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About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Company DescriptionVirtix Health partners with health plans across the country to drive clinical, financial, and operational results. Virtix Health offers virtual wellness visits, in-home health risk assessments, retrospective chart review, workflow technology and member/patient engagement service offerings for health plans of all sizes.&nbsp;&nbsp;The company supports health plans by creating elevated experiences for their members with the latest technology on an open, connected ecosystem, yielding insights that make a difference for customers and their members.&nbsp;Job DescriptionThe Quality Assurance (QA) Specialist for Product Management and Development is responsible for ensuring the quality and functionality of our products through the development and execution of test cases. This role will play a vital part in managing user acceptance testing (UAT), regression testing, and providing production support for product functionality inquiries. Additionally, the QA Specialist will be responsible for delivering application demos, developing standard operating procedures, and contributing to product documentation for both internal and external stakeholders.Role &amp; Responsibilities&nbsp;Test Case Development &amp; Execution:<ul><li>Develop and document comprehensive test cases based on product requirements and specifications.</li><li>Execute UAT and regression test cases across all products to ensure quality and identify any issues.</li><li>Identify, document, and track defects, collaborating with development teams to resolve issues promptly.</li></ul>Production Support &amp; Inquiries:<ul><li>Provide assistance for production support inquiries regarding product functionality, working closely with internal and external clients to resolve issues.</li><li>Serve as the point of contact for questions related to product functionality, ensuring effective communication and resolution of concerns.</li></ul>Application Demos &amp; Internal Training:<ul><li>Provide application demos to internal client partners, explaining new functionality and features.</li><li>Ensure internal teams are knowledgeable about product updates and changes.</li></ul>Documentation &amp; Standard Operating Procedures (SOPs):<ul><li>Develop and maintain standard operating procedures for new functionalities to support consistent implementation.</li><li>Contribute to the creation and maintenance of product user guides, ensuring they are up-to-date and reflect the current version of the product.</li></ul>Collaboration &amp; Continuous Improvement:<ul><li>Work closely with product management, development, and support teams to ensure the successful implementation of new features and functionalities.</li><li>Participate in continuous improvement initiatives to enhance the QA process and product quality.</li></ul>Qualifications:<ul><li>Experience:<ul><li>Minimum of 4+ years of experience documenting and executing test cases.</li><li>4+ years of experience in writing technical and business system documentation.</li><li>Experience in product management, product development, or software quality assurance is highly preferred.</li></ul></li><li>Technical Skills:<ul><li>Familiarity with UAT, regression testing, and test case management tools.</li><li>Strong experience with writing and maintaining documentation, including SOPs and user guides.</li></ul></li><li>Preferred but Not Required:<ul><li>1+ year of experience with automated test case creation and execution is a plus.</li></ul></li><li>Education:<ul><li>While an associate degree is welcome, it is not mandatory. We value hands-on experience and skills over formal education.</li></ul></li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CorroHealth

