Code Red Restaurant Menu Jobs in Usa
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General Manager (Upscale High-Volume Restaurant)
Miami, FL
Competitive Base Salary | Performance Bonus | Full Benefits | Confidential Search
This is a high-profile, high-volume concept where the energy is intentional, the standards are uncompromising, and the leadership bar is set accordingly. We're looking for a General Manager who knows how to hold a room operationally, culturally, and financially, and who takes pride in building something that runs well because of the people they develop.
If you've led complex, fast-moving operations and you're looking for a seat at the table where your decisions actually matter, this is worth your attention.
Responsibilities:
- Full operational oversight of front of house, back of house, and everything in between
- P&L management across an $8M+ revenue operation
- Hiring, developing, and retaining a management team that executes at a high level
- Guest experience standards that reflect the brand's reputation without exception
- Labor, inventory, and cost controls that protect margin without sacrificing quality
- A culture built on accountability, pride, and professional growth
Requirements:
- 5+ years as a GM in upscale, high-volume dining
- Nightlife fluency: late-night operations, high-energy service, and the guest profile that comes with it
- Hands-on P&L ownership
- Labor scheduling and deployment across a large hourly and management team
- Food and beverage cost controls: you've managed vendors, negotiated contracts, run tight inventory systems, and held your kitchen accountable to margins
- Revenue-driving experience: covers, table turns, upsell culture, private dining, and event execution at volume
- Opening and closing accountability
- Health, safety, and sanitation compliance
- POS fluency and reporting: you use your data, not just your gut
- Conflict resolution at the guest and team level
- Hiring, onboarding, and developing hourly and management staff in a high-turnover environment
- Experience working alongside or managing a culinary team
Recruited exclusively by Gecko Hospitality — Florida's hospitality leadership search firm.
Essential Job Functions:
* Employees will provide quick and friendly service to all customers.
* Greets customers and seats guests in Aarow.
* Makes reservations for guests using Aarow reservation system. Checks guests in using computer system.
* Cleans restaurant areas as needed, including counter tops, sinks, display shelves, tables, storage areas and lounge areas at assigned station.
* Handles and solves any concerns and questions customers may have.
* Performs all side work (stocking bus station and rolling silverware) and stocking of supplies at assigned station.
* Meets the attendance guidelines of the job and adheres to regulatory, departmental, and company policies.
* Must be able to get along with co-workers and work as a team.
* Ability to read, write, speak and understand English.
* Must present a well-groomed, professional appearance.
* Meets the attendance guidelines of the job and complies with all state, federal and regulatory policies and procedures.
* Must be able to work a varied schedule including holidays, nights and weekends as needed.
* Must be able to work a reasonable amount of overtime when required.
* Perform other duties as assigned.
* All team members will follow the Everyone Greets Everyone (EGE) policy. It is the expectation that every team member, front or back of house, should proactively seek out opportunities to greet guests and their fellow team members daily. EGE policy states teams members should: acknowledge guests and fellow team members within 10 feet; initiate friendly verbal greeting within 5 feet; keep your head up, look around (\"head on a swivel\"); look for opportunities to greet guests and others; please remember that when you are on the floor, you are \"on stage\".
* Team members will participate in all mandatory meetings and pre-shift BUZZ sessions
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Raising Cane's
- Corporal Max Donahue Lane
- Responsibilities: Hires and terminates management-level crewmembers including payroll process; Creates crewmember work and training schedules; Develops management-level crewmembers including performance management; Acts as manager on duty, opens and closes the restaurant, manages cash handling; Monitors profit and loss statements, develops and executes strategy in all areas of financial and operational performance
Arby's
- Broken Bow is looking for a full time or part time Store Supervisor for our location in Broken Bow, OK.
As a Store Manager, you will assist the General Manager in managing the operations and staff on a day to day basis, including the execution of all company policies, procedures, programs and systems.
The store supervisor also ensures compliance with all Federal, State and local laws and ethical business practices.
You will be actively involved in the selection, orientation and training of crew members at Arby's
- Broken Bow.
Qualified Store Supervisor candidates will have previous experience in restaurants or managing teams.
You should love working with people and be a team leader.
This role is full time or part time.
We are hiring immediately, so submit your application today!
$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights
- Position: Supervisor PB Surgical Coding
- Location: Warrenville, IL
- Full Time
- Hours: Monday-Friday, [hours and flexible work schedules]
A Brief Overview:
The Supervisor, Medical Coding, is responsible for overseeing the medical coding team, ensuring accurate code assignments, adherence to coding guidelines, and compliance with regulatory requirements. This position plays a pivotal role in maintaining financial accuracy and integrity within the hospital.
