• Regulatory Compliance Consultant

    HCA Healthcare (Nashville, TN)
    …**Education & Experience:** + Minimum of five (5) years' experience in a healthcare setting for coding , revenue cycle, clinical coverage, or other related ... have an exciting opportunity for you to join HCA Healthcare which is part of the nation's leading provider...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (09/04/25)
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  • Medical Billing Specialist

    KPH Healthcare Services, Inc. (Syracuse, NY)
    …Summary:** Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate ... assigned tasks. Establish, manage, and communicate the process of billing medical claims for specialty facilities. **Responsibilities** **Job Duties:** +… more
    KPH Healthcare Services, Inc. (10/08/25)
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  • Billing Integrity Analyst Credentialed

    HCA Healthcare (San Antonio, TX)
    …or healthcare license/certification required. + Minimum 1 year directly related Healthcare experience or coding experience required. + Knowledge of CPT/HCPCS ... of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (09/18/25)
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  • Medical Coder II

    Ellis Medicine (Schenectady, NY)
    …weekly chart audits for practice providers to optimize accurate documentation and coding . Additionally, all Medical Coder will participate in regularly scheduled ... insurance coding and billing experience required. + Working knowledge of healthcare revenue cycle functions, including coding and billing guidelines and… more
    Ellis Medicine (09/24/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Nampa, ID)
    …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... with various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation… more
    Molina Healthcare (09/22/25)
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  • Healthcare Analytics Business Consultant…

    CVS Health (FL)
    …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... and is ideal for a data professional with strong coding skills in SQL and Python who can transform...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
    CVS Health (10/08/25)
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  • Medical Records Tech 2

    State of Minnesota (Anoka, MN)
    …and claims processing. Provide training and education to DCT Medical Staff and other appropriate staff to ensure appropriate documentation and accurate ... + **Division/Unit** : DCT Support Services / DCT HIMS Coding + **Work Shift/Work Hours** : Day Shift +...claims processing. + Provide training and education to Medical Staff and other appropriate staff to ensure appropriate… more
    State of Minnesota (10/09/25)
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  • Medical Investigator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …documents including, but not limited to provider contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding ... and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. +...within one year of hire date. + Knowledge of medical record coding conventions (eg CPT, DRG,… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    …it relates to reimbursement methodologies Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 ... relates to reimbursement methodologies + Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10… more
    AdventHealth (08/19/25)
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  • Payment Integrity Auditor II

    Premera Blue Cross (Mountlake Terrace, WA)
    …and provider billing investigation. This role requires a deep understanding of medical claims adjudication, coding compliance, and regulatory guidelines. ... of itemized bills, medical records, and other claims data to validate coding accuracy and...auditing best practices. + Stay informed about changes in coding standards, payer policies, and healthcare regulations,… more
    Premera Blue Cross (09/24/25)
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