Inpatient Coding, Forensics and Compliance - Disputes, Claims & Investigations
$74k - $135kStout Risius Ross
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 MakeContribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations.Deliver accurate coding analyses that inform client decisions, regulatory responses, and litigation support.Identify billing, coding, reimbursement, and compliance risks.Support defensible findings through detailed documentation and analysis.Apply inpatient coding and reimbursement expertise to deliver exceptional client service.What You'll DoReview inpatient medical records for ICD-10-CM/PCS coding accuracy.Analyze coding, billing, and reimbursement practices.Support forensic analyses and compliance reviews.Assist with audits, investigations, and litigation support.Evaluate MS-DRG, APR-DRG, and APC assignments.Prepare reports and client-ready deliverables.Monitor coding trends and regulatory updates.Collaborate with clients, legal counsel, and engagement teams.What You'll BringBachelor's degree in Health Information Management or related field, or equivalent experience.Five years of acute-care inpatient coding experience.Active CCS, CIC, RHIT, or RHIA credential.Knowledge of MS-DRG, APR-DRG, APC reimbursement methodologies.Experience with coding audits and denials preferred.Knowledge of CMS, HIPAA, and the False Claims Act.Strong Microsoft Office, analytical, and communication skills.How You'll ThriveInterpret complex clinical and coding information accurately.Collaborate effectively with clients and colleagues.Take ownership and deliver high-quality work.Adapt to evolving regulations and priorities.Demonstrate integrity and embody Stout's core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and Great Communicators while delivering Relentless Excellence.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 $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - Chicago, IL; Arlington, VA; Cleveland, OH; Grand Rapids, MI; Detroit, MI; Baltimore, MD; Washington, DC; Tysons Corner, VAType: Full time
$120k - $215k
...insights is core to our success.A Senior Manager within our Disputes, Claims, and Investigations group will work on consulting assignments across a... ...and related financial analyses in litigation, fraud, and forensic matters, including intellectual property disputes and complex...ClaimsFull timeWork at officeLocal areaFlexible hours$120k - $215k
...insights is core to our success. A Senior Manager within our Disputes, Claims, and Investigations group will work on consulting assignments across a... ...and related financial analyses in litigation, fraud, and forensic matters, including intellectual property disputes and complex...ClaimsWork at officeLocal areaFlexible hours$60k - $130k
...consulting engagements involving coding audits, disputes, claims analysis, and investigations. Deliver high-quality,... ...deep expertise in inpatient coding, reimbursement systems, and compliance. What You’ll Do This... ...investigations. Support forensic analyses to identify compliance...ClaimsWork at officeLocal areaFlexible hours- Stout is seeking a Senior Manager in the Disputes, Claims, and Investigations group to lead economic damages analyses and financial modeling for litigation, fraud, and forensic matters across industries. You will manage engagement workstreams, supervise junior staff, and...Claims
- ...growth.Practice Overview: Ankura’s Global Investigations & Forensic Accounting team assists clients with... ...Practices Act (FCPA) matters, compliance, eDiscovery, information technology,... ...compliance risk assessments, forensic audits, disputes support or expert witness engagements...SuggestedFull timeRemote work
$150k - $400k
...litigation, transactional, and compliance matters in the market. Its... ...in healthcare, government investigations, litigation, corporate... ...experience handling False Claims Act (FCA) investigations,... ...allegations, reimbursement disputes, billing and coding issues, Anti-Kickback...ClaimsWork at officeLocal areaFlexible hours$198.18k - $278.05k
...that improve Stars performance, coding accuracy, and medical cost... ...types — including Parts C and D claims, clinical supplemental data,... ..., high-cost claimants, inpatient and post-acute utilization, and... ...standards• Work with BCBSA Legal, Compliance, and Actuarial functions to...ClaimsFull timeContract workWork at officeLocal areaShift work- Meaden & Moore invites qualified accounting students for Investigative Accounting Internship positions in Chicago. Interns will gain real-world experience working on engagements involving property insurers, evaluating physical damage and business income losses, with flexible...ClaimsFull timePart timeInternshipFlexible hours
$104.8k - $192.3k
...Philadelphia and San Francisco EY's Forensics Insurance and Federal Claims Services practice specializes in... ...insurance recovery, claims preparation, compliance, and financial analysis. The... ...insurance claims, forensic accounting, dispute advisory, consulting, or a related...ClaimsSummer holidayWork at officeFlexible hours- Efinancial, LLC in Chicago, IL seeks a Fraud Investigator to review claims, lead investigations, and ensure compliance with insurance regulations. Candidates should possess a Bachelor's degree and 5-8 years of relevant experience in insurance claims and fraud investigations...ClaimsRemote job
$145k - $300k
...to join our team.Job Title - Director, Mass TortsImpact You’ll Make· Lead complex client engagements within Stout’s Disputes, Claims, and Investigations group, with a focus on mass tort claims.· Provide value-added consulting services through high-quality economic damages...ClaimsFull timeLocal areaFlexible hours- The Auto Club Group is seeking a skilled Claim Investigator to review and investigate insurance claims for validity and accuracy. You will... ...examine documents, and identify potential fraud while ensuring compliance with policies and regulatory requirements. Responsibilities...ClaimsRemote job
