• Manager Rating/ Claims System Analyst

    Elevance Health (Norfolk, VA)
    …would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Medical Coding experience highly preferred. + Clinical Code editing ... **Manager Rating/ Claims System Analyst** **Location:** This role enables associates...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (10/02/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Louisville, KY)
    …understand the vocabulary used in hospital & professional revenue cycle operations, including healthcare coding such as DRGs, CPT/HCPC, Revenue Codes, APG and ... reports, and assessing strengths and weaknesses of competitors + Studying healthcare industry standards and staying up-to-date on industry changes and compliance… more
    Waystar (08/08/25)
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  • Specialist, Config Oversight ( healthcare

    Molina Healthcare (NE)
    …or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of… more
    Molina Healthcare (09/24/25)
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  • PRN - Medical Coder/Records Clerk

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    …companies and healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent with the ... research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing,… more
    Dallas Behavioral Healthcare Hospital (08/08/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge ... refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience +… more
    Molina Healthcare (09/06/25)
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  • Medical Claim Review LVN/LPN (CA LVN…

    Molina Healthcare (Long Beach, CA)
    …standards. **Knowledge/Skills/Abilities** * Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously ... years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review. **Required License, Certification, Association** Active,… more
    Molina Healthcare (09/17/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …* Bachelors degree or equivalent work experience Experience * Minimum of 3-5 years in medical claims coding required * Experience working with CMS, health ... working in an educational/training role preferred. Licensure, Certification, Registration Medical Coding Certification, Certified Professional Coder (CPC),… more
    Hartford HealthCare (09/11/25)
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  • Senior Analyst, Medical Economics (Vbc)…

    Molina Healthcare (NY)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
    Molina Healthcare (08/31/25)
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  • Manager, Medical Economics (Medicaid)…

    Molina Healthcare (Scottsdale, AZ)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
    Molina Healthcare (08/27/25)
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  • Outpatient Coder

    HCA Healthcare (Nashville, TN)
    …that invests in you as an Outpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team ... Monday-Friday Flexible Hours** **This position requires Facility Based Outpatient Coding ** **Benefits** Parallon offers a total rewards package that supports… more
    HCA Healthcare (09/06/25)
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