Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

$60k - $130k

Stout

At Stout, we're 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 You'll MakeThis 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 Stout's 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 Stout's reputation for excellence by applying deep expertise in inpatient coding, reimbursement systems, and compliance.What You'll DoHere, you'll 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 BringThis section details the skills, qualifications, and experience needed to excel in the role. * Bachelor's 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 You'll ThriveThis section highlights the competencies and behaviors that will set you up for success in this role and align with Stout's 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 -

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations in Cleveland, OH vacancy
  •  ...Company Overview: Certus Healthcare Management proudly owns...  ...and detail-oriented Medical Insurance Claims Specialist to lead our claims...  ...review, and reports. Lead investigations into potential fraud cases...  ...such as ICD-9/10 coding, CPT coding, HCPCS codes,... 
    Claims
    Work at office
    Monday to Friday

    Certus Healthcare

    Pepper Pike, OH
    1 day ago
  •  ...Associate, Disputes, Claims, & Investigations At Stout, we're 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... 
    Claims
    Local area
    Remote work
    Flexible hours

    Stout Risius Ross

    Cleveland, OH
    8 days ago
  • $33.52 - $49.18 per hour

    The State of Ohio is hiring a BWC Fraud Analyst in Cleveland. This full-time position requires 54 months of experience in claims or investigation, alongside skills in investigation and analytical software. You will analyze fraud detection outputs, collaborate with fraud... 
    Claims
    Hourly pay
    Full time

    State of Ohio

    Cleveland, OH
    4 days ago
  •  ...Insight Global is seeking a fully remote Claims Management Analyst to join the team of one of their largest healthcare clients. This individual will join the team as a direct employee for the client. The Claims Management Analyst is responsible for leading eBusiness initiatives... 
    Claims
    Work experience placement
    Remote work

    Insight Global

    Parma, OH
    1 day ago
  • $120k - $215k

     ...Draft, review and finalize expert reports, written analyses, presentations, and graphical exhibits prepared for litigation and dispute proceedings. Direct and participate in document review and analysis processes, including synthesis of case documentation, testimony... 
    Claims
    Local area
    Flexible hours

    Stout Risius Ross

    Cleveland, OH
    4 days ago
  • Provider Reimbursement Analyst - Job Overview Founded in 1934, Medical Mutual is the oldest...  ...what‑if” scenarios using claims data. Support fee...  ...scenarios using claims and healthcare data. Assist in...  ...negotiation strategies. Investigate claim disputes to validate pricing accuracy... 
    Claims
    Contract work
    Temporary work
    Work at office
    3 days per week

    Superior Dental Care, Inc.

    Cleveland, OH
    1 day ago
  •  ...seeking an experienced candidate to contribute to healthcare consulting engagements by conducting coding audits and delivering high-quality, accurate coding...  ...with daily tasks involving the review of inpatient medical records and collaboration with clients. Ideal candidates... 
    Claims
    Flexible hours

    Stout

    Cleveland, OH
    2 days ago
  • Description As a Healthcare Financial/Actuarial Senior Analyst you will contribute to a wide variety of complex analyses...  ...group benefit programs including medical, dental, life, disability,...  ...reserves. Delivers accurate and reliable claim reporting and financial modeling to... 
    Claims
    Temporary work
    Work at office
    Local area
    Remote work
    Visa sponsorship
    Work visa
    Flexible hours

    WTW

    Cleveland, OH
    15 hours ago
  • $80k - $100k

    Description As a Healthcare Financial/Actuarial Associate Manager you will contribute to a...  ...health and group benefit programs including medical, dental, life, disability, voluntary...  ...reserves Delivers accurate and reliable claim reporting and financial modeling to client... 
    Claims
    Temporary work
    Work at office
    Local area
    Remote work
    Flexible hours

    WTW

    Cleveland, OH
    15 hours ago
  • $20 - $22 per hour

     ...Company Overview: Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and...  ...and/or investigations experience BENEFITS: Medical, dental, vision, basic life, AD&D, retirement plan... 
    Claims
    Work experience placement
    Work at office
    Local area

