CorroHealth

Medical Billing and Coding

• Provide various components of coding services to support our clients.
• Calculate ProFee and/or Facility E/M levels by using an algorithm created by our company
• Recognize critical care cases by patient acuity.
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Interpret coding guidelines for accurate code assignment
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• 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

Facility SDS Coder

• Provide CPT, HCPCS and ICD-10-CM coding Outpatient Facility Emergency Department charts.
• Provide various components of coding services to support our clients.
• Calculate ProFee and/or Facility E/M levels by using an algorithm created by our company.
• Recognize critical care cases by patient acuity.
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS.
• Interpret coding guidelines for accurate code assignment.
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• Comply with all internal policies and procedures.

Facility ED Coder

• Provide various components of coding services to support our clients
• Calculate ProFee and/or Facility E/M levels by using an algorithm created by our company
• Recognize critical care cases by patient acuity
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Interpret coding guidelines for accurate code assignment
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact
• Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct
• Comply with all internal policies and procedures
• Actively participate in Company provided training and education
• Ensure individual compliance with all privacy and security rules and regulations

OP Diagnostic Ancillary Coder

• Coding Specialists are an important part of the Team at CorroHealth
• The Coding Team Member will provide CPT, HCPCS and ICD-10-CM coding Outpatient Facility Same Day Surgeries
• Must be able to work from home and be independent in their coding skills
• Provide various components of coding services to support our clients
• Calculate ProFee and/or Facility E/M levels by using an algorithm created by our company
• Recognize critical care cases by patient acuity
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Interpret coding guidelines for accurate code assignment
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact
• 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
• Comply with all internal policies and procedures
• Actively participate in Company provided training and education

Facility SDS and Observations Coder

Director

• Ensure production and quality metrics are met for all clients, while ensuring positive staff morale and development
• Work closely with AVP to meet client expectations
• Partner with Managers & Supervisors to ensure that Team Member engagement, performance and development are top priority
• Partner with Managers & Supervisors to create and document best policies and guidelines for effective performance
• Partner with AVP on client engagement tasks, which include creating and presenting reporting packages
• Ensure production, quality and effective scores are accurately captured, tracked, and feedback is provided to Team Members in a clear and timely manner
• Oversee that team special projects are executed in a timely and effective manner to ensure quality for client health
• Guide and develop Supervisors in all aspects of Team Member performance management including developing effective action plans, addressing performance challenges in a positive and supportive manner
• Calibrate audit process to ensure quality check is maintained
• Communicate with management on team member performance/improvement opportunities
• Work closely with leadership to ensure best training practices are executed

Senior Director, Clinical Solutions

Business Analyst

• Analyzing, identifying, and owning operational initiatives and ensuring efforts are focused on business critical, business improvement, and financially beneficial activities
• Collecting all operational initiatives based on the input of leadership and determining the prioritization of initiatives
• Creating succinct business requirements for our reporting applications and analytic teams
• Creating ad-hoc financial and operational reports as-needed
• Providing executive-level status updates
• Performing requirements elicitation for analytics and reporting initiatives supporting RCM performance, client (internal & external) reporting, and operational decision-making
• Translating healthcare business needs into clear and well-structured functional and technical requirements, user stories, and acceptance criteria
• Hypothesizing and developing analytical approaches for identifying, analyzing, and interpreting trends or patterns in complex data sets
• Identifying and recommending opportunities for data modeling optimization
• Developing reports, dashboards and visualizations to help key stakeholders understand and manage business performance
• Curating report portfolio/presentations for RCM operations leaders and client stakeholders regarding findings and insights
• Ensuring data integrity, consistency, and accuracy across recurring and ad hoc reporting
• Proactively identifying gaps, risks, and dependencies related to data, workflows, or compliance
• Managing stakeholder expectations and delivering high-quality reporting and analytics within established timeframes

Business Analyst – HealthCare, RCM

Insurance

• Resolve 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.
• Review medical documentation such as UB04 claim forms, EOB’s and medical records to determine the appropriate course of action for claim resolution.
• Maintain familiarity with client preferences and known issues.
• Meet monthly production and quality expectations.
• Comply with HIPAA privacy laws.
• Other duties as assigned.

