• Medical Review Nurse (RN)- Remote

    Molina Healthcare (Rio Rancho, NM)
    …an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical ... applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified… more
    Molina Healthcare (01/09/26)
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  • Certified Professional Coding Specialist

    Genesis Healthcare (PA)
    …of provider education around the importance and applicability of accurate and complete medical documentation and the ensuing billing documentation and coding; + ... Assist in the maintenance and monitoring of the PAI Medical Group Coding & Billing Compliance Program,...non-compliance to supervisor, Compliance Liaison or to the Compliance Office via the Integrity Line. JOB SKILLS: + Knowledge… more
    Genesis Healthcare (11/25/25)
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  • Surgical Anesthesia Compliance Auditor

    Northwell Health (Lake Success, NY)
    …MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor- Hybrid ... client's dynamic team! This hybrid position offers the perfect blend of in- office collaboration and remote work, all while contributing to an organization committed… more
    Northwell Health (12/20/25)
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  • Coding Compliance Auditor - Coding Services - Full…

    University of Southern California (Los Angeles, CA)
    …assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance ... assist in the continuing education of professional coders and providers. Understands coding/ billing computer systems such as Cerner, MediTech, Epic, and Athena IDX… more
    University of Southern California (11/19/25)
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  • Charge Capture Specialist

    Community Health Systems (Las Cruces, NM)
    …with clinical and non-clinical stakeholders. + Proficiency in electronic health records (EHR), billing systems, and Microsoft Office . + Attention to detail and ... As a **Charge Capture Specialist at MountainView Medical Group** you'll join a team and be...documentation to ensure accurate and timely charge capture for billing purposes. This role supports revenue integrity by identifying… more
    Community Health Systems (01/13/26)
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  • Coding Analyst Education Specialist

    CommonSpirit Health (Prescott Valley, AZ)
    …This role involves developing and delivering advanced, impactful coding and billing training, and crafting robust educational resources. The Specialist will be ... training and collaborative sessions. Please note there is no dedicated on-site office space available at the hospitals. Complies with all relevant laws, rules,… more
    CommonSpirit Health (12/06/25)
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  • Investigator

    Highmark Health (Harrisburg, PA)
    …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
    Highmark Health (12/12/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …and risk adjustment teams associated with the health plan. You will: + Conduct medical record audits for physicians (MD, DO, or NP) to ensure documentation and ... CM codes related to chronic conditions + Analyze coding patterns within medical groups. + Provide customized education and updating educational materials for… more
    UCLA Health (01/10/26)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …to management team. + Work in coordination with other members of the Physicians' Billing & Compliance Office as necessary + Recommend new approaches, policies, ... the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and...Director of Quality with an affiliation with the ambulatory billing & compliance team. The primary objective of this… more
    Penn Medicine (12/24/25)
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  • Business Practice Data Analyst - Medical

    Queen's Health System (Honolulu, HI)
    RESPONSIBILITIES **The Queen's University Medical Group (QUMG)** is an academic medical group practice of more than **600 providers** across **17 specialties** , ... and Certified Nurse Midwives). QUMG delivers care across **four hospitals** -The Queen's Medical Center, The Queen's Medical Center - West O'ahu, Moloka'i… more
    Queen's Health System (11/06/25)
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