Medical Coding
512 open positions
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Physician Advisor- Peer-to-Peer Medical Reviewer JobgetherRemote today Conduct clinical discussions with treating providers regarding utilization management determinations and requested services, reviewing documentation to assess medical necessity and determine appropriate levels of care.
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Subject Matter Expert - USRN SutherlandTaguig, NCR, Philippines, PAM, ph 1d Clinical and operational expert for the Clinical Claims Program, managing individual claims workload while providing coaching, case consultations, and process improvement support.
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Professional Coding Specialist II - Edits WvumedicineRemote, US 1d Ensures accurate medical coding, reimbursement, and compliance by analyzing medical records and assigning ICD-10, CPT, and modifier codes.
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Utilization Case Manager (Remote) UmiamiRemote 1d Review clinical utilization and authorize continued care to ensure optimal patient outcomes and avoid treatment delays.
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Prior Authorization Associate I AbbottRemote $0k–$0k1d Lead the Revenue Cycle team to ensure timely and accurate submission of claims, appeals, and cash posting while monitoring performance and coordinating workflows.
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Patient Account Representative – Diagnostic Scheduling Authorizations GuidehouseUS - TX, San Antonio 1d Obtains payer authorizations for scheduled diagnostic services, verifies requirements, submits requests, and follows cases through determination to prevent denials.
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Certificate of Need Project Analyst NcWake County, NC, US $58k–$58k1d Reviews and analyzes Certificate of Need (CON) applications for new health services, prepares written findings for approval/denial, and defends regulatory decisions in administrative hearings.
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Compliance Documentation Improvement Specialist AahAtrium Health Cleveland - 201 E Grover St, Shelby, NC, US $0k–$0k1d Reviews inpatient medical records to identify diagnoses and assign MS-DRGs based on clinical evidence to support corporate compliance and quality goals.
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Compliance Officer, Arizona CenteneRemote-AZ, US $135k–$135k1d Oversee all compliance functions for a health plan, including policy development, CMS Medicare SNP requirements, and state regulatory interactions.
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Claims Representative CignaRemote $37k–$54k1d Process Supplemental Health claims to adjudicate benefits for customers experiencing accidents, illnesses, and hospital stays.
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Care-coordinator - BEI BupaEgypt - Cairo 1d Evaluate and authorize complex medical preauthorizations and high-value claims for international health insurance members.
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Claim Benefit Specialist- Commercial Operations CvshealthFL - Work from home, US $0k–$0k1d Reviews and adjudicates medical claims, verifies policy coverage, and ensures accurate reimbursement processing for healthcare providers and patients.
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Licensed Physician Reviewer ChenmedRemote 1d Primary physician reviewer for Utilization Management (UM) cases, covering assigned territories and coordinating care for patients.
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AR Specialist II, Physician Billing UmmhWorcester, MA Worcester Business Center, US $0k–$0k1d Follow-up of complex surgical/procedural/multidisciplinary specialty claims for payments including coding and analyzing claims and claim payments/rejections.
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Coder I Certified, Marshall Professional Center, Full-time, Days↗ Huntsville Hospital Health SystemAlbertville, AL, US 1d Evaluate diagnostic information in medical records to determine accurate APC assignment for reimbursement and verify/abstract clinical data into the health database.
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Utilization Management Rep I ElevancehealthRemote 1d Coordinates cases for precertification and prior authorization review, managing incoming claims and determining benefit eligibility for inpatient and outpatient services.
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?Hospitalist Medical Director/Physician Advisor↗ Joliet, IL, US $243k–$243k1d Provides clinical, operational, and strategic leadership for the hospitalist program while serving as a physician resource for clinical documentation integrity, utilization management, quality improvement, and patient safety.
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QA/ Process Specialist - RCM HuronBangalore India - South 3rd Floor 1d Perform quality audits on medical claims, manage work allocation, and generate RCM metrics reports to ensure billing compliance and process improvement.
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Supv, HIM Release of Inform CookchildrensFort Worth, TX, US 1d Supervises daily operations of Health Information Management staff to ensure timely and compliant processing of protected health information requests, subpoenas, and court proceedings.
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Medical Director↗ Allstate InsuranceRemote 1d Provides clinical expertise, oversight, and strategic guidance for medical management functions, including appeals, rescissions, grievances, and DOI complaints within health insurance products.
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Coding Specialist↗ Pediatric Associates Family of CompaniesRemote 1d Review and apply diagnosis, procedure codes, and modifiers for physician and allied health services; manage internal quality coding audits to ensure compliance and optimal reimbursement.
