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 Stout
$60k - $130k
...and drive value across Stout's Healthcare Consulting practice. * Contribute... ...engagements involving coding audits, disputes, claims analysis, and investigations. * Deliver high-quality, accurate... ...detailed reviews of inpatient medical records to assess accuracy of ICD...ClaimsWork at officeLocal areaFlexible hours- Senior Associate, Disputes and Investigations Alvarez & M is a global consulting firm with over 10,000... ...understand insured merger & acquisition claims, determine financial damages, and... ...0,000 annually, discretionary bonus, healthcare plans, flexible spending accounts, life...ClaimsWork at officeRemote workFlexible hours
$72.8k - $130k
...entitled to the highest level of medical care. Here, you will be part... ...(CVOC) researches and investigates critical business problems through... ..., utilization metrics, healthcare costs, membership trends, and... ...of Member healthcare, claims Proficient in MS Excel and/...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- ...assisting with the resolution of problem claims, payment requests, and managed care... ...requires strong knowledge of medical terminology, CPT codes, computer systems, and customer service... ...services experience Experience in a healthcare insurance environment Skills...ClaimsFor contractorsWork at officeImmediate start
- ...Location: ADDISON, TX 75001 Overview A Healthcare Claims Denial Management Specialist is responsible... ..., and resolving denied or underpaid medical insurance claims. This role ensures... ...root causes. Correct claim errors, update coding or documentation as needed, and resubmit...Claims
$80k - $110k
...Senior Associate, Disputes and Investigations Alvarez & Marsal (A&M) is a global consulting firm with... ...and other insured transactional claims. The efforts include forensic accounting... ...Holdings' fringe benefits consisting of healthcare plans, flexible spending and savings...ClaimsPart timeWork at officeRemote workFlexible hours- ...highly motivated Independent Dispute Resolution (IDR) Claims / OON Specialist to join... ...requires expertise in medical billing, collection, and appeals... ...in-depth understanding of healthcare billing, regulations, and... ...of medical billing codes and regulations. • Excellent...Claims
- ...reputation as a leader in multifamily and healthcare finance, with $13 billion in loan... ...spirit and creativity. We are seeking an Analyst to join our Insurance Compliance team. This... .... If you are contacted by someone claiming to represent Greystone and suspect the communication...ClaimsWork experience placement
- ...Overview Prime Healthcare is an award-winning health system headquartered... ...opportunities. The Senior Analyst will apply analytical and... ...Registration, Billing, Denials, Coding, Reimbursement methodologies,... ...of UB04, 1500, 835/837, claims status codes with Billing / Coding...ClaimsFull timeWork experience placementLocal areaShift work
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote)... ...expert, blending deep coding domain expertise with advanced... ...integrity across the healthcare landscape. Your Future... ...Opportunities: Use claim data analysis to pinpoint... ...Translate Policy: Convert medical policy, CMS rules, and...ClaimsRemote work- ...Description Job Description The Risk Analyst will support clients and executive/... ...loss sensitive plans. Support external claim management service provider by providing... ...industrial, data center, production studio, healthcare, government, universities, and mixed-use...ClaimsWork at office
- ...Senior Healthcare Business Analyst Position Summary: We are seeking a detail oriented and analytical Healthcare Business Analyst to support... ...system requirements in the healthcare domain (payer, provider, claims, EHR/EMR, pharmacy, or regulatory compliance)....Claims
- ...Position Summary: We're looking for an Auto Investigator to dig into the details of motor vehicle... ...evidence, write reports, help with claims, and sometimes even show up in court. The... ...the violators. Reviewing records such as medical reports, autopsy reports, genetic test...ClaimsWork at officeLocal areaImmediate start
- AI Solution Business Analyst - Remote, United States (US) Solution Business Analyst - Healthcare Role Summary We are seeking an experienced Solution Business Analyst (SBA... ..., patient engagement bots, automation for claims and revenue cycle management, and operational...ClaimsRemote job
- ...Revenue Cycle Analyst Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare... ...processes and applications such as billing, coding, reimbursement methodologies, claim denial, etc. Proficient in business software applications...ClaimsFull timeWork at officeLocal areaImmediate startShift work
