CorroHealth

General

• Conduct clinical documentation tasks while meeting project productivity and quality standards
• Adhere to AHIMA and ACDIS coding and clinical documentation improvement guidelines
• Review clinical documentation and issue queries when appropriate
• Review medical records for completeness and accuracy related to severity of illness and risk of mortality
• Perform accurate and timely record reviews
• Apply knowledge of DRG payer issues, documentation opportunities, and clinical documentation requirements
• Analyze findings and identify potential root causes of errors
• Collaborate with physicians, nursing staff, patient caregivers, and medical records coding staff to improve documentation quality, specificity, accuracy, and completeness

Part Time CDI Specialist

Auditor

• Serve as a revenue cycle and coding consultant, partnering with the Director of HIM
• Perform complex concurrent and retrospective audits of hospital inpatient, facility, and outpatient claims
• Evaluate coding accuracy and documentation compliance by validating ICD-10, CPT, and HCPCS code assignments in accordance with CMS, AHIMA, AHA Coding Clinic, and official coding guidelines
• Analyze claim and coding data using proprietary software
• Identify opportunities for coding, billing, and revenue cycle improvement
• Develop standardized reports and communicate audit findings to clients
• Provide coding education and answer client questions
• Prepare written guidance and FAQs
• Support client meetings
• Collaborate with the revenue cycle consulting team to drive compliance, operational excellence, and reimbursement optimization
• Analyze findings and identify potential root causes of errors
• Prepare summary reports with specific supporting references
• Provide second-level review of processes and code assignments for compliance
• Research, analyze, and respond to compliance, coding, and denials inquiries
• Protect patient health and client information confidentiality and follow AHIMA Standards of Ethical Coding and official coding guidelines
• Conduct assigned audits while meeting record-type productivity standards and an expected billable productive-hours threshold of at least 80% when client work is available
• Prepare audit deliverables within required timelines
• Conduct independent QA of assigned audit results before final QA review; minimum accuracy expectation of 95%
• Report work time and work products accurately and promptly
• Communicate respectfully with coworkers and promote teamwork and knowledge sharing
• Interact professionally with clients and support company business interests
• Provide management with schedules of planned work activities, events, sites, and changes
• Maintain professional credentials and coding, reimbursement, and compliance knowledge through continuing education
• Travel periodically, as applicable
• Perform other assigned duties

Inpatient and Facility Coding Auditor, Claims Review Specialist

Medical Billing and Coding

• Provide CPT, HCPCS, and ICD-10-CM coding across 1–4 specialties
• Perform professional fee, facility, or HCC coding
• Code professional fee radiology diagnostic services including EEG, sleep studies, pulmonary function tests, MRI, and CT
• Apply ICD-10-CM diagnosis codes to the highest available specificity
• Accurately apply ICD-10-CM, CPT, HCPCS, and applicable modifiers
• Interpret coding guidelines for accurate code assignment
• Assess documentation importance and reimbursement impact
• Support client coding services
• Participate in company-provided training and education
• Protect personal health information and other confidential company information
• Perform other duties assigned by leadership
• Work at a computer terminal for 6–8 hours daily and handle prolonged sitting and occasional lifting up to 20 lbs

Radiology Coding Specialist

Nurse

• Perform comprehensive reviews of inpatient medical records to validate MS/APR DRGs for Medicare, Commercial, and Third-Party paid claims
• Validate ICD-10-CM/PCS codes, discharge disposition codes, HACs, and POA indicators affecting payment
• Ensure documentation is clinically supported and follows Official Coding Guidelines, compliant query practices, and current clinical validation criteria
• Use audit reference tools and applications, including proprietary denials management software, TruCode, and 3M encoder and grouper software
• Review denial-letter rationales and formulate custom appeal response letters
• Independently assess appeal cases for strengths and weaknesses
• Construct and document fact-based cases using clinical evidence, industry clinical guidelines, evidence-based medicine, and official coding guidelines
• Write professional appeal letters supporting each appeal argument
• Abstract denial audit findings into the proprietary application according to standard procedures
• Maintain subject-matter expertise in clinical validation, ICD-10-CM/PCS code sets, coding guidelines, clinical documentation integrity, and inpatient payment methodologies
• Attend continuing education workshops and webinars
• Meet production and quality expectations while performing complex medical record audits
• Perform other assigned responsibilities

