• Diagnosis Related Group Clinical Validation…

    Elevance Health (Louisville, KY)
    …accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing aberrant coding ... medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (01/05/26)
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  • Lead Investigator, Special Investigative…

    Molina Healthcare (Covington, KY)
    …integrity programs. The position must have the ability to determine correct coding , documentation, potential fraud, abuse, and over utilization by providers ... **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead...The position will review claims data, medical records, and billing data from all types of healthcare providers that… more
    Molina Healthcare (11/21/25)
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  • Registered Nurse Consultant (Nationwide)

    Vatica Health (Glasgow, KY)
    …physicians, advanced practice providers and medical office personnel such as Practice and Billing Manager , both verbally and written + Understanding of health ... care (ie, ICU/CCU/MICU) and/or ED) + Proficiency with Diagnosis, Billing , and Quality Measures Coding a plus...the top talent deserves the top dollar + Bonus Potential (based on role and is discretionary) - If… more
    Vatica Health (12/21/25)
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