QA, Product Management

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:IP Coding Specialist are an important part of the Team at CorroHealth. The Coding Team Member will provide CPT, HCPCS and ICD-10-CM coding for 4 or more specialties for one or more clients, facility, or multiple facilities or clients. The IP Coding Specialist will be an Inpatient coder or could be asked to help out and coder other chart types.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Team Member must be able to work from home and be independent in their coding skills.<ul><li>Provide various components of coding services to support our clients.</li><li>Perform accurate analysis of medical records to obtain necessary information for the appropriate sequencing and assignment of ICD-10, CPT, and HCPCS codes.</li><li>Recognize critical care cases by patient acuity.</li><li>Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.</li><li>Apply ICD-10-CM diagnosis codes to the highest level of specificity available.</li><li>Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS.</li><li>Interpret coding guidelines for accurate code assignment.</li><li>Identify the importance of documentation on code assignment and the subsequent reimbursement impact.</li><li>Must maintain quality and productivity standards.</li><li>Communicate with clients in a professional manner that fosters an excellent working relationship to support the company and its business interests</li><li>May assist Leadership, or Lead Coding Specialist, with reports as needed</li><li>Potential opportunity to begin helping with auditing.</li><li>Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program.</li><li>Comply with all internal policies and procedures.</li><li>All Coders must maintain at least one credential either through AAPC or AHIMA.</li><li>Actively participate in Company provided training and education.</li><li>Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.</li></ul>MINIMUM QUALIFICATIONS &amp; REQUIREMENTS:<ul><li>All coders MUST be certified through either the AAPC (CPC or COC) or AHIMA (CCS or CCS-P)</li><li>Preferred Certification is CCS</li><li>Must have a minimum of 2 years of experience.</li><li>Must have advanced working knowledge and experience with systems such as EMR, Billing, etc</li><li>Must be proficient in Microsoft programs like Excel and Outlook. Examples include:</li><li>Excel you should be able to open and add to a spreadsheet, perform basic formulas like adding or multiplying, and create a basic pivot table.</li><li>Outlooks you should be able to manage emails and schedule and attend meetings.</li><li>Must have current coding materials such as CPT and ICD-10-CM coding references.</li><li>Regular, predictable, and punctual attendance is required.</li><li>Will be required to maintain an ongoing productivity level and accuracy rate of 95% or higher.</li><li>Will be required to maintain an ongoing quality score of 95% or higher.</li><li>Ability to communicate effectively and professionally both verbally and written.</li><li>Ability to coordinate, analyze, observe, make decisions, and meet deadlines.</li><li>May be required to perform other duties as assigned by Leadership Team Member.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Inpatient Coding Specialist

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Location: Remote within US ONLYRequired Schedule: Monday - Friday, 8:00 AM EST - 5:00 PM ESTJob Summary<ul><li>Perform denial research and follow-up work with insurance companies via phone to resolve appeals that have been submitted but remain without a determination</li><li>Compile multiple documents into appeal bundles and submit appeal bundles to payers in a timely manner</li><li>Determine and document appeal timeframes and payer process per facility within CorroHealth proprietary system</li><li>Transcribe information from clients’ EMRs and payer portals into required electronic format; check completed work for accuracy</li><li>Monitor and complete tasks within shared inboxes and internal request dashboards</li><li>Receive and document incoming emails, calls, tickets, or voicemails</li><li>Follow up with the client or internal staff via email or phone for additional information as requested</li><li>Export and upload documents within CorroHealth proprietary system</li><li>Cross-trained on various functions within the department to support other teams as needed</li><li>Other responsibilities as requested by management</li></ul>Minimum Qualifications: <ul><li>Must love communicating with others over the phone</li><li>Computer proficient. Must have intermediate skills with Outlook and Excel.</li><li>Must be able to schedule meetings, log onto Teams for meetings.</li><li>Must be able to open a new excel workbook, use formulas such as; adding and subtracting, copying and pasting.</li><li>Must be able to type a minimum of 25wpm</li><li>Detail oriented</li><li>Shows initiative and responsibility in taking the necessary steps towards problem resolution</li><li>Works independently, but is a team player</li><li>Able to work in a fast-paced environment</li><li>Possess good verbal and written communication skills</li><li>Required to keep all client and sensitive information confidential</li><li>Strict adherence to HIPAA/HITECH compliance</li></ul>Education/Experience Required:<ul><li>High School Diploma or equivalent required</li><li>Bachelor’s degree preferred</li><li>Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines</li><li>Prior experience of accessing hospital EMR’s and Payer Portals preferred</li><li>Proficient in MS Word and Excel. Needs to be able to open a new excel workbook, copy and paste, do basic formulas such as adding, subtracting and copying and pasting.</li><li>Must have basic skils in Outlook. Should be able to create a meeting invitation, accept a meeting invitation, receive and respond ot email and set up folders.</li><li>Must be able to type a minimum of 25 wpm with a 90% accuracy rate.</li></ul>What we offer:<ul><li>Hourly Payrate: $18.27</li><li>Equipment provided</li><li>Medical/Dental/Vision Insurance</li><li>401k program</li><li>PTO: 80 hours accrued, annually</li><li>9 paid annual holidays</li><li>Tuition reimbursement</li><li>Professional growth and more!</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Coordinator, Appeals Management

