Medical Coding
1,066 open positions
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Risk Adjustment Coder Specialist OscarRemote $68k–$99k4d Review medical records to report ICD-10-CM diagnosis codes for Medicare Advantage and Affordable Care Act lines of business, ensuring compliance with CMS standards and participating in audits.
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PB Coder (Interventional Radiology Focused) Wolcott, Wood and Taylor Inc.Chicago 4d Review, analyze, and accurately code complex Neurointerventional and Interventional Radiology procedures to ensure compliance and optimal reimbursement.
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Lead Medical Director, Utilization Management JobgetherRemote $320k–$340k4d Senior physician leadership role overseeing utilization management activities, ensuring members receive appropriate, timely, and evidence-based healthcare across outpatient and inpatient settings.
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Clinical Consultant - Absence Operations Unum GroupChattanooga, TN, US $53k–$101k4d Review, analyze, and interpret medical information to assess claim files and determine appropriate next action steps for employee benefits.
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Clinical Denial RN GuidehouseUS - Remote (Any location) $68k–$113k4d Conduct pre- and post-service medical necessity reviews and retrospective medical record reviews to validate clinical documentation and resolve denials for inpatient, observation, and outpatient hospital encounters.
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Medical Lead Analyst - Cigna Healthcare CignaMadrid, Spain 4d Medical Lead Analyst providing medical management support, reviewing complex cases, and delivering high-quality medical services to customers worldwide.
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Manager, FWA & Connected Care PrudentialKuala Lumpur, MY 4d Provides strategic medical and clinical support to strengthen claims governance, Fraud, Waste & Abuse (FWA) controls, DRG implementation, and cost containment initiatives.
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Claims Analyst - CoxHealth Plans CoxhealthSpringfield, MO, US 4d Reviews and adjudicates member and provider submitted medical claims; performs accurate data entry of paper claim forms and validates scanned data.
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Cancer Registrar II Abstractor-Atrium Health Morehead Cancer Data Services AahRemote 4d Reviews and abstracts cancer data from clinical practices, codes data using ICD-O-3 and AJCC manuals, and performs case finding duties.
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Mitarbeiter (m/w/d) für das Sachgebiet Widerspruch Honorarverteilung Kassenärztliche Vereinigung BrandenburgRemote 4d Process member appeals against honor notices and create official administrative decisions for outpatient medical providers.
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HIM DRG Denial Coordinator CookchildrensRemote 4d Manage and maintain DRG denial correspondence by reviewing third-party payer denial letters, analyzing data, identifying root causes, and calculating financial impact.
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Health Information Management Specialist UtaustinAUSTIN, TX, US $35k4d Manage and organize healthcare data, ensure accuracy and privacy of patient records, and support data analysis for informed decision-making.
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Medizinische*r Dokumentationsassistent*in (MDA) - Intensivmedizin und Kardiologie Vivantes Netzwerk für Gesundheit GmbHBerlin, BERLIN 4d Collect and document DRG-relevant data and procedures to support medical billing and quality assurance in intensive care and cardiology.
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Senior Coding Specialist, PRN VumcNashville, TN, US 4d Reviews, accurately assigns, and abstracts diagnostic and procedural codes to patient encounters using designated coding classifications.
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Appeals Nurse Consultant (Remote) CvshealthRemote $67k–$143k4d Review and resolve clinical appeals by applying clinical judgment and regulatory knowledge to member and provider issues.
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Credentialing Program Assistant↗ Us Department of Veterans AffairsSan Diego, CA, US 4d First-line reviewer and data analyst for the Credentialing and Privileging (C&P) program, managing provider evaluations (FPPE/OPPE) and compliance tracking at a VA Medical Center.
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Medical Management Clinician Associate ElevancehealthFL-TAMPA, 5411 SKYCENTER DR, STE 700 & 800, US 4d Review clinical information and assess medical necessity for less complex benefit plans and contracts to ensure appropriate administration of plan benefits.
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Medical Auditor/Medizinischer Rechnungsprüfer/Mitarbeiter Medizinische Rechnungsprüfung - Vollzeit Diplomatische MissionMünchen, BAYERN 4d Review and validate hospital and physician invoices for medical and billing accuracy, ensuring compliance with German fee schedules and DRG systems.
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Change Analyst Revenue Integrity (Remote)↗ Trinity HealthRemote 4d Audits department information, captures and analyzes revenue data, and produces reports to ensure accurate CPT/ICD-10 documentation and charge reconciliation for patient billing.
