CorroHealth Benefits Overview

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.

Performs inpatient DRG validation and quality audits, reviewing ICD-10-CM/PCS coding, POA indicators, SOI/ROM, HCC capture, and reimbursement accuracy. Applies CMS, payer, clinical, and official coding guidelines; identifies query opportunities; supports CDI audits, reporting, training, and client communication. Maintains confidentiality, productivity, accuracy, and compliance standards while managing multiple projects and electronic medical records.

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.