NewAttorney - FCA/Healthcare Fraud Enforcement JobotAttorney - FCA/Healthcare Fraud EnforcementChicago, IL$150,000–$400,000 / yearExperience representing hospitals, health systems, physician groups, Medicare Advantage organizations, managed care organizations, pharmacy benefit managers (PBMs), healthcare technology companies, or private equity-backed healthcare platforms. Demonstrated experience representing clients before the U.S. Department of Justice (DOJ), U.S. Attorney's Offices, Department of Health and Human Services Office of Inspector General (HHS-OIG), Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, and other federal or state enforcement authorities.
NewMedical Scribe - Bilingual Spanish Required Oak Street HealthMedical Scribe - Bilingual Spanish RequiredBlue Island, IL$17–$31.30Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
NewMedical Scribe Oak Street HealthMedical ScribeHammond, IN$17–$28.46Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
NewMedical Scribe - Cantonese Bilingual Required Oak Street HealthMedical Scribe - Cantonese Bilingual RequiredChicago, IL$17–$31.30Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Revenue Cycle Coding Edit Specialist CommonSpirit HealthRevenue Cycle Coding Edit SpecialistChicago, ILRemoteAs one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. Review medical documentation and health information within various electronic medical or health systems to address coding claim edits and other requests from other departments, such as Patient Financial Services, in a timely manner ensuring DNFC KPI metrics are met.
Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL) Northwestern Memorial HealthCareCoding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL)Chicago, ILRemoteThe Coding Quality Auditor and Specialist is responsible for maintaining quality work queues and quality reports, advanced and complex project work that includes, but is not limited to, Risk Adjustment, Mortality Review, Hospital Acquired Condition (HAC) and Patient Safety Indicator (PSI) Review, Quality Abstraction and Analysis, and/or special and non-traditional project work. Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorIL$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
NewCoding Auditor – Ambulatory/Professional Coding/Profee Huron Consulting ServicesCoding Auditor – Ambulatory/Professional Coding/ProfeeChicago, IllinoisPHYSICAL DEMANDS : This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
NewCoding Auditor - Ambulatory/Professional Coding/Profee Huron Consulting Group IncCoding Auditor - Ambulatory/Professional Coding/ProfeeChicago, IL$26.44–$37.50 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
Coding Integrity & National Strategy Sr. Principal Blue Cross and Blue Shield AssociationCoding Integrity & National Strategy Sr. PrincipalChicago, ILThis role is ideal for a sales leader who blends deep healthcare knowledge with a strong track record in enterprise sales, GTM planning, and product positioning in complex payer environments. A candidate's position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.
Mkt Manager Revenue Cycle Inpatient Coding CommonSpirit HealthMkt Manager Revenue Cycle Inpatient CodingChicago, ILAs one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. As our Market Manager, Revenue Cycle Input Coding you will provide strategic oversight of coding teams, holding them accountable to enterprise-established Key Performance Indicators (KPIs), including critical metrics like 'Discharge Not Final Coded' (DNFC).
Security Engineer - AI Coding Agent - AI Trainer MercorSecurity Engineer - AI Coding Agent - AI TrainerChicago, IllinoisRemoteUse frontier AI coding agents to complete and evaluate complex security engineering tasks . Regular use of AI coding agents such as Cursor, Claude Code, Codex, Windsurf, or Gemini CLI.
Manager, Coding Lundbeck LLCManager, CodingILRemoteThe role of the Coding Manager includes establishing and maintaining positive relationships with current and past client contacts, coders, and team members from various revenue cycle management departments, both internal and external. This position will assist with the ongoing and continuous development and implementation of all coding services by managing resources and ensuring employees work efficiently while maintaining quality expectations for their assigned client(s).
NewMedical Billing & Coding Specialist CrewBloomMedical Billing & Coding SpecialistChicago, ILRemoteYou will work closely with healthcare practitioners in private practices and medical clinics to accurately review, assign, and manage medical codes, ensuring compliant billing, timely reimbursements, and efficient revenue cycle operations. While industry certifications are a plus, what matters most is hands-on experience with medical billing and coding, particularly a strong understanding of Eye Care Practice (ECP) coding guidelines and regulations.
NewCoding Business Analyst II - Policy Review Centene Corporation GroupCoding Business Analyst II - Policy ReviewIL$56,200–$101,000 / yearMonitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.
Outpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL - Sign-on bonus eligible) Northwestern Memorial HealthCareOutpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL - Sign-on bonus eligible)Chicago, ILRemoteFollows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinics, interprets ICD-10-CM coding conventions and instructional notes to select appropriate diagnoses with a minimum of 95% accuracy. Identifies opportunities to enhance CAC (computer assisted coding), i.e. notifying IT liaison of documents filing to Default folder, incorrect system assigned codes, etc.
