Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
$60k - $130kDiversityJobs Inc
At Stout, were dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
Impact Youll Make This section outlines the key outcomes and contributions expected from the role. It highlights how your work will shape engagements, support clients, and drive value across Stouts Healthcare Consulting practice. Contribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations.
Deliver high-quality, accurate coding analysis that informs client decisions, regulatory responses, and litigation support.
Identify risks related to billing, coding, and reimbursement, including potential fraud, waste, and abuse.
Support the development of defensible findings and recommendations through detailed documentation and analysis.
Enhance Stouts reputation for excellence by applying deep expertise in inpatient coding, reimbursement systems, and compliance.
What Youll Do Here, youll find the core responsibilities and day-to-day duties of the role. These tasks are designed to help you achieve desired outcomes while supporting team and organizational goals. Perform detailed reviews of inpatient medical records to assess accuracy of ICD-10-CM/PCS coding and alignment with clinical documentation.
Analyze coding, billing, and reimbursement practices across engagements involving audits, disputes, and investigations.
Support forensic analyses to identify compliance risks, inefficiencies, and reimbursement discrepancies.
Assist in audits, regulatory reviews, and litigation support by gathering evidence, analyzing issues, and contributing to reporting.
Evaluate DRG/APR-DRG/APC assignments and reimbursement implications based on clinical documentation.
Collaborate with internal teams, clients, and legal counsel to support engagement objectives.
Prepare clear, well-structured reports, analyses, and client-ready deliverables summarizing findings and recommendations.
Monitor coding trends, denials, billing edits, and regulatory updates to inform analyses and engagement insights.
Contribute to internal knowledge sharing and continuous improvement within the Healthcare Consulting practice.
What You Bring This section details the skills, qualifications, and experience needed to excel in the role. Bachelors degree in Health Information Management or related field (or equivalent experience).
Minimum of five (5) years of recent acute-care inpatient facility coding experience.
Strong experience with DRG and PCS coding, including auditing; denials experience preferred.
Active coding credential required (CCS, CIC, RHIT, or RHIA).
Knowledge of MS-DRG, APR-DRG, APC methodologies and reimbursement frameworks.
Experience reviewing clinical documentation for accuracy, compliance, and reimbursement optimization.
Familiarity with healthcare regulatory frameworks (e.g., CMS, HIPAA, False Claims Act).
Proficiency in Microsoft Office (Excel, Word, PowerPoint); experience with data visualization tools is a plus.
Strong analytical, problem-solving, and written/verbal communication skills.
How Youll Thrive This section highlights the competencies and behaviors that will set you up for success in this role and align with Stouts culture. Analytical and Detail-Oriented: Ability to interpret complex clinical and coding data and draw well-supported conclusions.
Collaborative and Client-Focused: Works effectively with cross-functional teams and builds strong client relationships.
Accountable and Proactive: Takes ownership of work, manages priorities, and delivers high-quality results on time.
Adaptable and Curious: Thrives in a fast-paced consulting environment and continuously learns new regulations and methodologies.
Quality and Integrity Driven: Demonstrates commitment to ethical coding practices and compliance standards.