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs. We are currently seeking full-time Jr. Denial Coordinators for our office location in Iselin, NJ. The Jr. Denial Coordinator role is an excellent way to start your career at a growing company in a fast-paced industry. Learn the ins and outs of healthcare Revenue Cycle Services, with a specialty in Denials Management.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Responsibilities include, but are not limited:<ul><li>Scanning, faxing and filing highly confidential documents</li><li>Downloading and printing medical records</li><li>Generating appeal letter templates</li><li>Packaging certified mail</li><li>Logging events on accounts in workflow system</li><li>Adding notes to accounts in hospital patient accounting systems</li></ul>Minimum Qualification<ul><li>Four-year degree preferred, or equivalent years of work experience.</li><li>Healthcare experience a plus.</li><li>Strong multi-tasking skills.</li><li>MUST possess strong computer skills.</li><li>Proficiency with MS Office.</li><li>Excellent oral and written communication skills.&nbsp;</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Jr Coordinator, Denials Management

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Denial Specialist - Meditech Magic and Denial follow up expertise. Will analyze and follow up on denials in Meditech Magic. Communicate to leadership trends that are found, and potential fixes that could be put in place.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.<ul><li>Resolve complex, higher-dollar unpaid/denied claims by leveraging proprietary software system, making phone calls, generating letters, accessing client systems and insurance carrier web portals in the pursuit of getting a claim resolved.</li><li>Identify and report trends found during the account resolution process such as CPT/HCPCS errors/deletions, duplicate claims, revenue code mapping mismatches, missing charges, no claim on file.</li><li>Perform financial account assessment functions including but not limited to adjustments and NRP to patient. Work within client systems to complete rebill functions.</li><li>Perform administrative functions including but not limited to medical record submissions, billing claims, patient assistance outreach, obtaining documents from client systems and insurance plan code updates, review corrected claim requests and approve for client assistance or correct the bill within client platform, review and submit payment verification assistance requests.</li><li>Maintain familiarity with client preferences and known issues across multiple client accounts.</li><li>Support special projects for clients as needed.</li><li>Other duties as assigned.</li></ul>QUALIFICATIONS<ul><li>High School Diploma or equivalent </li><li>5+ years relevant industry experience in registration, billing, collections, required</li><li>3+ years experience with insurance carrier claims resolution, required</li><li>3+years of Epic, Cerner, Meditech or other EMR experience preferred</li><li>Knowledge of UB04 claim forms, EOB’s and medical records required</li><li>ICD-9, ICD-10, CPT and HCPCS coding knowledge required</li><li>Ability to conduct detailed research to resolve complex claims</li><li>Intermediate mathematics skills (addition, subtraction, ability to identify trends, etc.)</li><li>Advanced knowledge of Excel and Power Point</li><li>Ability to compile and summarize data</li><li>Strong verbal and written communication skills</li><li>Ability to analyze and interpret complex documents, contracts, notes, and other correspondence</li><li>Ability to prioritize and multitask in a fast-paced environment</li><li>Ability to work effectively in a remote environment</li><li>Investigative mind set to identify issues and implement solutions.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Denials Specialist

