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 -
$60k - $130k
...Make This role will contribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations. You will deliver high‑quality accuracy... ...Perform detailed reviews of inpatient medical records to assess ICD‑10‑CM/PCS coding...ClaimsWork at officeLocal area$60k - $130k
Stout Risius Ross, LLC is seeking a healthcare consultant to contribute to coding audits and claims analysis. You will review inpatient medical records for coding accuracy and support forensic analyses. The position requires strong coding experience and an analytical mindset...Claims$90k - $115k
As an Analyst in Hilco Global Investigations & Dispute Resolution practice, you will support engagement teams on a range of investigative, forensic accounting, financial analysis, and dispute-related matters. You will work closely with more senior professionals to conduct...SuggestedWork at office$90k - $115k
Hilco Corporate Finance, LLC, seeks an Analyst to join their Global Investigations & Dispute Resolution practice. The ideal candidate will support investigation teams by conducting research, analyzing financial data, and helping in the development of client-ready materials...Suggested- ...become part of a dynamic global healthcare platform, agile and... ...market. Your Role The Lead Data Analyst at Inizio Evoke plays a critical... ...Independently—and with our team—investigate complex business problems... ...Healthcare and pharmaceutical data: claims, patient‑level, referral,...Claims
$85k - $110k
...become part of a dynamic global healthcare platform-, agile and... .... Your Role The Data Analyst at Inizio Evoke plays a critical... ...Independently - and with our team - investigate complex business problems... ...data is strongly preferred: claims, patient-level, referral, Salesforce...ClaimsFlexible hours- **Job Title: Medical Assistant / Reception / Medical Insurance Biller... ...Medical Assistant to join our healthcare team, where you will play a... ...- Process patient insurance claims efficiently and accurately, adhering to current billing codes and regulatory requirements....ClaimsWork at office
- ...Review alerts, referrals, and claims for indicators of fraud or... ...caseload of complex, high-value investigations from intake through... ...claim records, policy files, medical records, financial statements... ...variety of plans to fit your healthcare needs. Employer-Paid Vision...ClaimsRemote jobTemporary workWork at officeFlexible hours
$74k - $135k
...to communicate that you are utilizing this accommodation to express interest in a specific open position. Please reference the job code to help us process your request. Please understand that this option is only available to those in need of an accommodation related to...ClaimsFull timeWork at officeLocal areaFlexible hoursShift work$20.69 - $30 per hour
...for managing insurance claims and resolving billing and... ...insurance policies and healthcare regulations. Monitor... ...accurate claim submissions. Investigate and resolve claim denials and disputes, providing necessary... ...Development Various Medical, Dental, and Vision options...ClaimsHourly payFull timeFor contractorsMonday to FridayFlexible hours- Pharmacy Rebate Analyst AscellaHealth | Berwyn, PA | Hybrid (3 days... ...Remote Shape the Future of Healthcare We’re seeking a Rebate... ...audit checks across rebate, claims, and financial datasets. Maintain... ...years of experience in pharmacy/medical rebates, PBM operations,...ClaimsContract workWork at officeLocal areaRemote workWorldwideFlexible hours
$67k - $97k
## Analyst, Reimbursement Strategy & AnalyticsApplylocations: Chicagotime... ...medicine and advancing the healthcare industry?**Recent... ...reporting. This role will analyze claims and reimbursement data, assist... ...compensation, restricted stock units, medical and other benefits depending...ClaimsContract workWork experience placement$17 - $19.5 per hour
...seeking a highly detail-oriented Medical Biller with specialized... ...IWCC) and commercial insurance claims. You will take ownership of the... ...claims with 100% accuracy. Coding Integrity: Review patient... ...the formal appeal process for disputed payments. AR & Payment Posting...ClaimsFull timeWork at officeMonday to Friday$90k - $125k
...HIM & Coding Manager This hybrid position requires... ...regulatory compliance. Investigate coding denials, data discrepancies... ...and clean claims. Collaborate with providers... ...Management, Healthcare Administration, or related... ...healthcare operations and/or medical coding experience 2+...ClaimsPermanent employmentWork at office$90k - $125k
