e4health

Auditor

• Complete regularly scheduled quality assurance reviews for clients
• Complete onboarding quality assurance reviews for newly hired consultants
• Provide training for newly hired coding consultants as needed
• Communicate quality issues to management
• Assist with identification, drafting, implementation, and monitoring of quality improvement action plans
• Maintain reports and accuracy rates for coding consultants and clients
• Respond to client quality-assurance needs at management’s direction
• Provide educational sessions on error trends to coding consultants
• Notify management of compliance concerns or incidents
• Handle patient information appropriately while maintaining confidentiality and discretion
• Attend educational conference calls
• Provide coding support to the business as needed
• Perform other project duties as needed
• Maintain required productivity and quality requirements
• Maintain coding credential requirements
• Complete quality assurance reviews of outpatient coding specialists or external providers across facility-based chart types
• Validate accurate data abstraction into client electronic medical record systems
• Follow ICD-10-CM, CPT, HCPCS, AMA CPT, and CMS coding guidance
• Track and trend educational opportunities and report quality results
• Provide educational support and training to coders and providers
• Maintain a coding auditing accuracy rate of 95% or better while meeting productivity standards

Outpatient Auditor

Manager

• Provide subject matter expertise and lead direction for the CDI and Quality business line
• Assist operational effectiveness and enhance delivery of services to clients and the CDI and Quality business unit
• Develop and deliver education
• Perform and lead CDI assessments and audits
• Supervise CDI and Quality business units, teams, and/or work efforts
• Provide CDI, Quality, HIM, coding, and compliance expertise and consulting services
• Compose CDI tips and education
• Seek client feedback to support ongoing business relationships
• Work with Leadership on product delivery processes
• Participate in team building, operational improvements, and professional growth
• Provide initial and ongoing training for CDI staff at client sites
• Communicate with and support clients as needed
• Maintain confidentiality, security, and ethical standards
• Manage time, prioritize, organize work, and complete responsibilities accurately within deadlines
• Travel to field sites may be required up to 15% of the time

CDI Manager

Consultant

• Review assigned patient medical records for complete and accurate documentation of relevant diagnoses and procedures
• Initiate and complete queries as necessary to reflect accurate inpatient or outpatient visit data
• Adhere to guidelines set forth by ACDIS, AAPC, and AHIMA
• Maintain strict confidentiality of patient information in accordance with HIPAA
• Evaluate DRG payer issues, audit risks, documentation opportunities, quality metrics, and hierarchical condition categories
• Work with providers and coders to ensure documentation reflects patient complexity
• Educate and interact with providers
• Collaborate with clients, co-workers, and management to meet assignment needs
• Use computer software according to client requirements
• Travel to field sites up to 15% of the time may be required

CDI Consultant

• Provide timely reviews of patient medical records to ensure accurate and complete documentation reflecting the patient’s severity and complexity of illness
• Work with providers and coders to ensure documentation reflects patient complexity
• Educate and interact with providers
• Perform concurrent and/or potential retrospective health record reviews
• Identify opportunities for documentation clarification and improvement
• Collaborate with providers and healthcare professionals using clinical expertise, critical thinking, and coding and regulatory knowledge
• Follow customer-established procedures
• Review assigned medical records for complete and accurate documentation of relevant diagnoses and procedures
• Initiate and complete queries as necessary to reflect accurate patient visit data
• Adhere to ACDIS, AAPC, and AHIMA guidelines
• Maintain strict confidentiality of patient information in accordance with HIPAA
• Apply knowledge of DRG payer issues, audit risks, documentation opportunities, quality metrics, and hierarchical condition categories
• Work with clients, coworkers, and management to meet assignment-specific needs
• Utilize computer software according to client requirements

Medical Billing and Coding

• Accurately abstract data into appropriate client electronic medical record systems
• Follow Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding, AMA CPT Guidelines, and CMS directives
• Perform data entry of required abstracted patient information into the client’s information system
• Query physicians to clarify conflicting, imprecise, incomplete, ambiguous, and/or inconsistent clinical information
• Interact with Clinical Documentation staff according to account requirements
• Assign appropriate ICD-10-CM, CPT, HCPCS codes and modifiers to facility-based Ancillary, Emergency Department, Observation, and/or Outpatient Surgery accounts
• Abstract and enter coded data and/or charges for hospital statistical and reporting requirements
• Communicate documentation improvement opportunities and coding issues for follow-up and resolution
• Communicate with Clinical Documentation Improvement and/or Revenue Cycle teams for follow-up and account reconciliation
• Maintain required productivity and quality requirements
• Maintain coding credential requirements
• Maintain a coding accuracy rate of 95% or better while meeting productivity standards

