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. About Stout’s Forensics and Compliance Group Stout’s Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements. What You’ll Do As an Analyst, you will play a hands‑on role in client engagements, contributing independently while collaborating closely with senior team members. Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post–go‑live support. Prepare clear, well‑structured analyses, reports, and client‑ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout’s Healthcare Consulting team. What You Bring Bachelor’s degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master’s degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You’ll Thrive Analytical and Detail‑Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well‑supported conclusions. Collaborative and Client‑Focused: You communicate clearly, work well in team‑based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high‑quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast‑paced consulting environment. Growth‑Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. 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 - #J-18808-Ljbffr
$71.7k - $153.3k
...Healthcare Business Systems Analyst Category: Business Analysis (functional and technical... ...plus. Healthcare Claims: 3+ years of experience... ..., disability, pregnancy, medical condition, military and veteran... ...complete a background investigation. Background investigation...ClaimsFull timeLocal areaShift work$46.42 - $47.79 per hour
...Functional Consultant (Disputes) Pay Rate Range: $46.42 - 47.79/hr. Role: Functional... ...-end dispute process lifecycle: intake, investigation, provisional credit, representment, arbitration... ...unauthorized transactions, ATM cash claims, merchant disputes, and ACH returns •...Claims- ...growing, busy and patient-focused medical office dedicated to providing top-quality healthcare in a supportive and... ...authorizations, assisting with claim submissions, contacting insurance... ...current on insurance policies, coding changes, and regulatory updates....ClaimsWork at office
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...Functional Consultant (Disputes) Pay Rate Range: $46.42 - 47.79/hr. Role: Functional Consultant... ...-end dispute process lifecycle: intake, investigation, provisional credit, representment,... ...unauthorized transactions, ATM cash claims, merchant disputes, and ACH returns Proficiency...Claims$118.7k - $218.6k
...Life Sciences team, you will: Review medical records, claims documentation, and benefit materials... ...underpaid claims, assess documentation, coding, and policy interpretation issues, and... ...Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS)...Claims- ...working with at least three or more major healthcare IT systems Experience with analytics for... ...Clinical, Financial, Labor, Supply chain, Payer/Claims, Population Health, Revenue Cycle,... ...etc. Familiarity with healthcare industry code sets (RXNORM, LOINC, SNOMED, CPT, ICD-9,...Claims
$80.55k - $115k
...definition, technical design, prototype, code development, testing, release to... ...ATM messaging, fraud strategies, dispute processing, EFT billing and... ...kind, pursuing any discrimination claim, or cooperating in related investigations. Requests for full corporate job...ClaimsWork at officeLocal areaRemote work$19 - $25.5 per hour
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$125k - $130k
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- Company Overview Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation... ...insurance investigations experience Benefits Medical, dental, vision, basic life, AD&D, and disability...ClaimsFull timeWork at officeLocal area
$65k - $103k
...Overview The Insurance Risk Analyst manages the end-to-end lifecycle... ...programs and complex claims. This role focuses heavily on... ...incentive and a full range of medical, retirement, and other benefits... ...criminal and financial background investigation, drug test, previous...ClaimsWork at officeLocal areaFlexible hours- ...technology is driving advances in medical radioisotope production in... ...: The Insurance Risk Analyst manages the end-to-end lifecycle... ...insurance programs and complex claims. This role focuses heavily on... ...and financial background investigation, drug test, previous employment...ClaimsFor contractorsWork at officeLocal areaFlexible hours
$45k - $56k
Description Our Medicare IT Analyst - Pricing Procedures... ...of processing and coding guidelines. This... ...assist the Technical Claims team with various projects... .... WPS has been making healthcare easier for the people... ...screening and background investigation including...ClaimsContract workFor contractorsLocal areaImmediate startRemote work- ...Analytics team, the Data & Reporting Senior Analyst will be responsible for reporting, analysis, and data management for GI Claims Fraud and Recovery (F&R). This position... ...years in Business Analysis, Risk, Fraud (investigative services) and/or Claims Recovery ~ Bachelor...Claims
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- ...Reimbursement payment system. Knowledgeable of the nursing and medical practices and procedures, as well as laws, regulations, and... ...Measures (QM) and the CMS Five Star Rating. Supports accurate claims and billing. Leads and participates in program improvement...ClaimsFlexible hours
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$90k - $150k
...to meet you. We are seeking an experienced business analyst to work across teams to assist with a massive multiyear... ...of discrimination of any kind, pursuing any discrimination claim, or cooperating in related investigations. #J-18808-Ljbffr Jack Henry & Associates, Inc.ClaimsWork at officeLocal areaRemote work- ...Senior Business Analyst We are seeking an experienced Senior Business Analyst with strong expertise in the Insurance Property & Casualty... ...The ideal candidate will have hands-on experience working with Claims processes, strong data analysis capabilities using Snowflake (...Claims
- ...for an Accounts Receivable Representative (Medical Billing) to join our Revenue Cycle team... ...insurance account balances and resolving claim issues with insurance and/or patient.... ...medical claims for bundling and medical coding-related issues. ~ Responsible for timely...ClaimsWork experience placementWork at office
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