33 Results for

Coding Jobs in Kailua, HI

Jobs

IT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, Informatics Kaiser Permanente

Honolulu, HI

$129,200–$167,200 / year

Essential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; and recognizing and capitalizing on improvement opportunities. Job Summary: The Concergent Data Modeler within the Convergent Medical Terminology team (CMT) is responsible for designing, maintaining, and optimizing clinical terminology models using SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms).

15 days ago

HOUSING-ZONING CODE INSPECTOR I (SR-14) [1 vacancy] City and County of Honolulu

Honolulu, HI

To ensure proper delivery, please make sure you: use a valid e-mail account; verify your e-mail address is entered correctly on your GovernmentJobs account; are subscribed to e-mail notices; check your spam folders; and. Professional experience refers to work that generally involves independent critical thinking, solving complex, non-routine problems, preparing reports, and interpreting and applying technical information.

30+ days ago

RN Case Management - REMOTE TEEMA Group

"-", HI

Remote

$86,000–$98,000
Quick Apply

Our client is seeking a dedicated Case Manager to provide exceptional case management services to beneficiaries, focusing on high-quality care and positive outcomes. Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care.

11 days ago

Supervisor, Utilization Management TriWest Healthcare Alliance

Honolulu, HI

Remote

Full time

Technical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.

6 days ago

Psychiatric Nurse Practitioner (PMHNP-BC) OhanaPsych

HONOLULU, HI

Remote

Quick Apply

You will carry a defined panel, manage acute and chronic psychiatric conditions, prescribe and monitor psychotropic medications including controlled substances, and coordinate care with primary care, therapy, and community resources. Ohana offers a competitive benefits package, subject to plan terms, which may include medical, dental, vision, paid time off, retirement plan with employer contribution, malpractice coverage (for licensed roles), CME allowance (for licensed roles), and license/credentialing fee reimbursement (for licensed roles).

30+ days ago

Medical Assistant III Kaiser Permanente

Kaneohe, HI

Assists practitioner by setting up sterile and unsterile fields and assisting with routine, minor surgical procedures as delegated by nursing supervisor, nurse and/or practitioner, in accordance with established guidelines, policies and procedures, and upon completion of clinical competency requirements. Job Summary: Supports practitioner and clinical team to accomplish proactive patient management as delegated by and under indirect supervision of clinic nursing supervisor, and with direction from charge nurse, staff nurse, or practitioner.

30+ days ago

Clinical Documentation Improvement Specialist (Onsite in Oahu) UnitedHealth Group Inc

Honolulu, HI

$72,800–$130,000 / year

Primary Responsibilities: Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition and acuity of care provided. The Clinical Document Improvement Specialist - (CDS) is responsible for providing CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients' patients.

30+ days ago

Clinical Documentation Improvement Specialist (Onsite In Oahu) UnitedHealth Group Inc.

Honolulu, HI

$72,800–$130,000 / year

4 days ago

Healthcare Advocate - Field-Based Position UnitedHealth Group Inc.

Honolulu, HI

$72,800–$130,000 / year

The Healthcare Advocate serves as a strategic partner to physicians, medical groups, IPAs, and hospitals, supporting accurate documentation and coding practices to ensure a complete and accurate health picture of members across government and regulated lines of business, including Medicare Advantage, Medicaid, and ACA. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

3 days ago

Medicaid Payment Integrity SME BerryDunn

Kapolei, Hawaii

$110,000–$140,000 / year
Full time

You will work as a part of the BerryDunn Program Integrity team, and work closely with the MQD Program Integrity staff, audit and TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, escalate issues for leadership, and support recovery efforts. Overview: BerryDunn is seeking an experienced Senior Consultant with subject matter expertise in Medicaid payment integrity to support Hawaii Med-QUEST's (MQD) Fraud, Waste, and Abuse (FWA), program integrity, audit, third party liability (TPL), payment integrity, and claims review initiatives.

30+ days ago

Home Health Administrator Oahu

Honolulu, Hawaii

We are looking for a Home Health Administrator with expertise in Medicare compliance, billing, and coding to ensure our agency operates smoothly and in full compliance with regulations. If you're detail-oriented, experienced in healthcare administration, and passionate about making a difference, we’d love to meet you!

30+ days ago

Home Health Administrator Always Best Care

Honolulu, HI

30+ days ago

Clinical Data AMS Sr. Consultant Deloitte

Honolulu, HI

$120,200–$140,000 / year

This role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.

