Virtix Health

Implementation Specialist

• Manage the full implementation lifecycle for assigned clients, including onboarding, platform configuration, and service activation
• Coordinate cross-functional teams (Product, IT, Operations, Reporting) to ensure alignment and timely delivery of project milestones
• Track and manage project plans, timelines, and deliverables, proactively identifying and resolving risks
• Support the development and delivery of client-facing documentation, including solution overviews, integration guides, and onboarding materials
• Serve as the primary point of contact for clients during implementation, ensuring clear communication, expectation alignment, and high satisfaction
• Translate client requirements into executable tasks, collaborating with internal teams to ensure accurate and timely delivery
• Foster a culture of accountability, collaboration, and client-first thinking

Client Implementation Manager

Medical Director

• Conduct regular reviews to monitor the appropriateness of care provided to beneficiaries and recommend any necessary interventions or adjustments need to align with CMS National and Local Coverage Determinations (NCD/LCD)
• Assist in the training and development of clinical teams on CMS NCD/LCD guidelines, clinical documentation and compliance
• Provide recommendations for improvements in clinical practices based on findings from record reviews, data analysis, and best practices in the field
• Participate in the development and implementation of quality improvement initiatives to enhance care delivery and achieve CMS performance goals
• Maintain accurate and up to date records of all clinical reviews, audits and quality improvement efforts.

Orthopedist, Medical Director

Analyst

• Analyze and ascertain pertinent information from multiple sources (e.g., hospital systems, medical records, claims) to identify true causality for underpayments.
• Recognize payor and client trends and perform research to maximize profitability.
• Consider account profitability and cost analysis when reviewing for potential rebills.
• Analyze payer contracts for revenue risks when business needs arise.
• Facilitate and communicate results of rebills with auditors.
• Mentor and assist with onboarding of incoming Revenue Analysts.
• Coordinate and lead training for incoming team members.
• Facilitate and or annotate internal team meetings.
• Collaborate with manager and project leads to perform client work as assigned.
• Manage multiple internal projects while adhering to deadlines and weekly goals.
• Other duties as assigned.

Revenue Analyst 2, Zero Balance

• Conduct regular reviews to monitor the appropriateness of care provided to beneficiaries and recommend any necessary interventions or adjustments need to align with CMS National and Local Coverage Determinations (NCD/LCD)
• Assist in the training and development of clinical teams on CMS NCD/LCD guidelines, clinical documentation and compliance
• Provide recommendations for improvements in clinical practices based on findings from record reviews, data analysis, and best practices in the field
• Participate in the development and implementation of quality improvement initiatives to enhance care delivery and achieve CMS performance goals
• Maintain accurate and up to date records of all clinical reviews, audits and quality improvement efforts

Internist, ABIM/AOBIM Medical Director

Neurologist, Medical Director

Auditor

• 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.
• 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.
• 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.
• 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).
• Develop specifications and procedures to identify and troubleshoot contractual, coding, and administrative areas of underpayment risk using Access, SQL, Excel, and other programs.
• Conduct review of zero-balance hospital accounts to identify underpaid inpatient and outpatient claims.
• Present clear documentation of process, findings, and results of audits.
• Make recommendations to improve internal processes and external client contracts/processes.
• Work with data analyst team to build and validate pricing models.
• Work across project teams to research and outline next steps on identified underpayment trends.
• Other duties as assigned.

Auditor 2, Zero Balance

Operations

• Managing relationships with Health Information Handlers (HIH) vendors, Electronic Health Record (EHR) vendors and providers.
• Monitoring project performance, ensuring the accuracy and timeliness of data, and addressing escalations.
• Act as the primary point of contact for escalations related to vendor performance or project delivery.
• Run and analyze reports to monitor the performance and progress of projects.
• Act as the liaison between internal departments and external vendors.
• Review and reconcile vendor and provider invoices to ensure accuracy.
• Ensure that suppliers deliver on their commitments, including meeting contractual SLAs, deadlines, and quality standards.