What you will do:
- Supervise and provide leadership to a team of medical coders, offering guidance, training, and support to ensure high-quality code assignments.
- Oversee and review diagnostic (ICD-10-CM) and procedural (CPT) codes assigned to medical records, validating their accuracy and adherence to coding guidelines.
- Conduct internal coding audits to monitor coding accuracy and consistency, providing feedback and guidance to coding staff.
- Collaborate with clinical staff, physicians, and clinical documentation specialists to ensure accurate coding and identify opportunities for documentation improvement.
- Stay current with coding guidelines, conventions, and regulatory changes, and disseminate information to the coding team.
- Ensure coding practices comply with federal, state, and local healthcare regulations and standards, including HIPAA.
- Generate coding reports, analyze coding data, and provide insights into coding accuracy, trends, and process improvement opportunities.
- Provide ongoing training and development opportunities for coding staff, ensuring they stay updated on best practices and regulations.
- Collaborate closely with clinical staff, health information management, and other departments to streamline the flow of coding-related information.
- Maintain strict confidentiality and security of patient data, complying with HIPAA and other privacy regulations.
What you will need:
- Bachelors Degree Health Administration Required or Bachelors Degree Information Technology Required
- 5+ Years of medical coding experience, with at least 2 years in a supervisory or leadership role.
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Required And
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Required
Benefits:
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
* Position: Senior Coding Educator
* Location: Skokie, IL
* Full Time
* Hours: Monday-Friday, 8:00am-4:30pm
A Brief Overview:
The purpose of this job is to educate physicians, other qualified billing providers, and ancillary staff on their documentation for all specialties and review providers progress notes, as needed, to ensure coding/billing compliance in accordance with coding rules, third party payor guidelines, governmental regulations, and MG's Coding Compliance Program. The Senior Analyst will conduct face-to-face summary review sessions to report findings to the Practice Manager, Provider audited, and/or Senior Management of the MG. Through the audit/review process, this person will also conduct a report back to the provider and practice manager any income enhancing opportunities that might be uncovered in the investigation. The Senior Analyst, as a coding and billing expert, will assist all freestanding and provider-based outpatient departments with ICD-10, CPT-4, and HCPCS coding education and billing regulation interpretation. They will also assist in conducting department presentations.
What you will do:
* Analyzes progress notes, op reports, pathology reports, encounter forms, explanation of benefits, patient insurance information, and various other health information documents for pro-fee coding and billing accuracy.
* Assigns appropriate ICD-10, CPT, and HCPCS codes to medical record documentation under review by applying physician specialty coding rules, third party payor guidelines, and Medicare Local Medical Review Policies.
* Assists Manager/Director with providing information to the physician or medical specialty based on the Office of Inspector General's (OIG) and Centers for Medicare and Medicaid Services (CMS) risk areas. Reads the OIG's Semi-Annual reports and the OIG'S/CMS's Annual Workplan, in addition to notifications published on government websites.
* Performs physician and departmental documentation reviews based on industry standard coding and billing guidelines and payer policies to provide documentation and workflow improvement opportunities.
* Works with MG physicians or clinic personnel, HIRS, to interpret medical record documentation and/or documentation summary as necessary.
* Works with Customer Service and MG Operations to review and resolve escalated patient coding disputes.
* Works collaboratively with Billing, HIRS, overseeing provider/specialty and Denials Management Team to provide educational and/or income enhancing opportunities when issues are identified by those teams.
* Conducts educational sessions with Site Directors, Practice Managers, and providers on frequently seen coding errors in their site and assists with implementing changes to improve coding quality and minimize compliance risk.
* Provides feedback to Manager/ Director that identifies inefficient coding/operational processes.
* Assists with related special projects as assigned by Manager/ Director.
* Initiate and provide coding education to all MG billing providers, focusing on Evaluation and Management (E&M) documentation and billing requirements, as well as any specialty-specific coding guidelines.
* Works on special projects with the Hospital Billing Business Office and/or the Finance Department to perform reimbursement analysis functions as assigned by Manager/ Director.
* Submits ideas to Manager of Coding Quality & Auditing departmental newsletter based on coding/billing issues, coding help-line questions, or results of provider audits. May produce Monthly Newsletter if assigned.
* Participates in Coding and Business Operation Education in-services assigned by Manager
* Researches multi-specialty coding and billing questions received from the Coding Help-line/email for EHMG provider/staff and provides verbal or written response as appropriate. Maintains filing system of all questions received and answers provided to caller.
* Identifies trends or patterns of questionable coding and billing practices at Hospital Outpatient and Medical Group sites and reports issues to Manager.