Aligned with Stout Values: Embodies Relentless Excellence through teamwork, responsiveness, and strong communication.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here -
- ...Provider Claim Recovery Analyst Bring your drive for excellence, teamwork, and customer... ...that include financial adjustments, investigations on disputed claims overpayments, analyze... ...or more years' experience in the healthcare or health insurance industry. ~...Claims
$89.17k - $142.68k
...highly skilled Senior Data Analyst with deep expertise in... ...flows (enrollment, claims, supplemental), HCC modeling... ...staff, financial/medical expense staff and other... ...procedures are used to access, investigate, and analyze data.... ...platforms and manage code migrations and changes...ClaimsWork at officeLocal areaRemote workFlexible hours2 days per week$29 per hour
...REVENUE INTEGRITY ANALYST Camden, NJ... ...charging related claim edits and Revenue... ...to charging and/or medical necessity. Coordinates... ...and internal coding and charging audits... ...Cooper University Healthcare Policies and Procedures... ...well, likes to investigate Education Requirements...ClaimsHourly payFull timePart timeShift work- ...Hill Rehabilitation & HealthCare Center Description... ...- Review and verify medical billing information for... ...Prepare and submit medical claims to insurance companies... ...billing inquiries and disputes - Maintain patient... ...in medical billing codes and regulations Requirements...ClaimsFull timeWork at officeMonday to Friday
- ...looking for a detail-oriented Medical Billing Specialist to support healthcare billing operations. The... ...someone who can manage claims activity accurately,... ...accuracy and timeliness. • Investigate account issues, respond... ...• Review claims for coding accuracy, required...ClaimsContract work
$95k - $104.69k
...Nurse Risk Management Analyst Review & track incident reports... ...follow-ups are complete; perform investigations under direction of in-house... ...complete clinical summaries for medical legal reviews, provide risk... ...Steering Committee, Nursing Claims Review Committee, etc.). Provides...ClaimsLocal areaFlexible hours- ...Revenue Integrity Analyst PRIMARY FUNCTION: Works... ...authorization, coding and billing guidelines... ...reduce charge-related claim edits/rejections. Advises... ...claims issues/rejections; investigates complex issues as... ...Accounting, Management, Healthcare Administration. CERTIFICATES...ClaimsFull timeShift work
- ...Summary The Senior Provider Reimbursement Analyst leads the development, evaluation, and... ...of complex reimbursement issues and claim payment discrepancies by analyzing claims... ...Bachelor’s degree in Business, Finance, Healthcare Management, Information Science, or a related...ClaimsContract workWork at officeRemote workMonday to Friday2 days per week3 days per week
- ...support our client with their healthcare revenue cycle operations by... ...focuses on maintaining clean claims, improving billing accuracy,... ...completeness Enter charges and coding information into billing... ...eligibility, charge entry, or medical billing Knowledge of insurance...ClaimsWork at officeImmediate start
- ...Administrator Intern Company: Neuropath Healthcare Solutions Location: Cherry Hill, New... ...will gain hands‑on experience in Medicaid claims processing, billing compliance, and... ...Medicaid regulations. Some familiarity with medical coding standards, including ICD‑10, is a plus....ClaimsTraineeshipInternshipH1bWork at officeVisa sponsorshipWork visaMonday to FridayFlexible hoursDay shift
- ...Investigative Analyst Help As an Investigative Analyst at the GS-1805-9 level, some of your typical work assignments may include: Gathering, researching, and analyzing various types of data from federal, state, local and public agencies. Providing administrative...Local area
- ...Business Analyst Philadelphia, PA 06 months plus contract DOE US Citizens and Green Card, GC-EAD and TN VISA accepted. Job Description: Claims/Encounter processing, Clinical applications, healthcare domain Required onsite reporting but remote position...ClaimsContract workRemote work
- Seeking strong Business Analyst to support BlueCard daily... ...and improve claims processing experience for... ...or more of experience in medical claims processing and adjusting or healthcare administration. Expertise... ...Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims...ClaimsWork experience placementWork at office
- ...in preparing annual CMS bid submissions, including benefit design, cost projections, and revenue estimates. Evaluate historical claims and utilization data to support the pricing of benefit differentials and cost-sharing structures across Medicare plan designs. Collaborate...ClaimsWork at officeRemote workMonday to Friday2 days per week3 days per week
- ...Senior Data/Business Systems Analyst The Senior Data/Business Systems Analyst will play... ...data-focused initiatives within the healthcare payor domain. This role requires deep techno... ...expertise across payor data, including claims, population health, and industry data...Claims
