Remote Coding Clinical Analyst - Claims & Records Expert
University of Minnesota School of Nursing
- Remote job
Optum is seeking a M&R Coding Clinical Analyst to determine the accuracy of claims by comparing provider submissions to medical records and to provide coding expertise in pre-payment reviews. This remote opportunity within the United States requires independent judgment on complex payment decisions and strong computer skills across multiple systems. The Senior Recovery Resolution Analyst will manage a caseload, interpret data daily, and ensure timely adherence to client-compliance turnaround #J-18808-Ljbffr University of Minnesota School of Nursing
- ...Clinical Analyst & Coding Specialist - Contract - Columbia, SC Location... ..., SC Hybrid (80% remote, onsite for required... ...as a Subject Matter Expert (SME) for medical coding... ...activities. Review medical records against established... ...policy remediation. Claims processing systems...Remote workClaimsContract workRelocation
- Optum in the United States is seeking a Senior M&R Coding Clinical Analyst to validate claims by comparing provider submissions with medical records. This remote role offers flexibility to telecommute from anywhere in the U.S. and requires careful judgment in line with...Remote jobClaims
- UnitedHealth Group is seeking a M&R Coding Clinical Analyst to verify the accuracy of provider claims by comparing medical records to submitted data. This role requires independent... ...with state and federal guidelines. Remote work is available within the U.S. The position...Remote jobClaims
- Optum is seeking a M&R Coding Clinical Analyst to verify claim accuracy by comparing provider records to medical documentation, applying CPT/HCPCS/ICD coding rules and compliance policies. You will assess service levels and potential billing issues in a telecommuting environment...Remote jobClaims
$107k - $130k
...-forward Business Analyst, Clinical & Reimbursement Policy... ...into our claims environment. You... ...primary Subject Matter Expert (SME), translating... ...general national coding guidelines. ~Strategic... ...a proven track record of interpreting... ...internet stipend, remote-first culture, paid...Remote workClaimsFull timeWork at officeLocal areaFlexible hours$63k - $74k
Profile We offer remote work opportunities (AK, AR... ...medical claims review for coding and pricing determinations... ...assignment. Subject matter expert on medical claims coding... ...support to non-clinical and clinical staff on... ...Certified Electronic Health Records Specialist (CEHRS)...Remote workClaimsContract workTemporary workFor contractorsFor subcontractorInterim roleLocal areaWork from homeShift work- TriWest Healthcare Alliance is seeking a Clinical Coding expert to conduct retrospective medical claims review for inpatient and outpatient services. This role supports... ...DRG assignment and coding determinations. Remote work is available with a Department of Defense background...Remote jobClaims
- POSITION TITLE: Sr. Clinical Study Analyst LOCATION: Cambridge, MA (hybrid) OR U.S. remote This position reports to our global HQ in... ...TriNetX LIVE™ Apply standard coding schemes (ICD, CPT, SNOMED, etc... ...clinical information systems, EMR, claims, etc. Familiarity with...Remote workClaims
- Clinical Research Revenue Integrity Analyst VA, United States (Hybrid) Job Description Inova... ...ensuring billing compliance in claims review of clinical trials... ...work schedules,and remote and hybrid career opportunities... ...Terminology (CPT) coding for billable procedures.Serves...Remote workClaimsFull timeContract workWork at officeMonday to FridayFlexible hoursShift workDay shift
- ...Solventum is seeking a Clinical Analyst to work remotely in Connecticut, focusing on methodologies for outpatient care. This role involves designing... ...industry, with strong knowledge of outpatient coding and claims processing. The position offers competitive compensation...Remote workClaims
$107k - $130k
...forward Business Analyst, Clinical & Reimbursement Policy... ...into our claims environment.... ...primary Subject Matter Expert (SME), translating... ...general national coding guidelines. Strategic... ...a proven track record of interpreting and... ...Additionally, we embrace a remote-first culture that...Remote jobClaimsFull timeWork experience placementWork at officeLocal areaFlexible hours- Overview Clinical Appeals Analyst (Remote) - FTThe Clinical Appeals Analyst is responsible... ...• Review patient medical records and utilize clinical and... ...to determine why cases/claims are denied and complete an... ...providing compassionate, expert care, and to support...Remote workClaimsFull timeLocal area
$37 per hour
...continuously discovering clinical innovations and... ...DescriptionThe Senior Chargemaster Analyst position requires a healthcare clinical or coding certification, college... ...for charge edits, claim edits, denials relative... ...tip sheets, reports, and records while ensuring...Remote workClaimsFull timePart timeWork experience placement- ...Registered Nurse (RN) – Expert Medical Examination... ...schedule (three days remote, two days onsite).... ...performing detailed clinical and administrative reviews... ...medical record reviews, claim evaluations, and clinical... ...appropriateness of care, coding accuracy, and regulatory...Remote jobClaimsLong term contractFull timeContract work
