Medical Coding
584 open positions
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Clinical Provider Auditor II ElevancehealthGA-ATLANTA, 740 W PEACHTREE ST NW, US 2d Examines claims for compliance with billing guidelines to identify fraud, waste, and abuse risks before payment.
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Prior Authorization Coordinator, Pharmacy Buisness office, 40hr, Day UmmhWorcester, MA University Campus, US $0k–$0k2d Obtains authorization numbers from insurance companies, reviews prior authorization requests for medical necessity, and determines appropriate benefit coverage for general and oncology infusion clinics.
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Coder - Radiology↗ University of Colorado MedicineRemote 2d Review and process professional charges for radiology services, ensuring accurate billing by assigning ICD-10 codes and verifying CPT accuracy and modifiers.
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Medical Coder - Outpatient Coding - Part Time UmmcRemote 2d Reviewing and coding outpatient medical records and documentation for healthcare services rendered to ensure accurate reimbursement and compliance.
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Remote Medical Director, Pharmacy CenteneRemote $237k–$237k2d Provide medical leadership for utilization management, cost containment, and quality improvement activities for a health insurance business unit.
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Medical Director Medical Operations- Geisinger Health Plan GeisingerRemote 2d Lead medical management for all Health Plan inpatient activity including acute care, LTAC, observation, SNF, rehab, and ambulatory surgery within a regional network.
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Provider Credentialing and Onboarding Coordinator WvumedicineOperations Support Center, US 2d Coordinates the transition of provider credentials, licenses, and privileges for new physicians and APPs, ensuring compliance with state boards and hospital standards.
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Senior Claim Benefit Specialist - Remote CvshealthRemote $0k–$0k2d Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines.
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Medical Review II (Medicare) BroadwayventuresRemote $62k–$62k2d Licensed Registered Nurse performing complex medical review of Medicare claims for Inpatient Rehabilitation Facility (IRF) services, including pre-claim and post-payment determinations.
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CDQI Nurse Specialist DatavantUSA $0k–$0k2d Conduct daily evaluations of inpatient medical records to enhance documentation clarity, completeness, and accuracy for DRG-based payer patients.
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Credentialing Specialist, Bureau of Revenue City-Of-New-YorkLong Island City, NY, us 2d Verify clinical provider qualifications and manage insurance network enrollment to ensure regulatory compliance and revenue collection for patient care.
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Medical Director - OP Medicare JobgetherRemote $224k–$224k2d Remote physician leadership role focused on complex outpatient utilization management for Medicare populations, applying clinical expertise to evaluate authorization requests, medical necessity, level of care, and site-of-service decisions.
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Associate Clinical Documentation Improvement Specialist - Part Time Mercy HealthJoplin, Missouri 3d Reviews inpatient medical records to ensure accuracy, completeness, and compliance, reflecting true clinical scenarios, Severity of Illness (SOI), and Risk of Mortality (ROM) for quality care measurement and reporting.
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Team Lead, Clinical Care Review CareSourceRemote, US $72k–$72k3d Provide direct oversight of Clinical Care Review (CCR) employees, manage day-to-day workflow, and ensure cost-effective delivery of healthcare services for CareSource members.
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Payment Integrity Concept Development Analyst - Outpatient↗ MachinifyRemote $80k–$80k3d Develop, maintain, test, and optimize payment integrity audit concepts for government and commercial healthcare claims to ensure accurate billing and compliance.
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Authorization Specialist I SaintfrancisRemote - OK, US 3d Ensures accuracy of insurance information and procures prior authorization and predetermination for scheduled patient appointments and inpatient admissions to prevent claim denials.
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Grievance Specialist DevotedRemote $0k–$0k3d Resolve member grievances and Medicare Advantage appeals with accuracy, efficiency, and compassion while ensuring regulatory compliance.
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Grievances & Appeals Rep - IRT HumanaRemote $48k–$48k3d Manage Level 1 appeal cases by reviewing clinical documentation to determine if further action is needed and validate final determinations for Humana members.
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Cancer Registry Registrar DenverhealthFully Remote (CO), US $56k–$56k3d Compiles and maintains statistical diagnostic and treatment information on cancer patients, managing case finding, coding, abstracting, and state reporting for Denver Health's Cancer Registry.
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Required Doctors _ Non Clinical _ Working from Office _ Freshers↗ Medi Assist Insurance Tpa Private LimitedJH, IN $264k–$264k3d Auditing processed claims and pre-authorizations to validate process guidelines, quality, and terms while ensuring no financial implications for the organization during settlement.
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Health Claims Investigator (Field Staff)↗ Ocean GroupTN, IN $120k–$180k3d Investigate insurance claims related to medical treatments and procedures to determine legitimacy and accuracy.
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Prior Authorization Specialist AdaptivebiotechnologiesRemote $45k–$45k3d Obtain insurance approvals for Adaptive Biotechnologies' clonoSEQ MRD Assay to facilitate patient access to essential laboratory services.
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Coder III, Professional Billing↗ Hackensack Meridian HealthRemote $0k–$0k4d Accurately abstract patient data and assign medical codes for reimbursements, research, and compliance across the Hackensack Meridian Health network.
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EMR Support Specialist↗ Parrish Medical CenterTitusville, FL, US 4d Ensures EMR integrity, acts as super-user for HIM applications, monitors scanned document quality, audits medical records, and compiles/reports data for stakeholders.
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Lead Coding Outpatient Specialist (Emergency Medicine Facility Coding) - REMOTE↗ Vanderbilt HealthRemote 4d Lead the review, accurate assignment, and abstraction of diagnostic and procedural codes for outpatient facility encounters.
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Medical Officer↗ Vidal Health Tpa Private LimitedRemote $250k–$250k4d Review and assess medical claims by verifying diagnosis, treatment details, and medical records to evaluate medical necessity and detect fraud.
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RN Clinical Documentation Education & Compliance Consultant BannerhealthRemote 4d Educate and mentor Clinical Documentation Improvement (CDI) staff and providers on documentation standards, audit charts for compliance, and develop training materials to ensure accurate clinical documentation and DRG alignment.
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Team Lead, Auditing CoherehealthRemote $100k–$100k4d Lead a team of auditors to conduct comprehensive reviews of inpatient, outpatient, and professional claims, ensuring coding accuracy and maximizing overpayment identification using AI-driven tools.
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Physician Advisor – (P2P) Medical Reviewer (1099 Contractor) CloverhealthRemote - USA $240k–$240k4d Licensed physician conducting peer-to-peer clinical discussions to determine medical necessity and level of care for Medicare Advantage members.
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Release of Information Specialist Charlie Health Behavioral Health OperationsRemote $44k–$44k4d Ensures secure and authorized exchange of protected health information while maintaining compliance with privacy laws.
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