Claim Review Specialist – Remote

Use your outpatient and Profee coding expertise to support hospitals nationwide through detailed audits, accurate claim review, and high-level reimbursement analysis.

About CorroHealth
CorroHealth partners with healthcare systems across the US to improve financial performance through scalable revenue cycle solutions. Their teams rely on clinical expertise, advanced proprietary software, and rigorous analytics to reduce errors, strengthen compliance, and enhance overall reimbursement accuracy. CorroHealth invests heavily in development and career growth—your skills grow with their mission.

Schedule
• Full-time, fully remote
• Standard business hours; must maintain reliable, private workspace
• Equipment and software access provided

Responsibilities
• Assist the Director of HIM with outpatient and Profee claim audits
• Review client claims using proprietary PARA Data Editor software
• Identify billing, coding, and documentation issues across OPPS, CAH, and Profee claims
• Validate CPT, HCPCS, ICD-10-CM, and PCS (if applicable), including rev codes, MUEs, CCI edits, and payer-specific rules
• Audit for omitted charges, incorrect units, incorrect codes, and guideline misalignment
• Review E/M (facility and Profee), IR, SDS, OBS, ER, ancillary, and I&I coding
• Identify revenue cycle trends and recommend improvements
• Prepare written Q&A entries, client education materials, and audit summaries
• Participate in client presentations via web meetings
• Stay updated on CMS, Medicaid, payer guideline changes, and official coding rules
• Maintain accurate documentation and uphold all certifications
• Support consulting team members as needed

Requirements
• 5+ years of directly related coding/auditing experience
• Expert-level outpatient and Profee coding knowledge (ER, SDS, OBS, ancillary, IR, E/M, I&I)
AHIMA CCS, COC, or AAPC CPC certification required
• Strong revenue cycle understanding, including CMS and Medicaid guidelines
• Proficiency in ICD-10-CM/PCS, CPT/HCPCS, rev codes, NCCI, and MUE policies
• Strong analytical and critical-thinking skills
• Excellent written and verbal communication
• Solid computer skills; advanced Microsoft Excel, PowerPoint, Word, and OneNote
• Medical terminology and anatomy knowledge
• Clinical Documentation and Inpatient coding experience preferred (must be willing to learn IP)
• Professional, polished client-communication skills

Benefits
• Competitive compensation
• Medical, dental, and vision insurance
• 401(k) with company match
• PTO and paid holidays
• Tuition reimbursement
• Equipment provided
• Growth-focused environment with ongoing training

If you’re a coding expert ready to partner with clients and support high-accuracy claim review, this role offers long-term stability and impact.

Happy Hunting,
~Two Chicks…

APPLY HERE