• SIU Program Integrity Investigator - Remote (In…

    Magellan Health Services (Boise, ID)
    …policies, Medicaid/Medicare rules and statutes, etc. + Conduct research on medical policies and practices, provider characteristics, and related topics + Interview ... five years of experience in fraud investigations, related behavioral or medical healthcare insurance experience in claims, clinical, auditing, compliance, provider… more
    Magellan Health Services (12/27/25)
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  • Outpatient Coding Resolution Specialist

    HCA Healthcare (Richmond, VA)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (12/05/25)
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  • Physician Coding Specialist (Full Time, 40, Day)

    Queen's Health System (Honolulu, HI)
    …A. Education/Certification and Licensure: 1. Certification as an Outpatient Physician Coder (CPC) or Certified Coding Specialist -Physician based (CCS-P). 2. ... October 2014, knowledge of ICD-10 shall be required. 3. Knowledge of medical terminology and abbreviates. B. Experience: 1. Broad based knowledge of services… more
    Queen's Health System (12/09/25)
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  • Director, Compliance on Special Investigations…

    LA Care Health Plan (Los Angeles, CA)
    …lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Public Policy or Related Field Experience Required: ... Experience in coordinating with external regulators and law enforcement agencies. Preferred : Prior leadership of a Special Investigations Unit (SIU) or equivalent… more
    LA Care Health Plan (11/06/25)
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  • Software Developer 3: Senior Software Engineer

    Oracle (Hartford, CT)
    …and implementing distributed, cloud-scale systems. You should be both a rock-solid coder and a distributed systems generalist that is comfortable diving deep into ... C, C++, C#, Go, or Python, with proficiency in additional languages preferred + Validated understanding of operating system fundamentals + Strong understanding of… more
    Oracle (01/14/26)
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  • Investigator 1 - FWA Prepayment Review

    Point32Health (Canton, MA)
    …involving internal and external research, detailed data analysis, review of medical records, and interviews of members, providers, and other third parties. ... substantial prepayment claims including extensive administrative tasks, review of medical records, and communicating with providers through the prepayment Hotline.… more
    Point32Health (10/30/25)
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  • Sr Revenue Integrity Clinical Charge Specialist

    HCA Healthcare (Richmond, VA)
    …(CVIR) services are charged and coded correctly. This position is a specialized senior medical coder with RN or ARRT clinical expertise in the Cath Lab, ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
    HCA Healthcare (12/23/25)
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  • Medicare Biller

    Robert Half Accountemps (Boca Raton, FL)
    …policies and industry standards. * Maintain confidentiality of sensitive financial and medical information. Requirements * CPC (Certified Coder ) certification is ... providers and administrative staff. Responsibilities: * Conduct thorough audits of medical documentation to identify coding discrepancies and ensure accuracy in… more
    Robert Half Accountemps (12/21/25)
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  • Senior Revenue Integrity Charge Analyst

    HCA Healthcare (Richmond, VA)
    …Radiology (CVIR) services are charged and coded correctly. This position is a specialized senior medical coder in the Cath Lab, IR, and EP service lines. The ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
    HCA Healthcare (12/19/25)
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  • NP/PA Paneled

    CenterWell (Shreveport, LA)
    …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...documentation in a timely manner working with a quality-based coder to optimize coding specificity. + Follows policy and… more
    CenterWell (12/19/25)
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