Coordinator, HIH Operations

Data Analyst

• Analyze large volumes of hospital claim data for payment accuracy
• Extract, clean, and validate data from clients
• Develop, troubleshoot, and configure tools for analysis
• Provide optimization and maintenance of internal applications
• Look for solutions and enhancements to technical processes
• Communicate issues and present solutions effectively
• Validate, analyze, and provide reporting for generated data

Revenue Financial Data Analyst – Zero Balance

Data Entry

• Accurately and efficiently conduct medical record abstraction services
• Scan relevant components of the medical record to support reviews to be performed
• Electronically download review assignments to the laptop and data collection tool; daily upload completed assignments and scanned medical records
• Complete required training
• Complete quality, accuracy and inter-rater reliability testing as requested in a timely manner
• Communicate effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities and CorroHealth Team
• Travel to medical facilities in specified area of region from home to complete review services as assigned by CorroHealth
• Represent CorroHealth with medical facility staff
• Maintain compliance with CorroHealth's policies, procedures and mission statement
• Adhere to all confidentiality and HIPAA requirements as outlined within CorroHealth Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position

Site Data Collector – Call Center

• Accurately and efficiently conduct medical record abstraction services both in-person and electronically
• Travel to medical facilities in specified area of region from home to complete review services as assigned by Virtix Health and represent Virtix Health with medical facility staff
• Scan relevant components of the medical record to support clinical reviews to be performed
• Contact provider offices to request copies of medical records
• Identify and coordinate the retrieval method and scheduling of record retrieval with provider offices
• Schedule retrieval with accurate and timely updates using the Virtix Health retrieval application
• Provide professional communication and customer service with provider offices throughout the record retrieval process
• Make regular and consistent phone calls to complete timely retrieval
• Enter and maintain records into the in-house computer application to document and track record retrievals
• Report daily productivity numbers to immediate supervisor through accurate and consistent maintenance of a spreadsheet
• Pass quality and accuracy testing as requested in a timely manner

Communications

• Contact provider offices to request copies of medical records
• Identify and coordinate the retrieval method and scheduling of record retrieval with provider offices
• Schedule retrieval with accurate and timely updates using the Virtix Health retrieval application
• Provide professional communication and customer service with provider offices throughout the record retrieval process
• Make regular and consistent phone calls to complete timely retrieval
• Enter and maintain records into the in-house computer application to document and track record retrievals
• Report daily productivity numbers to immediate supervisor through accurate and consistent maintenance of a spreadsheet

Communication Center Representative

Call Center Representative

• In a medical chart retrieval capacity, the Field Tech/ Call Center Agent represents the clients/health plans in requesting and collecting medical records from healthcare providers;
• Hybrid role; collect medical records both in person and electronically from providers offices; provide telephonic assistance to schedule and retrieve medical records by contacting provider offices gathering and recording appropriate data, verifying existing information, and ensuring records are timely retrieved;
• Essential Functions: Accurately and efficiently conduct medical record abstraction services both in-person and electronically; Travel to medical facilities in specified area of region from home to complete review services as assigned by Virtix Health and represent Virtix Health with medical facility staff; Scan relevant components of the medical record to support clinical reviews to be performed; Contact provider offices to request copies of medical records; Identify and coordinate the retrieval method and scheduling of record retrieval with provider offices; Schedule retrieval with accurate and timely updates using the Virtix Health retrieval application; Provide professional communication and customer service with provider offices throughout the record retrieval process; Make regular and consistent phone calls to complete timely retrieval; Enter and maintain records into the in-house computer application to document and track record retrievals; Report daily productivity numbers to immediate supervisor through accurate and consistent maintenance of a spreadsheet; Pass quality and accuracy testing as requested in a timely manner; Fulfill those responsibilities and/or duties that may be reasonably provided by Virtix Health for the purpose of achieving operational and financial success of the Company.

Client Implementation Manager

Orthopedist, Medical Director

Revenue Analyst 2, Zero Balance

Internist, ABIM/AOBIM Medical Director

Neurologist, Medical Director

Auditor 2, Zero Balance

Coordinator, HIH Operations

Revenue Financial Data Analyst – Zero Balance

Site Data Collector – Call Center

Site Data Collector – Call Center

Communication Center Representative

Field Tech/Call Center Agent