Remote Prepay Coding Investigator (CPT)
ISHE
- Remote job
Optum is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings and guide investigations. The role offers telecommuting from anywhere in the United States and targets 8:00am–5:00pm hours with occasional overtime. Responsibilities include reviewing claims with medical records, ensuring payment accuracy, and collaborating with clients, providers, and legal teams. #J-18808-Ljbffr ISHE
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud, audit CPT coding, and provide guidance to investigators. The role supports internal and external projects, mentoring colleagues, and ensuring regulatory compliance. The position...Remote job
- Optum, a leader in health care technology and services, seeks a Coding Consultant to investigate and resolve healthcare fraud and coding issues. The role uses CPT guidance to support investigations, mentor teammates, and collaborate with internal and external stakeholders...Remote jobFlexible hours
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...Remote job
- ...Job TitleProvides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA).Essential Job Duties• Independently... ...policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements....Remote workContract workWork at officeLocal area
$19.64 - $42.55 per hour
...JOB DESCRIPTION Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves... ..., Current Procedural Terminology (CPT) guidelines and provider contract requirements...Remote workHourly payContract workWork experience placementWork at officeLocal area$70.5k - $94.4k
...responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according... ...interpreting requisite documentation to conduct low level investigations. The incumbent will also support the...Remote workLive inLocal area$60.2k - $107.4k
...have the flexibility to work remotely as you take on some tough challenges... ...Collaborate with clinical coding consultant to apply knowledge... ...behavior through an Investigation Summary and compliance package... ...settlements Familiar with CPT code terminology *All Telecommuters...Remote workMinimum wageFull timeWork experience placementLocal area- ...Coder or Clinical Coder/Fraud Investigator to join our team.... ...discuss to make appropriate coding determinations as needed) Analyze... ...report as needed Abstracts CPT, HCPCS, Revenue Codes, DRG codes... ...development initiatives ~ Remote work eligible REMOTE WORK...Remote workFull timeFlexible hours
- ...Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract CPT/HCPCS/Revenue Codes, DRG and ICD-9/ICD-10,... ...subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and professional...Remote job
- ...Shield is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters.... ...analyze medical records, abstract CPT/HCPCS/ICD-10 codes, and prepare reports while... ...and the ability to work independently. Remote work eligibility is available. #J-18...Remote job
$56.2k - $101k
...workplace flexibility. Please note: this is a remote role with preference on candidates residing within Ohio. Position Purpose: Investigate allegations of potential healthcare fraud... ...and analyze health care claims and coding required. Pay Range: $56,200.00 - $101...Remote workFull timePart timeWork at officeFlexible hours- ...Location: Franklin, TN corporate office with remote work flexibility Travel: Up to 25% The Compliance Investigator is responsible for conducting and overseeing prompt... ...regulatory compliance Billing and coding concerns Fraud, waste, and abuse risks HIPAA...Remote workWork at office
$19.64 - $42.55 per hour
...JOB DESCRIPTION Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting... ...appropriateness of care, and recognizing and adhering to national and local coding and billing guidelines in order to maintain coding accuracy...Remote workHourly payContract workWork experience placementWork at officeLocal area$64k - $68k
...We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN... ...a favorably adjudicated DOD background investigation for this position. Veterans, Reservists... ...CPT4, ICD-10-CM, HCPCS, DRG and Revenue Code coding conventions. Knowledge of...Remote workContract workTemporary workFor subcontractorInterim roleLocal areaShift work$25.6 - $42.67 per hour
...Sentara Health Plan is currently hiring a Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote!Status: Full-time, permanent position (40 hours)Work... ...pharmacy, physician, ancillary and hospital-based coding in routine desk audits as well as occasional on-site...Remote workPermanent employmentFull timeTemporary workLive inCurrently hiringShift work$62.7k
...Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged... ...provider facility payment methodology, claims processing systems and coding and billing proficiency Must have understanding of...Remote workContract workFor contractorsWork at officeLocal area- ...Medical Coding SpecialistOptum is a global organization that delivers care, aided by technology, to help millions of people live healthier... ...from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA3+ years of CPT coding experienceRecent professional coding/auditing experience...Remote workMinimum wageFull timeWork experience placementLocal areaMonday to FridayWeekend work
- ...is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical... ..., documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a...Remote jobFull time
- ...Investigator Position For more than 165 years, the Office of the Indiana Attorney General (OAG) has been committed to serving the best... ...experience. Working knowledge of health care operations, billing, coding and documentation guidelines is preferred but not required....Remote workFull timeWork at officeNight shift
- CorroHealth, Inc. is seeking a remote Certified Medical Coder to join our coding team in the United States. This role focuses on CPT, HCPCS, and ICD-10-CM coding for Observations and injections, with at least 6 months of on-the-job experience. You will code using CPT, ICD...Remote jobWork from home
- ...company in New Orleans is seeking a Healthcare Coding Specialist. This role involves ensuring... ...a strong background in medical coding, CPT, and ICD-10 systems, and be able to communicate... ...clients. The position offers flexibility with remote or hybrid options. #J-18808-Ljbffr...Remote work
- ...to review and abstract professional medical records, ensuring accurate code assignment across CPT, ICD‑10‑CM, and HCPCS. The role emphasizes coding quality, compliance, and productivity in a remote setting. You will validate documentation supports all codes, query providers...Remote work
$56.2k - $101k
...Fraud, Waste, and Abuse Investigator Position Purpose: Conduct fraud... ...1, H-1B1, F-1, J -1, OPT, or CPT. Responsibilities: Conducts... ...medical records, billing and coding documentation, provider data,... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeH1bWork at officeFlexible hours$56.2k - $101k
...fraud, waste, and abuse (FWA) investigations by reviewing referrals,... ...1, H-1B1, F-1, J -1, OPT, or CPT. Conducts fraud, waste, and... ...medical records, billing and coding documentation, provider data,... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timePart timeH1bWork at officeFlexible hours- ...UnitedHealth Group, via Optum, offers a telecommute coding role spanning office, outpatient, inpatient, and other care settings. You will code using CPT, HCPCS, and ICD-10, prepare claims, and coordinate with providers and auditors. The role emphasizes accuracy, compliance...Remote workWork at office
- ...Presidential Staffing Solutions, LLC seeks a Remote Medical Coder to support the Captain James A. Lovell Federal Health Care Center. You will apply ICD-10-CM, CPT, HCPCS codes while navigating VA systems and coding standards. The role emphasizes attention to detail...Remote workFlexible hours
- ...ScionHealth is seeking a Medical Coder to code diagnoses, procedures, and operations in patient records using ICD-10-CM and CPT guidelines. You will enter data into the automated... ...certification preferred. This role offers remote work with periodic onsite presence at...Remote work
- ...Hospital is seeking a Coder to assign ICD-10, ICD-10-PCS and CPT/HCPCS codes for inpatient and outpatient services. The role involves resolving... ...denials, and maintaining high chart review accuracy in a remote capacity. Qualified candidates will have CCS or RHIT with CCS...Remote job
$21 per hour
...Position Summary: The Security Investigator is responsible for conducting detailed inquiries into... ...locations. Where required, including for remote-eligible roles, local pay ranges are... ...student visa sponsorship, including F-1 OPT or CPT. Candidates must have authorization to...Remote workHourly payTemporary workWork experience placementLocal areaImmediate startShift workAfternoon shift$25 - $28 per hour
...Overview Investigator - Network Services Knoxville, Tennessee Immediate need for an undercover investigator within the worldwide... ...including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.) About Us: CoventBridge...Remote workHourly payFull timeH1bH2bLocal areaImmediate startWorldwideFlexible hoursNight shift
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