HIM Coding Supervisor -- Coding & Data Registry -- Document Center Building Charleston Area Medical Center Health System IncHIM Coding Supervisor -- Coding & Data Registry -- Document Center BuildingCharleston, WVAssociate's Degree (Required) Experience: 5 yrs coding experience with at least 3 of the years with progressive coding; dependent on coding specialty - outpatient coding experience with strong grasp of coding guidelines and rules or inpatient experience with strong grasp of coding and rules; experience in Clinical Documentation Improvement Substitution: May substitute 5 yrs progressive coding experience in addition to required experience for the Associates Degree in Health Information Technology. The position will also act as a liaison with Clinical Documentation Specialists and Coders to settle differences in coding and DRG assignment; with Coders and Patient Accounts to resolve coding and billing issues; and provide clinical and documentation clarification facility-wide.
NewInpatient Coding Manager Huron Consulting Group IncInpatient Coding ManagerCharleston, WV$90,000–$130,000 / yearREQURIED SKILLS: Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members. is directly responsible for the daily oversight of coding operational processes and workflow, including but not limited to delivering timely and accurately coded cases for facility billing and for reporting hospital and provider quality metrics.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWV$17–$28.46 / hourPerforms claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department.
Nurse Investigator The Health PlanNurse InvestigatorCharleston, WVRequired: Registered Nurse; Certified Coder (or eligible within 12 months)or similar certification; Basic knowledge of ICD-9/10, CPT, HCPCS, DRG and/or Rev codes; Proficiency with Office products, including Word and Excel; Critical problem-solving skills and attention to detail. The successful candidate will utilize their unique blend of coding, claims payment, clinical, and payment integrity/investigations expertise to assist the SIU in achieving its mission to prevent, detect, investigate, and resolve healthcare fraud, waste, and abuse.
Medical Records Coder 1 Charleston Area Medical Center Health System IncMedical Records Coder 1Charleston, WVEffectively utilize the APCpro features of 3M with the 3M encoder and grouper software to identify appropriate assign modifiers, make appropriate changes to charges, notify departments to make changes, identify missing documentation, and prepare the account as a clean claim for billing to the third party payer. Participate in the Coding Hotline by responding to callers+ needs for coding advice, identify callers needs that must be referred to a higher level of coding skill, and overall act as a liaison between coding and other departments that need coding services.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)WV$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Senior Product Manager (PM/RCM) - Full Time - Remote Experity IncSenior Product Manager (PM/RCM) - Full Time - RemoteWVRemote$107,750–$151,400 / yearResponsibilities: Own day-to-day execution of the Revenue Cycle Management product roadmap, ensuring on-time delivery of capabilities across charge capture, coding, claim creation and submission, payer processing, payment posting, denial management, accounts receivable, patient balances, reporting, and related billing workflows. Deep knowledge of healthcare revenue cycle management, including charge capture, coding, claim submission, clearinghouses, payer adjudication, remittance processing, denial management, accounts receivable, and payment posting.
Bioinformatician -- Health Services & Outcomes Research -- Chesterfield Bldg 4-Center for Learning & Charleston Area Medical Center Health System IncBioinformatician -- Health Services & Outcomes Research -- Chesterfield Bldg 4-Center for Learning &Charleston, WVThe Bioinformatician will provide high level professional and technical skills in support of systems development, analyzing large datasets, using computational tools to solve problems in healthcare, clinical care, or research with responsibilities including algorithm design, data management, computational programing, statistical analysis, and change management. Preferred: A doctorate in informatics with background in computer science, including writing code for data analysis, statistics, machine learning, data processing and visualization, and competency in verbal and written communication.
Medical Director MPO CVS Health CorpMedical Director MPOWV$174,070–$374,920 / yearIn this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. Additional responsibilities may include: Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
(Hybrid) Research Associate Analyst - Health Affairs Institute West Virginia University(Hybrid) Research Associate Analyst - Health Affairs InstituteCharleston, WVFrom the groundbreaking R1 research at our flagship campus in Morgantown to the career-oriented programs at WVU Potomac State in Keyser, and the technology-intensive programs at WVU Tech in Beckley, the contributions of WVU employees resonate across the state, touching lives and shaping futures. '',''Jun 1, 2026'',''Jun 1, 2026'',''FE/AP'',''FE/AP'',''Exempt'',''Exempt'',''Yes'',''Yes'',''Full-time'',''Full-time'',''false'',''377938'',''377938'',''true'',''377938'',''false'',''Submission for the position: (Hybrid) Research Associate Analyst - Health Affairs Institute - (Job Number: 29560)'',''false'',''377938'',''false'',''true''.
