• Utilization Review Nurse - Remote

    Martin's Point Health Care (Portland, ME)
    …use effective relationship management, coordination of services, resource management, education , patient advocacy and related interventions to ensure members receive ... the review of medical claims disputes, records, and authorizations for billing, coding , and other compliance or reimbursement related issues + Collaborates with… more
    Martin's Point Health Care (01/16/26)
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  • Billing/Follow-up Specialist - Government Billing

    PeaceHealth (Vancouver, WA)
    …rate is dependent upon several factors, including but not limited to education , training, work experience, terms of any applicable collective bargaining agreement, ... billing of claims, and receipt of payment. + Handles submission of issues to coding for review to ensure organizational and revenue cycle processes are followed. +… more
    PeaceHealth (01/14/26)
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  • Senior Clinical Doc Specialist

    Kaleida Health (Buffalo, NY)
    …to the clinical team and collaborates extensively with Physicians/Providers, HIM coding team, Nursing, Patient Management, Quality Department and ancillary staff to ... perform concurrent analytical review of clinical documentation and coding data. Facilitates obtaining appropriate clinical documentation for any clinical conditions… more
    Kaleida Health (01/14/26)
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  • Senior Nurse Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    …pay or deny a claim or claim lines using clinical and/or coding , billing, or reimbursement knowledge. Maintain appropriate records and supporting documentation ... teams to correlate review findings with appropriate actions (eg, provider education through original, complex, and technical letters, meeting and negotiating with… more
    CareFirst (01/13/26)
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  • Clinical Investigator Behavioral Health

    Centene Corporation (Harrisburg, PA)
    …years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred. ... investigative support to the Special Investigations Unit (SIU) related to coding and billing issues and identifies potential overpayments and suspected health… more
    Centene Corporation (01/11/26)
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  • Revenue Integrity Analyst

    Hartford HealthCare (Farmington, CT)
    …reporting to the Revenue Integrity Manager. 4) Provides guidance, communication and education on correct charge capture, documentation, coding and billing ... Responsibilities:_* *Key Areas of Responsibility* 1) Evaluates current charging and coding structures and processes in revenue generating departments to ensure… more
    Hartford HealthCare (01/08/26)
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  • Manager, Denial, Appeal, & Audit

    Guthrie (Sayre, PA)
    …tools + Ability to manage multiple priorities in a fast-paced environment Education Bachelor's degree in health administration, Nursing, Business or related field ... required. This requirement may be satisfied through an equivalent combination of education and 10 years prior experience in healthcare, or insurance with… more
    Guthrie (01/02/26)
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  • Full Stack Cloud Developer (AI/ML integration)

    St. George Tanaq Corporation (Tallahassee, FL)
    …architecture diagrams, deployment/runbooks) in approved repositories. + Ensure secure coding , automated testing, CI/CD, and alignment with 508 accessibility and ... with CI/CD and DevSecOps integration. + Front-end development expertise designing and coding user interfaces with frameworks React.js and React + TypeScript. +… more
    St. George Tanaq Corporation (12/30/25)
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  • Software Database Developer

    CACI International (Sterling, VA)
    …self-motivated, fast-learning, and organized and have solid software development knowledge, coding experience, and the ability to perform complex SQL Server database ... such as theft or fraud + Applicable combination of education and experience: + Software Database Developer T3 -...more experience in incremental software development projects + Strong coding skills in C#, .NET, Angular, Java, Python, etc.… more
    CACI International (12/25/25)
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  • Senior HIMS Technician

    Banner Health (Greeley, CO)
    …monitoring functions. CORE FUNCTIONS 1. Assist with the orientation, training and re- education of HIMS staff. Liaison between management and the HIMS staff for ... release of health information and HIPAA. 6. Support the coding function, acting as a liaison between HIMS operations,...completion of one or more years of post-high school education or experience in medical records and information systems… more
    Banner Health (12/19/25)
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