Outpatient SDS Coder

• Review assigned patient medical records for complete and accurate documentation of relevant diagnoses and procedures
• Initiate and complete queries as necessary to reflect accurate patient inpatient or outpatient visit data
• Adhere to guidelines set forth by ACDIS, AAPC, and AHIMA
• Maintain strict confidentiality of patient information in accordance with HIPAA
• Apply knowledge of DRG payer issues, audit risks, documentation opportunities, quality metrics, and hierarchical condition categories
• Work closely with clients, co-workers, and management to meet assignment-specific needs
• Utilize computer software according to specific client requirements
• Travel to field sites up to 15% of the time may be required

CDI Consultant – Smarter DX Experience Required

Accounting Manager

• Participate in end-to-end Oracle Health Patient Accounting (OHPAC) implementations, including discovery, design, configuration, testing, deployment, and post-go-live support
• Analyze existing patient accounting workflows and translate business requirements into OHPAC configuration and solution designs
• Apply knowledge of Soarian Financials workflows, including patient accounting, billing, claims, payments, adjustments, financial transactions, and related revenue-cycle processes
• Leverage Oracle Health Patient Accounting build expertise to determine how functionality should be migrated, redesigned, or optimized within OHPAC
• Perform workflow and configuration assessments across legacy environments
• Configure and validate OHPAC functionality based on organizational requirements and Oracle Health implementation standards
• Develop and execute functional test scenarios, including unit, system integration, regression, and end-to-end revenue-cycle testing
• Support data validation, conversion activities, reconciliation, and financial integrity testing
• Collaborate with revenue-cycle SMEs, patient accounting teams, technical teams, integration resources, and Oracle Health implementation stakeholders
• Identify gaps between current-state Soarian/Millennium workflows and future-state OHPAC functionality
• Document workflows, configuration decisions, business requirements, test scripts, defects, and resolution approaches
• Support defect triage and resolution throughout implementation and stabilization
• Participate in cutover planning, go-live readiness, and post-production support

Patient Accounting Analyst

Project Manager

• Lead end-to-end Epic Gallery implementation projects, including planning, execution, testing, deployment, and go-live
• Develop and maintain project plans, milestones, dependencies, risks, issues, and resource requirements
• Serve as primary liaison between the health system, Epic, HIM, IT, clinical, and operational stakeholders
• Coordinate Gallery workflow design covering document types, indexing, scanning, fax queues, routing, workqueues, exceptions, ambulatory workflows, document filing, reconciliation, and legacy document migration
• Facilitate future-state workflow design and identify operational gaps
• Coordinate technical and operational dependencies with Epic application teams
• Lead requirements gathering, workflow validation, design sessions, issue resolution, and decision tracking
• Coordinate unit, integrated, workflow, and end-user testing
• Validate document types, indexing rules, routing, queues, and downstream workflows before go-live
• Manage legacy document migration, including scope definition, assessment, mapping, validation, reconciliation, and cutover planning
• Partner with HIM leadership on scanning, indexing, document quality, incomplete indexing, duplicate documents, and operational workflows
• Identify project risks and develop mitigation strategies
• Coordinate training, communications, readiness assessments, and operational transition activities
• Lead status meetings, steering committee updates, issue escalation, and executive reporting
• Manage project scope, timelines, deliverables, resources, and vendor/partner dependencies
• Develop go-live, cutover, stabilization, and post-production support plans
• Coordinate post-go-live issue management and optimization activities

• Provide timely second-level reviews of patient medical records
• Ensure accurate and complete documentation reflecting patient severity and complexity of illness
• Work with providers and coders to ensure chart documentation reflects patient complexity
• Educate and interact with providers
• Conduct concurrent and post-discharge record reviews
• Ensure Present on Admission conditions are accurately documented within regulatory timeframes
• Ensure documentation reflects accurate safety ratings and quality-of-care scores, including PSIs
• Participate in education sessions and provide feedback to coders, CDI Reviewers, and Hospital Quality Departments
• Conduct regular standardized audits for POA, HAC, and PSI documentation compliance
• Track and trend data for quarterly CDI and Coding team data-quality reviews
• Escalate issues affecting documentation or coding quality
• Ensure coding and DRG assignments comply with CMS rules, regulations, coding practices, and conventions
• Use the OIG workplan to identify payer denial patterns and target education and focused audits
• Apply coding, DRG, and quality-score changes affecting data quality or revenue through Case Mix Index (CMI)
• Travel to field sites up to 15% of the time may be required

Outpatient Auditor

CDI Manager

CDI Consultant

CDI Consultant

Outpatient SDS Coder

CDI Consultant – Smarter DX Experience Required

Patient Accounting Analyst

Project Manager

CDI Consultant – Second Level Review, Part Time