Role Description We are seeking a Team Lead, Auditing to join our dynamic Payment Integrity team. This critical role involves leading a team of auditors (such as Inpatient, Outpatient, Professional) conducting comprehensive reviews to ensure the accuracy of claims and maximize overpayment identification. If you possess a CCS credential, a deep understanding of inpatient, outpatient and professional auditing, and a passion for deep analytical work, you will be instrumental in supporting Cohere Health’s commitment to accurate reimbursement solutions. This opportunity requires a self-motivated individual who thrives on precision, compliance, and continuous learning in a high-growth environment. What You'll Do: - Lead and mentor a team of auditors, managing workloads and supporting professional development. - Collaborate cross-functionally to align on production, quality review and meeting defined timelines. - Conduct comprehensive coding reviews to ensure accuracy and reimbursement. - Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. - Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations. - Utilize advanced DRG encoder tools to drive efficiency and accuracy in audits. - Meet or exceed company quality and productivity standards, including strong uphold rates for appeals. - Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge. - Adhere to HIPAA and company policies and procedures to ensure data security and regulatory compliance. - Maintain and apply knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language. Qualifications - 8+ years experience of performing MS-DRG and ARP-DRG reviews for a Payment Integrity vendor or Payer. - 2-3 years of supervisory/management experience, including supervising and training in a remote work environment. - CCS (Certified Coding Specialist) credential highly preferred. - RHIA, or RHIT credential, Associate's Degree in Health Information Management, Nursing, or related field preferred. - Preference for candidates holding both a coding credential and an HIM credential (RHIA/RHIT). - Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. - Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, ensuring recommendations reflect professional expertise. - Experience using CMS NCDs/LCDs and clinical criteria guidelines. - Self-motivated and able to work independently in a remote environment while maintaining high performance. - Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously. - Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning. - Excellent written and verbal communication skills, strong analytical skills, and attention to detail. - Inpatient audits experience for case rate and per diem. - Preference for candidates with outpatient and professional claims auditing experience. - Experience working in a start-up or high-growth company environment, demonstrating agility and adaptability. - Familiarity with working with a diverse, global team of talent. - Excellent computer skills and familiarity with a Mac. Benefits - 💻 Fully remote opportunity with about 5% travel - 🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program - 📈 401K retirement plan with company match; flexible spending and health savings account - 🏝️ Time Off + company holidays - 👶 Up to 14 weeks of paid parental leave - 🐶 Pet insurance Interview Process - Connect with Talent Acquisition for a Preliminary Phone Screening - Meet your Hiring Manager! - Interview with Subject Matter Expert - Behavioral Interview

• Support orthopedic revenue cycle and denial management operations • Understand the full revenue cycle, including coding, claim submission, payer follow-up, denial resolution, and appeals • Initially focus on orthopedic denials and ERISA appeals • Support billing, coding, accounts receivable, claims follow-up, and denial management needs across multiple specialties

• Promote ANI’s PCG for Acute Gouty Arthritis through clinical education and strategic engagement with targeted HCPs. • Build and execute territory-specific plans to drive physician awareness, patient identification, and market growth. • Educate providers and staff on treatment access, insurance coverage, and documentation requirements. • Coordinate with internal teams including Market Access, Patient Support Services, and Medical Affairs to ensure seamless patient onboarding and therapy initiation. • Maintain detailed communication logs and follow-up documentation to support continuity of care. • Cold call and engage new accounts across Primary Care, Podiatry, and Orthopedics. • Collaborate with cross-functional teams to ensure logistical readiness and patient support. • Contribute to building and scaling a new commercial footprint within an expanding Acute Care business. • Demonstrate compliance and integrity in all interactions.

Role Description The Facility Coordinator is responsible for overseeing and coordinating the effective delivery of a variety of services including the management of the life cycle of work orders. This is done by ensuring that vendors adhere to SLAs and complete work on time to maintain a high level of customer service. In addition, the coordinator ensures adherence to policies and procedures, ensuring data integrity, quality planning, and KPI work order metrics are achieved. Qualifications - Strong written and verbal communication - Knowledge of RealSuite and other BGIS applications (1-3 years experience) - Strong customer-oriented skills (1-3 years experience) - Strong administrative and organizational skills (1-3 years experience) - Analytical and problem-solving skills (1-3 years experience) - Ability to work independently (1-3 years experience) - Strong attention to detail and data accuracy (1-3 years experience) - Excel experience in managing large amounts of data (1-3 years experience) - Ability to communicate clearly and effectively with others for the purpose of data exchange, clarification and follow up (1-3 years experience) - Experience working in a Shared Service environment (1 year experience) Requirements - Manage work orders to completion in BGIS or client-based web application. - Facilitate alignment of client required services with contracts, schedules, and Pos. - Review work orders to determine if invoiceable or non-invoiceable. - Schedule access for internal and external service providers with the facility when required. - Prepare weekly/monthly summaries of work order performance for internal and external service providers. - Follow up with internal and external service providers to ensure all SLA’s are achieved. - Review compliance documentation and upload to RealConnect. - Create on demand work orders for service delivery. - Ensure client required supporting documentation for quote and invoice submissions are provided. - Review and submit all estimates to the required approver(s) following client quote process. - Generate required data for SLA Scorecard. - Available to work evenings and weekends. - Other duties as assigned. Benefits - This is a regular, full-time position with a salary range of $54,185 - $67,732 per annum. - The starting salary will be based on the successful candidate’s competencies, including but not limited to experience, education, professional designations and performance related to this role.