• Clinical Appeals Specialist

    BJC HealthCare (St. Louis, MO)
    …work experience) **Additional Information About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist to assist with infusion appeals ... Responsible for resolving clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to multi-task and maintain a high… more
    BJC HealthCare (12/19/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Jefferson City, MO)
    …guidance and expertise to ensure the application of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations ... Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular… more
    Evolent (12/18/25)
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  • DRG Coding Auditor Principal

    Elevance Health (St. Louis, MO)
    …Coding Specialist , CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). + Requires minimum of 10 years experience ... may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding...Clinics, and the ICD-10 Alphabetic and Tabular Indices), complex clinical guidelines and maintaining objectivity in the performance of… more
    Elevance Health (12/24/25)
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  • Medical Management Auditor

    Centene Corporation (Jefferson City, MO)
    …to audit errors + Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + ... the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and… more
    Centene Corporation (12/05/25)
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