Dispute Coding Analyst — Pre-Pay Claims Review
Molina Healthcare of Illinois
Molina Healthcare is seeking a detail-oriented provider denial coding specialist to support the denial coding dispute process. You will review medical records, denial reasons, and claims history to determine whether documentation substantiates services billed. In this production-focused role, you will conduct audits, decide to overturn or uphold denials, and communicate determinations to providers with guideline links. Proficiency in Microsoft Office and strong communication are required. #J-18808-Ljbffr Molina Healthcare
$22.78 - $29.62 per hour
...AM Minimum to Midpoint Pay Rate: $22.78 - $29.62 /... ...reduce or prevent future claim denials. Employs... ...following applicable billing, coding and reimbursement... ...third party payer billing disputes. Additionally, resolves... ...edits as appropriate, reviews Medicare intermediary and...ClaimsFull timeRemote workShift work- ...the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides... ...years of clinical experience Experience in medical claims processing, appeals, or coding strongly preferred Medicare Part B experience...ClaimsFull timeFor contractorsWork experience placementWork at officeLocal areaRemote workMonday to FridayShift workEarly shift
$88.85k
...Utilization Management (UM) Claims Review Nurse RN II is... ...through retrospective and pre-payment review processes... ...supports billed services, coding is accurate and aligned... .... Complete Provider Dispute Review (PDR) clinical evaluations... ...: The expected pay range is based on many...ClaimsFull time- ...rooms. Summary The Epic Analyst works as a member of... ...efficient workflows and claim scrubber edits, and implement... ...items for PB coding, including but not limited... ...for the preparation and review of analysis for various... ...transfer, retention, rate of pay and all other terms and...ClaimsTemporary workWork at officeLocal areaFlexible hours
$96k - $125k
...storyteller: you turn dense claims and clinical data into... ...-ready. As a Data Analyst, you will: Build and maintain... ...high-cost claimant reviews, avoidable utilization... ...: risk adjustment (HCC coding, RAF scores), utilization... ...-Verify company. Final pay is based on several...ClaimsWork experience placementWork at officeRemote workFlexible hours$34.3k - $49k
Reimbursement Analyst - Remote Date: Aug 25, 2026 Location... ...responsible forfull claim overpayment analysis.... ...minimal supervision. Review paid claims and member... ...analysis, medical billing/coding, patient accounting,... ...professional growth. The pay range for this position...ClaimsRemote jobContract workFlexible hours$24 - $43 per hour
...Growing together. As a Performance Analyst, you will be a member of the... ...team. Conducts chart review to code for diagnoses and quality. Monitors... ...Together - Competitive Base Pay, a Full And Comprehensive... ...and ICD-10 codes and reading claims forms/reports Access to reliable...ClaimsHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaRemote workShift work$26.14 - $56.64 per hour
...needed for the Medical Review Nurse: Registered Nurse... ...utilization review, medical claims review, claims auditing,... ...necessity review and/or coding experience Excellent... ...administrative law judge pre-hearings, state... ...Employer (EOE) M/F/D/V. Pay Range: $26.14 - $56.64 /...ClaimsRemote jobHourly payWork experience placementWork at officeMonday to Friday$70k - $85k
Risk Adjustment Coding Specialist II (CST/EST) Department: Quality... ...conducting high-volume chart reviews to identify coding gaps, trends... ...assess, monitor, and document claims and encounter coding information... ...The national target pay range for this role is $70,000...ClaimsFull timeWork at officeRemote workHome office- The Utilization Review Nurse gathers demographic and clinical... ...to the appropriate claims staff/customer Collects... ...knowledge of both CPT and ICD coding Ability to interface... ...orthopedics preferred PAY RANGE: CorVel uses a market... ...Illness Insurance Pre-paid Legal Insurance Parking...ClaimsMinimum wageWork at officeLocal areaRemote workFlexible hours
$100k - $110k
...accurately represented. By combining deep clinical and coding expertise with advanced technology, our team... ...difference. Job Summary The Clinical Coding Analyst (CCA) performs pre-bill inpatient medical record reviews to identify coding opportunities, potential compliance...Local areaRemote workMonday to Friday$20.75 - $24.75 per hour
Overview The Client Service Analyst (CSA) role ensures... ...client-facing team on coding and policy aswell as operational... ...each month. Reviews, analyzes, and responds... ...Healthcare industry and claims analysis experience. Excellent... ...to receive overtime pay for hours worked in...ClaimsHourly payWork at officeImmediate startRemote workNight shift- ...inpatient medical records are coded within Medical Information... ...the Inpatient Coding Quality Analyst serves as a subject matter expert... ..., resolves inpatient claim and coding edits, supports denial... ...downgrade risk through targeted pre‑bill review, trend analysis, and feedback...ClaimsWork at officeRemote work
- ...Licensing & Contracting Forms Analyst, where you'll play a key role... ...Solutions — supports end-to-end claims handling with analytic and... ...Verisk property. Verisk will NOT pay a fee for any placement resulting... ...Reading/writing XSL/XML Code Ability to interpret complex business...ClaimsFull timeRemote workWork from homeMonday to Thursday
- ...Job Category : Billing, Coding, and Collection... ...States Research unpaid claims, determine denial root... ...the patient's record. Review, comprehend, and execute... ...Resolves disagreements and disputes fairly and professionally... ...LinkedIn, please know that pay bands are auto assigned...ClaimsFull timeWork at officeRemote work
