursement.
Perform accurate analysis of medical records to assign appropriate ICD-10, CPT, and HCPCS codes across multiple specialties. Maintain high quality and productivity standards while ensuring compliance with ethical coding standards and privacy regulations.
The Medical Director will assess the quality of clinical services provided to Medicare beneficiaries, ensuring compliance with clinical guidelines and regulations after mentored training. Daily work involves reviewing clinical records to ensure practices meet the highest standards of care and adhere to CMS policies.
CDI Specialists will collaborate with healthcare professionals to improve the quality and accuracy of clinical documentation. They will conduct chart reviews and issue queries to ensure compliance with documentation standards.
