Teams at CorroHealth

Perform retrospective coding audits and second-level reviews for professional fee (ProFee) encounters to ensure accurate diagnosis, procedure, and billing codes per AHA/CMS/AMA guidelines. Identify root causes of coding errors, provide coder feedback/training, suggest physician queries, prepare reports, and maintain QA standards and professional coding credentials.

Investigate and resolve unpaid or denied medical claims by reviewing UB04s, EOBs and medical records; use proprietary software, EMR portals, phone and written correspondence to obtain claim resolution while meeting production and quality targets and complying with HIPAA.

Review and audit outpatient and professional fee hospital claims using proprietary PARA Data Editor. Identify coding, billing, and charge issues; apply CMS/payer rules, ICD-10-CM, CPT/HCPCS, NCCI/MUE edits; prepare reports, client education materials, and present findings. Support revenue cycle consulting team and maintain coding certifications and current knowledge.