• Clinical Government Audit Analyst & Appeal…

    Stanford Health Care (Palo Alto, CA)
    …Denial Analysis: Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding with ICD, HCPCS, CPT ... comprehensive appeal letters to payors after a detailed review of medical records. Ensure compliance with Medicare, Medicaid, third-party guidelines, Local Coverage… more
    Stanford Health Care (10/10/25)
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  • Certified Risk Adjustment Coding/Audit Specialist

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …AAPC or AHIMA Certification (CPC, CRC, CCS) REQUIRED + Certified Risk Adjustment Coder - PREFERRED Knowledge + Knowledgeable of medical and clinical terminology, ... long-term success including education assistance, scholarships, and career training. With medical and dental coverage, access to childcare & fitness facilities on… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Coding Specialist, Coding & Compliance, Full Time

    Trinity Health (Fresno, CA)
    …for the designated specialty areas and other major procedural areas. The Certified Medical Coder focuses their work on the detailed physician chart abstraction ... Type:** Full time **Shift:** Day Shift **Description:** Reporting to the Manager Medical Group Revenue Cycle Site Operations, Fresno, this position is responsible… more
    Trinity Health (10/23/25)
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  • Payment Integrity Auditor II

    Premera Blue Cross (Mountlake Terrace, WA)
    …equivalent combination of education and experience. + (3) years of related medical coding/auditing experience. + Certified Professional Coder Designation (CPC, ... a critical role in identifying audit opportunities, complex analysis, and provider billing investigation. This role requires a deep understanding of medical more
    Premera Blue Cross (09/24/25)
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  • Certified Coding Specialist - Profee

    UPMC (Pittsburgh, PA)
    …offices as needed. In this role, you will be responsible for reviewing medical charts to identify opportunities for process improvement. You will conduct audits to ... suggestions for operational improvements. + Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate… more
    UPMC (10/08/25)
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  • Compliance Auditor (FT- 1.0, Day Shift)

    Bozeman Health (Bozeman, MT)
    …compliance with applicable laws, regulations, payer rules, and internal policies. + Reviews medical and billing records for coding accuracy and medical ... role partners with departments across the organization to assess billing , coding, privacy/security, and operational practices; identifies vulnerabilities; and… more
    Bozeman Health (10/02/25)
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  • Inpatient Coding Review Specialist (H)

    University of Miami (Medley, FL)
    …ensure accurate and compliant coding on all Mortality cases prior to billing . The Inpatient Coding Review Specialist also performs quality reviews that specifically ... CORE JOB FUNCTIONS + Reviews, analyzes, and interprets the complete electronic medical record (EMR) after initial coding to identify missed coding opportunities… more
    University of Miami (10/21/25)
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  • CDI Specialist II

    Mayo Clinic (Rochester, MN)
    …can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical : Multiple plan options. + Dental: Delta Dental or reimbursement account for ... package to secure your future. **Responsibilities** Reviews inpatient and/or outpatient medical records to ensure accurate representation of severity of illness.… more
    Mayo Clinic (10/15/25)
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  • Supervisor Provider Coding Specialist

    Tidelands Health (Myrtle Beach, SC)
    …the institution. Serves as a resource and technical expert for complex coding/ billing issues. Informs, educates, and coordinates with other Revenue Cycle, Clinical ... will do** + Leads and guides staff that performs medical coding functions and supervises the processes and systems...of staffing schedule to achieve timely coding, provider and coder audits, identification of and implementation of proactive denial… more
    Tidelands Health (10/01/25)
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  • RN or LPN - Utilization Manager

    Northeast Alabama Regional Medical Center (Anniston, AL)
    …meet payor requirements. Maintains records of review information and outcomes for billing purposes and for compliance with requirements of regulatory agencies and ... for retrospective reviews by outside agencies. Reviews the patients' medical record for documentation issues as they relate to...relate to the working DRG developed by the Case Manager/ Coder . Assists with special projects as directed or requested… more
    Northeast Alabama Regional Medical Center (09/27/25)
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