    Allied Universal® Compliance and Investigations

    Cleveland, OH
    16 days ago
  • $2,690 - $3,190 per week

     ...Epic HIM/PB Analyst - Cleveland, OH (On-site, Permanent) Epic HIM/PB Analyst in...  ...analyst needed for an on-site, permanent healthcare IT role. Join a technology-focused team...  ...Ohio to improve clinical documentation, coding and revenue cycle processes while supporting... 
    Weekly pay
    Permanent employment

    GHR Travel Nursing

    Cleveland, OH
    15 hours ago
  • $18 - $24 per hour

     ...benefits package to include medical, dental, vision, 401K, Short/...  ...Description: Prepares and sends claims monthly to payers for...  ...least 3 years' experience in a Healthcare Accounts Receivable setting is...  ...Knowledge of basic medical coding and third-party operating procedures... 
    Claims
    Hourly pay
    Temporary work
    Work at office

    Centers for Dialysis Care

    Beachwood, OH
    1 day ago
  • $251k

     ...treat patients with appropriate medical diagnostic and treatment...  ...confines of the medical staff code of conduct. REQUIRED EXPERIENCE...  ...the best place to work in healthcare. We are committed to providing...  ...payment or personal details claiming to come from reputable organizations... 
    Claims
    Full time
    Live in
    Worldwide
    Relocation

    Cleveland Clinic

    Cleveland, OH
    4 days ago
  • $90k - $110k

     ...perspective.They will conduct on-site surveys, investigate risk exposures and accidents, and...  ...property concerns to HAI Group’s Underwriting, Claims, Account Management, and Agency...  ...paid volunteer days and paid holidays Medical, vision and dental Insurance Company paid... 
    Claims
    Remote job
    Full time
    Contract work
    Temporary work
    Work experience placement
    Work at office

    HAI Group, Inc.

    Cleveland, OH
    4 days ago
  • $314.5k

     ...treat patients with appropriate medical diagnostic and treatment...  ...confines of the medical staff code of conduct. Required Experience...  ...the best place to work in healthcare. We are committed to providing...  ...payment or personal details claiming to come from reputable organizations... 
    Claims
    Full time
    Worldwide

    Cleveland Clinic

    Cleveland, OH
    3 days ago
  • $24 - $44 per hour

     ...tracking, and documentation processes Engagement / Client Support Assist with engagement setup and lifecycle processes (project codes, conflict checks, closeouts) Track engagement metrics including retainers and accounts receivable Support project teams with... 
    Claims
    Hourly pay
    Work at office
    Local area
    Flexible hours

    Stout Risius Ross

    Cleveland, OH
    12 days ago
  •  ...Insurance Company (FCIC) is seeking an experienced Casualty Claims Specialist in Cleveland, Ohio to investigate and settle automobile bodily injury claims. The role...  ...evaluations. Benefits include competitive salaries, medical and dental coverage, a 401k match, and tuition... 
    Claims

    First Chicago Insurance Company (FCIC

    Cleveland, OH
    3 days ago
  •  ...health is everything. Our strength in healthcare innovation empowers us to build a...  ...appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer...  ...departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS.... 
    Claims
    Permanent employment
    Full time
    Work at office
    Local area

    Johnson & Johnson

    Cleveland, OH
    4 days ago
  •  ...Nephrologists to ensure patient needs are met Knowledge of medical terminology and office procedures are essential Has knowledge of medical billing, including claims and payment processing and medical coding Understands Electronic Medical Records (EMR) and is... 
    Claims

    Centers for Dialysis Care

    Fairview Park, OH
    22 hours ago
  • $34 - $36 per hour

     ...be responsible for actively managing trade related deductions/claims and activities related to trade deductions/claims for the business...  ...new job is posted. Sign in to set job alerts for “Financial Analyst” roles. International Equity – Associate Investment Analyst... 
    Claims
    Contract work
    Work experience placement
    Remote work
    Relocation
    Monday to Friday

    TechnoSmarts

    Cleveland, OH
    1 day ago
  •  ...HRIS Analyst - Full-Time (Exempt) GNCO, Inc. | Brooklyn Heights, OH (Hybrid) Reports To: Senior Director of Human Resources and...  ...administration, including broker relationships, vendor management, claims resolution, reporting, and employee communications.... 
    Claims
    Full time
    Local area

    GNCO Inc.