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Grievances & Appeals Expedited Case Rep HumanaRemote $43k–$43k1d Review and evaluate expedited Medicaid and AIP (dual) appeals cases by analyzing clinical documentation to determine if an appeal is warranted.
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Remote Care Coordinator Coder / Clinical Coder / Medical Administrator (non-clinicians)↗ Nova Healthcare Solutions LtdRemote $25k–$25k1d Administrative support for workflow management, coding, and actioning of healthcare documents in primary care settings.
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ED Profee Coders/QA↗ Eclat Health SolutionsMH, IN 1d Reviewing and assigning accurate CPT, ICD-10-CM, HCPCS, and E&M codes for Emergency Department professional fee encounters to ensure compliance with payer regulations and CMS guidelines.
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Sr Executive - HIM services↗ Corrohealth Infotech Private LimitedUP, IN 1d Extracting and validating patient record information to assign medical codes for billing and compliance.
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AVP, Medicare Advantage C-SNP Compliance↗ Verda HealthcareHuntington Beach, CA, US 1d Lead compliance for CMS Medicare Advantage Chronic Special Needs Plans (C-SNP), overseeing regulatory adherence, audit readiness, and Model of Care implementation.
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Senior Clinical Doc Improvement Specialist Mercy HealthOklahoma City, Oklahoma 1d Conduct reviews of inpatient medical records to identify missing, vague, or incomplete components and communicate needs to clinical providers to ensure documentation integrity.
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Medical Auditor RemoteJobsOneRemote $62k–$62k2d Review and audit outpatient professional fee coding for accuracy and compliance to train next-generation AI systems.
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HEALTHCARE CLAIMS ADJUSTOR Heya South AfricaJohannesburg, Gauteng 2d Reviewing, assessing, and adjudicating incoming U.S. healthcare claims for accuracy and completeness, then processing payments to providers in line with Benefit Plan rules.
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Médico Auditor Hospital Nipo-BrasileiroSão Paulo, Estado de São Paulo 3d Evaluate clinical pertinence of procedures and analyze hospital accounts for compliance with care guidelines and contracts.
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Persönlichkeit für den Bereich ambulante Leistungen / Region Brugg / Fest absolutLIV AGRemote 3d Reviewing and auditing invoices for outpatient services across all medical specialties, ensuring compliance with legal, medical, and insurance regulations, and managing payment or rejection of claims.
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In Hospital Case Manager The Recruitment StudioCentral Johannesburg, Johannesburg 3d Utilizing clinical knowledge to mitigate financial risk through accurate coding of hospital events, justifying levels of care and length of stay, and communicating with funders.
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Process Associate eNoah iSolution India Private LtdCoimbatore, Tamil Nadu 3d Review and edit AI-generated summaries of medical documents for accuracy, completeness, and relevance to support underwriting decision-making.
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?Field Reimbursement Manager - Med Device (Remote)↗ Remote 3d Field-based specialist supporting accurate coding, billing, and payer contract navigation for Flex Vascular medical device products.
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Medical Claims Review Senior Analyst Cigna GroupBangalore, Karnataka 3d Provides clinical review expertise for high-dollar and complex medical claims, identifying coding/billing errors, fraud, and abuse while ensuring application of reimbursement policies.
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Medical Claims Reviewer, 6 Month Contract (Remote) BroadwayventuresRemote $67600k–$67600k4d Conduct medical reviews by comparing End Stage Renal Disease (ESRD) patient medical records against data submitted to CMS EQRS and CDC NHSN to identify and classify discrepancies.
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Technicien d’Information Médicale (H/F) Groupe Hospitalier Paris Saint JosephParis, IDF, fr 4d Translating patient medical records into standardized diagnostic and procedure codes (PMSI) to ensure accurate hospital stay valuation and financing.
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CONFERENCE OFFICER City-Of-New-YorkNew York, NY, us 4d Provide administrative rationale and documentation for fair hearing compliance, manage staff performance and attendance, and coordinate with legal teams and external agencies regarding case status and compliance issues.
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Koordynatorka / Koordynator ds. Nadzoru Usług Medycznych (PZU Zdrowie) PZU Zdrowie SA.Warszawa, mazowieckie 4d Planning and executing audits of medical and billing documentation for healthcare providers, verifying service correctness, and analyzing data to identify irregularities and risks.
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Neuro science gradautes for medical coding Nestem TechnologiesIndia $128k–$128k4d Converting verbal medical descriptions into numeric or alphanumeric codes using ICD 10 CM, CPT, and HCPCS standards.
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Assistant Manager- Physician Reviewer↗ Exl ServiceTN, IN 4d Review and analyze patient medical records to extract clinical information, interpret diagnoses and treatments, and summarize insights for decision-making.
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