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Healthcare Auditors develop contract models for analysis and identify potential insurance reimbursement issues through extensive reviews of hospital claim data and related documents. Auditors also contribute to our knowledge base by conducting research on reimbursement risk areas, reviewing data and processes for quality control, and providing feedback for areas of improvement.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.<ul><li>Create and update audit plans, including outlining potential risk areas of a hospital-payer contract based on reimbursement structure and how to manually identify within the data.</li><li>Model and create/update pricing documents based on hospital contracts to calculate expected payments, including percentage of charge, per diems, MSDRG, outlier and/or stoploss, implants, drugs, Medicare, Medicaid, some outpatient, and other reimbursement models.</li><li>Review insurance payments, research applicable sources (contracts, state and federal legislation, insurance payer policies, medical records, etc.) to determine if payment is correct and make recommendations on appropriate next steps.</li><li>Identify contractual and clinical risk areas from commercial and government payors (e.g., Medicare, Medicaid) as well as other specialized audits (such as coordination of benefits and workers’ compensation).</li><li>Develop specifications and procedures to identify and troubleshoot contractual, coding, and administrative areas of underpayment risk using Access, SQL, Excel, and other programs.</li><li>Conduct review of zero-balance hospital accounts to identify underpaid inpatient and outpatient claims.</li><li>Present clear documentation of process, findings, and results of audits.</li><li>Make recommendations to improve internal processes and external client contracts/processes.</li><li>Work with data analyst team to build and validate pricing models.</li><li>Work across project teams to research and outline next steps on identified underpayment trends.</li><li>Other duties as assigned.</li></ul>MINIMUM QUALIFICATIONS &amp; REQUIREMENTS:<ul><li>High School Diploma or equivalent required</li><li>Minimum of 3 years of experience working with large sets of (healthcare) data</li><li>Minimum of 2 years of experience in areas of research and analysis</li><li>Minimum of 2 years of experience with managed care contracts (government and commercial) and hospital reimbursement</li><li>Minimum of 2 years of experience working with inpatient claims</li><li>Minimum of 1 year of experience working with Medicare, Medicaid, outpatient facility claims</li><li>Minimum of 1 year of experience with contract modeling</li><li>Ability to translate complex contract language and healthcare data into actionable information and insights</li><li>Ability to work independently to solve problems and recommend technical solutions (ex. provide calculation/formula to price in Alteryx)</li><li>Intermediate Excel skills, including knowledge of complex formulas and functions (CONCATENATE, IF, pivot tables)</li><li>Basic knowledge of Access (link tables, select/update query, manipulate data in tables) and SQL preferred</li><li>Strong verbal and written communication skills</li><li>Strong organization skills and attention to detail</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Auditor 2, Zero Balance

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Essential Duties and Responsibilities<ul><li>Conduct clinical documentation tasks, meeting productivity and quality standards as set for each project.&nbsp;</li><li>Adhere to all coding and clinical documentation improvement guidelines as endorsed by AHIMA and ACDIS.&nbsp;</li><li>Perform review on clinical documentation and issue queries when appropriate.</li><li>Review medical records for completeness and accuracy for severity of illness and risk of mortality.&nbsp;</li><li>Accurate and timely record review.&nbsp;</li><li>Demonstrate knowledge of DRG payer issues, documentation opportunities, and clinical documentation requirements.&nbsp;</li><li>Analyze findings and identify potential root causes of produced errors.&nbsp;</li><li>Ability to run/analyze reports for reporting purposes is a plus</li></ul>Knowledge, Skills &amp; Abilities: Qualifications Desired Minimum Qualifications:<ul><li>Experience with telecommuting, working with EMRs and other electronic tools.&nbsp;</li><li>Strong analytical skills.&nbsp;</li><li>Strong Microsoft Office skills.&nbsp;</li><li>Works well with numbers.&nbsp;</li><li>Strong team player.&nbsp;</li><li>Ability to work with multiple and diverse clients and projects.&nbsp;</li><li>Ability to work with minimal supervision.&nbsp;</li><li>Ability to maintain and access multiple files.&nbsp;</li><li>Assure that work product is completed with high levels of accuracy and attention to detail.&nbsp;</li></ul> Education &amp; Experience:<ul><li>CCDS, CDEI, or CDIP certification required.</li><li>Current clinical license (RN, NP, PA, MD).&nbsp;</li><li>Two years CDI experience.</li><li>Two years or more clinical experience in an acute care setting preferred.</li><li>Coding professional with CCS or RHIT/RHIA and CDI credential. Minimum three years CDI experience in IP CDI reviews required.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CDI Specialist

