Jobs at CorroHealth

Coordinates peer-to-peer appeals by calling payers, scheduling medical director calls, following up on overdue cases, documenting call outcomes, updating account statuses across databases, and supporting case entry and appeals functions. The role requires extensive phone communication, accurate data entry, multitasking across systems, confidentiality, HIPAA/HITECH compliance, and independent as well as collaborative work.

Investigate and resolve unpaid or denied medical claims by reviewing UB04s, EOBs and medical records; use proprietary software, EMR portals, phone and written correspondence to obtain claim resolution while meeting production and quality targets and complying with HIPAA.

Provides remote facility observation coding using CPT, HCPCS, ICD-10-CM, and ICD-10-PCS, with specialized experience in infusions and injections. Applies coding guidelines, assigns diagnoses and procedures accurately, evaluates documentation, protects patient health information, and maintains required productivity, quality, and accuracy standards. Requires AAPC or AHIMA certification, facility coding experience, EMR and billing-system familiarity, and proficiency with Microsoft Office.

Manage healthcare authorization processes from initial notification through determination and discharge. Responsibilities include verifying eligibility and benefits, documenting records in EMR and payer systems, coordinating with hospital staff and payers, tracking pending authorizations, resolving processing barriers, escalating potential delays or denials, and maintaining HIPAA compliance. The role requires healthcare or authorization experience, medical terminology knowledge, insurance-process expertise, strong organization, and proficiency with EMR, payer portals, and Microsoft Office.

Supports hospital charge capture and revenue integrity through Epic or Cerner system builds, workflow documentation, CDM process development, compliance audits, and staff training. Collaborates with clinical, billing, coding, revenue integrity, and IT teams to identify gaps and implement accurate, compliant charge-capture workflows. This is a remote, US-only position.

The DRG Revenue Integrity Auditor performs audits on inpatient charts to ensure coding accuracy and compliance with clinical guidelines. Responsibilities include chart reviews, training new hires, and maintaining coding best practices while analyzing data for client reporting.

Supervise DRG coding audits, ensuring compliance with coding guidelines, provide training, conduct quality assurance, and generate reports for clients.

Provide professional fee coding across multiple specialties using CPT, HCPCS, ICD-10-CM, and ICD-10-PCS. Calculate evaluation and management levels, identify critical care cases, apply accurate diagnosis and procedure codes, interpret coding guidelines, and assess documentation impacts on reimbursement. Maintain coding credentials, confidentiality, productivity, and quality standards while working independently from home and participating in training.

Audits inpatient, outpatient, and physician practice coding using medical record documentation and official coding guidelines. Identifies errors and root causes, prepares client reports, performs compliance reviews, researches coding and denial inquiries, and develops coding education. Maintains audit accuracy and productivity standards, protects patient confidentiality, collaborates with clients and consulting teams, and maintains professional coding credentials. This is a remote role with periodic travel.

Coordinates peer-to-peer appeal activities by contacting payers to schedule calls with medical directors, following up on overdue cases, documenting payer communications, and updating account statuses across multiple databases. Provides case-entry, peer-to-peer, and appeals support while maintaining confidentiality and HIPAA/HITECH compliance. The role requires extensive phone communication, accurate documentation, multitasking across systems, problem-solving, and collaboration in a remote, fast-paced environment.

Audits zero-balance hospital accounts to identify underpaid inpatient and outpatient claims. Reviews payer contracts, medical records, policies, regulations, and payment data; models reimbursement methodologies; researches underpayment trends; and develops audit plans, pricing documents, and technical procedures using Excel, Access, and SQL. Senior auditors lead complex investigations, provide quality reviews, mentor staff, and recommend process improvements.

Lead and continuously improve pre-bill DRG validation, QA, and training programs to ensure coding accuracy and compliance. Oversee audits, performance benchmarks, second-level adjudication, cross-functional collaboration with CDI, physician advisors, compliance and revenue cycle, and manage a team, budget, and reporting to reduce DRG mismatches, denials, and revenue leakage.

CDI Specialists collaborate with healthcare teams to improve clinical documentation quality, ensuring accuracy for coding and reporting outcomes. They conduct reviews, issue queries, and meet productivity standards while adhering to guidelines.

Remote role resolving outstanding insurance balances for hospital and physician accounts. Perform account research in client systems (including Prism), prepare appeals, follow client and federal guidelines, meet cash and quality targets, document actions, and maintain compliance with HIPAA, FDCPA, and related regulations.