Outpatient Payment Integrity Specialist
MedReview Inc.
MedReview Inc. is seeking an Outpatient Payment Integrity Production Coder to perform claim-level outpatient coding reviews, ensuring accuracy, defensible audit findings, and client savings. You will apply CPT/HCPCS, ICD-10-CM, NCCI, and CMS guidance to identify overpayments and enforce correct billing practices. The role requires 3+ years in outpatient coding, CPC/COC/CCS/RHIT/RHIA or equivalent credentials, and strong written communication to document audit rationale and support conclusions. #J-18808-Ljbffr MedReview Inc.
- A leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role. Candidates must be based in EST or CST and comfortable with EST hours. Responsibilities include analyzing medical records, handling claims, and utilizing systems like Facets and...SuggestedRemote jobContract work
- Senior Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be based in EST or CST and must be comfortable working EST-hours Terms of Employment This position is 100% remote. Candidates must...SuggestedContract workRemote work
- ...into actionable opportunities using deep knowledge of claim infrastructure, workflows, and data models. You will provide SME on Payment Integrity edits, respond to inquiries, document coding rules, and collaborate with partners to scope improvements, deriving insights to...Suggested
$76k - $99k
Remote - USA The Payment Integrity team is a group of innovative thinkers sitting at the intersection of Clover's provider Network, Claims, and Tech teams. The Payment Integrity team ensures that Clover pays claims in an accurate manner, with a particular focus on reducing...SuggestedWork experience placementWork at officeRemote workFlexible hours- ...models to translate stakeholder friction into actionable opportunities. Responsibilities: Provide subject matter expertise on Payment Integrity edits, vendor edits, and reimbursement policies. Respond to inquiries and disputes, document coding rules, and recommend policy...SuggestedRemote job
- ...Health is seeking an Inpatient Clinical Coder to ensure accurate payment of medical claims and identify overpayments within a remote, USA-based role. You’ll work with Clinical, Claims, and Payment Integrity colleagues to review DRG-related issues and verify clinical...Remote job
- Mosaic Life Care, a health care system serving northwest Missouri, seeks a Payment Validation Analyst to ensure accurate payment from payors. The role reports to the Director of Revenue Integrity and focuses on resolving contractual underpayments, price discrepancies,...Remote job
- ...looking for a detail-oriented, organized, and motivated Payment Posting Specialist to join our team on a temporary/contract basis. This is an... ...Specialist, you'll play an important role in maintaining revenue integrity, reducing accounts receivable (AR) aging, and supporting...Contract workTemporary work
- ...actively recruiting for a Cash Posting Specialist to join our Revenue Cycle Team to handle... ...to advance within the organization. The Payment Posting Specialist will: Post payments,... ...and reimbursement, including inpatient, outpatient, emergency department, and professional...Remote workFlexible hours
$83k - $132.8k
Job Summary: The FWA Payment Integrity Data Analyst III is responsible for developing, implementing, managing and presenting in-depth analyses that meet the information needs associated with Fraud, Waste and Abuse. Essential Functions: Lead and implement data analytic Ideation...Work experience placementWork at office- CareSource is hiring a senior Data Analyst III for FWA Payment Integrity to develop and present in-depth analyses that address fraud, waste, and abuse across multiple lines of business. You will lead ideation, validate vendor outputs, and partner with PI vendors to translate...
- JOB DESCRIPTION Job Summary This position supports Payment Integrity through the research and development of post-pay recovery concepts and claims edits. The role analyzes healthcare claims, medical billing and coding requirements, and reimbursement policies to identify...Remote jobWork at office
- Ultimus Fund Solutions is seeking a Treasury Associate I to manage payment processing, including wires, ACHs, and checks, across multiple... ...collaboration with internal teams to maintain client payment integrity and compliance with industry standards. #J-18808-Ljbffr...