Insurance Specialist

• Coding Specialists aid in providing CPT, HCPCS, and ICD-10-CM coding.
• Cater to a minimum of 1-4 specialties such as UR, Podiatry, Plastics, Pediatrics, etc.
• Code professional fee specialties and facility types.
• Ensure compliance with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics.
• Actively participate in Company provided training and education.

Inpatient Coding Specialist

Manager

• Oversee (2) Supervisors and the quality assurance, documentation completeness, regulatory adherence across pre- and post- shipment workflows
• Develop and refine workflows to enhance turnaround time, quality assurance, and escalation management
• Oversee communications for the Appeals Pre- and Post- Shipment divisions
• Serve as the key liaison between Operations, Quality, and Leadership
• Partner with senior leadership to identify process improvement opportunities
• Analyze root causes of resubmissions, rework, and rejected/returned appeals

Manager, Appeal Shipment Teams

Medical Reviewer

• Provide clinical review support on a full-time basis to assist with an increase in inventory and client demand
• Review medical records for medical necessity, level of care, authorization compliance, and payer guideline alignment across inpatient and outpatient services
• Support timely appeal submissions and inventory management while maintaining quality and compliance standards

Clinical Review Specialist

• Provide CPT, HCPCS and ICD-10-CM coding across 1-4 specialties
• Recognize critical care cases by patient acuity
• Code surgical procedures typical of an ER setting
• Apply ICD-10-CM diagnosis codes with specificity
• Maintain compliance with coding standards and policies
• Participate in company training and education sessions
• Ensure confidentiality and compliance

Office Coding Specialist

• Coding Specialists are an important part of the Team at CorroHealth.
• The Coding Team Member will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties.
• Will be Coding Professional Fee surgeries.
• Professional Fee Specialties could include General Surgery, Trauma, and more complex surgeries.
• Team Member must be able to work from home and be independent in their coding skills.
• Provide various components of coding services to support our clients.
• Recognize critical care cases by patient acuity.
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Interpret coding guidelines for accurate code assignment
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• 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.
• Comply with all internal policies and procedures.

Surgical Coding Specialist

• Manage AR claim follow up
• Review and transmit claims using electronic and manual methods
• Review patient bills for accuracy and completeness
• Obtain missing information as needed
• Identify and bill secondary or tertiary insurances
• Correct Medicaid claims via appropriate portal or DDE
• Identify opportunities to streamline billing process

Dental Insurance Specialist

Solutions Engineer

• Provides strategic and operational leadership for the design, delivery, and ongoing support of healthcare data interoperability solutions.
• Leads a team of integration engineers, HL7/FHIR specialists, and implementation analysts in deploying interface and integration projects that connect clinical, financial, and administrative systems.
• Partners with clients, internal product teams, and vendors to ensure seamless data exchange, regulatory compliance, and high-quality implementation outcomes.
• Define strategic vision for interface/integration services aligned with organizational goals
• Manage budgets, resource allocation, and workforce planning
• Drive continuous improvement using metrics, client feedback, and industry trends
• Oversee end-to-end HL7/FHIR interface implementations (scoping through post-go-live)
• Ensure adherence to timelines, budgets, and client milestones
• Champion FHIR API adoption including SMART on FHIR, OAuth 2.0, and RESTful patterns
• Ensure compliance with ONC 21st Century Cures Act, CMS Interoperability Rule, and TEFCA Guide

Senior Director, Software Implementation Services

Auditor

• HCC Coding Quality Specialist Team Members will be responsible for reviewing the accuracy of HCC coded records.
• Auditors will support their findings utilizing Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements.
• Ensure that the codes captured are supported by the documentation within the record and are properly coded.
• Support your findings so the coder can easily identify and learn from the error.
• Assist with the creation of PowerPoints presentations for training purposes.
• Will be required to maintain a quality score of 95% or higher.
• Will be required to maintain an ongoing productivity level based on project requirements.