Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
$60k - $130kStout
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 -
- ...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,...ClaimsWork at officeMonday to Friday
- ...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...ClaimsLocal areaRemote workFlexible hours
$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...ClaimsHourly payFull time- ...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...ClaimsWork experience placementRemote work
$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...ClaimsLocal areaFlexible hours- 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...ClaimsContract workTemporary workWork at office3 days per week
- ...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...ClaimsFlexible hours
- 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...ClaimsTemporary workWork at officeLocal areaRemote workVisa sponsorshipWork visaFlexible hours
$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...ClaimsTemporary workWork at officeLocal areaRemote workFlexible hours$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...ClaimsWork experience placementWork at officeLocal area$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 payPermanent employment$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...ClaimsHourly payTemporary workWork at office$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...ClaimsFull timeLive inWorldwideRelocation$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...ClaimsRemote jobFull timeContract workTemporary workWork experience placementWork at office$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...ClaimsFull timeWorldwide$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...ClaimsHourly payWork at officeLocal areaFlexible hours- ...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
- ...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....ClaimsPermanent employmentFull timeWork at officeLocal area
- ...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
$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...ClaimsContract workWork experience placementRemote workRelocationMonday to Friday- ...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....ClaimsFull timeLocal area
- ...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
$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...ClaimsLive in- ...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...ClaimsWork at officeLocal areaRemote work
$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...ClaimsWork at officeFlexible hours$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...ClaimsFull timeLive in$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...ClaimsWork at officeLocal areaFlexible hours- ...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...ClaimsWork at officeShift work
$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...ClaimsFull timeLive inWorldwide- ...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
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!
- IT analyst Cleveland, OH
- call center workforce analyst Cleveland, OH
- cash analyst Cleveland, OH
- recruiting analyst Cleveland, OH
- grants analyst Cleveland, OH
- language analyst Cleveland, OH
- category analyst Cleveland, OH
- etl analyst Cleveland, OH
- agriculture analyst Cleveland, OH
- internal audit analyst Cleveland, OH