- The Elevance Health Company seeks a DRG Coding Auditor to audit inpatient medical records and generate high-quality recoverable claims for all lines of business. You will apply... ...DRG assignments. Responsibilities include clinical reviews of medical records, documenting audit...Remote jobClaims
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) CGI is seeking a results... ...to rules design, clinical validation, and... ...a subject matter expert, blending deep coding domain expertise... ...Opportunities: Use claim data analysis to... ...arrests and conviction records in accordance...Remote workClaimsLocal area$70.1k - $126.2k
...members and improve their clinical outcomes. This Data Analyst III focuses on... ...multiple sources including claims, provider, member,... ...of programmatic coding languages such as... ...approach to work with remote, hybrid, field or office... ...or conviction records will be considered in...Remote workClaimsFull timeContract workPart timeH1bWork at officeFlexible hours- UASI is seeking a Risk Adjustment Clinical Documentation Specialist to... ...documentation accuracy in a fully remote capacity. The role focuses on supporting coding accuracy, HCC capture, regulatory... ...settings. You will review medical records, use Epic and OPAs for prospective...Remote job
- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis of hospital... ...framework and must understand the claim review process, clinical review, medical record review, and billing guidelines. #J-18...Remote jobClaims
- ...Organization, Inc. seeks an experienced RN Clinical Case Manager to support a disability claim review program. You will guide... ...start to finish. You will work remotely within allowed US states,... ...developing plans, and coordinating records with providers and employers, ensuring...Remote jobClaims
$100k - $110k
...represented. By combining deep clinical and coding expertise with... ...network of clinical experts, you'll work alongside... ...The Clinical Coding Analyst (CCA) performs pre-bill inpatient medical record reviews to identify coding... .... This is a fully remote position requiring strong...Remote workFull timeLocal areaMonday to Friday$111.54k - $188.73k
...reviews post service prepayment facility claims for contract compliance, industry... ...acquired conditions/never events. The Clinical Coding Analyst RN, Consultant will report to the Senior... ...infusions. This person will review medical records and perform coding analysis on all...ClaimsFull timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week$84 per hour
...Jack Dorsey . Position: Clinical Documentation Integrity (CDI)... ...: $84/hour Location: Remote Role Responsibilities Lead... .... Collaborate with coding, compliance, and clinical teams... ...ability to interpret medical records and clinical documentation....Remote jobContract workSummer work$77k - $100k
...as the Subject Matter Expert (SME) for clinical data completeness and... .... As a Data Analyst, you will: ~Proactively... ...sources like structured claims, clinical care... ...incongruence in clinical records. ~Establish and maintain... ...& internet stipend, remote-first culture, paid...Remote workClaimsFull timeWork at officeFlexible hours$87.7k - $157.8k
...workplace flexibility. Remote Available. ~... ...improve their clinical outcomes. ~... ...including claims, provider, member... ...subject matter expert for data... ...partners. ~Mentor analysts on analytic... ...of programmatic coding languages such... ...or conviction records will be considered...Remote workClaimsFull timeH1bWork at officeFlexible hours$66.94k - $101.26k
...Payment Integrity Analyst is responsible for... ...pre- and post pay claim audits based on client... .... This is a remote position.... ...communication Use clinical judgement to appropriately... ..., IDC-10 Coding, and DRG Validation... ...capabilities Proven track record of delivering...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$73.35k - $113.25k
...Payment Integrity Analyst (Team Lead) assists... ...pre and post pay claim audits based on client... ...other claim or record that requires... ...policies. This is a remote position.... ...PPI QC analysts and clinical appeal review teams... ...processing, ICD-10 Coding, DRG Validation, Coordination...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$96k - $125k
...that delivers clinical insights to providers... ...you turn dense claims and clinical... ...As a Data Analyst, you will:... ...adjustment (HCC coding, RAF scores), utilization... ..., we embrace a remote-first culture... ...and technology experts, Counterpart... ...and conviction records. We are an E-Verify...Remote workClaimsFull timeWork experience placementWork at officeFlexible hours- ...seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records, ensuring clinical... ...reimbursed. The role emphasizes ICD-10 coding expertise and DRG validation across... ...extensive experience in claims auditing and clinical documentation...Remote jobClaims
- ...a Subject Matter Expert (SME) and Expert Witness... ..., CCI edits, and clinical validation rules... ...of medical records, itemized bills,... ...translating complex coding systems (CPT, ICD-... ...are provided for remote workspace. About... ...200,000 insurance claims annually for leading...Remote workClaimsContract workTemporary work
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