• Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding more
    Commonwealth Care Alliance (08/26/25)
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  • Director of Payment Integrity Consulting

    CGI Technologies and Solutions, Inc. (Charlotte, NC)
    …roles, leading projects and teams . 5 years of experience in healthcare claims adjudication, medical coding , DRGs, and/or reimbursement methodologies . 5 ... long-term relationships with key client stakeholders, including executive leadership, claims operations, finance, compliance, and clinical teams. * Lead client… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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  • Medical Necessity Coding Compliance…

    HCA Healthcare (Salem, VA)
    …NC, SC, TN, TX, UT, VA). Do you have the career opportunities as a Medical Necessity Coding Compliance Coordinator you want with your current employer? We have ... of colleagues. Do you want to work as a Medical Necessity Coding Compliance Coordinator where your...substitute education requirements. + Minimum 3 years of hospital coding experience preferred. + Minimum 5 years healthcare more
    HCA Healthcare (09/27/25)
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  • Vendor Resource Management Profee Coding

    HCA Healthcare (Nashville, TN)
    …Resource Management Profee Coding Manager? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible ... are appropriately educated + Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/ medical resources… more
    HCA Healthcare (07/19/25)
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  • Inpatient Coding Resolution Specialist

    HCA Healthcare (Miami, FL)
    …bachelors) degree in HIM/HIT or related degree required Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding ... Monday-Friday flexible schedule. This position requires acute care/facility based Inpatient Coding experience. Are you passionate about the patient experience? At… more
    HCA Healthcare (09/27/25)
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  • Compliance Coding Auditor

    Sharp HealthCare (San Diego, CA)
    …Auditor will analyze and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG ... Sharp HealthCare 's (SHC) compliance audit function and maintaining Sharp HealthCare 's view of coding , billing and reimbursement compliance audits. **Required… more
    Sharp HealthCare (10/08/25)
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  • Clinical Denials Coding Review Specialist

    HCA Healthcare (Brentwood, TN)
    **Description** **Introduction** Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family… more
    HCA Healthcare (09/05/25)
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  • Medical Biller - Healthcare

    Guidehouse (San Marcos, CA)
    …or customer service. + Working knowledge can be of the following: insurance claims , billing, coding , follow-up, finance, accounting or customer service related ... Required** **:** None **What You Will Do** **:** The ** Medical Biller** is expected to perform all areas of...billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the… more
    Guidehouse (09/18/25)
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  • Revenue Integrity Specialist / Revenue Cycle Cmdr…

    Hartford HealthCare (Farmington, CT)
    …appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding , by reviewing the medical record, facility protocol, and other ... every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in...and resolve specific billing edits and denials that require coding and billing expertise with some clinical knowledge that… more
    Hartford HealthCare (10/07/25)
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  • Inpatient Medical Coding Auditor

    Humana (Boise, ID)
    …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims more
    Humana (09/24/25)
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