The Medical Reimbursement Specialist is responsible for resolving outstanding balances through research, follow-ups, and appeals with insurance carriers and patients. They must also maintain Medicare claims, monitor patient accounts for accuracy, and ensure compliance with current regulations.
CorroHealth
24 Remote Job Openings at CorroHealth
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.
Patient Services Rep 2 - Registration (Remote, Hawaii Time Zone)
CorroHealth
·
Full Time
·
7 days ago
CorroHealth
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.
Director, Pre-Bill DRG Review - Quality Assurance, Training & Education
CorroHealth
·
Full Time
·
10 days ago
CorroHealth
Leads the internal pre-bill DRG validation program to ensure coding accuracy and compliance prior to claim submission. Responsible for designing the quality assurance framework and managing the training and education infrastructure for coding and CDI staff.
Perform complex retrospective analysis of medical records to identify coding and billing errors while ensuring compliance with legal and procedural policies. Provide technical support and feedback training to internal coding staff to improve accuracy and productivity.
The Manager will drive adoption and outcomes for customers to ensure they achieve Risk Adjustment and Quality Improvement objectives. This includes managing strategic account plans, leading executive business reviews, and identifying opportunities for service expansion and renewals.
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.
Claim Review Specialist - Coding Certification Required
CorroHealth
·
Full Time
·
18 days ago
CorroHealth
The specialist will perform claim audits and recommend coding and billing changes for hospital outpatient and professional claims using proprietary software. They are also responsible for developing standardized reports, providing client education, and preparing written FAQ documentation.
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.
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.
Lead and scale a clinical team responsible for writing persuasive and compliant appeal letters to payers. Oversee quality assurance, operational efficiency, and alignment with financial goals while engaging with clients and hospital executives.
Insurance Specialist 2 - (Remote within Honolulu, HI)
CorroHealth
·
Full Time
·
21 days ago
CorroHealth
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.
Insurance Specialist 3 - Long Term Care Biller (REMOTE - HI)
CorroHealth
·
Full Time
·
a month ago
CorroHealth
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 Revenue Analyst investigates incorrectly paid medical insurance claims and pursues underpayments through correspondence with insurance companies. They analyze payer contracts, identify revenue risks, and mentor new team members while managing internal projects.
Product Owner, Hospital/Provider Revenue Cycle (Remote) (USC or GC req'd)
CorroHealth
·
Full Time
·
a month ago
CorroHealth
The Product Owner guides the development of the technology product suite and supports enterprise transformation initiatives. They translate product vision into actionable tasks, manage the product backlog, and coordinate between engineering and business stakeholders.
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.
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.
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 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 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
·
Full Time
·
5 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
·
Full Time
·
6 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.