...markets they serve. We help healthcare organizations build... ..., hospitals and medical clinics are under immense... ...the enterprise. HIM & Coding Manager is responsible... ...regulatory compliance Investigate coding denials, data discrepancies... ...and clean claims Collaborate with providers...ClaimsPermanent employmentWork at office- ...Nurse Analyst The Nurse Analyst is responsible for collecting... ...and creation of investigative strategies and case objectives... ...detailed summaries of: medical records; charts;... ...assessment instruments; ICD-9/10 coding; CPT coding; and, Medicaid claims/utilization data....ClaimsWork experience placementWork at office
$85.6k - $124k
The Knowledge Management Senior Analyst (“KM Senior Analyst”) will be part of the Healthcare Practice Area Team (“Healthcare PAT”) and the Global Life Sciences (... ...healthcare enforcement settlement materials, False Claims Act (FCA) opinions, as well as exemplar forms,...ClaimsWork at office$85k - $200k
...leader in health care disputes, compliance, and investigations. We combine... ...knowledge related in coding, revenue cycle and... ...information in a patient's medical record according to... ...Understands Healthcare Compliance concepts... ...understanding of in claims processing procedures...ClaimsRemote work$92k - $95k
...data and analytic solutions for the healthcare industry. You will own and scale proprietary... ...audiences Deep understanding of claims billing processes and code sets (e.g., ICD‑10, CPT, HCPCS),... ...and their families. This includes medical, mental health, dental and vision coverage...ClaimsApprenticeshipEasy work- ## Data Modeler / Analyst - HealthcareUnited States · Full-time... ...databases and able to write pseudo-code for ETL requirements.· Data... ...Experience and knowledge of Healthcare domain preferred – knowledge... ...required. Knowledge of Claims (Medical and Pharmacy), EMRs, EHR required...ClaimsFull timeRemote workFlexible hours
$20 - $28 per hour
Description: Job Title: Investigator I Job Location : Chicago, IL Job Type: Part-Time, Billable Hours, Non-exempt Reports To... ...join our team! This role involves conducting thorough insurance claims investigations, which include performing scene investigations...ClaimsHourly payWeekly payPart timeWork at officeWork from homeFlexible hours$110k
...YOUR IMPACT You will be part of Social, Healthcare and Public Entities (SHaPE) Healthcare Access... ...perform a variety of analyses such as claims analyses, trend identification, industry... ...and their families. This includes medical, mental health, dental and vision coverage...ClaimsApprenticeshipWork at officeEasy work- ...part of a world-class academic healthcare system at UChicago Medicine... ...Intelligence - Value Based Care Analyst for the Finance Managed Care... ...SQL and background in payer claims and sourcing data from EDWs... ...: Finance, Managed Care CBA Code: Non‑Union #J-18808-Ljbffr UChicago...ClaimsFull timeRemote workMonday to FridayShift work
- ...subject matter expert in the healthcare revenue cycle industry... ...with experts in coding, billing, denial management, CDI, and medical collections, we make it... ...submitting and following up on claims for Illinois Medicare... ...insurance carriers. Investigate and resolve denied,...Claims
- Efinancial, LLC in Chicago, IL seeks a Fraud Investigator to review claims, lead investigations, and ensure compliance with insurance regulations.... ...report metrics. A comprehensive benefits package, including medical and 401(k), is offered, making it an attractive...ClaimsRemote job
$97k - $185k
...Consider an actuarial opportunity on CNA’s Healthcare and Surety Reserving team. In this... ...of a complex nature for CNA’s Healthcare medical malpractice and Surety books of business... ...needed. Proactively monitors reserving and claim trends for Healthcare & Surety and...ClaimsWork experience placementWork at office- ...in Chicago is hiring a Customer Care & Dispute Specialist to manage invoice discrepancies... ...timely cash flow. This role involves investigating root causes of disputes and working closely... ...with various teams to resolve customer claims effectively. The ideal candidate will have...Claims
- ...Medical Billing Specialist job application. Apply for MedBillersPro... ...-on billing role focused on claim accuracy, AR discipline, and... ...hands‑on experience managing healthcare claims, processing payments,... ...understanding of ICD-10, CPT coding, and claim submission processes...Claims
$45k - $55k
...precision medicine and advancing the healthcare industry? Recent... ...Responsibilities: Audit ICD-10 codes and make appropriate changes... ...billing, ICD-10 coding, medical record requests, COB/expired... ...coding methodologies, claim adjudication, Medicare policy...Claims$22 - $26 per hour
...Specialist - Liability Industry: Healthcare / Medical Billing Location:... ...attorneys and insurance carriers to resolve claims efficiently. This role requires strong... ...documentation to support claim processing Investigate claim denials and coordinate appeals...ClaimsFull timeWork at officeLocal areaRemote workWork from homeMonday to FridayFlexible hours
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