Associate Director, Medical Review Lead, MSRM - Remote Agios PharmaceuticalsAssociate Director, Medical Review Lead, MSRM - RemoteBoston, MARemote$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
Accounts Receivable Lead SarnovaAccounts Receivable LeadBoston, MAThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
Prepay Coding Consultant UnitedHealth Group IncPrepay Coding ConsultantPlymouth, MA$24–$43 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. We have received recent reports of fraudulent LinkedIn messages and emails alleging or claiming to be sent from UnitedHealth Group, UnitedHealthcare, or Optum Executives.
Inpatient Coding Quality Specialist Mass General BrighamInpatient Coding Quality SpecialistSomerville, MassachusettsEnsure coding practices align with official coding conventions, guidelines, and regulatory requirements set forth by organizations such as the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other relevant bodies. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Outpatient Technical Advisor, Coding Brigham and Women's HospitalOutpatient Technical Advisor, CodingSomerville, MA$63,648–$90,750.40 / yearThe Technical Advisor advises on external/internal coding reviews and audits, new coding/billing regulations impacts, coding and billing interlinking billing issues, coding education and workflow training for outpatient coding, claim edits and denials related to ambulatory surgery coding/charging. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Outpatient Technical Advisor, Coding Mass General BrighamOutpatient Technical Advisor, CodingSomerville, MassachusettsThe Technical Advisor advises on external/internal coding reviews and audits, new coding/billing regulations impacts, coding and billing interlinking billing issues, coding education and workflow training for outpatient coding, claim edits and denials related to ambulatory surgery coding/charging. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Coding Education Specialist, Remote Brigham and Women's HospitalCoding Education Specialist, RemoteSomerville, MARemote$63,648–$90,750.40 / yearThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. This role ensures that coding professionals have the knowledge and skills required to accurately assign medical codes, maintain compliance with coding guidelines, and contribute to the revenue cycle management process.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorMA$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
Coding Education Specialist, Remote Mass General BrighamCoding Education Specialist, RemoteSomerville, MassachusettsRemoteThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. This role ensures that coding professionals have the knowledge and skills required to accurately assign medical codes, maintain compliance with coding guidelines, and contribute to the revenue cycle management process.
Inpatient Coding Quality & Education Specialist Brigham and Women's HospitalInpatient Coding Quality & Education SpecialistSomerville, MA$63,648–$92,570.40 / yearThe specialist partners closely with Coding Operations, Coding Quality, Clinical Documentation Integrity (CDI), Revenue Integrity, Quality, and other operational teams to identify trends, develop educational strategies, improve coding workflows, and support quality reporting methodologies including Vizient, Elixhauser, mortality, severity of illness (SOI), risk of mortality (ROM), expected length of stay, and other coding-sensitive measures. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities.
Technical Product Owner - AI Coding Platforms Boston Scientific CorpTechnical Product Owner - AI Coding PlatformsMarlborough, MAServe as the primary product interface with external AI partners, including vendors such as OpenAI, Anthropic and other strategic providers, to manage joint roadmaps, influence feature direction, resolve enterprise adoption barriers and accelerate the rollout of AI coding capabilities at Boston Scientific. This role will own the portfolio of AI coding capabilities that support engineers, data scientists, researchers and technical teams in using AI assistants, coding agents, large language model-powered developer tools and workflow automation safely and effectively within enterprise guardrails.
Inpatient Coding Quality & Education Specialist Mass General BrighamInpatient Coding Quality & Education SpecialistSomerville, MassachusettsThe specialist partners closely with Coding Operations, Coding Quality, Clinical Documentation Integrity (CDI), Revenue Integrity, Quality, and other operational teams to identify trends, develop educational strategies, improve coding workflows, and support quality reporting methodologies including Vizient, Elixhauser, mortality, severity of illness (SOI), risk of mortality (ROM), expected length of stay, and other coding-sensitive measures. Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities.
NewScratch & Intro to Coding Teaching Opportunities Concorde EducationScratch & Intro to Coding Teaching OpportunitiesBoston, Massachusetts£50–£100 / hourSome programs provide established lesson plans and project guides, while others allow instructors flexibility to incorporate age-appropriate coding activities and creative projects that align with assignment objectives and school expectations. Assignment offers remain contingent upon factors including program availability, instructor qualifications, school partner approval, scheduling compatibility, successful completion of any legally required background review or clearance process, and final written assignment confirmation.
