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📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding We’re seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical records and documentation. This role ensures accurate coding and clinical support for DRG assignments, helping improve billing accuracy, reimbursement, and compliance. You’ll work independently to review records, validate coding, and communicate findings clearly and professionally. * Chart Review & Validation Review medical records to validate DRG assignments and ensure clinical documentation supports coding decisions. * Physician Documentation Review Confirm that physician notes and clinical indicators support assigned DRGs. * Audit & Compliance Conduct audits to verify coding accuracy, enhance reimbursement, and identify cost-saving opportunities. * Coding Expertise Apply ICD-10-CM and PCS coding guidelines, payer rules, and regulatory standards (Medicare, Medicaid, CMS). * Communication & Reporting Clearly document findings and communicate results in a professional and concise manner. * Other Duties Support additional documentation and coding-related tasks as assigned. • Licensure: RN or LPN/LVN license required — or RHIT credential for non-nurses., • Experience:, • Minimum 1 year of recent DRG auditing experience in a hospital or health plan setting., • Inpatient ICD-10 coding experience required., • CDI candidates are encouraged to apply., • Certifications:, • National coding certification through AHIMA (preferred) or AAPC., • CCS or CIC strongly preferred., • Technical Skills:, • Proficient in MS and APR DRG methodology., • Familiarity with Coding Clinic citations and Official Coding Guidelines., • Strong understanding of Medicare/CMS documentation requirements., • Soft Skills:, • Exceptional attention to detail., • Strong problem-solving and critical thinking abilities., • Effective verbal and written communication., • Ability to work independently in a fast-paced, production-driven environment., • Tools: Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.

Job Description The Bill Review Manager is responsible for the overall operation of a designated bill review office. The Manager participates in formulating and administering company best practices as well as developing long-range goals and objectives, analyzing costs, activities and operations, supporting the goals of Bill Review department and of CorVel. This is a hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Responsible for financial operations, including, but not limited to: productivity, profitability, expenses, budgeting, billing and collections, • Responsible for implementing new business development, including marketing and sales activities, • Responsible for directing a team of employees in their day-to-day operations ensuring productivity and quality goals are met in accordance with company expectations, • Responsible for quality provider, claims, and client interaction, • Responsible for human resources matters, • Must be able to travel overnight and attend meetings, • Requires regular and consistent attendance, • Visit CorVel customers and participate in training sessions with management, • Represents the company in a professional manner to both internal and external customers and clients, • Directs the performance and development of the employees in their department. Assures peak performance of the team through continued training and coaching, coupled with regular performance evaluations, • Ensures staff compliance with Workers’ Compensation laws and ensures mandated regulatory reporting requirements, • Utilizes Jurisdictional Expertise and knowledge of regulatory rules, statutes and procedures governing the jurisdictions assigned to ensure compliance Acts as subject matter expert for appropriate jurisdictions, • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses, • May be required to visit customers and participate in training sessions with management, • Monitors operational workflow and manages appropriate/adequate staffing levels and staff retention strategies, • Develops and oversees the implementation of common bill review practices and procedures, • Promotes operational efficiency and quality by continuously improving processes, people and systems to enhance efficiency, consistency and quality, • Ensures consistent and complete compliance with CorVel’s policies and procedures, • Comply with all safety rules and regulations during work hours in conjunction with the Injury Illness Prevention Program (IIPP), • Additional projects and duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to assist team members to develop knowledge and understanding of bill review practice, • Effective quantitative, analytical and interpretive skills, • Technical knowledge of laws, policies, and procedures in defined territory, • Strong leadership, management and motivational skills, • Ability to travel overnight and attend meetings if required, • Ability to remain poised in stressful situations and communicate diplomatically via telephone, computer, fax, correspondence, etc., • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to work both independently and within a team environment, • Knowledge of processing bills on multiple lines of business, • Knowledge of medical terminology, medical billing codes, applicable state fee schedules and/or U&C charge processing, • Contract interpretation, • Ability to be a liaison between multiple departments within the company EDUCATION & EXPERIENCE: • Bachelor's degree, national certification or a combination of education and related experience, • Minimum of 2 years’ experience medical billing and supervisory/management experience, • Certified Professional Coder (CPC) designation preferred, • Licenses as required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 – $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid

Job Description The Coding Network (TCN) is looking to contract with an Ophthalmology E&M coder to perform the Ophthalmology E&M coding for a number of clients throughout the country. The coder will access the operation reports via a remote connection to the client's EMR and return the coded cases. Hours can range from a 15-40 hour/week commitment. NOTE: We do not have needs for surgical Ophthalmology at the moment, our current needs are for E&M only. If you are a coder with non-ophthlamology coding experience please apply directly at our website All applicants must: · Have a minimum of 3 years of Ophthalmology E&M Specific Coding · Have an active coding certification (CPC, RHIA, RHIT) · Live and work in the · Take and pass TCN’s Ophthalmology E&M Coding Exam If you meet the above criteria and are willing to test please submit your resume. Job Types: Full-time, Part-time, Contract Work Location: Remote Company DescriptionTCN has been providing specialty specific medical coding for over 20 years. TCN's 800+ US based coders cover over 55 medical specialties and subspecialties for clients in all 50 states. For more information visit has been providing specialty specific medical coding for over 20 years. TCN's 800+ US based coders cover over 55 medical specialties and subspecialties for clients in all 50 states. For more information visit