- UASI is seeking an Outpatient CDI Specialist to support coding accuracy and HCC capture in a fully remote capacity. The role emphasizes clinical judgment and documentation integrity. You will review records from physician practices, utilize Epic/OPAs, and monitor CDI outcomes...Remote job
$37.75 - $40.25 per hour
...Cotiviti Healthcare is a leading provider of payment accuracyservices to the most recognized... ...the improvement of healthcare payment integrity, consider an opportunity to join our... ...recovery team as a Senior Payment Accuracy Specialist. The Senior Specialist position is...Hourly payContract workWork at office- ...emergency department, same-day surgery, outpatient clinic, observation, inpatient OB/newborn... ...and procedures. A Outpatient Coding Specialist who excels in this role: Assign appropriate... ...standards. Must be familiar with Ambulatory Payment Categories (APCs, the Outpatient...Remote jobFull timeTemporary workPart timeLocal areaFlexible hours
- Bmsfamilyhealth is seeking a Payment Posting Specialist for a temporary/contract, on-site role. You will ensure accurate posting of payments, adjustments, and denials while supporting revenue integrity. The role emphasizes researching discrepancies, reconciling accounts...Temporary work
- Payments Reconciliation Specialist - Contract Full Description Finance | 100% Remote in the U.S | Contract WHO WE ARE Finalsite is the most valued... ...more than 7,000 schools and districts worldwide with an integrated platform for websites, communications, mobile apps, enrollment...Permanent employmentContract workRemote workWorldwide
$10k
...Bureau of Bronx Neighborhood Health seeks to hire a Systems Integration Specialist to help develop and implement systems to improve service... ...forgiveness and repayment assistance programs that lessen your payments or even fully forgive your full balance. For more...Work at officeWork from home2 days per week$44.37 - $57.97 per hour
...resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and... ...the appropriate operational teams. This role is part of Revenue Integrity and collaborates with OR/Cath/IR departments, Purchasing/...Full timeTemporary workPart timeFlexible hours- Yale New Haven Health is seeking an Outpatient Coder I to review medical records and assign ICD-10-CM, CPT, and ICD-10-PCS codes in a high... ...clinicians as needed to ensure compliant coding and revenue integrity. Experience with Epic and the 3M encoder is preferred. #J-188...
- ...Sciences University is seeking a full-time TH Medical Records Specialist / Outpatient Coding Specialist. Job Summary The Outpatient Coding... ...documentation deficiencies, maintain coding accuracy, and support the integrity of the institution's health information and revenue cycle...Full time
$25.75 - $29.75 per hour
...Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized... ...the improvement of healthcare payment integrity, consider an opportunity to join our... ...healthcare recovery team as a Payment Accuracy Specialist. A Payment Accuracy Specialist 1 is a...Hourly payContract workWork at officeImmediate startRemote work- ...is to develop an all-in-one financial B2B solution that integrates banking functions, accounting, financial management, and... ...employees, partners, and, of course, our business. Senior Specialist, T2 (Target2) Payment Operations Location: Remote in Netherlands, Spain,...Remote workWorldwide
- ...collaborating with external vendors in a healthcare claims or payment integrity environment, including implementation support, claim-edit... ...Certified Professional Coder (CPC) with AAPC Certified Coding Specialist with AHIMA certifications Education: High School Diploma or...Full timePart timeWork experience placementWork at officeLocal areaWork from homeShift work
- Community Health Systems, Inc. is seeking an Outpatient Coder to assign ICD-10-CM, CPT, and HCPCS codes for outpatient services, including... ...and collaborates with CDI and billing teams to maintain data integrity and accurate reimbursement. Strong knowledge of coding...
- ...Health Sciences University seeks a full-time TH Medical Records Specialist / Outpatient Coding Specialist to review and code outpatient records,... ...and Health Information Management staff to maintain coding integrity. The position requires knowledge of medical terminology,...Full time
- Acacia Network seeks a CASAC Counselor to deliver integrated outpatient counseling services addressing substance use and mental health barriers to employment. Under supervision, you will perform screenings, assessments, treatment planning, and case management in individual...
- Cotiviti Healthcare seeks a Payment Accuracy Specialist to join our data mining team in the United States. You will audit client data and generate high-quality recoverable claims, applying CMS/NAIC guidelines and our Recovery Management System to identify over- and under...Remote job
- Simera seeks an Accounts Receivable specialist to manage invoicing, payment application, and account reconciliations from a remote environment in the United States. The role supports monthly close activities and requires excellent communication with customers and internal...Remote job
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