Coding Specialist, Pain Management Brigham and Women's HospitalCoding Specialist, Pain ManagementSomerville, MA$25.50–$36.49 / hourProvides technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Inpatient Coding Specialist Brigham and Women's HospitalInpatient Coding SpecialistSomerville, MA$25.50–$36.49 / hourThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.
Coding Specialist, Pain Management Mass General BrighamCoding Specialist, Pain ManagementSomerville, MassachusettsProvides technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Inpatient Coding Specialist, Remote Mass General BrighamInpatient Coding Specialist, RemoteSomerville, MassachusettsRemoteThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. The Inpatient Coding Specialist is responsible for the accurate and timely assignment of ICD-10-CM/PCS codes and DRGs for inpatient encounters in compliance with federal regulations, payer guidelines, and organizational policies.
Billing & Certified Coding Specialist I (Remote) Lahey Hospital and Medical CenterBilling & Certified Coding Specialist I (Remote)MARemote$25–$34 / hourReviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Stays current on quarterly CCI Edits, bi-monthly Medicare Bulletins, Medicare''s yearly fee schedule, Medicare Website, and specialty newsletters.
Coding & Compliance Manager, Surgery Lahey Hospital and Medical CenterCoding & Compliance Manager, SurgeryBoston, MA$92,955–$125,091 / yearMay perform additional job duties as time permits, such as: developing and presenting performance metric reports with a review of findings with Attending Physicians, Directors, Managers and Chiefs; service on committees; maintains relationship with third party billing companies to ensure continuous excellence in services; fosters relationships with affiliates related to coding and compliance. Monitors, proposes, and minimizes billing and coding operational inefficiencies by reviewing accuracy and production levels and communicating data analysis on audit trends, scrubber data, government audit requests, denials/appeals as well as developing and implementing corrective action plans for setting performance targets.
Coding Specialist II, Anesthesia Brigham and Women's HospitalCoding Specialist II, AnesthesiaSomerville, MA$22.22–$31.71 / hourThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.
Coding Specialist II, Pain Management Mass General BrighamCoding Specialist II, Pain ManagementSomerville, MassachusettsThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.
Coding and Compliance Auditor South Shore HealthCoding and Compliance AuditorWeymouth, MAThe Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. Support all departments of the Health System with coding guidance: Pertaining to compliance training / education as requested from providers and/or staff related to coding, billing and documentation in the inpatient, outpatient, professional, surgical and Home Health divisions of the Health System to ensure accuracy and support program objectives.
Medical Coding Educator & Auditor StratAcuity Staffing Partners IncMedical Coding Educator & AuditorMARemote$65,000–$75,000 / yearIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. This highly visible role supports more than 400 physicians across multiple specialties and requires a unique blend of advanced coding expertise, audit experience, and the ability to confidently educate and present to both small groups and large physician audiences.
Coding & Compliance Auditor South Shore Health Systems IncCoding & Compliance AuditorWeymouth, MA$73,000–$104,400 / yearResponsibilities if Required: Education if Required: License/Registration/Certification Requirements: Certified Coding Associate - American Health Information Management Association (AHIMA), Certified Coding Specialist - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physician Based - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator - American Health Information Management Association (AHIMA). The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders.
Professional Production Coder - Elliot Professional Coding Services - Full Time - Remote US SolutionHealthProfessional Production Coder - Elliot Professional Coding Services - Full Time - Remote USManchester, New HampshireRemoteThe Professional Production Coder collaborates with providers and coding leadership to resolve coding discrepancies, contribute to quality improvement efforts, and uphold organizational goals related to revenue cycle performance and compliance. The Professional Production Coder is responsible for accurately assigning CPT, HCPCS, and ICD-10 codes to professional services in accordance with current coding guidelines, payer requirements, and regulatory requirements.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Boston, MAIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Manager Professional Billing Coding Operations - Remote Boston Medical CenterManager Professional Billing Coding Operations - RemoteMARemote$78,000–$113,000 / yearThe hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet - an integrated health care delivery systems that includes many community health centers. Provides training to healthcare professionals, coders, and Revenue Cycle staff in ICD, CPT, HCPCS Level II coding guidelines, proper documentation guidelines and other information related to coding.
