Medical Coding
512 open positions
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Process Associate HarriscomputerOffice - Coimbatore, IN 5d Review and edit AI-generated summaries of medical documents to ensure accuracy for underwriting decisions.
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Supervisor, Utilization Management (RN) CenteneRemote $75k–$75k5d Supervises Prior Authorization, Concurrent Review, and Retrospective Review Clinical Review teams to ensure appropriate care to members and manages day-to-day utilization management activities.
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Compliance Manager-Ohio Medicaid ElevancehealthOH-COLUMBUS, 8940 LYRA DR, STE 300, US $89k–$89k5d Manage foundational and strategic compliance responsibilities, overseeing regulatory audits, risk assessments, investigations, and corrective actions for Ohio Medicaid operations.
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Individual Benefit Cashless, Claims AiaKuala Lumpur, MY-AIA Malaysia 5d Provide technical medical expertise for claims decisions, resolve customer enquiries, and manage healthcare services for policyholders.
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TPA Executive↗ Claimbuddy Technologies Pvt LtdCT, IN $217k–$217k5d Process health insurance claims, provide medical opinions, and manage cashless requests for hospital insurance.
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Provider Credentialing and Onboarding Coordinator WvumedicineOperations Support Center, US 5d Coordinates the transition of provider credentials, licenses, and privileges for new physicians and APPs, ensuring compliance with state boards and hospital standards.
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Coder - Radiology↗ University of Colorado MedicineRemote 5d Review and process professional charges for Radiology services to ensure accurate and timely billing.
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Medicare Risk Adjustment Compliance Auditor (CPC, CCS, or CCS-P Required) (Remote) AlignmenthealthcareRemote $64k–$64k5d Conduct provider and coder level reviews and audits to ensure accurate risk adjustment data is submitted to CMS, while developing tracking tools and monitoring corrective action plans.
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Medical Claims Review Senior Analyst CignaBengaluru, India 5d Provides clinical review expertise for high-dollar and complex medical claims, including facility and professional bills, while identifying coding/billing errors and potential fraud.
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Sr Auditor, Nursing EnsemblehpRemote - Nationwide, US 5d Leads complex audits of high-risk claims, identifies systemic issues, and ensures compliance with clinical and financial standards to enhance revenue cycle performance.
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Medical Director Medical Operations- Geisinger Health Plan GeisingerRemote 5d Lead medical management for all Health Plan inpatient activity including acute care, LTAC, observation, SNF, rehab, and ambulatory surgery within a regional network.
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Staff Auditor I MaineAugusta, Maine, US $51k–$51k5d Perform professional audit work on MaineCare Providers and Community Agencies receiving state and federal funds, completing financial and compliance audits for conformance to laws and regulations.
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Medical Director - OneHome HumanaRemote $224k–$224k5d Review clinical cases to determine medical necessity for Medicare and Medicaid members, ensuring compliance with CMS guidelines and organizational policies.
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Trauma Registrar VcuhealthRichmond, VA, US $0k–$0k5d Maintains a trauma registry database for VCU Health System's adult and pediatric trauma programs to support Level 1 Trauma Center verification and quality improvement.
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Senior Claim Benefit Specialist - Remote CvshealthRemote $0k–$0k5d Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines.
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Medical Claims Review Senior Analyst↗ The Cigna GroupKA, IN 5d Provides clinical review expertise for high-dollar and complex medical claims, identifying coding/billing errors, ensuring policy application, and detecting fraud/abuse.
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Prior Authorization Coordinator, Pharmacy Buisness office, 40hr, Day UmmhWorcester, MA University Campus, US $0k–$0k5d Obtains authorization numbers from insurance companies, reviews prior authorization requests for medical necessity, and determines appropriate benefit coverage for general and oncology infusion clinics.
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Clinical Development Analyst - Computer Assisted Coding SolventumMelbourne, Victoria 5d Develop, localize, and manage Computer-Assisted Coding (CAC) content and logic for healthcare classification systems.
