- Bozeman Health (Bozeman, MT)
- …guidelines, payer requirements, HIPAA Privacy and Security Rules, and foundational healthcare regulations (eg, Anti‑Kickback Statute, False Claims Act, EMTALA). ... compliance with applicable laws, regulations, payer rules, and internal policies. + Reviews medical and billing records for coding accuracy and medical … more
- Humana (Springfield, IL)
- …and quality related topics. + Educate on processes including claims submissions, recoupments, reconsiderations, authorizations, referrals, medical record ... limits. **Preferred Qualifications** + Bachelor's Degree. + Understanding of claims systems, adjudication, submission processes, coding , and/or dispute… more
- VetsEZ (CA)
- …platforms, we enable smarter decisions, seamless patient engagement, and more efficient claims management. Together, we are shaping a healthcare ecosystem that ... and deploy scalable, AI-enabled microservices using AWS, Node.js, and Python to power healthcare platforms that handle high-volume clinical and claims data. +… more
- UPMC (Pittsburgh, PA)
- …technical school diploma is preferred. + 3 or more years of experience in medical coding , billing, auditing and compliance. + Extensive knowledge of CMS, and ... Compliance Auditor!** Are you passionate about ensuring accuracy and compliance in healthcare documentation and billing? Do you thrive in a dynamic environment where… more
- University of Washington (Seattle, WA)
- …Follow-Up Specialist, Medicare** is responsible for the optimal payment of claims from Medicare through work queues throughout the Revenue Cycle, including ... and accurate work with the goal of resolving outstanding claims quickly and maximizing appropriate revenue. + Accurately decipher...analyzing rejection issues. + Identify and resolve payor specific coding issues and provide feedback to Coding … more
- State of Montana (Helena, MT)
- …for this Career Opportunity ** * Knowledge of Medicaid rules, medical claims processing, medical terminology and coding principles and practices. * ... information, accounting, business, or social sciences related field. o Two years of experience with medical claims , medical coding , or medical review… more
- Adecco US, Inc. (Florence, SC)
- **We're Hiring: Experienced Medical Biller for Pediatric Office** Are you a detail-oriented, compassionate professional with a passion for pediatric healthcare ? ... make a meaningful impact in the lives of children and families! **Position:** Medical Biller **Location:** Lake City SC **Schedule:** Monday - Friday (No weekends!)… more
- Centene Corporation (Lansing, MI)
- …within a managed care environment related to HEDIS record review, quality improvement, medical coding or transferable skill sets that demonstrates the ability to ... performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Assists in delivering provider specific...education to providers and provider staff OR 2 years medical coding or other transferable experience and… more
- CVS Health (Salt Lake City, UT)
- …skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical coding , and regulatory frameworks. + Excellent ... and coding practices, verifying document authenticity, and identifying false claims or improper billing. + **Data-Driven Analysis** : Utilizes advanced data… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …The Billing Specialist will be responsible for processing the full lifecycle of medical claims -from charge entry and claim submission to payment posting, denial ... + High school diploma or equivalent required; associate degree or certification in medical billing/ coding (eg, CMB, CMRS) strongly preferred. + Minimum 2 years… more