- ...Finally, La Rabida provides forensic and treatment services... ...leads the Billing and Coding teams in a specialized... ...maintaining expert compliance with Illinois Medicaid... ...g., Days in AR, Clean Claim Rate, Denial Rate) and... ...Meditech (Hospital/Inpatient) and Athena (Ambulatory...ClaimsFull timeWork at office
- ...experience across all types of disputes. We are skilled in the... ...Critiquing opposing parties claims Qualifications Bachelor's... ...assets; corporate accounting investigations; regulatory and reporting obligations... ...enterprise and regulatory compliance risk. Ocean Tomo assists...ClaimsWork at office
$30.46 - $45.69 per hour
Billing Compliance, Senior Auditor Hourly Pay Range: $30.46 - $45.6... ...retrospective and prospective coding, billing, and documentation... ...support internal Compliance investigations in response to billing... ...activities, including interviews, claim reviews, control assessments...ClaimsHourly payFor contractorsRemote workMonday to Friday$55.9k - $123.5k
...responsible for auditing clinical, billing, coding and lowest cost setting reviews for... ...policy, and other information to validate claims submitted and billed. Conducting... ...of findings and consulting with special investigation and the affordability of care area as needed...ClaimsRemote workWork from home- EY’s Forensics Insurance and Federal Claims Services practice specializes in helping clients recover financially after disasters, guiding claims preparation, compliance and financial analysis. As a Manager, you will lead complex engagements, advise clients through large...Claims
- HCSC is seeking a claims auditing professional to review clinical, billing, coding, and cost-setting reviews pre- and post-payment. You will research findings,... ...document them thoroughly, and consult with special investigations and affordability teams as needed. The role...ClaimsRemote job
$20 - $23 per hour
Company Overview Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader,...ClaimsWork experience placementWork at office$27 - $32 per hour
Company Overview Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader,...ClaimsWork at officeLocal area- ## Senior Fire Investigator, IAAI-CFIApplylocations: Chicago, IL: Naperville, IL: Aurora, IL:... ...laboratory testing and specialty consulting. Our forensic investigation, engineering and... ...RESPONSIBILITIES* ## Investigates assigned claims suspected of insurance fraud, this...ClaimsFull timeLive inWork at officeLocal areaRemote work
- EY in the United States seeks a leader for its Forensics Insurance and Federal Claims Services practice, focusing on disaster recovery funding and compliance for government and public sector clients. You will guide engagement teams, interact with local governments, and...ClaimsWork at officeLocal area
- Stout Risius Ross, LLC in Chicago is seeking a Senior Manager to lead disputes, claims, and investigations engagements. You will oversee economic damages calculations, financial analyses, and forensic work across industries, delivering concise, technically rigorous...Claims
$26.44 - $36.06 per hour
The Inpatient Coding Auditor will be responsible for auditing inpatient coders and offshore inpatient... ...coders and auditors to ensure compliance with client SOPs and coding guidelines.... ...compliance and correct identified errors before claims are rebilled. Conduct analysis and...ClaimsHourly payPermanent employmentWork at officeFlexible hours$194.6k - $361.4k
...will provide leadership, management and coaching, operations, compliance, and budget oversight for their aligned regions in support of... ...process, including expertise in acquisition, billing and coding, claims processing, and reimbursement. Proven track record of building...ClaimsFull timeContract workLocal areaRemote workRelocation package$100k - $150k
...Compensation Attorney to represent clients in claims and disputes arising from workplace injuries and... ...matters, including intake, investigation, claim development, and litigation.Provide... ...settlement agreements and ensuring compliance with legal requirements.Coordinate with...Claims- Submit billing claims that are timely and accurate with correct CPT/ICD10 codes, modifiers, units and amounts. Resolve rejections/denials on a routine and timely... ...documentation and coding clarification Ensure compliance with payer guidelines, Medicaid and HIPAA regulations...ClaimsWork at office
$26.44 - $37.5 per hour
...engagement across the enterprise. The Coder-Inpatient provides high level technical competency... ...needs may require this coder to also code other outpatient health records. Key Responsibilities... ...decrease denials. May work Inpatient claim edits and may code consecutive/combined...ClaimsHourly payDaily paidPermanent employmentLocal areaFlexible hours$280k - $400k
...significant growth in our Forensic, Litigation & Valuation... ...long standing clients in a compliance/consulting role. You will... ..., fraud, contractual disputes, matrimonial claims, Intellectual Property disputes... ...valuation, and forensic investigations. Divided into five main...ClaimsLocal area- ...Inpatient Coding Auditor Huron helps its clients drive growth, enhance performance and sustain... ...documentation guidelines. Monitor compliance of coding guidelines and ensure errors... ...corrective action is initiated before the claim is rebilled to the insurance....ClaimsPermanent employmentWork at officeLocal areaImmediate startFlexible hoursDay shift
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