• Clinical Documentation

    Elevance Health (Richmond, VA)
    ** Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model ... Document Improvement Director** is responsible for leading encounter processing, diagnostic documentation and claims integrity across CareBridge. The ideal… more
    Elevance Health (07/18/25)
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  • Clinical Documentation

    UCLA Health (Los Angeles, CA)
    Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... documentation , working closely with physicians, IPA coders, and risk...or more years of experience in providing education to clinical and non- clinical staff, required + Understanding… more
    UCLA Health (05/16/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding ... reports. **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and… more
    Commonwealth Care Alliance (05/28/25)
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  • Pharmacist - Claims Auditor/Reviewer…

    Conduent (Alexandria, VA)
    …where individuality is noticed and valued every day. **Pharmacist - Claims Auditor/Reviewer (Part-Time)** **Conduent Payment Integrity Solutions** **Are you ... help improve accuracy in healthcare billing?** **About the Role** Conduent's Payment Integrity Solutions team performs detailed pharmacy claims audits on behalf… more
    Conduent (06/21/25)
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  • Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    …physician reimbursement is achieved and claims denials are reduced by ensuring documentation integrity . * Educates all members of the patient care team on ... Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical more
    University of Texas Rio Grande Valley (06/25/25)
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  • (Remote) Epic Application Coordinator Resolute…

    Trinity Health (Livonia, MI)
    …architectures, system selection, strategy, electronic health and/or financial records, clinical systems implementations and clinical process transformation as ... direction for application integration decisions with impacts across applications and clinical / business units. Assists product teams in development of design… more
    Trinity Health (04/24/25)
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  • Payment Integrity : Reimbursement Policy…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …Conduct comprehensive weekly/monthly/ad hoc invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices ... all clinical editing inquiries, software update, QA/UAT, system updates, documentation and change requests. + Ability to work independently to resolve issues… more
    Blue Cross Blue Shield of Massachusetts (06/22/25)
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  • Manager- Revenue Integrity

    Fairview Health Services (St. Paul, MN)
    …related area Experience + 5 years' experience in coding, clinical documentation improvement (CDI) professional revenue integrity , quality, or a directly ... **Job Overview** **Fairview is looking for a Manager- Revenue Integrity to join our team.** The Manager Revenue Integrity is responsible for the leadership,… more
    Fairview Health Services (06/18/25)
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  • Payment Integrity Clinician (Remote)

    Highmark Health (Harrisburg, PA)
    …satisfaction. The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review ... basis. Review process includes a review of medical documentation , itemized bills, and claims data to assure appropriate level of payment and resource… more
    Highmark Health (07/12/25)
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  • Revenue Integrity Specialist / Revenue…

    Hartford HealthCare (Farmington, CT)
    …codes as appropriate including charge corrections 2. Identify charging, coding, or clinical documentation issues and work with appropriate leadership and ... denials that require coding and billing expertise with some clinical knowledge that are delaying claims from...Patient Financial Services, HIM, departments, etc. regarding charging and clinical documentation issues. 3. Participate as a… more
    Hartford HealthCare (07/09/25)
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