CorroHealth · 9 hours ago
Coding Claim Review Specialist (IP/OP)
United States
Full-time
Onsite
Senior Level
5+ years expCorroHealth is dedicated to helping clients achieve their financial health goals through scalable solutions and clinical expertise. The Coding Claim Review Specialist will assist in preparing claim audits, review and recommend coding changes, and support the revenue cycle consulting team using proprietary software.
AnalyticsFinanceFinancial ServicesFinTechHealth Care
Responsibilities
Become proficient in the use of the PARA Data Editor, our proprietary software
Select and review claims for review based on trends/data analysis in the PARA Data Editor; organize information and access to medical documentation
Audit all aspects of claim including (but not limited to):
Omitted or incorrect charges
Review OPPS and CAH charges and apply guidelines
CMS/Payer specific guidelines
Coding accuracy for ICD-10 CM, PCS (if applicable), CPT/HCPCS (including but not limited to 10000-69999, 80000, 90000, J codes, G codes, Q codes, etc)
Departmental review for inaccuracies, omitted data/documentation and charges
NCCI edits, MUE edits, Medi-cal and Medicare guidelines/CMS Manual guidance
Units of services
E/M Profee/Facility
Units of services
Documentation improvement
Assist in preparing written documents for publication under the direction of the Director, HIM, i.e., Q&A entries
Develop a working understanding of the outpatient hospital reimbursement process, including documentation, coding, and billing
Participate in presentations to clients and prospective clients, typically over web meetings
Develop and maintain the skills and knowledge necessary related to the assigned specialty areas and the related services. Keep current on all related information from journals and bulletins. Distribute and pass on all necessary materials, including copying for reference files when relevant
Maintain current certifications and accreditations (as applicable)
Research new guidelines, data elements, payer specifications, etc
Other duties may be assigned as necessary
Qualification
Required
AHIMA CCS, COC or AAPC CPC certification required
5+ years of directly related experience
Expert knowledge in revenue cycle and Outpatient coding (ER, SDS, OBS, ancillary, IR, Profee, E/M facility, I&I)
Medical Terminology and anatomy knowledge is required
Must have strong understanding of revenue cycle, CMS Manual/guidelines, Medicaid guidelines
Strong Microsoft Excel, PowerPoint, Word and OneNote skills
Must have strong understanding of the Official Coding Guidelines, OP coding and billing (i.e. including but not limited to knowledge of rev codes, HCPCS, MUE and CCI edits, UoS)
Strong analytical capability, independent thinker and good decision-making skills
Excellent written and verbal communication and presentation skills
Strong computer and technology knowledge and skills
Highly professional demeanor, great client satisfaction skills
Preferred
Clinical Documentation and Inpatient coding experience is preferred. New hires will be expected to learn IP during employment
Company
CorroHealth
CorroHealth is a provider of revenue cycle management solutions for healthcare organizations, including health systems, and health plans.
10001+ employees
H1B Sponsorship
CorroHealth has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (1)
2022 (1)
Funding
Current Stage
Late StageTotal Funding
$376.27MKey Investors
Patient Square Capital
2024-10-24Private Equity
2023-10-05Private Equity· $50M
2022-05-17Series Unknown· $16.6M
Leadership Team
Patrick Leonard
Chief Executive Officer
Becky Blake
Chief People Officer
Recent News
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