The Clinical Documentation Specialist performs concurrent and retrospective reviews of medical records to ensure accurate clinical documentation and severity of illness representation. They collaborate with physicians, nursing staff, and coders to identify documentation improvement opportunities and manage compliant physician queries.
The coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for hospital outpatient services based on clinical documentation. They must also resolve coding edits, charge discrepancies, and claim issues to support efficient revenue cycle operations.
The Director of Customer Success will serve as the primary point of contact for a strategic healthcare client, managing relationships and ensuring alignment between client expectations and operational delivery. They will oversee medical coding quality, productivity, and compliance while driving continuous improvement and identifying opportunities for account growth.
The Pharmacy Intake Specialist manages the end-to-end prescription referral process, including data entry, insurance verification, and coordination with healthcare providers. They serve as a primary liaison to ensure accurate documentation and timely fulfillment of patient prescriptions while maintaining strict HIPAA compliance.
Perform professional fee Internal Medicine coding for hospital visits while ensuring accurate assignment of CPT, modifiers, and ICD-10 codes. Maintain productivity and quality standards while working directly within the client's EMR system.
The Billing Specialist is responsible for the accurate preparation, review, and submission of medical and pharmacy claims across various infusion and specialty pharmacy services. They must monitor claim transmission, resolve rejections, and collaborate with internal teams to ensure successful reimbursement outcomes.
Coders will review member and claim data to validate diagnoses, provider signatures, and service details. They are responsible for confirming existing diagnoses and adding valid, unreported risk-adjusting diagnoses.
The Director of Customer Success will lead strategic partnerships with healthcare organizations and serve as the executive bridge between client objectives and operational excellence. This role involves monitoring KPIs, driving account growth, and translating complex revenue cycle performance data into actionable business insights.
The role involves performing comprehensive inpatient coding audits to ensure regulatory compliance and quality standards. Additionally, the lead will manage daily audit operations, mentor staff, and prepare performance metrics for leadership.
Review outpatient same day surgery medical records to assign accurate ICD-10-CM, CPT, and HCPCS codes for billing. Ensure compliance with NCCI edits and payer guidelines while reconciling charges for complete capture.
Perform comprehensive audits of medical records to ensure accurate coding and compliance with regulatory requirements. Collaborate with teams to resolve discrepancies and provide education to staff based on audit findings.
The Inpatient Auditor conducts prebill audits for facility coders to ensure accuracy, compliance with CMS regulations, and adherence to official coding guidelines. They also provide targeted education and feedback to the coding team to support continuous quality improvement.
Perform professional fee coding for internal medicine outpatient and clinic encounters. Ensure accurate assignment of CPT, modifiers, and ICD-10 codes while meeting productivity and quality standards.