DRG Appeals Nurse, RN

• Provide CPT, HCPCS, and ICD-10-CM coding across 1–4 specialties
• Perform Professional Fee, Facility, or HCC coding
• Provide coding services supporting clients
• Calculate Professional Fee and/or Facility E/M levels using the company algorithm
• Recognize critical care cases based on patient acuity
• Code ER-setting surgical procedures to capture additional revenue when appropriate
• Apply ICD-10-CM diagnosis codes to the highest available specificity
• Accurately assign ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS diagnosis and procedure codes
• Interpret coding guidelines for accurate code assignment
• Assess documentation importance and reimbursement impact
• Follow AHIMA ethical coding standards, company ethics and compliance requirements, and internal policies
• Participate in company-provided training and education
• Maintain privacy and security compliance and protect confidential information and PHI
• Perform additional duties assigned by leadership

Outpatient Multi-Service Facility Coder

• Provide CPT, HCPCS, and ICD-10-CM coding across 1–4 specialties
• Perform professional fee, facility, or HCC coding
• Calculate ProFee and/or Facility E/M levels using the company algorithm
• Recognize critical care cases based on patient acuity
• Code ER surgical procedures to capture additional revenue when appropriate
• Apply ICD-10-CM diagnosis codes to the highest available specificity
• Apply ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS diagnosis and procedure codes accurately
• Interpret coding guidelines for accurate code assignment
• Assess documentation importance and reimbursement impact
• Follow AHIMA Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct
• Comply with internal policies, procedures, privacy, and security regulations
• Protect confidential Company information, including Personal Health Information
• Participate in Company-provided training and education
• Perform other duties assigned by leadership

Hospitalist Coding Specialist

Client Services Representative

• Lead resolution of complex client service issues as the first escalation point
• Ensure timely follow-up, especially for high-volume areas such as UM Appeals
• Serve as a subject matter expert in UM Appeals and key operational workflows
• Apply payer-specific requirements, timely filing guidelines, and documentation standards
• Monitor and analyze operational performance and identify improvement opportunities
• Deliver actionable insights to enhance service delivery and client satisfaction
• Develop and maintain training resources, SOPs, and best practices
• Mentor and onboard new team members
• Collaborate with Strategic Advisors, technical teams, and operational stakeholders
• Resolve escalated issues, support strategic initiatives, and improve client outcomes
• Perform additional duties aligned with departmental and company growth initiatives

Senior Coordinator, Client Services

Director

• Own the end-to-end design, execution, and continuous improvement of the pre-bill DRG validation program across assigned client engagements
• Establish program goals, KPIs, and service-level commitments; report performance to executive leadership and clients
• Develop and maintain review methodologies, case selection logic, and prioritization criteria
• Identify opportunities to expand service offerings and support business development through subject-matter expertise, proposal input, and client presentations
• Serve as senior clinical and coding authority for DRG validation, clinical validation, and query practice
• Ensure reviews comply with ICD-10-CM/PCS Official Guidelines, AHA Coding Clinic, CMS regulations, ACDIS/AHIMA query guidelines, and payer policies
• Adjudicate escalated and complex cases, including clinical validation disputes, conflicting documentation, and high-dollar DRG shifts
• Maintain a quality assurance program with inter-rater reliability targets, second-level review, and corrective action
• Recruit, onboard, develop, and retain clinical validators, DRG auditors, and CDI professionals
• Set productivity and quality expectations; conduct evaluations; manage coaching, development plans, and corrective action
• Design and deliver education on regulatory changes, coding updates, and clinical validation topics
• Manage staffing models, capacity planning, and workload distribution
• Act as executive point of contact for client HIM, CDI, Compliance, and Revenue Cycle leadership
• Lead client governance meetings, present outcomes and trend analyses, and provide documentation and coding improvement recommendations
• Resolve client escalations and manage program changes, scope adjustments, and issue remediation
• Ensure compliance with HIPAA, OIG guidance, and CorroHealth policies; support audits
• Partner with Analytics on dashboards and reporting for DRG changes, financial impact, query response, denials, and reviewer performance
• Collaborate with Technology and Product teams on workflow tooling, case routing, and automation
• Manage program budget, labor costs, vendor relationships, and profitability targets