- ...Nurse Auditor to join our healthcare compliance team. In... ...management, medical necessity, and evidence... ...patient medical records, claims, and billing documentation... ...Identify documentation, coding, charging, and billing... ...to external audits, investigations, and inquiries from government...ClaimsFor contractorsWork at officeMonday to FridayFlexible hours
- ...specializes in Independent Dispute Resolution (IDR) through The... ...regulations for out-of-network healthcare providers, leveraging... ...Job Summary: The Refund Analyst is a critical aspect of our... ...or issues requiring further investigation. Assist in month-end reporting...Work experience placementWork at office
$28 - $32 per hour
...Job Description Description: Command Investigations, LLC is seeking an Insurance Field Investigator... ...): ~ Accrued Paid Time Off ~ Medical, Dental, Vision, and Life Insurance ~4... ...Do: In this role, you will conduct claims investigations by gathering evidence, interviewing...ClaimsHourly payFull timePart timeWork at officeRemote workFlexible hours- ...Technical Business Analyst – Healthcare Data Reporting Dallas, TX - Hybrid (3x in office/week)... ...healthcare data related to accumulators, claims, eligibility, and benefit structures.... ...analytics programs. Benefits: ~ Medical Insurance ~ Dental Insurance ~...ClaimsTemporary workWork at office
- ...we believe in a world where healthcare functions efficiently. Join us... ...analytically driven Business Analyst with a strong foundation in healthcare... ...Authorization and Enriched Claim Status Automation Product... ...payer clinical policies, medical necessity criteria, and prior...ClaimsWork at officeRemote workLong distanceShift work
- Sr. Business Data Analyst - Health Economics life insurance, parental... ...on transforming complex healthcare data into actionable insights... ...complex healthcare datasets (claims, EMR, market, financial, etc.... ...being, and work-life harmony. Medical, dental and vision plans are...ClaimsWorldwideFlexible hours
- ...their childhood! Job Posting Title: Sr. Healthcare Data Analyst - Epic Location: Dallas - Hospital Additional... ...data from multiple sources including electronic medical records, patient experience surveys, claims, and administrative systems to discover...ClaimsRemote work
- Allied Universal is seeking a Special Investigations Unit (SIU) Investigator in Dallas, Texas.... ...involves investigating suspected fraudulent claims related to various insurance coverage,... ...Benefits include a company credit card, medical insurance, and paid holidays. This...ClaimsFlexible hours
- ...the very best care for our patients. The Epic Analyst supports many users and departments within the healthcare system.Your Job Requirements:Bachelor's degree... ...experience in healthcare is preferredFamiliarity with medical codes and terminology is very helpful.Ability to...Shift work
- A leading company in insurance investigations is hiring a Surveillance Investigator in Dallas,... ...confirm claimant activities for insurance claims. Candidates must have a high school... ...clear report writing. Benefits include medical, dental, and 401(k) enrollment. Join us...ClaimsFlexible hours
- A leading insurance investigation company is seeking an Experienced Field Investigator in Dallas, Texas. This role entails conducting surveillance... ...and investigative activities to detect fraudulent insurance claims. The investigator will utilize covert surveillance techniques...ClaimsFlexible hoursNight shift
- A healthcare organization is seeking a Denials & Appeals Specialist in Dallas, TX. The... ...reviewing and resolving denied healthcare claims and preparing appeals to insurance... ...experience and a strong understanding of medical billing, coding, and payer policies. Experience with...Claims
- ...Plutus Health Inc. is a healthcare revenue cycle management firm... ...technology to ensure that your medical billing and collections processes... ...everything from medical coding and credentialing to denial management... .... Job Title: Business analyst Report To: Project...Full timePart timeWorldwideShift work
- ...Job Description Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents...ClaimsWork at officeAfternoon shift
$18 - $22 per hour
...Medical Billing Specialist – 100% Remote $18–22/hour... ...Our team partners with healthcare providers and hospital organizations... ...denials and unpaid claims, we'd love to hear from... ...for billing accuracy Investigate eligibility discrepancies, coding issues, payer denials,...ClaimsPermanent employmentFull timeTemporary workWork at officeRemote workFlexible hours
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