Qualitative Coding Assistant Northeastern UniversityQualitative Coding AssistantBoston, MAMaster's degree or Doctor of Education (EdD) in Education, Economics, Public Policy, Psychology, Sociology, Communication, or related social science. Demonstrated experience with qualitative coding using established frameworks such as thematic analysis, content analysis, or discourse analysis.
Inpatient Coding Specialist (Coder III) - Fully Remote Lowell General HospitalInpatient Coding Specialist (Coder III) - Fully RemoteBurlington, MARemote$31.92–$39.90 / hourPerforms job junctions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, colleagues and community. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment.
Lead Coding Instructor Code NinjasLead Coding InstructorCanto, MassachusettsWe are looking for a Lead Coding Instructor to join our team of dynamic, energetic, forward-thinking minds, working toward our common goal: providing a fun and safe learning environment for children. Growth Opportunities: Code Ninjas is a rapidly growing organization, and strong team members have opportunities for career progression into leadership and management roles within the center.
Coding Instructor Home HelpersCoding InstructorActon, MassachusettsWe recognize our direct care staff as our greatest asset and offer: competitive compensation, initial & ongoing training, flexible hours, and a FRIENDLY & SUPPORTIVE WORK ATMOSPHERE. As part of our school outreach program, we offer classes in all surrounding public school districts of Acton, Westford, Concord, Lexington, Arlington, Bedford, Burlington and Belmont areas.
Coding Instructor Home Helpers of South ShoreCoding InstructorBelmont, MA, MAAs part of our school outreach program, we offer classes in all surrounding public school districts of Acton, Westford, Concord, Lexington, Arlington, Bedford, Burlington and Belmont areas. An ideal candidate for this position will be someone who has completed or currently pursuing undergraduate/graduate in Computer Science or similar STEM related fields.
NewSTEM & Coding Teaching Opportunities Concorde EducationSTEM & Coding Teaching OpportunitiesBoston, Massachusetts$50–$100 / hourPreferred qualifications include: • At least 60 college credits, where required by the applicable assignment or site; • Experience with coding, programming, computer science, or related technology subjects; • Experience teaching, tutoring, coaching, mentoring, or leading activities with school-age students; • Strong communication, organization, and classroom facilitation skills; • Availability to provide services for the accepted assignment schedule and communicate schedule issues as soon as reasonably practicable; and. Payment for completed services is generally made by direct deposit on the fifteenth day of the month following the month in which services were completed, unless otherwise stated in the accepted assignment terms or required by applicable law.
Coding Instructor Code NinjasCoding InstructorHopkinton, MassachusettsWe are looking for a Coding Instructor to join our team of dynamic, energetic, forward-thinking minds, working toward our common goal: providing a fun and safe learning environment for children. Parents are thrilled as their children gain confidence and new skills including coding, math, logic, and problem-solving, as they progress from white to black belt.
NewCoding Manager, 40hrs Hybrid TaraVistaCoding Manager, 40hrs HybridDevens, MA$83,000–$103,000 / yearThe Coding Manager oversees coding staff productivity and quality, develops departmental policies and procedures, coordinates coding education, partners with Clinical Documentation Improvement (CDI), Revenue Cycle, and Finance, and ensures compliance with AHIMA, AAPC, CMS, and other regulatory requirements. The position ensures accurate, compliant, and timely assignment of ICD-10-CM, ICD-10-PCS, and CPT codes for inpatient hospital and professional services.
No-Code Business Analyst Creatio EMEA LTDNo-Code Business AnalystBoston, MAVersion Control: Utilize Git/SVN for version control, ensuring seamless collaboration, code integrity, and efficient management of application changesRequired Skills & Competencies:Proven experience in conducting business analysis and research tasks, including market research, competitor analysis, and gathering business requirements to shape product features. Web Services Integration: Create web services for system integration using no-code tools, including designing RESTful APIs and SOAP interfaces to enable seamless data exchange, ensuring adherence to security protocols, and providing documentation for developers and third-party systems.
Oasis, Coding and Quality Documentation Specialist Emerson HospitalOasis, Coding and Quality Documentation SpecialistConcord, MA$36.75–$47.82 / hourThis role focuses on data integrity, workflow efficiency, and the precise application of coding guidelines to support the agency"s financial and regulatory health. Home Care Clinical Specialist-OASIS (HCS-O), or Certification of OASIS Specialist-Clinical (COS-C) required.