    Brooklyn Heights, OH
    3 days ago
  •  ...Description Insight Global is seeking a Digital & IT Senior Analyst focused on manufacturing quality systems and processes. This role...  ...in CX and/or CRM processes related to customer service (Cases, Claims). o Experience with platforms such as Salesforce, Microsoft... 
    Claims

    Insight Global

    Pepper Pike, OH
    3 days ago
  • $222.5k

     ...patient safety initiatives, and medical school and residency...  ...infrastructure supports both investigator-initiated and industry-funded...  ...year. The Cleveland Clinic healthcare system was recently ranked 2...  ...payment or personal details claiming to come from reputable organizations... 
    Claims
    Live in

    Cleveland Clinic

    Cleveland, OH
    1 day ago
  •  ...Functions and Responsibilities Keying and coding ambulance transports with the correct ICD...  ...of communication. File all insurance claims daily, including Medicare, Medicaid, and...  ...least 2 years of experience working with medical terminology, emergency medical services coding... 
    Claims
    Work at office
    Local area
    Remote work

    Cleveland County

    Cleveland, OH
    2 days ago
  • $51.3k - $77k

     ...Overview The Business Analyst will support the Client Services Management team to develop...  ..., and successes in a client's claim data. The analyst will report to the Manager...  ...advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including... 
    Claims
    Work at office
    Flexible hours

    AmTrust Financial

    Cleveland, OH
    15 hours ago
  • $190.25k

     ...most distinguished academic medical centers, is seeking a Staff...  ...industry partnerships, and investigator initiated studies. The program...  ...and the best place to work in healthcare. We are committed to...  ...payment or personal details claiming to come from reputable organizations... 
    Claims
    Full time
    Live in

    Cleveland Clinic

    Cleveland, OH
    3 days ago
  • $87.18k - $101k

     ...Services & Insurance Mgr Data Analyst PRIMARY PURPOSE: To manage a staff...  .... Skills & Knowledge Strong coding skills in SQL and Python...  ...including but not limited to, medical, dental, vision, 401k and matching...  ...the world’s leading risk and claims administration partner, which... 
    Claims
    Work at office
    Local area
    Flexible hours

    Sedgwick

    Cleveland, OH
    2 days ago
  •  ...7040) Location: METROHEALTH MEDICAL CENTER Biweekly Hours: 80.0...  ...pending clinical and professional claims. Upholds the mission, vision...  ...’s degree in Nursing, Healthcare Administration, Public Health...  ...conducting adverse event investigations and root cause analyses in complex... 
    Claims
    Work at office
    Shift work

    The MetroHealth System

    Cleveland, OH
    1 day ago
  • $339.75k

     ...board certified in neurology or medical oncology with a career focus...  ...NRG, industry and our own investigator-initiated trials. BTNC is...  ...and the best place to work in healthcare. We are committed to...  ...payment or personal details claiming to come from reputable organizations... 
    Claims
    Full time
    Live in
    Worldwide

    Cleveland Clinic

    Cleveland, OH
    22 hours ago
  •  ...Pharmacy Analyst Oswald Companies seeks goal-driven professionals ready to take their...  ...reviews. Assist in analyzing pharmacy claims data to identify utilization trends,...  ...clients outlining claim outcomes, high-cost medication impacts, and year-over-year pharmacy... 
    Claims

    Oswald Companies

    Cleveland, OH
    3 days ago

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!