* Reports compliance concerns to Manager or compliance hotline according to the Endeavor Healthcare Corporate Compliance Policy/Procedures.
* Develops physician coding tools such as ICD-10 and CPT-4 cheat sheets, coding grids, tip sheets and other educational material for multi-specialty providers to identify appropriate codes or modifiers reimbursed by payers for services performed.
* Assists in the creation of progress note templates per specialty utilizing the CMS documentation regulations or CPT Assistant guidelines as requested by physician's) or assigned by supervisor.
* Attends multi-specialty physician coding, billing, reimbursement seminars to maintain and increase coding, billing, reimbursement expertise/ knowledge.
* Maintains coding credential by obtaining the requiring continuing education credits per calendar year.
What you will need:
* Degree: Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related field required; equivalent years of work experience in related field will be considered in lieu of degree
* Certification: RHIA, RHIT, CCS-P, CCS, or CPC required. CPMA preferred.
* Experience: 3-5 years of related experience in physician and hospital outpatient medical billing, reimbursement, physician audits, chart review, coding compliance, medical office or patient accounts. 1-2 years' experience working with Senior Physician Management a plus
Other required skills
* The ability to work independently, with little to no supervision
* Strong presentation and communication skills
* The ability to interpret and analyze medical record documentation, encounter forms, and lab reports, Explanation of Benefits, CMS claim forms, third party payor guidelines and government regulations.
* Aptitude for medical terminology, ICD-10, CPT-4, and HCPCS coding systems.
* Demonstrated expertise in multi-specialty evaluation & management (E/M) coding.
* Knowledge of research steps utilized to identify appropriate code selection or billing requirements.
* Proficiency in MS Office's suite of products, including Excel and PowerPoint, and the internet.
* Experience with Epic Billing Systems, including chart review, transaction inquiry, etc.
Benefits:
* Career Pathways to Promote Professional Growth and Development
* Various Medical, Dental, and Vision options
* Tuition Reimbursement
* Free Parking at designated locations
* Wellness Program Savings Plan
* Health Savings Account Options
* Retirement Options with Company Match
* Paid Time Off and Holiday Pay
* Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents. For more information, visit you work for Endeavor Heal
$24.86 - $37.29 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
- Position: Coding Educator
- Location: Skokie, IL
- Full Time
- Hours: Monday-Friday, [hybrid]
What you will do:
- Ongoing growth and development from participation in events such as workshops, in-service programs and departmental meetings.
- Provides care based on physical, psychological, educational and related criteria appropriate to the age and type of the patients/customers served in their area.
- Acts as a coding resource for physicians, charge entry staff, other coders, and clinical staff.
- Participates in continuing education and in-service programs to maintain coding and billing skills.
- Communicates coding changes and updates physicians based on department standards.
- Queries physician and/or staff regarding incomplete or missing documentation.
- Works resolute charge review work queues with the purpose of correcting coding errors, reviewing documentation and applying coding guidelines to ensure the accurate and timely filing of charges.
- Ensure service, procedure and diagnoses codes are accurately reported and linked.
- Assigns CPT, ICD-10 and HCPCS codes based on coding guidelines.
- Queries Physician/Provider when applicable
- Maintains productivity and aging levels based on department standards.
- Identifies trends in coding issues and works with manager to educate and implement solutions.
- Work follow-up work queues with the purpose of reviewing denial codes and remarks and apply coding and billing guidelines for resubmission to obtain final adjudication of claim.
- Use coding resources (NCCI manual, LCD's payor bulletins) to assist with correct resubmission.
- Maintains productivity based on department standards.
- Work account work queues with the purpose of resolving patient disputes by applying coding and billing guidelines.
- Communicates with practice managers and/or physicians if applicable.
- Maintains productivity based on department standards.
- Consistently utilizes coding and billing resources and reference tools.
- Reports identified or potential coding compliance issues to manager and/or Coding Compliance Department in accordance with established policy and procedures.
- Implements findings to improve processes and workflows.
What you will need:
- Education: High School Diploma Required
- Certifications: CCS or CCS-P or CPC or RHIT required
- Experience: 3 years of outpatient coding experience
Benefits:
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Coverage
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential. Please explore our website ( ) to better understand how
Endeavor Health delivers on its mission to ?help everyone in our communities be their best?. Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
Position Details
Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.
Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.
Active - Benefit Eligible and Accrues Time Off
Work Hours per Biweekly Pay Period: 80.00
Shift: Flexible Hours and/or Flexible Schedule
Location: 210 South Florida Avenue Lakeland, FL
Pay Rate: Min $19.37 Mid $24.22
Position Summary
Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.