Director, Pre-bill DRG Validation Program

Supervisor

• Manage client service level agreement metrics, delivery expectations, and turnaround timeframes
• Drive monthly client meetings by phone or in person
• Communicate regularly with key members to meet client and corporate objectives
• Monitor client satisfaction, progress, and success using various metrics
• Identify and resolve client problems or issues in a timely manner
• Provide periodic client status reports to leadership teams
• Meet with clients monthly to review reporting packages and operational issues
• Manage direct reports, including performance reviews, team-member development, and corrective action
• Resolve coding and charge-capture issues with client points of contact
• Collaborate with Quality Assurance teams on coding quality issues
• Improve existing products and services and help develop new products and services
• Assist direct reports with diagnosis and procedure coding using ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Provide or assist with interpretation of coding guidelines
• Ensure direct reports understand documentation requirements and reimbursement impacts
• Align conduct with AHIMA’s Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct
• Promote compliance with internal policies, privacy and security rules, and protection of confidential information including PHI
• Participate in risk mitigation and correction of deficiencies
• Complete assigned duties and support company training and education requirements

Supervisor, Coding Solutions

Manager

• Manage coding workflows to reduce backlogs, troubleshoot system issues, and optimize revenue cycle processes
• Communicate regularly with coding staff, CDI staff, physicians, and other departments
• Monitor satisfaction levels
• Identify and resolve problems or issues in a timely manner
• Provide periodic client-status reports to leadership teams
• Schedule department staff based on volumes and prioritize workloads
• Develop and present an executive-level reporting package quarterly
• Manage direct reports, including performance reviews, team-member development, and corrective action
• Perform regular audits to monitor coding quality and accuracy
• Collaborate with the team to improve existing products and services
• Collaborate with the team to develop new products and services
• Assist direct reports with accurate application of diagnosis and procedure codes using ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS
• Provide or assist direct reports with interpretation of coding guidelines for accurate code assignment
• Ensure direct reports understand documentation requirements, code assignment, and reimbursement impacts
• Promote alignment with AHIMA’s Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct
• Promote compliance with internal policies and procedures
• Participate in company-provided training and education and ensure direct reports complete mandatory training by established deadlines
• Ensure compliance with privacy and security regulations and protect confidential information, including Personal Health Information
• Evaluate risk, participate in risk-mitigation activities, and correct deficiencies
• Perform other duties assigned by leadership

Manager, Coding Solutions

Data Entry

• Enter and update information in company databases, spreadsheets, and digital systems
• Review and verify documents or raw data and correct basic errors
• Organize and maintain electronic files, records, and administrative documents
• Communicate with team members to resolve missing or inconsistent information
• Protect confidential company and customer data
• Perform repetitive, high-volume data entry while meeting daily deadlines

Coding Data Entry Specialist

• Provide CPT, HCPCS, and ICD-10-CM coding across at least 1–4 specialties
• Perform professional fee, facility, or HCC coding
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate
• Apply ICD-10-CM diagnosis codes to the highest available level of specificity
• Accurately assign ICD-10-CM, CPT®, and HCPCS diagnosis and procedure codes
• Interpret coding guidelines for accurate code assignment
• Assess the importance of documentation on code assignment and reimbursement impact
• Work independently from home while supporting clients with coding services
• Follow AHIMA’s Standards of Ethical Coding, the Company’s Code of Ethics and Business Conduct, and internal policies
• Participate in company-provided training and education
• Maintain compliance with privacy and security regulations and protect confidential information and PHI
• Perform other duties assigned by leadership

ED Facility Coding Specialist

• Call payers to schedule Peer to Peer calls with CorroHealth Medical Directors.
• Call payers on cases that are past the Peer to Peer scheduled time frame.
• Document payer-call information in CorroHealth’s proprietary system.
• Enter account status into multiple databases.
• Support case entry, Peer to Peer, and appeals functions within the department.
• Work independently while collaborating within a team setting.
• Perform other duties as assigned.

Coordinator, P2P Appeals

Insurance

• Resolve unpaid/denied claims using proprietary software, phone calls, letters, client systems, and insurance carrier web portals
• Review UB04 claim forms, EOB’s, medical records, and other medical documentation to determine claim resolution actions
• Maintain familiarity with client preferences and known issues
• Meet monthly production and quality expectations
• Comply with HIPAA privacy laws
• Perform other duties as assigned