Outpatient Coding Auditor
Perform coding audits on various facility outpatient record types to ensure accuracy and quality. Identify coding trends and formulate final reports with recommendations and corrective action plans.
Perform coding audits on various facility outpatient record types to ensure accuracy and quality. Identify coding trends and formulate final reports with recommendations and corrective action plans.
The Inpatient Coding Specialist will perform accurate inpatient coding in an acute care setting while meeting client productivity and quality targets. The role requires maintaining a committed regular schedule and utilizing various office software for communication and data management.
The specialist performs prospective medical record reviews to validate chronic conditions and ensure documentation accuracy, clinical integrity, and HCC capture. They also monitor and report on CDI outcomes and documentation trends to support program goals and regulatory compliance.
Review and evaluate medical record documentation to ensure completeness, accuracy, and regulatory compliance. Collaborate with healthcare providers to identify documentation improvement opportunities that support coding accuracy and clinical outcomes.
The manager will implement organizational education, training, and quality management initiatives while overseeing the QM team's auditing and mentoring activities. They will also collaborate with leadership to design training programs and partner with sales teams for business development opportunities.
The Nurse Auditor performs comprehensive charge audits and billing validation to ensure accuracy, compliance, and revenue integrity. They collaborate with clinical and billing teams to identify discrepancies and provide actionable insights to prevent recurring audit issues.
Perform comprehensive coding audits and reviews across various professional fee specialties and record types. Assist in the design of educational seminars and contribute to senior-level projects including assessment, analysis, and tool development.
The Resource Optimization Specialist will manage capacity forecasting, real-time resource utilization, and staffing alignment across client engagements. They will also monitor productivity KPIs and collaborate with internal teams to identify staffing risks and improve resource deployment.
Review and evaluate medical record documentation for completeness, accuracy, and compliance with regulatory requirements. Collaborate with physicians and coding professionals to identify documentation improvement opportunities that support quality care and reimbursement.
The specialist performs prospective medical record reviews to validate chronic conditions and ensure coding accuracy and HCC capture. They also monitor documentation trends and report outcomes to support program goals and regulatory compliance.
The Denials Specialist reviews provider documentation to ensure accurate coding and resolves claim denials related to billing and payer policy compliance. They identify coding errors and trends to recover revenue and prevent future denials.
Responsible for reviewing complex payer denials and crafting evidence-based appeal letters to maximize reimbursement recovery. The role involves analyzing medical records, identifying payer weaknesses, and collaborating with clinical teams to overturn denials.
Perform accurate code assignments for facility outpatient, same day surgery, and observation records. Maintain a coding quality rate of 95% or greater while meeting client productivity targets.
The role involves performing inpatient medical coding for diagnosis and procedure codes in an acute care setting. The specialist must meet client productivity targets while maintaining a coding quality accuracy of 95% or greater.
Perform accurate code assignments for Emergency Department facility and professional fee records. Maintain a coding quality rate of 95% or greater while meeting client productivity targets.
The CDI Auditor performs high-level secondary case reviews to ensure clinical documentation is accurate, complete, and compliant with regulatory standards. They identify documentation gaps and provide education to staff to improve coding accuracy and reimbursement integrity.
Perform inpatient coding audits and reviews for client sites remotely to identify trends and formulate corrective action plans. Provide educational seminars and in-service training to clients and staff based on audit findings.
Perform accurate code assignments for inpatient and outpatient professional fee records across various specialties. Maintain a coding quality rate of 95% or greater while meeting client productivity targets.
Perform professional billing and CPT coding for surgical cases in both inpatient and outpatient settings. Maintain a coding quality rate of 95% or greater while meeting client productivity targets.