Role Description The Health Information Specialist II (HIS II) supports Release of Information (ROI) processing in a remote, work-from-home capacity. This role is critical to ensuring the timely, accurate, and compliant fulfillment of medical record requests, including subpoenas and legal documentation, while safeguarding patient privacy and maintaining full HIPAA compliance. This is a production-based role requiring advanced ROI knowledge, strong problem-solving skills, and the ability to independently manage complex and high-risk requests. Key Responsibilities - Managing advanced and complex ROI requests, including subpoenas and legally sensitive records. - High-volume ROI processing with a focus on accuracy, compliance, and timeliness. - Processing certified ROI requests and subpoenas in accordance with legal and regulatory standards. - Reviewing and validating authorizations, subpoenas, and court documents. - Utilizing EMR systems to retrieve, compile, and release medical records. - Ensuring all disclosures meet HIPAA, state, and client-specific requirements. - Maintaining detailed documentation and workflow tracking. - Supporting quality assurance initiatives and adhering to defined production metrics. - Communicating professionally with internal teams regarding escalations or complex cases. Qualifications - High School Diploma or GED required. - Must be 18 years of age or older. - Prior ROI experience required; subpoena experience strongly preferred. Requirements - Strong attention to detail with a high level of accuracy. - Advanced problem-solving skills to resolve complex ROI and subpoena-related issues. - Effective time management and ability to meet productivity standards. - Reliability, punctuality, and consistent schedule adherence. - Adaptability in a fast-paced, remote production environment. - Prior experience with subpoenas and legal ROI requests. - Comfortable working independently in a remote setting. - Ability to multitask and manage competing priorities. - Proficiency with computer applications, databases, and document management systems. - Strong organizational and documentation skills. - Clear, professional written and verbal communication. Benefits - Pay range: $16 - $20.50 USD per hour. - Post-offer health screenings and proof/completion of various vaccinations may be required. - Exemptions from health requirements may be available based on specific criteria.

Home infusion standard template Joining us is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.

iMedX is accepting applications for experienced inpatient facility coders. Facility coders worked on behalf of facilities and have extensive experience with DRG-based reimbursement for inpatient coding. This position does not apply to those pro-fee coders who have expertise in coding for physicians attending to patients in inpatient care. Full-time, part-time, and independent contractor status will be considered. Applicants must have a minimum of 3 years of broad-based acute care inpatient coding experience and have the requisite credentials to demonstrate compliance with this requirement. This is a remote (work-from-home) position. Purpose: The Medical Coding Specialist abstracts clinical information from health records and assigns accurate and complete codes in accordance with Official Guidelines for Coding and Reporting and iMedX standards as appropriate. Organizational Structure: The Coding Specialist reports to the Coding Manager. Key Responsibilities: - Abstracts relevant clinical information from the health records. - Identifies the principal and secondary diagnoses based on the Official Guidelines for Coding and Reporting (OGCR) - Assigns ICD-10-CM codes to the principal and secondary diagnoses. - Identifies ICD-10-PCS codes for procedures based on OGCR. - Possesses thorough understanding of the impact of DRG-based reimbursement on inpatient coding. - Able to identify instances where a physician query is necessary for accurate code assignment and demonstrates ability to compose required objective queries - Has sufficient knowledge regarding Clinical Documentation Improvement (CDI) strategies to effectively communicate with Facility CDI staff in promotion of their initiatives. - Exhibits familiarity with facility data systems such as EPIC, Cerner, MediTech and CPSI. - Exhibits working knowledge and familiarity with encoders such as 3M and TruCODE. - Meets or exceeds the iMedX coding quality standards. - Understands and adheres to all requirements related to coding compliance. - Performs coding in an efficient and productive manner, utilizing good time management and professional work habits. Meets productivity standards for position. - Refers coding questions to the Coding Manager in a timely manner for feedback and coding guideline development. - Continually enhances coding skills. Participates in team meetings and educational conferences to ensure coding practice remains current. - Maintains confidentiality and safeguards the privacy of protected health information (PHI). - Promotes the Company’s values. - Performs other job related duties as may be assigned or required. Education: High school diploma or GED equivalent. Completion of a formal coding program. Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other AHIMA or AAPC approved coding credential preferred. Experience: Minimum of three years’ coding work experience and working knowledge of the ICD coding system; medical terminology; anatomy and physiology; and health record content. Exhibits a sense of urgency towards work, possesses intermediate level computer skills, attention to detail, excellent customer service and written and verbal communication skills.

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs. About the Opportunity As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. This position requires an in-depth understanding of clinical guidelines, coding protocols, and regulatory requirements to ensure accurate payment determinations. In this role, you will meticulously document findings, provide detailed clinical, policy, and regulatory support and collaborate with relevant stakeholders to ensure compliance with payment standards. Your expertise will be critical in ensuring that payment decisions are supported by accurate and complete documentation, ultimately contributing to the integrity and efficiency of the payment process. What you’ll do - Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement. - Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers. - Collaborate with team leaders to ensure thorough review of DRG denials. - Conduct audits in alignment with organizational quality and timeliness standards. - Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters. - Recommend improvements to the audit system to enhance efficiency. - Ensure compliance with HIPAA regulations for protected health information. - Perform other duties as assigned. What you bring (Role Requirements) Education Requirements: - An associate or bachelor’s degree in nursing (active/unrestricted license); or in health information management is required. - Work experience may be considered in lieu of formal education at leadership discretion. Certification (at least one of the following is required): - RHIA - Registered Health Information Administrator - RHIT- Registered Health Information Technician - CCDS - Certified Clinical Documentation Specialist - CDIP - Clinical Documentation Improvement Practitioner - CCS - Certified Coding Specialist - CIC - Certified Inpatient Coder Qualifications: - Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required - Strong focus on quality and attention to detail. - Deep curiosity and analytical skills to understand root causes of events and behaviors. - Proven ability to apply critical judgment in clinical and coding determinations. - In-depth knowledge of clinical criteria and documentation requirements to support code assignments. - Expert in DRG methodologies (e.g., MS & APR). - Expertise in ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA’s Coding Clinic Guidelines. - Ability to work independently and efficiently with minimal supervision. What We Offer: - Work from anywhere in the US! Machinify is digital-first. - Top Medical/Dental/Vision offerings - FSA/HSA - Tuition reimbursement - Competitive salary, 401(k) with company match - PTO - Additional health and wellness benefits and perks - Flexible and trusting environment where you’ll feel empowered to do your best work The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks. Pay range: $90,000 - $115,000, plus quarterly bonus. Equal Employment Opportunity at Machinify We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/