- ...AI Integration Business Analyst LOCATION - Hybrid – 3 Days Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA; Dallas... ...12 months INTERVIEW TYPE - Video Role Description The Claims Business Analyst is responsible for developing detailed...Claims
$50k - $60k
...Subrogation Damages Analyst The Subrogation Damages Analyst plays a key role in the subrogation recovery process by preparing comprehensive... ...summary packets for large loss property damage subrogation claims. This position supports the subrogation team by gathering claim...ClaimsWork at office$1,000 per month
...Correspondence & Disputes Specialist III - Credit Corrections At... ...requires conducting thorough daily investigations of indirect disputes and... ...to determine validity of claim, and submit Block Notification... ...self. Company Benefits: ~ Medical, dental, and vision insurance...ClaimsCasual workWork at officeWeekend workAfternoon shift- ...inquiries Maintain accurate patient records and ensure HIPAA compliance Medical Billing & Coding Duties: Assign accurate ICD-10 , CPT , and HCPCS codes Submit and track insurance claims (electronic and manual) Manage prior authorizations for pain...ClaimsWork at office
- The City and County of Honolulu, HI is seeking a Claims Investigator to manage property damage and personal injury claims. You will work closely with legal staff and claimants to ensure timely resolutions. This full-time role will require investigating claims, preparing...ClaimsFull time
- ...comprehensive, cost-effective medical care for individuals... ...is backed by leading healthcare investors like Define... ...looking for a Data Analyst to join our Data &... ...means using AI-assisted coding to accelerate development... ...-specific data (claims, clinical, eligibility...ClaimsRemote workWork from homeFlexible hours
$81.07k - $129.71k
...perform peer reviews for less experienced analysts. What You Bring ~ Bachelor's... ...the autonomy to dogreat work ~ Medical, dental, and vision coverage along... ...individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield...ClaimsWork at officeLocal areaRemote workFlexible hours2 days per week- ...Description: Becker & Company is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is perfect... ...investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability...ClaimsFlexible hours
- ...and collections of all HIPAA compliant claims to insurance companies for payment of all... ...Competitive Compensation ~ Excellent Medical, Dental, Vision and Prescription Drug Plan... ...respected providers of hospital and healthcare services, Universal Health Services, Inc...ClaimsLocal area
- Compensation Analyst Philadelphia Insurance Companies, a member of the Tokio Marine Group,... ...Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company... ...on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family...Claims
$40k - $75k
...Analyst, Marketing Automation Position at CMI Media Group Do you thrive on turning data into dynamic customer journeys? Are you passionate about using technology to improve healthcare outcomes? CMI Media Group, the industry leader in healthcare marketing, is seeking...- ...oriented people to join our team. If this describes you, we want to speak with you. Ensures accurate medical coding related to technology assessments, medical policies, claim payment policies and adhoc coding projects. Develops code lists for benefit application,...ClaimsWork experience placementWork at office
$50k - $90k
...Senior Analyst, SEM Position at CMI Media Group At CMI Media Group, innovation isn't just a buzzword – it's our driving force in the pharmaceutical and healthcare industries. We channel this passion to empower leading organizations dedicated to improving our society...- ...thing in life, and the American healthcare system is completely broken... ...Dietitians, physicians, medications, lab testing, and AI agents... ...patient billing tickets, managing claim workflows, and building and... ...to, resolving denials, investigating patient responsibility questions...ClaimsFull timeRemote work
$101.7k - $155.9k
...to delivering exceptional underwriting, claims, and risk management expertise to our... ...The Senior Claims Specialist on the Healthcare team plays a critical role in our growing... ...and determine coverage, manage the claim investigation, evaluate the overall claim, communicate...ClaimsTemporary work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations. Be the first to apply!
- health analyst Philadelphia, PA
- hospitality analyst Philadelphia, PA
- senior contracts analyst Philadelphia, PA
- incident response analyst Philadelphia, PA
- manufacturing analyst Philadelphia, PA
- military analyst Philadelphia, PA
- pharmacy analyst Philadelphia, PA
- senior internal controls analyst Philadelphia, PA
- proposal analyst Philadelphia, PA
- senior database analyst Philadelphia, PA