30+ days ago

MED ASSISTANT III Kaiser Permanente

Honolulu, HI

30+ days ago

Autism Services Navigator TriWest Healthcare Alliance

Honolulu, HI

Remote

Full time

In support of TRICARE beneficiaries enrolled in the Autism Care Demonstration (ACD), the Autism Services Navigator (ASN) collaborates and oversees the assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services for TRICARE beneficiaries diagnosed with autism spectrum disorder (ASD). • Current unrestricted licensure in an appropriate state or territory of the United States, as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Registered Nurse, or other licensed mental health professionals who possess a Certification in Case Management (CCM).

4 days ago

Manager, Case Management Special Programs TriWest Healthcare Alliance

Honolulu, HI

Remote

Full time

Technical Skills: Knowledge of TRICARE policies and procedures, Case Management, Utilization Management, Managed Care concepts, Behavioral Health practices and principles, Medicaid and Medicare eligibility requirements and benefits, community resources, alternative funding programs, medical management systems, and protected health information; proficiency with the use of medical necessity criteria to evaluate care requests; working knowledge of medical coding. Problem Solving / Analysis: Thorough knowledge of health care delivery, UM, CM, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and level-of-care determinations.

4 days ago

Revenue Assurance Specialist IV - CDM and Epic experience needed Kaiser Permanente

Honolulu, HI

Performs routine review and maintenance of system codes by: performing a regular review (e.g., quarterly, annually) of coding records to ensure codes are updated, compliant, and accurately reflect policy and regulatory changes; conducting pre- and post-implementation assessments of automated and manual charge capture for quality and accuracy; analyzing moderately complex billing issues related to charges/codes and proposing and implementing action plans to resolve charge capture issues; and contributing to the maintenance of all Current Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) codes, descriptions, revenue codes, Relative Value Units (RVU) information, and generic codes to assist in the understanding of fee schedule implications. Executes monitoring activities and process improvements by: independently performing tasks that support monitoring activities of the region(s) documentation, charge capture, coding, billing, and/or compliance activities; recording findings in accordance with relevant policies/procedures to ensure complete and consistent data integrity, partnering with other departments to resolve moderately complex deficiencies and/or compliance issues identified through monitoring activities; communicating results of monitoring activities to senior team members and/or department leaders; and implementing corrective action plans resulting from monitoring activities.

30+ days ago

Patient Account Rep - Hosp Insurance Collections Hawaii Pacific Health

Honolulu, HI

$23.90–$26.56 / hour

This includes: accurate and timely preparation and submission of claims and statements to third party payers and patients/guarantors; follow-up on accounts receivables with third party payers and patients to complete the insurance collection process; and handling third party payer and patient questions/concerns appropriately. Like an engine, the healthcare industry's revenue cycle has many moving parts and the Revenue Cycle team is comprised of business minded, forward thinking, efficient and analytical people who are dedicated to building a high powered revenue management team that is vital and useful to the organization.

30+ days ago

Referral Specialist TriWest Healthcare Alliance

Honolulu, HI

Remote

Full time

Ensures accuracy and completion of authorization data from customer information, medical records, referral/authorization forms, Military Treatment Facility electronic transmission and other documents into medical management system. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

4 days ago

Senior Referral Specialist TriWest Healthcare Alliance

Honolulu, HI

Remote

Full time

4 days ago

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Coding Jobs in Kailua, HI

IT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, Informatics Kaiser Permanente

HOUSING-ZONING CODE INSPECTOR I (SR-14) [1 vacancy] City and County of Honolulu

RN Case Management - REMOTE TEEMA Group

Supervisor, Utilization Management TriWest Healthcare Alliance

Psychiatric Nurse Practitioner (PMHNP-BC) OhanaPsych

Medical Assistant III Kaiser Permanente

Clinical Documentation Improvement Specialist (Onsite in Oahu) UnitedHealth Group Inc

Clinical Documentation Improvement Specialist (Onsite In Oahu) UnitedHealth Group Inc.

Healthcare Advocate - Field-Based Position UnitedHealth Group Inc.

Medicaid Payment Integrity SME BerryDunn

Home Health Administrator Oahu

Home Health Administrator Always Best Care

Clinical Data AMS Sr. Consultant Deloitte

MED ASSISTANT III Kaiser Permanente

Autism Services Navigator TriWest Healthcare Alliance

Manager, Case Management Special Programs TriWest Healthcare Alliance

Revenue Assurance Specialist IV - CDM and Epic experience needed Kaiser Permanente

Patient Account Rep - Hosp Insurance Collections Hawaii Pacific Health

Referral Specialist TriWest Healthcare Alliance

Senior Referral Specialist TriWest Healthcare Alliance

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