Medical Director - ENT CVS Health CorpMedical Director - ENTWV$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Claims Analyst The Health PlanClaims AnalystCharleston, WVUnder the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviews each claim flag in sequence, totally completing one at a time in accordance with established criteria/payment guidelines.
Registered Nurse CDI Specialist Charleston Area Medical Center Health System IncRegistered Nurse CDI SpecialistCharleston, WVUtilizes clinical knowledge and coding guidelines to establish the appropriate diagnoses, reviews clinical reports and physician orders to identify undocumented conditions relative to the current hospitalization. Bachelor's Degree (Required) Experience: 5 - 7 YEARS Acute Care or Critical Care Nursing Experience SUBSTITUTION: Associate Degree in Nursing with 7-10 years Acute Care or Critical Care Nursing Experience.
Physician Assistant - Charleston, WV Wellbe Senior MedicalPhysician Assistant - Charleston, WVCharleston, West Virginia$101,500–$156,000 / yearThe Physician Assistant role is a key member of the team that will be accountable for the care of their patient panel, maintaining accurate, timely and current patient records, and will as part of our longitudinal model will support assuring patients are followed regularly with initial, urgent, transition of care and follow up appointments as needed to care for their health needs. Educational/ Experience Requirements : Minimum Master’s Degree in Physician Assistant Studies (ARC-PA) from an accredited PA education program that meets the West Virginia state requirement of Accreditation Review Commission on Education for the Physician Assistant or its successor or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs.
Hema/Onc Physician Salary Charleston Area Medical Center Health System IncHema/Onc Physician SalaryCharleston, WVThe employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Nurse Practitioner, Adult or Gerontology CommuniCareNurse Practitioner, Adult or GerontologyCharleston, West VirginiaPHP Nurse Practitioners have a passion for delivering quality care to seniors and other residents in a variety of healthcare settings that can include, but are not limited to, skilled nursing facilities, assisted living, and independent living communities, as well as via telehealth. The NP collaborates with PCPs and interdisciplinary teams in the medical management of their assigned population and involves the residents and their families in developing plans of care.
Senior Performance Engineer- JMeter, JavaScript - Remote MaximusSenior Performance Engineer- JMeter, JavaScript - RemoteCharleston, WVRemoteFull timeDesign, develop, and maintain performance testing frameworks, automation utilities, CI/CD integrations, and cloud-native testing capabilities supporting AWS services, Kubernetes clusters, Docker containers, Helm deployments, and microservices architectures. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Pre-Certification Specialist Charleston Area Medical Center Health System IncPre-Certification SpecialistCharleston, WVThe employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Correspond with medicare and various insurance companies to facilitate obtaining pertinent data on compliance, authorizations, verifications, progress notes, medical necessity guidelines and precertification and pre-authorization requirements.
Pre-Certification Specialist -- Vascular Center of Excellence -- Heart & Vascular Center Charleston Area Medical Center Health System IncPre-Certification Specialist -- Vascular Center of Excellence -- Heart & Vascular CenterCharleston, WVThe employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Correspond with medicare and various insurance companies to facilitate obtaining pertinent data on compliance, authorizations, verifications, progress notes, medical necessity guidelines and precertification and pre-authorization requirements.
NewDirector Salesforce Platform Ryder System IncDirector Salesforce PlatformCharleston, WVStakeholder leadership, business alignment, and enterprise decision-making:Build durable relationships with Sales Operations, Service, Product, Application Support, Security, Enterprise Architecture, Data, Integration, Infrastructure, Risk, Finance, Procurement, and business-segment leaders; translate competing priorities into enterprise choices. Enterprise Salesforce strategy, roadmap, and governance:Collaborate with key stakeholders to establish a multi-year Salesforce vision, target-state architecture, org strategy, capability roadmap, and investment plan aligned to Ryder's sales, service, customer, data, and digital strategies.