• RN or LPN - Utilization Manager

    Northeast Alabama Regional Medical Center (Anniston, AL)
    …to ensure accurate and thorough documentation that will result in correct DRG assignment and improve reimbursement. Performs admissions and continued stay reviews to ... assure hospitalizations meet payor requirements. Maintains records of review information and outcomes for billing purposes and for compliance with requirements of… more
    Northeast Alabama Regional Medical Center (11/15/25)
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  • ProFee Audit Specialist FT- 2,500 Sign on Bonus

    Datavant (Boise, ID)
    …on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper ... for review by the facility or CCS HIM director. + Review disagreements on APC/ DRG changes with the appropriate manager. + Prepare the final reports for the… more
    Datavant (11/05/25)
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  • Inpatient Coder IV

    Dignity Health (Rancho Cordova, CA)
    …emergency department, same-day surgery, and observation charts if needed. + Review provider documentation to determine the principal diagnosis, co-morbidities and ... Coding in relation to DRGs + Abstract additional data elements during the chart review process when coding, as needed + Utilize technical coding principals and MS-… more
    Dignity Health (11/20/25)
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  • HIM Coder I - HIM Financial - Full Time 8 Hour…

    University of Southern California (Alhambra, CA)
    …a minimum of 95% coding accuracy rate as determined by any internal or external review of coding and/or department quality review (s). + Ability to achieve a ... data elements as determined by any internal or external review of coding and/or department quality review (s)....on coding issues and questions. + Ability to improve MS- DRG assignments specific to the documentation & coding of… more
    University of Southern California (11/19/25)
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  • Regulatory Compliance Manager - Hybrid/Remote

    University of Utah (Salt Lake City, UT)
    …Recruitment** External Posting **Pay Rate Range** $47,600-$70,000 **Close Date** 02/13/2026 **Priority Review Date (Note - Posting may close at any time)** **Job ... **Responsibilities** **Essential Functions** + Supports Compliance Administrator in policy review and creation. + Monitors and assists in drafting required… more
    University of Utah (11/15/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Nashville, TN)
    …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued stay ... should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with clinical… more
    Datavant (11/12/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Rochester, NY)
    …team and key stakeholder meetings (PowerPoint) + Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... reports and makes recommendations based on relevant findings. + Provides peer review of pricing configuration to ensure accuracy of financial modeling + Provides… more
    Molina Healthcare (12/08/25)
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  • Registered Nurse Coding Auditor

    Northwell Health (Glen Cove, NY)
    …the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes ... State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules… more
    Northwell Health (12/03/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Miami, FL)
    …team and key stakeholder meetings (PowerPoint) * Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... reports and makes recommendations based on relevant findings. * Provides peer review of pricing configuration to ensure accuracy of financial modeling * Provides… more
    Molina Healthcare (11/21/25)
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  • Coder Sr.

    Corewell Health (Caledonia, MI)
    …Related Groups ( DRG ) or All Patient Refined Diagnostic Related Groups (APR- DRG ) accuracy.The outpatient senior coder will review multiple service lines of ... Job Summary The inpatient senior coder will thoroughly review inpatient record accounts to assign correct ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes… more
    Corewell Health (11/21/25)
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