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Serves in a consulting role by evaluating the work of client’s coders in their assignment of ICD-10, CPT and/or HCPCS codes to hospital inpatient, outpatient and/or physician practice encounters.&nbsp; Performs concurrent or retrospective reviews to inventory code assignments and report the data to the client.&nbsp; Develops and delivers educational content to clients related to audit findings.ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.Essential Functions: Perform complex, concurrent and/or retrospective analysis of medical record documentation to Validate coded data as recognized by the AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, and CPT Assistant. Analyze findings and identify potential root causes of produced errors. Prepare summary reports of findings to clients, supplying specific references supporting findings contained within the provided audit report. Provides second-level review of processes to ensure compliance with legal and procedural policies and to ensure appropriate code assignments. Research, analyze, and respond to inquiries regarding compliance, coding, and denials. In all situations, protect the privacy and confidentiality of patient health and client information, and follow the Standards of Ethical Coding as set forth by AHIMA and adhere to official coding guidelines and compliance practices, standards, and procedures. Functions as a member of the Consulting Services Team which develop and provide coding education to clients. Conduct Audits as assigned meeting the productivity standards as set by record type for each audit. The threshold for billable productive hours, when client work is available, is expected to be at or above 80%. Prepare deliverables for the client as required for the audit scope while meeting timelines. Conduct independent QA of their assigned audit results prior to final submission for QA review and approval. The minimum accuracy expectation is 95%. Report work time and work products in a timely and accurate manner. Communicates with coworkers in an open and respectful manner that promotes teamwork and knowledge sharing. Interact with clients in a professional manner that, always, exhibits excellent relationships, work performance and communication skill so as to support the company and its business interests. Provide schedule of planned work activities, events and sites, and any changes to same, to Management and appropriate staff. Maintenance of professional credentials and knowledge of coding, reimbursement, and compliance issues through continuing education. Periodic travel, as applicable. Other duties and responsibilities, as assigned.Knowledge, Skills &amp; Abilities:&nbsp; Recognized credential from AHIMA or AAPC. Experience with telecommuting and electronic medical record systems required. Strong analytical skills. Proficient computer skills, specifically Microsoft Office products. Strong team player. Ability to work with multiple and diverse clients and projects. Ability to work with minimal supervision. Ability to maintain and access multiple files. Assure that work product is completed with high levels of accuracy and attention to detail. 5+ years’ experience coding and/or auditing in an acute care facility or clinic, of patient types listed in the Job Summary of this document, or other relevant experience.PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Auditing & Education Consultant

