• Carelon Medical Coding /Auditing…

    Elevance Health (Hanover, MD)
    **Carelon Medical Coding /Auditing Manager - Behavioral Health** **Supports Payment Integrity & Behavioral Health** **Location: Must be located in Maryland.** ... and insightful analytics to improve the delivery of care. The **Medical** ** Coding /Auditing** ** Manager ** is responsible for ensuring the accuracy of claims… more
    Elevance Health (09/23/25)
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  • Billing and Credentialing Specialist

    WestCare Foundation (Dandridge, TN)
    …programs, and other payers. + Charge Entry: Accurately enter charges into the billing system based on patient services and coding information. + Payment ... regular audits of patient accounts to ensure accuracy in billing and coding , and identify any discrepancies...other key metrics for review by the Revenue Cycle Manager . + Collaboration: Work closely with the coding more
    WestCare Foundation (09/04/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. + Knowledge ... **DRG CODING AUDITOR** **_Virtual_** **_: _** _ _ _​_...letter writing). + Identifies new claim types by identifying potential claims outside of the concept where additional recoveries… more
    Elevance Health (10/13/25)
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  • Denials Specialist 2 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    coding guidelines. *_Working Relationship:_* *This Job Reports To (Job Title):*HIM Manager Coding Quality and Education *Education* . Minimum: Associate ... regular audits of clinical documentation to ensure it supports coding and billing practices and meets payer...that proper documentation is collected and maintained to avoid potential denials or incomplete information. . Develop and implement… more
    Hartford HealthCare (09/30/25)
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  • Coding & Reimbursement Spec

    Children's Mercy Kansas City (Kansas City, MO)
    …experience. The incumbent must understand and be able to successfully apply all billing , coding and documentation regulations related to transport or EMS ... transport charge capture process by ensuring accurate and timely documentation, coding and charge entry of transport services. Collaborates with transport… more
    Children's Mercy Kansas City (10/14/25)
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  • Manager , Denial, Appeal, & Audit

    Guthrie (Sayre, PA)
    …payer-specific appeal timelines and protocols + Collaborate with clinical, utilization management, billing , HIM, and coding teams to resolve medical necessity ... Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management...in healthcare or insurance with responsibility in revenue cycle billing , reimbursement and denial mitigation. Must possess excellent working… more
    Guthrie (10/03/25)
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  • Risk Score Accuracy (RSA) Program Manager

    Bon Secours Mercy Health (Cincinnati, OH)
    …BSMH coders and Revenue Cycle team, BSMH Compliance and Internal Audit teams, Ensemble coding and billing leaders, BSMH leaders, and Population Health team to ... Function/General Purpose of Position** The Risk Score Accuracy (RSA) Program Manager provides leadership, oversight, coordination, and subject matter expertise for… more
    Bon Secours Mercy Health (10/04/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Sioux Falls, SD)
    …expertise with both pharmacy and medical/buy & bill benefits (as applicable), coding , and billing . + Reimbursement or relevant managed care experience ... state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access acumen as it relates… more
    J&J Family of Companies (10/03/25)
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  • Field Reimbursement Manager Immunology GI-…

    J&J Family of Companies (Seattle, WA)
    …relationship + Demonstrated expertise with both pharmacy and medical/buy & bill benefits, coding , and billing + Reimbursement or relevant managed care experience ... state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access acumen as it relates… more
    J&J Family of Companies (09/27/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Columbus, OH)
    …expertise with both pharmacy and medical/buy & bill benefits (as applicable), coding , and billing . + Reimbursement or relevant managed care experience ... Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will...Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
    J&J Family of Companies (10/09/25)
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