• Clinical Government Audit Analyst and Appeal…

    Stanford Health Care (Palo Alto, CA)
    …Denial Analysis: Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding with ICD, HCPCS, ... medical and insurance terminology, MS-DRG, APR-DRG, CPT, ICD coding structures, and billing forms (UB, 1500). + Experience...structures, and billing forms (UB, 1500). + Experience with coding , clinical validation, and medical necessity for… more
    Stanford Health Care (11/14/25)
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  • Medical Director - Claims Mgmt…

    Humana (Sacramento, CA)
    …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements… more
    Humana (11/01/25)
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  • Charge Description Master Specialist…

    Providence (CA)
    …RC CHARGE DECR MSTR **Address:** TX Lubbock 3615 19th St **Work Location:** Covenant Medical Center **Workplace Type:** Remote **Pay Range:** $see posting - $see ... **Description** **Charge Description Master Specialist \* Remote -Most states eligible As a member of the...ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided.… more
    Providence (11/22/25)
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  • Revenue Integrity Program Manager ( Remote

    Stanford Health Care (Palo Alto, CA)
    …existing tools to evaluate CDM requests with a focus on regulatory coding , compliance, and adherence to SHC internal guidelines regarding CDM maintenance, standard ... ease of communication with Clinical staff and faculty + Solid understanding of coding conventions and current third-party payer rules and regulations Knowledge of … more
    Stanford Health Care (10/14/25)
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  • HCC Risk Adjustment Coder - Full Time…

    Datavant (Sacramento, CA)
    …healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring ... Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the...guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by… more
    Datavant (11/14/25)
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  • CDQI Nurse Specialist - Part Time - Remote

    Datavant (Sacramento, CA)
    …you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication ... with providers to enhance documentation clarity, completeness, and overall medical record quality. By ensuring accurate and comprehensive physician documentation,… more
    Datavant (11/11/25)
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  • ( Remote ) Claims Team Lead - Workers…

    Sedgwick (Sacramento, CA)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance ( Remote ) Claims Team Lead - Workers Compensation | AZ, CO, UT Jurisdictions Are ... recommendations and written summaries as needed. + Ensuring accurate claim coding and documentation by examiners. **QUALIFICATIONS** Education & Licensing: 5+ years… more
    Sedgwick (11/08/25)
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  • Claims Examiner | Multi-Line | Public Entity…

    Sedgwick (Sacramento, CA)
    …in Financial Services & Insurance Claims Examiner | Multi-Line | Public Entity | Remote Are you looking for an opportunity to join a global industry leader where ... client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management.… more
    Sedgwick (10/15/25)
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  • Claims Examiner | General Liability BI | Captive…

    Sedgwick (Sacramento, CA)
    …in Financial Services & Insurance Claims Examiner | General Liability BI | Captive | Remote As a Claims Examiner at Sedgwick, you'll have the opportunity to take on ... daily work and your career path. This is a remote , work-at-home, telecommuter position. + Be a part of...+ Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to… more
    Sedgwick (09/06/25)
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  • Senior Field Sales Manager ( Remote )

    Wolters Kluwer (Sacramento, CA)
    Senior Field Sales Manager- Remote Work with Healthcare Providers, Payers, Consultants, Insurance Companies, Corporations and State/Local Government Agencies to sell ... and maintain Wolters Kluwer Healthcare Regulatory & Coding Solutions. **_ This position will work from a remote office and can be based anywhere in the US_**… more
    Wolters Kluwer (09/10/25)
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