Perform DRG validation and quality audits on inpatient charts to ensure accurate coding and clinical representation in compliance with federal laws. Responsibilities include validating ICD-10 codes, analyzing records for query opportunities, and providing training to new hires.
CorroHealth
30 Remote Job Openings at CorroHealth
Provide professional fee and facility coding services using CPT, HCPCS, and ICD-10-CM guidelines. Ensure high accuracy and productivity levels while maintaining compliance with ethical coding standards and privacy regulations.
Maintains the operational integrity of internal business applications and manages the Charge Description Master (CDM) to ensure accurate billing. Validates CPT/HCPCS and revenue codes to maximize reimbursement and maintain regulatory compliance.
Configure and manage charging and billing modules within the Epic EHR system to ensure accurate documentation and billing. Serve as a subject-matter expert in charge-capture workflows, revenue integrity, and regulatory reimbursement methodologies.
Perform professional fee inpatient cardiology coding, including E/M levels, observations, and bedside procedures. Ensure accurate application of ICD-10 and CPT codes while maintaining high productivity and quality standards.
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 complex retrospective analysis of medical records to identify coding and billing errors while ensuring compliance with legal and procedural policies. Provide technical support, training, and quality audits to internal coding staff to maintain high accuracy and optimal reimbursement.
Provide accurate CPT, HCPCS, and ICD-10-CM coding for outpatient clinic visits across various medical specialties. Ensure high productivity and accuracy rates while adhering to AHIMA ethical standards and company compliance policies.
Evaluates the accuracy of ICD-10, CPT, and HCPCS code assignments for hospital and physician encounters. Develops and delivers educational content to clients based on audit findings to improve coding accuracy.
Review and analyze patient medical records to abstract ICD-10 codes specifically mapping to HCC, RxHCC, and ESRD models. Maintain high quality scores and productivity levels while adhering to Medicare and client-specific guidelines.
Provide accurate CPT, HCPCS, and ICD-10-CM coding for Outpatient Facility Same Day Surgeries and Observation cases. Ensure high productivity and accuracy rates while adhering to AHIMA ethical standards and company compliance policies.
Manage the end-to-end authorization process, including submission, follow-up, and determination for healthcare patients. Act as a liaison between hospital staff and health payers while maintaining detailed documentation in EMR and internal systems.
Business Analyst (HealthCare/RCM) FT/REMOTE (USC or GC req'd)
CorroHealth
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Full Time
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14 days ago
CorroHealth
The Business Analyst is responsible for analyzing and owning operational initiatives to ensure they align with business goals and improve financial outcomes. This includes collecting operational initiatives, creating business requirements, and providing executive-level status updates.
Assist the Director of HIM in preparing claim audits and recommending coding and billing changes for hospital outpatient and Profee claims. Develop standardized reports, provide client education, and support the revenue cycle consulting team using proprietary software.
Perform clinical reviews of inpatient and outpatient medical records to determine medical necessity and level of care. Write clear, persuasive clinical appeals and ensure compliance with payer-specific guidelines and internal policies.
Provide professional fee and facility coding services using CPT, HCPCS, and ICD-10 standards across various medical specialties. Ensure high accuracy and productivity levels while adhering to AHIMA ethical standards and privacy regulations.
Collaborate with healthcare providers to improve the accuracy, specificity, and completeness of clinical documentation for outpatient encounters. Review medical records to ensure valid DRG assignment, risk adjustment, and compliance with regulatory guidelines.
Perform retrospective medical necessity reviews to determine appeal eligibility for clinical validation DRG downgrade denials. Construct fact-based clinical cases to support appeals using appropriate medical necessity criteria and clinical facts.
Provide professional fee coding services across various specialties using CPT, HCPCS, and ICD-10-CM guidelines. Ensure high accuracy and productivity levels while adhering to ethical coding standards and privacy regulations.
Provide professional fee surgical coding for various specialties including general surgery and trauma. Ensure accurate application of diagnosis and procedure codes while maintaining high productivity and quality standards.
Physician, Concurrent Inpatient Review (FT/30/Weekends/Remote) (Hospital Advocacy)
CorroHealth
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Full Time
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a month ago
CorroHealth
Perform concurrent clinical case reviews to establish appropriate admission status and provide recommendations for hospital clients. Interact with attending physicians to improve compliance and ensure appropriate payment for care delivered.
The role focuses on clinical documentation and DRG management to help clients exceed financial health goals. It involves utilizing automation and clinical expertise to optimize the reimbursement cycle.
Responsible for reviewing the accuracy of HCC and RxHCC coded records to ensure compliance with Medicare and ICD-10-CM guidelines. The role involves supporting findings for coder education and maintaining high quality and productivity scores.
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.
Responsible for completing patient registration and scheduling for hospital or physician services while verifying health plan coverage. Ensures accurate documentation of patient demographics and maintains compliance with federal and state regulations.
The Coding Specialist will provide professional fee coding services across multiple specialties including Family Medicine, Pediatrics, and Internal Medicine. Responsibilities include calculating E/M levels, managing claim edits and denials, and ensuring compliance with coding guidelines and ethical standards.
The role involves conducting research and development activities as an independent contractor. The individual will support Virtix Health in driving clinical, financial, and operational results through various health-related services.
Remote Physician (MD/DO), (IC to FTE) PMR, Orthopedics or Neurology, Outpatient Prior Authorizations (REMOTE/FT)
CorroHealth
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Full Time
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3 months ago
CorroHealth
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 Specialist, RN/BSN, CCDS (FT/REMOTE) (CDI experience req'd)
CorroHealth
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Full Time
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5 months ago
CorroHealth
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.
The Sr Executive - Clinical Documentation Review will be responsible for reviewing clinical documentation and ensuring compliance with Humana PI-RN DRG eligibility criteria. The role involves working closely with teams to support client program operations and enhance the revenue cycle process.
