RN focused on verifying that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the member's documented clinical condition, services rendered, and billed charges.
Responsibilities
Provides support for inpatient and outpatient clinical claim review activities.
Assess medical records for clinical accuracy, acuity alignment, and documentation integrity.
Reviews inpatient and/or outpatient claims to ensure diagnoses, procedures, revenue codes, itemized charges, and Diagnostic Related Groups (DRG) assignments accurately reflect the documented clinical condition and services provided.
Integrates ICD‑10 coding principles, DRG methodologies, revenue code logic, and evidence‑based clinical guidelines when reviewing claims.
Performs DRG validation reviews by verifying principal and secondary diagnoses, complications/comorbidities, procedure coding, severity level, and correct grouping logic.
Requirements
Registered Nurse (RN)
Nice to have: Certified Coding Specialist (CCS)
Nice to have: Registered Health Information Administrator (RHIA)
Nice to have: Registered Health Information Technician (RHIT)
We are seeking a Primary Care Physician to join our team in a unique remote role. This is a fully virtual position focused on comprehensive and longitudinal management of a new patient panel.
Compensation
$211,000-$225,000 base compensation
Responsibilities
Conducting virtual visits across a broad spectrum of care
Comprehensive and longitudinal management of a new patient panel
Expanding One Medical's virtual primary care footprint
Combining clinical excellence with a proactive, growth-oriented approach to patient engagement
Collaborating with virtual teams, health coaches, and specialists
Provide primary care to high acuity patients in their home Monday - Friday
Compensation
Posted Max Pay Rate
Posted Min Pay Rate
Pay Transparency
Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.
Responsibilities
Provide primary care to high acuity patients in their home Monday - Friday
Assist with appointments in select markets
Provide company car with driver in select markets
Requirements
Licensed as a NP in the State where HarmonyCares Medical Group office located
Per diem, hourly clinician role providing acute, chronic, and well visits both in-office and via tele-health.
Compensation
The hourly rate for this role is $96.00. Final determination of starting pay may vary based on factors such as practice experience and patient care schedule.
Responsibilities
Seeing patients with a broad array of patient needs
Conducting a mix of acute, chronic, and well visits (not a panel-building role)
Treating patients in-office as well as conducting occasional tele-health visits
Ongoing collaboration with in-office teammates via daily huddles, as well as with virtual clinical teams
Utilization of specific clinical training and opportunities to perform in-office procedures
Casual/Per Diem clinician role providing acute, chronic, and well visits, both in-office and via telehealth.
Compensation
The hourly rate for this role is $177.00. Final determination of starting pay may vary based on factors such as practice experience and patient care schedule.
Responsibilities
Seeing patients with a broad array of patient needs
Conducting a mix of acute, chronic, and well visits
Treating patients in-office as well as conducting occasional tele-health visits
Ongoing collaboration with in-office teammates via daily huddles and with virtual clinical teams
Utilization of specific clinical training to perform in-office procedures
Requirements
Enrolled in, or have completed, an accredited Internal or Family Medicine residency program
Board Certified in Family Medicine or Internal Medicine
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