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.
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.
JOB SUMMARY:
Support the Director of Health Information Management (HIM) by conducting comprehensive claim audits and reviewing hospital outpatient and professional fee (ProFee) claims for coding accuracy, revenue integrity, and billing compliance. Utilizing proprietary software, this role evaluates coding opportunities, identifies revenue cycle improvement recommendations, and assists clients in optimizing claim quality and reimbursement outcomes.The ideal candidate is an experienced outpatient facility coding professional with strong analytical skills, extensive knowledge of revenue cycle operations, and the ability to communicate complex coding concepts clearly to both clients and internal team members.
This is a remote position
ESSENTIAL DUTIES AND RESPONSIBILITIES:
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.
Key Responsibilities
- Perform detailed audits of hospital outpatient and ProFee claims to identify coding, billing, charging, and revenue cycle improvement opportunities.
- Review and recommend coding, charge capture, revenue integrity, and claim optimization strategies.
- Utilize proprietary software to analyze audit findings and develop standardized client reports.
- Present audit results and recommendations to clients in a clear, professional manner.
- Respond to coding and compliance-related inquiries with concise, grammatically correct written and verbal communication.
- Collaborate with revenue cycle consultants, coding professionals, and client stakeholders to support project goals.
- Develop educational materials, FAQs, and client-facing guidance on coding and billing best practices.
- Assist with special projects and other duties as assigned.
Qualifications
Required
- AHIMA or AAPC coding certification required (CPC-A not accepted).
- Minimum 5 years of hospital outpatient facility coding experience.
- Advanced knowledge of:
- Emergency Department (ED)
- Same Day Surgery (SDS)
- Observation (OBS)
- Injection & Infusion (I&I)
- Facility Evaluation & Management (E/M)
- Ancillary outpatient services
- Strong understanding of revenue cycle processes, billing principles, and coding compliance.
- Excellent written and verbal communication skills.
- Proficiency interpreting audit findings and presenting recommendations to clients.
Preferred
- Inpatient facility coding experience.
- Critical Access Hospital (CAH) coding experience.
- Revenue integrity, compliance, or coding audit experience.
- Experience presenting findings to healthcare clients and leadership teams.
We Offer:
Quality of life with a remote predictable, full-time schedule
Competitive Salary commensurate to experience
Medical, Dental, Vision coverage and more
Long-term disability insurance, and life insurance
Ample parental leave
401K with company match
Certification and Tuition Reimbursement
Holidays, Flexible Time Off
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.