NewPart-Time Faculty, Live Coding and Algorithmic Performance Berklee College of MusicPart-Time Faculty, Live Coding and Algorithmic PerformanceBoston, MA$66.96–$138 / hourStudents engage with contemporary practices including electronic music production, sound design, digital instrument performance, coding, immersive audio, game audio, interactive media, and emerging creative technologies. This course explores programming as a creative and performative practice, enabling students to generate, manipulate, and perform music, visuals, and interactive systems through code in real time.
Senior/Principal Code Consultant RimkusSenior/Principal Code ConsultantBoston, MAEmployee is frequently required to stand, walk on slope roofs, sit, climb ladders, work from stationary and moveable scaffolding (aka swing stages), bend, climb inside attics and crawl under homes and tunnels, balance, stoop, kneel, crouch, talk, hear, and drive a motor vehicle to job sites. Consulting services include; but are not limited too; providing code analysis and interpretation via email, phone call, and in-person or remote meetings; drafting memos to address code issues; meeting with local officials and fire departments on the client’s behalf; and supporting the in-house engineering and design teams.
Experienced Medical Billing Coordinator - Part Time Evolve Chiropractic & WellnessExperienced Medical Billing Coordinator - Part TimeBoston, MAWe are looking for someone with knowledge of PIP insurance billing, verifications, authorizations, obtaining referrals, and collecting money. Evolve is looking for an experienced Medical Billing Coordinator to join our dynamic team!
Medical Billing Specialist Mi Familia & Summit Home Health and HospiceMedical Billing SpecialistNashua, NHRemote$58,000–$74,000The Medical Billing Specialist will be responsible for processing medical claims, managing insurance reimbursements, resolving billing issues, and ensuring accurate and timely revenue cycle operations. Summit Home Health & Hospice is a Texas-based healthcare organization dedicated to enhancing the lives of patients and families through compassionate home health and hospice services.
Medical Coder II Lynn Community Health CenterMedical Coder IILynn, MAReviews medical records prospectively to ensure that the care of the patient is recorded in language that payers can interpret which accurately and completely depicts acuity of the patient and resources expended. Experience with computer systems required, including EMR, web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Billing Compliance Reviewer Dana-Farber Cancer Institute IncBilling Compliance ReviewerBROOKLINE, MARemote$84,000–$91,300 / yearPartner with clinical providers, coding/HIM, revenue integrity, pharmacy, nursing, research billing, and practice operations to remediate findings, implement internal controls, and monitor corrective actions; track effectiveness of remediation through defined metrics. Reporting to the Director of Billing Compliance, the Billing Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective actions to mitigate compliance risk.
Director Billing Compliance Dana-Farber Cancer Institute IncDirector Billing ComplianceBROOKLINE, MARemote$154,200–$170,800 / yearResponsibilities include leading routine monitoring, assessing for and identifying areas of risk assessments, conducting investigations, responding to audits, providing consultation/guidance, and sharing program findings with providers and leadership. Reporting to the VP, Chief Compliance Officer with a dotted line reporting relationship to the VP, Revenue Performance Management, the Director of Billing Compliance is a strategic leader and subject matter expert responsible for ensuring the integrity, accuracy, and compliance of billing practices across the organization.
NewInpatient DRG Reviewer ZelisInpatient DRG ReviewerBoston, MassachusettsWhere the regrouped ‘new DRG’ differs from what was originally claimed by the provider, write a customer facing ‘rationale’ or ‘findings’ statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Medical Physician Coder Boston Children's HospitalMedical Physician CoderBoston, MA2. Knowledge of medical terminology, anatomy and physiology, pathophysiology, ICD-9/10-CM and CPT-4 or ASA classification systems, and regulatory agency requirements related to primary or non-surgical services. Establishes and maintains working relationships with Physicians to resolve specific case issues, as well as general questions and or principles.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorMA$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Denial Specialist 1-Professional Billing Lahey Hospital and Medical CenterDenial Specialist 1-Professional BillingMA$22.05–$29.68 / hourActual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. The PFS Denial Specialist I role is vital to ensure that hospital denied accounts are thoroughly reviewed for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement.
NewInpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerBoston, MA$79,000–$99,750 / yearWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistMA$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.