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:JOB SUMMARY: The Patient Business Services Rep II-Access Registration is responsible for tasks relating to the completion of patient registration for hospital and/or physician services. The Patient Business Services Rep-Access Registration will be required to have flexibility to learning and comprehending complex hospital systems in order to communicate directly with patients, healthcare providers, physician offices and ensuring the information collection is complete and accurate. The Patient Business Services Rep-Access Registration will be responsible that their patient, payer and provider interactions are carried out according to company, client and federal guidelines. The Patient Business Services Rep-Access Registration will be required to work schedules that accommodate a 24/7 work schedule and be able to independently make compliant decisions on how to apply HIPAA and FCC regulations. *this position is REMOTE - candidates must reside in Hawaii to be considered*ESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.ESSENTIAL JOB FUNCTIONS:Access Registration Tasks&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; <ul><li>Exceed productivity standards as outlined by business line</li><li>Complete patient registration (post clinical triage of patient) by obtain and verify health plan coverage</li><li>Accurately document patient demographics and health plan information</li><li>Support access registration, insurance verification and authorization functions</li><li>Contact physician offices and/or payers for follow-up on eligibility and authorizations and</li><li>Maintain quality scoring and accuracy on all accounts worked</li><li>Ability to work independently and make responsible decisions</li><li>Completes timely follow-up on assigned accounts to ensure no cash loss</li><li>Demonstrates the ability to prioritize work with minimal oversight to meet outlined goals</li><li>Acts as a knowledge resource for team members</li><li>High level understanding of client host system functions</li><li>Clearly documents actions taken and next steps for account resolution in patient accounting system</li></ul>Ensure all accounts are worked within client standards and Federal Regulations.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<ul><li>Work within federal, state regulations, department/division &amp; all Compliance Policies&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li><li>Maintain clear, concise, and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications&nbsp;&nbsp;</li></ul>Maintain continuing education, training in industry career development&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<ul><li>Maintain current knowledge of and comply with all federal and state rules and regulations governing phone calls and collections including HIPAA, FDCPA, Privacy Act, FCRA, etc.</li><li>Attend training sessions as directed by management and disseminate to colleagues</li><li>Integrate information obtained through training sessions and policy changes immediately into daily routine</li></ul>EDUCATION: High SchoolEXPERIENCE: <ul><li>Minimum of 1 year of Access Registration or front office physician healthcare experience</li><li>Minimum of 3 year in hospital or physician operation</li><li>Minimum of 1 year of basic computer skills to include MS Office apps: Outlook, Word, Excel</li></ul>OTHER HELPFUL EDUCATION OR EXPERIENCE-State other desired, but not required, education or experience.<ul><li>Epic hospital system experience</li><li>Demonstrate knowledge of communication regulations relating to HIPAA and TCPA and other FCC requirements</li><li>Experience with Insurance payers (Medicare, Medicaid, Commercial, Workers Compensation) preferred</li><li>Remote working experience</li></ul>KNOWLEDGE, SKILLS and ABILITIES - Describe specific minimum knowledge, skills, and abilities required for this position.&nbsp; Also, list any special courses, certifications, or physical requirements that are necessary.&nbsp; This is especially critical for screening candidates.<ul><li>Exceptional customer service skills.</li><li>Excellent verbal and written communication skills.</li><li>Dedication to treating both internal and external constituents as clients and customers, maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality.</li><li>Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.</li><li>Ability to follow regulations outlined by state, federal, and third-party coverage procedures.&nbsp;</li><li>Ability to model the basic values of the mission, vision and values of Xtend Healthcare and the client.</li><li>Ability to manage multiple tasks simultaneously and adjust to issues as needed in a dynamic work environment.</li><li>Ability to prioritize and effectively anticipate and respond to issues as they arise.</li><li>Ability to post transactions in multiple systems.</li><li>Good analytical and problem-solving skills.</li><li>Ability to work independently.</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Patient Business Service Rep II - Registration

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:The Denials Analyst is responsible for managing the denials reporting process, identifying and tracking trends in denials, and collaborating with internal and client leadership to resolve underlying issues. This role plays a key part in identifying process gaps and developing workflows, policies, and reporting tools to reduce future denials, optimize revenue cycle processes, and accelerate cash flow. MUST HAVE: Denial reporting, claims rejection experience IL Medicaid knowledge strongly preferred Hospital Billing experience strongly preferred SQL experience preferred HYBRID - Chicago, ILESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.<ul><li>Oversee and manage the daily, weekly, and monthly denials reporting.</li><li>Analyze and identify trends in denials across various clients and service lines.</li><li>Work closely with internal teams and client leadership to investigate root causes of denials.</li><li>Collaborate with key stakeholders to identify process gaps contributing to denials and work on corrective action plans.</li><li>Develop and implement workflows, policies, and best practices to prevent denials.</li><li>Create effective reporting tools to provide ongoing monitoring of denials and track resolution progress.</li><li>Partner with revenue cycle management and finance teams to optimize cash collections and reduce denials.</li><li>Present analysis and findings to leadership teams and offer recommendations for process improvements.</li><li>Stay up to date with industry best practices related to denials management and compliance.</li></ul>Qualifications and Requirements:<ul><li>Bachelor’s degree</li><li>Proven experience in denials management, revenue cycle, or healthcare finance.</li><li>Strong analytical skills with the ability to identify trends and draw actionable insights.</li><li>Excellent communication and collaboration skills for partnering with cross-functional teams and clients.</li><li>Proficiency in reporting tools and software (e.g., Excel, SQL, or other reporting platforms).</li><li>Knowledge of healthcare billing and coding practices and regulations.</li><li>Ability to multitask and manage time effectively in a fast-paced environment.</li></ul>Preferred Skills:<ul><li>Experience in healthcare claims or revenue cycle management.</li><li>Familiarity with denial codes, payer policies, and billing systems.</li><li>Problem-solving skills and a proactive approach to identifying and mitigating risks.</li><li>Experience using Epic</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

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