The HIM Manager oversees the Health Information Management team, ensuring quality standards, productivity, and effective workflows for medical record requests. This role also fosters collaboration between payers and providers while maintaining strict compliance with HIPAA privacy and security regulations.
The Senior Performance Analyst will collaborate with internal and external partners to improve data quality, streamline concept development, and optimize workflows. They are responsible for interpreting complex healthcare data to provide actionable insights and recommendations to leadership and IT departments.
The Nurse Coder DRG Auditor III independently audits inpatient and outpatient claims by applying coding and clinical guidelines to validate diagnoses and procedures. They also perform quality checks for team members, provide appeal responses, and support management with strategic enterprise-level recommendations.
The Manager of Payer Clinical Services oversees hospital bill audits to ensure accuracy, compliance, and revenue performance while fostering client relationships. They are responsible for mentoring staff, developing training programs, and reporting clinical trends to improve operational efficiency.
The Nurse Coding Auditor validates the accuracy of CPT, HCPCS, and revenue codes on inpatient and outpatient facility claims. They perform hospital bill audits and itemized bill reviews to ensure services are appropriately documented and billed according to CMS guidelines.
