Greenlife Healthcare Staffing

Medical Billing and Coding

• Review clinical documentation for accuracy and completeness
• Support coders by providing clinical insight and clarification
• Assist with audit reviews and quality improvement
• Query providers for missing or unclear clinical details
• Stay updated on coding and clinical documentation regulations

Claims Specialist – Registered Nurse, Coding Specialist

Medical writer

• Perform detailed retrospective and prospective coding audits
• Prepare audit findings and summary reports
• Identify compliance risks and recommend corrective actions
• Provide education to coders and clinical staff

Claims Specialist – Medical Auditor, Clinical Documentation & Coding Compliance

Claims Specialist

• Review claims for accuracy and compliance.
• Assist with appeals and disputes.
• Interpret payer policies and communicate updates.
• Identify reimbursement trends and risks.
• Support the revenue cycle and compliance team.

Claims Specialist – Healthcare Insurance Professional

Administrative Assistant

• Oversee daily administrative operations
• Supervise billing and coding staff
• Ensure accurate claims submission and follow-up
• Implement office policies and productivity standards
• Monitor compliance with federal and payer requirements
• Manage staff schedules, reporting, and performance

Claims Specialist – Medical Office Manager, Billing & Coding

• Review documentation for completeness
• Support coding team with clinical clarification
• Assist in audits and quality improvement
• Follow up with providers for needed information

Claims Specialist – Licensed Practical Nurse

• Act as point-of-contact for appeal/dispute adjudication programs.
• Liaise with healthcare plans, providers, patients, and clients to coordinate requests, correspondence, and submission of case documentation, as necessary.
• Monitor appeal/dispute status and communication received on client portals.
• Conduct initial eligibility reviews and recommend a course of action to internal team and department management.
• Track and assign cases using commercial off-the-shelf and custom software applications.
• Review and provide case documentation to assigned billers/coders, nurses, physicians and clinicians internal teams, and key stakeholders to facilitate clinical and coding reviews.
• Monitor and measure key performance indicators, including, but not limited to, timeliness, adherence to quality and accuracy standards, and deadlines for contract deliverables.
• Identify barriers and roadblocks in work processes, recommend solutions to solve problems, and execute approved solutions.
• Routinely present case/project status in huddles and scrums while using an agile, iterative approach to implementation and data presentation.
• Schedule regular team status meetings and record decisions (e.g., assigned tasks and next steps).
• Prepare billing invoices at the conclusion of cases, submit them to the Finance department, and liaise with accounting to track and trend payments.
• Mentor and train new staff, at all levels, on process steps and case progression.
• Other activities as may be deemed necessary

Claims Specialist – Contract

Medical Reviewer

• Conduct utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and making level one denial decisions when necessary.
• Conduct quality and clinical study data collection reviews.
• Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures.
• Participate in collaborative training specific to clinical study objectives.
• You will be using InterQual criteria to review the medical records of inpatient high cost hospital stays for admission and acute level of care.
• You'll also review and validate itemized bills and need to have the ability to write up responses to send to the hospital.
• Other activities as may be deemed necessary

Registered Nurse – Medicaid Clinical Reviewer

• Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes
• Ensure compliance with federal, state, and payer-specific guidelines
• Query providers for clarification as needed
• Assist with coding audits and quality improvement initiatives
• Maintain productivity and accuracy benchmarks
• Support coding education for internal teams and providers

Certified Medical Coder, CPC, CCS, CCS-P

Registered Nurse – Coding Specialist

• Conduct comprehensive coding and documentation audits to ensure compliance with industry standards, regulations, and payer rules.
• Perform detailed retrospective and prospective coding audits
• Prepare audit findings and summary reports
• Identify compliance risks and recommend corrective actions
• Provide education to coders and clinical staff
• Monitor trends and regulatory updates from CMS, OIG, and payers

Medical Auditor – Clinical Documentation & Coding Compliance

Paralegal

• Support healthcare attorneys and executives with regulatory research, dispute resolution, and compliance documentation
• Ensure adherence to CMS, OIG, and managed care requirements
• Facilitate payer appeals and investigations
• Assist with legal research on healthcare regulations and payer rules
• Draft documents for appeals, disputes, and regulatory responses
• Prepare case files and maintain documentation
• Support attorneys during investigations or audits
• Track regulatory changes and prepare summaries

Paralegal, Healthcare Regulatory – Dispute Resolution

Insurance

• Support revenue cycle operations through expert claims review, payer policy analysis, and reimbursement optimization, ensuring compliance and maximizing financial performance for healthcare services.
• Review claims for accuracy and compliance.
• Assist with appeals and disputes.
• Interpret payer policies and communicate updates.
• Identify reimbursement trends and risks.
• Support the revenue cycle and compliance team.

Healthcare Professional – Insurance Background

Medical Office Manager – Billing & Coding

Licensed Practical Nurse – Coding Specialist

Bilingual

• Provide psychological assessment and therapy to children aged 6 or above
• Conduct diagnostic evaluations and develop treatment plans
• Maintain active Medicaid provider status
• Collaborate with team members
• Provide culturally competent care to diverse populations
• Maintain accurate clinical documentation and records