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Appeals RN Utilization Review↗ MedStar HealthMD, US $89k–$163k4d Facilitate and manage medical appeals, investigate and resolve member and practitioner appeals within regulatory timeframes, and perform ER review activities to approve or deny payment of services.
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Compliance Monitor, Licensing↗ Cpsbc CareersVancouver, BC, CA $61k–$91k4d Temporary compliance monitor supporting the College of Physicians and Surgeons of BC to ensure applicants and licensees comply with legislation, bylaws, and policies through file reviews, audits, and process support.
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Clinical Reviewer, Dental Hygienist DevotedRemote $58k–$75k4d Perform first-level clinical reviews of dental claims and pre-treatment estimates using established guidelines to ensure accurate, timely, and compliant utilization management.
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Mitarbeiter:in Medizinische Schnittstelle (D/W/M)↗ Tiplu GMBHRemote 4d Transferring data from electronic patient records into software, analyzing and categorizing billing-relevant medical data (medications, lab values, documents), and maintaining structured medical data to ensure high data quality.
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Kodierfachkraft (m/w/d)/ Kodierkraft (m/w/d) Klinikum Lippe GmbHDetmold, NORDRHEIN_WESTFALEN 4d Coding and billing specialist ensuring accurate medical documentation and revenue collection for a university hospital.
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Physician Advisor↗ Holy Cross HealthSilver Spring, MD 4d Physician Advisor providing expertise in utilization/level of care management, length of stay optimization, patient flow, clinical documentation improvement, and care coordination.
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Revenue Integrity Analyst↗ University of WashingtonRemote $84k–$108k4d Ensure accuracy and integrity of healthcare billing and charge capture data across UW Medicine to optimize reimbursement and mitigate denials.
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Remote Medical Director, Pharmacy↗ Centene CorporationRemote $237k–$449k4d Provide medical leadership for utilization management, cost containment, and quality improvement activities for a health insurance business unit.
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Onsite Physician Advisor↗ Christus St. VincentSan Antonio, TX 4d Physician advisor serving as a consultant and resource to utilization review and care management staff on medical necessity, level of care, patient care progression, and denial management.
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Medical Coder Professional_ Part Time UmmcRemote 4d Review outpatient medical records to assign appropriate ICD-10, CPT, and HCPCS codes, ensuring compliance with regulations and payer policies to facilitate correct reimbursement.
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Coding & Compliance Auditor AoncologyRemote 4d Perform E/M audits, summarize results, communicate outcomes, and complete follow-up or educational needs for physicians and claims specialists.
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Appeals Specialist II HcscRemote 4d Process and adjudicate complex non-utilization management appeals for members according to federal, state, and NCQA requirements; respond to member inquiries via phone, in person, or writing.
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Quality Control Indexing Analyst↗ Houston MethodistHouston, TX, US 4d Reviewing quality of scanned patient medical records and loose documents in the medical record imaging system, indexing documents to appropriate patient folders, and performing document prepping and scanning.
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Corporate MD Grievance & Appeals HumanaRemote $246k–$344k4d Provide clinical interpretation and independent determinations regarding the appropriateness, necessity, and quality of healthcare services for grievance and appeal cases across Medicare, Medicaid, and Commercial products.
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RCM OPH/RCM Specialist-Vision EcpcareersRemote 4d Manage revenue cycle operations for ophthalmology practices, including billing, coding, payment posting, and accounts receivable follow-up.
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Nurse, Concurrent Review Wns-Global-ServicesRemote $75k5d Performs concurrent inpatient utilization review using InterQual criteria to determine medical necessity for admission, continued stay, and transitional care.
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Lead Medical Director, Utilization Management CloverhealthRemote $320k–$340k5d Lead Medical Director responsible for evaluating outpatient referrals and inpatient admissions for medical necessity, managing a team of Utilization Management Medical Directors, and developing clinical policies.
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Responsable PMSI (F/H) Groupe Hospitalier Paris Saint JosephParis, IDF, fr 5d Manage PMSI (French hospital activity-based funding) data quality, coding, and reporting for two hospitals to support medical-economic performance.
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Medicare Advantage Utilization Management Physician (Agency Temp, Part-time) ScanhealthplanRemote 5d Physician-level decision-making for prior authorization, concurrent review, and appeals in Medicare Advantage plans, serving as clinical authority for medical necessity determinations.
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