• Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing ... and clinical coding and reimbursement edits and necessary coding ...employment - + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA)… more
    Commonwealth Care Alliance (11/25/25)
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  • Authorization Specialist , Digestive Health…

    UPMC (Pittsburgh, PA)
    …regulations to determine medical necessity or the clinical appropriateness for inpatient admissions, outpatient facility , office services, durable medical ... UPMC Digestive Health Care is hiring a full-time Authorization Specialist to join their team at Shadyside Medical Building, Pittsburgh! In this position, you will… more
    UPMC (12/12/25)
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  • Billing Specialist -Msh-78319-029

    Mount Sinai Health System (Elmhurst, NY)
    **Job Description** Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a ... High School Diploma. Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC /… more
    Mount Sinai Health System (09/18/25)
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  • Clinical Documentation Specialist RN

    Hackensack Meridian Health (Red Bank, NJ)
    inpatient admissions and observations as specified by the facility 's Utilization Management/Review Committee for documentation completeness and compliance with ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
    Hackensack Meridian Health (12/05/25)
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  • Senior Revenue Cycle Specialist

    Stony Brook University (East Setauket, NY)
    Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the **Senior Revenue Cycle Specialist ** will act as an operational leader in the ... variances and denials. + Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies. + Expert knowledge of third party… more
    Stony Brook University (11/22/25)
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  • Health Information Specialist / Office…

    State of Minnesota (Anoka, MN)
    …Management Service (HIMS) team for an exciting opportunity as a Health Information Specialist ! This position will work closely with facility staff in regard ... **Working Title: Health Information Specialist ** **Job Class: Office and Administrative Specialist...requests for medical records for admissions and discharge for inpatient and outpatient programs + Manage data collection of… more
    State of Minnesota (12/12/25)
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  • Transplant Charge Specialist - Kidney…

    University of Southern California (Los Angeles, CA)
    The Transplant Charge Specialist (TCS) is responsible for the comprehensive review of charges under the transplant program and revenue capture surrounding transplant ... liver, kidney, pancreas, etc.) for commercial, Medicare, hospital-based, provider-based inpatient and outpatient transplant accounts to support appropriate allocation… more
    University of Southern California (11/19/25)
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  • Denials Prevention Specialist , Clinician…

    Datavant (Nashville, TN)
    …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of ... medical necessity and necessity of continued stay in the inpatient patient care setting and/or discharge to an alternative...requirements as mandated by the TAT Standards of the facility and/or CIOX Health Standards + Work directly with… more
    Datavant (11/12/25)
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  • Scheduling Specialist - Physician…

    Bon Secours Mercy Health (Greenville, SC)
    …operational excellence. **Primary Function/General Purpose of Position** The Surgery Scheduling Specialist is responsible for accurately scheduling all inpatient ... scheduled procedures and any changes to the schedule. The surgery scheduling specialist would be responsible for verifying patient benefits and precertification from… more
    Bon Secours Mercy Health (11/06/25)
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  • CDI Specialist

    Albany Medical Center (Albany, NY)
    …Shift: Day (United States of America) Salary Range: $71,612.39 - $110,999.20 This CDI Specialist opening is located at Glens Falls Hospital. The CDI Specialist ... clinical information used for measuring and reporting physician and facility outcomes Education: + Bachelor's degree in nursing or...Certification such as CDIP or CCDS preferred + Valid Coding certification such as CCA or CCS preferred +… more
    Albany Medical Center (11/28/25)
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