Integrated Resources

*** Please note: The manager would like to see a bigger focus on inpatient coding experience, with CPT codes, modifiers, and retrospective coding reviews. *** Team prefers to see candidates with 3 -5 years of experience. Candidates must has IDRE experience and be able to explain the IDR process during the interview Location: Remote Duration: 6 months - Term to Perm Hours: 9a - 5:30pm EST Mon - Fri Description : We are seeking a highly motivated and detail oriented professional to join our team and perform retrospective payment reimbursement reviews. The ideal candidate thrives in a fast paced, deadline driven environment and can effectively manage multiple priorities with accuracy and efficiency. This individual must have a strong understanding of how modifiers impact reimbursement and how CPT codes interact with one another. The candidate should also be proficient in reading and interpreting Explanations of Benefits (EOBs), including recoupments, corrections, and...

Job Title: Specialty Physician Coder Job Location: Fountain Valley, CA Job Duration: 3 Months (possibility of extension) Payrate: $45.00 - $48.27/ hr. on w2 Job Summary: Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement, ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder will also collaborate with the Coding Compliance Manager to identify coding trends, irregularities, and required action items. Essential Functions and Responsibilities: Meet productivity standards established by management Meet quality standards established by management In adherence with standard work, analyze...

Job Summary: This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends. The role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. The position also provides education and guidance on ICD-10-CM coding, DRG assignment, payment methodologies, and auditing practices. Key Responsibilities: Lead hospital billing and coding audits, both on-site and remote Identify and present billing discrepancies and coordinate improper claim payment referrals Analyze trends related to documentation, billing errors, and provider contract interpretation issues Compile audit reports, statistics, and findings for internal teams and regulatory agencies Review and enhance audit processes to align with clinical...