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Clinical Documentation Improvement Specialist EpworthRichmond, Victoria $16k–$16k5d Improve clinical documentation standards to ensure accurate information capture for patient safety, quality of care, and hospital reimbursement.
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Medical Review II (Medicare) BroadwayventuresRemote $62k–$62k5d Licensed Registered Nurse performing complex medical review of Medicare claims for Inpatient Rehabilitation Facility (IRF) services, including pre-claim and post-payment determinations.
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CDQI Nurse Specialist DatavantUSA $0k–$0k6d Conduct daily evaluations of inpatient medical records to enhance documentation clarity, completeness, and accuracy for DRG-based payer patients.
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Credentialing Specialist, Bureau of Revenue City-Of-New-YorkLong Island City, NY, us 6d Verify clinical provider qualifications and manage insurance network enrollment to ensure regulatory compliance and revenue collection for patient care.
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Supervisor - Audit/Investigation JobgetherUS 6d Lead audit and investigation activities to identify and address Medicare and Medicaid fraud, waste, abuse, and compliance issues while overseeing a team of auditors and investigators.
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Hospitalist Physician RemoteJobsOneRemote $146k–$146k6d Review medical records and clinical notes to train next-generation AI systems for inpatient care and documentation standards.
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Required Doctors _ Medical Officer_ Working from Office _ Freshers / Experineced↗ Medi Assist Insurance Tpa Private LimitedAS, IN $264k–$264k6d Evaluate treatment plans and validate claims processing against medical guidelines to ensure no financial implications for the organization.
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Payment Integrity Concept Development Analyst - Outpatient↗ MachinifyRemote $80k–$80k6d Develop, maintain, test, and optimize payment integrity audit concepts for government and commercial healthcare claims to ensure accurate billing and compliance.
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Medical Coder-Outpatient UmmcJackson, MS, US 6d Review outpatient medical records and documentation to assign accurate ICD-10, CPT, and HCPCS codes for healthcare services rendered.
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Health Claims Investigator (Field Staff)↗ Ocean GroupTN, IN $120k–$180k6d Investigate insurance claims related to medical treatments and procedures to determine legitimacy and accuracy.
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Cancer Registry Registrar DenverhealthFully Remote (CO), US $56k–$56k6d Compiles and maintains statistical diagnostic and treatment information on cancer patients, managing case finding, coding, abstracting, and state reporting for Denver Health's Cancer Registry.
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Authorization Specialist I SaintfrancisRemote - OK, US 6d Ensures accuracy of insurance information and procures prior authorization and predetermination for scheduled patient appointments and inpatient admissions to prevent claim denials.
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Medical Director, Post-Service Review & Medical Claims Review (MCR) CareSourceRemote, US $195k–$195k6d Provide clinical review services, peer-to-peer discussions, and physician review for clinical appeals and post-service audits to determine medical necessity and payment integrity for CareSource members.
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Associate Clinical Documentation Improvement Specialist - Part Time Mercy HealthJoplin, Missouri 6d Reviews inpatient medical records to ensure accuracy, completeness, and compliance, reflecting true clinical scenarios, Severity of Illness (SOI), and Risk of Mortality (ROM) for quality care measurement and reporting.
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Grievance Specialist DevotedRemote $0k–$0k6d Resolve member grievances and Medicare Advantage appeals with accuracy, efficiency, and compassion while ensuring regulatory compliance.
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Casual - Clinical Data Collector – Nursing/Health Background Work From Anywhere Access TelehealthRemote 6d Review patient records and enter clinical data (diagnoses, medications, hospital events) into a national clinical quality registry for aged care.
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Clinical Coder HealthscopeSydney, New South Wales 6d Perform accurate and timely clinical coding of inpatient episodes, abstracting diagnostic and procedural codes to support casemix analysis and quality improvement.
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Prior Authorization Specialist AdaptivebiotechnologiesRemote $45k–$45k6d Obtain insurance approvals for Adaptive Biotechnologies' clonoSEQ MRD Assay to facilitate patient access to essential laboratory services.
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