Position Responsibilities
People At The Heart Of All That We Do
- Fosters an inclusive and engaged environment through teamwork and collaboration.
- Ensures patients and families have the best possible experiences across the continuum of care.
- Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
Safety And Performance Improvement
- Behaves in a mindful manner focused on self, patient, visitor, and team safety.
- Demonstrates accountability and commitment to quality work.
- Participates actively in process improvement and adoption of standard work.
Stewardship
- Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
- Knows and adheres to organizational and department policies and procedures.
Standard Work Duties: Coder II - Outpatient
- Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding
- Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment.
- Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement.
- Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers.
- Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
- Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
- Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
- Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily.
- Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
- Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
Competencies & Skills
Essential:
- Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
- Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision.
- Knowledge of anatomy and physiology, pharmacology, and medical terminology.
Qualifications & Experience
Essential:
- High School or Equivalent
Nonessential:
- Associate Degree
Essential:
- High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.
Other information:
Certifications Essential: CCS
Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Experience Essential:
2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.
Position Details
Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.
Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.
Active - Benefit Eligible and Accrues Time Off
Work Hours per Biweekly Pay Period: 80.00
Shift: Flexible Hours and/or Flexible Schedule
Location: 210 South Florida Avenue Lakeland, FL
Pay Rate: Min $24.73 Mid $30.92
Position Summary
Under the direction of the Coding and Clinical Documentation Improvement Manger , reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, physician advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract, Participates in ongoing continued education to assure knowledge and compliance with annual changes.
Position Responsibilities
People At The Heart Of All That We Do
- Fosters an inclusive and engaged environment through teamwork and collaboration.
- Ensures patients and families have the best possible experiences across the continuum of care.
- Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.
Safety And Performance Improvement
- Behaves in a mindful manner focused on self, patient, visitor, and team safety.
- Demonstrates accountability and commitment to quality work.
- Participates actively in process improvement and adoption of standard work.
Stewardship
- Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
- Knows and adheres to organizational and department policies and procedures.
Standard Work Duties
- Determines whether the coding assigned was properly assigned based upon clinical indicators and review of the medical documentation and application of coding guidelines.
- Develop and apply appeal arguments to defend the coding and clinical decisions while being able to address and refute the coding determination made by the carrier/payer.
- Drafts appeal letters, including the coding argument with clinical and coding references, to support the coding decision. This may include providing additional medical record documentation.
- Identifies areas for education to improve complete and accurate coding and billing and provide feedback to management regarding trends or patterns noticed in the coding for discussion.
- Continued follow-up on denials as payers may continue to deny. Collaboration with Physician Advisor as required to continue appeal process.
- Continuously reviews changes in coding rules and regulations including in Coding Clinic, CMS, and other payer guidelines.
- Complete denials/appeals reports for leadership.
- Documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.
- Assigns and sequence documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.s diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines.
- Performs special projects and/or other duties as assigned.
Competencies & Skills
Nonessential:
- Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
- Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision
- MS-DRG and APR-DRG methodology expertise required. Strong knowledge of ICD-10-CM, ICD-10-PCS, POAs, HACs, PSIs, SOIs, ROMs and mortality rates as well as physician queries.
Qualifications & Experience
Nonessential:
- Associate Degree
Essential:
- High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.
Other information:
Certifications Essential: CCS
Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Experience Essential: 2-5 years acute care hospital inpatient coding experience within the past five years.
The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions.
The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely.
Principal duties and responsibilities:
Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers.
Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met.
Qualifications:
CPC/CCS-P with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings.
Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. The focus will be in the primary care sector (fee-for-service and risk-based), though experience in specialties such as dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health experience is also a plus.
Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc.
Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny.
Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances.
Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes.
Solid working knowledge of various EHR/EMR systems; experience accessing these remotely.
Strong organizational skills and task management
Highly organized with a high level of attention to detail
Ability to work in a fast paced and rapidly changing environment.
Skilled at multi-tasking with the ability to handle several different priorities simultaneously.
Strong communication skills with experience in articulating audit findings and interpretation of coding regulations
Experience with HIPAA, data privacy, and/or data security processes.
Experience working with regulators governing (public or private) health insurance carriers.
A minimum of AAPC or AHIMA certification required, that could include:
· Certified Professional Coder (CPC)
· Certified Outpatient Coder (COC™)
· Certified Professional Medical Auditor (CPMA)
· Certified Risk Adjustment Coder (CRC™)
· Certified Coding Specialist (CCS)
· Certified Coding Specialist – Physician based (CCS-P)
For consideration, please email resume and cover letter as attachments with salary expectations to with the subject title “Certified Coding Auditor - Behavioral Health.”
Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position.
The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.