- ...producing computer matches, claiming systems, and personnel systems... ...recruiting for one (1) Procurement Analyst II, to function as Jr. Asset... ..., who will:Assist in the review and evaluation of user... ...related tasks.Assist in designing, coding, testing, maintaining, and enhancing...ClaimsFull timeContract workWork at officeRelocationShift work
- ...The Revenue Integrity Associate Analyst plays a critical role in... ...the charge master, regulatory code changes, work queues, charge capture... ...billing errors, denials, and claim edits. Educates on best... ...specific requirements to provide pay transparency. Compensation decisions...ClaimsLocal areaRemote work
$79.3k
...progressive scope and complexity. 5 years with coding languages, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data. 3... ...as company policies and training requirements. Pay Range Minimum $79,300.00 Pay Range Maximum $12...ClaimsFor contractorsWork at officeLocal areaShift work$113k - $173k
...curious Senior Actuarial Analyst with a strong... ...and Other Data Calls, Claims, Compliance, Underwriting... ...by sharing knowledge, reviewing work, and supporting the... ...Suite; familiarity with coding languages such as Python... ...CCPA Job Applicant: Pay Range: $113,000-$173,00...ClaimsLive inWork at officeLocal area- ...care.? Requirements The Nurse Reviewer performs complex medical record... ...Medicare Part A/B and DMEPOS claims that require clinical judgment... ...medical/claims review, including pre- and post-payment claims... ...review experience CPC (or similar) coding certification Prior work as a...ClaimsContract workFor contractorsLocal areaRemote work
$95k - $110k
...to receive an alert: DRG Nurse Reviewer Appeals and Hearings- Remote... ...redeterminations using approved clinical and coding guidelines and documents... ...perform reviews of multiple claim types to provide a flexible... ...on an ongoing basis. The pay range for this position is $95...ClaimsFull timeRemote workWork from homeRelocation packageFlexible hours$42.46 - $56.02 per hour
Description Medical Coding Support accurate outpatient coding, billing... ...compliance through the review and coding of Epic Simple Visit... ...the Epic Simple Visit Coding Analyst 2, you will review charges from... ...with routine coding edits and claim-related coding issues. Communicate...ClaimsHourly pay$92.3k - $138.4k
The Principal Analyst is responsible for creating, maintaining... ...modules for key Dispute Resolution Services (... ...through quality control reviews. Empower through training... ...all state and local pay transparency laws and regulations... ...InformationFINRA’s Code of Conduct imposes...Full timeTemporary workFor contractorsFor subcontractorLocal areaImmediate start$59.2k - $109.02k
Healthcare Data Analyst (Medicaid Finance & Policy) Milliman... .... Responsibilities Claims datasets including... ...and using data models. Reviewing, evaluating, and summarizing... ...to write or learn SAS code without point-and-click... ...Accounts (FSA) - Pre‑tax savings for dependent...ClaimsFull timeTemporary workWork experience placementWork at officeRemote workWorldwideFlexible hours- ...Role We are looking for a Data Analyst to join our Data & Analytics... ...recurring Quarterly Business Reviews to ad hoc analyses that answer... ...that means using AI-assisted coding to accelerate development, applying... ...healthcare-specific data (claims, clinical, eligibility, pharmacy...ClaimsRemote workWork from homeFlexible hours
- ...working with the billing vendor to ensure claims are being processed accurately. Essential... ...departmental communication through daily review of email messages. Develop, maintain, and... ...obtain basic procedural and/or diagnosis codes. Supervisory Responsibility None Work...ClaimsFull timeWork at officeMonday to Friday
$64.97k - $97.46k
...improvement initiatives. Collaborates with coding, billing, clinical, and charge champions... ...risk through effective and timely review of RAC Audit requests, ensuring timely appeals... ...data elements associated with all types of claim forms* Certified Revenue Cycle...ClaimsLocal areaImmediate startShift work$78k - $153k
...Environment - Must reside in Hawaii** Pay Range: $78,000 - $153,000 Note... .... Strong Working knowledge of claims, health plan financial data,... ...for program driving accurate coding and documentation to optimize... ...analysis. Mentors junior analysts and may be assigned project lead...ClaimsWork experience placementWork at office- ...Repricing Quality Assurance Analyst I Job Category : CERIS... ...is responsible for reviewing, analyzing, and monitoring... ...of repricing claims processing, and contractual... ...Bachelor's degree preferred PAY RANGE CorVel uses a... ...Critical Illness Insurance, Pre-paid Legal Insurance,...ClaimsMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours
$54k - $103k
...technical direction, conducts on-site Claim audits of Auto Physical Damage... ...levels of customer service. Reviews and makes recommendations... ...process improvement. Conducts pre-review of Claim decisions which... ...Washington, the national base pay range for this job level is $54...ClaimsWork experience placementWork at officeLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Dispute Coding Analyst — Pre-Pay Claims Review. Be the first to apply!
- entry level program analyst Brooklyn, NY
- merchandising analyst Brooklyn, NY
- accessibility analyst Brooklyn, NY
- hybrid analyst Brooklyn, NY
- video analyst Brooklyn, NY
- operational due diligence analyst Brooklyn, NY
- integration analyst Brooklyn, NY
- ar analyst Brooklyn, NY
- medical coding analyst Brooklyn, NY
- revenue cycle analyst Brooklyn, NY