Coding Manager - Epic Professional Billing Huron Consulting Group IncCoding Manager - Epic Professional BillingChicago, IL$90,000–$130,000 / yearE/M, Emergency Medicine, Family practice, Hospitalists, OB, critical care, ancillary, IV infusion, outpatient departments, Urgent Care, Primary Care, Inpatient E/M, Pediatrics, Observation, Ancillary services, and claim edit work queues. The US Professional Coding Manager is responsible for the day-to-day operations and oversight of multi-shore professional coding services processes to ensure timely, accurate, consistent and compliant assignment of diagnosis and CPT/HCPCS codes.
Coding Manager - Epic Professional Billing Huron Consulting ServicesCoding Manager - Epic Professional BillingChicago, IllinoisE/M, Emergency Medicine, Family practice, Hospitalists, OB, critical care, ancillary, IV infusion, outpatient departments, Urgent Care, Primary Care, Inpatient E/M, Pediatrics, Observation, Ancillary services, and claim edit work queues. The US Professional Coding Manager is responsible for the day-to-day operations and oversight of multi-shore professional coding services processes to ensure timely, accurate, consistent and compliant assignment of diagnosis and CPT/HCPCS codes.
Senior Healthcare Coding Analyst (Hybrid) American Medical AssociationSenior Healthcare Coding Analyst (Hybrid)Chicago, IL$99,410–$131,637 / yearThis role is responsible for supporting and enhancing the activities of the CPT Editorial Panel and/or the CPT Editorial Assistant Board in maintaining the CPT code set by working with national medical specialty societies, non-physician professional organizations, public and private payers, pharmaceutical and device manufactures, and other high profile stakeholders. Author and develop educational content to support the policies of the CPT Editorial Panel and/or the CPT Editorial Assistant Board, in the form of books, newsletters, electronic products and advice, to assist AMA members, physicians, non-physician health care professionals and other CPT stakeholders in appropriately applying the CPT code set.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Chicago, ILIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Inpatient Auditor - Coding Integrity Specialist Huron Consulting Group IncInpatient Auditor - Coding Integrity SpecialistChicago, ILRemote$26.44–$36.06 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
Coding Specialist II InsightCoding Specialist IIChicago, IllinoisUtilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, and Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers. REQUIRED KNOWLEDGE, SKILLS AND ABILITIES: Completion of an AHIMA-approved coding program or an AAPC-approved coding program, or Associate degree in Health Information Management or a related field or an equivalent combination of years of education and experience is required.
Inpatient Auditor - Coding Integrity Specialist Huron Consulting ServicesInpatient Auditor - Coding Integrity SpecialistChicago, IllinoisRemotePHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
CODING AUDITOR Methodist Hospitals IncCODING AUDITORMerrillville, INPerforms comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement. Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts.
Senior Consultant - Healthcare Financial Transformation - Clinical Integrity (Surgical Coding, CDI) GuidehouseSenior Consultant - Healthcare Financial Transformation - Clinical Integrity (Surgical Coding, CDI)Chicago, IllinoisCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. In this visible role, you will lead team meetings, and guide, manage, and coach consultants and senior consultants, providing constructive feedback on project participation and overall career development.
NewInpatient Coding Auditor Huron Consulting Group IncInpatient Coding AuditorChicago, ILRemote$38.46–$52.40 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
NewInpatient Auditor - Coding Integrity Specialist HuronInpatient Auditor - Coding Integrity SpecialistChicago, IL$26.44–$36.06 / hourTechnical Qualifications Required certifications: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or Certified Documentation Improvement Practitioner (CDIP).Preferred certifications: AHIMA micro‑credential “Auditing: Inpatient Coding (AIC)”; RHIA preferred. Advanced proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint).Analytical skills (problem solving, quantitative analysis, workflow process).Strong attention to detail and follow‑through skills.
Inpatient Coding Auditor Huron Consulting ServicesInpatient Coding AuditorChicago, IllinoisRemotePHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
Senior Consultant - Healthcare Financial Transformation - Clinical Integrity (Surgical Coding, CDI) Guidehouse IncSenior Consultant - Healthcare Financial Transformation - Clinical Integrity (Surgical Coding, CDI)Chicago, IL$89,000–$148,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Manager-Coding Northwestern Memorial HealthCareManager-CodingChicago, ILThis health system position manages a group of professionals supporting all campuses including NMH, LFH, CDH, Delnor, Kishwaukee, Valley West, Marianjoy and Centegra and is responsible for their recruitment, coaching, performance management and salary administration. The key to this role is the ability to compel changes in documentation to facilitate accurate representations of patient characteristics within the medical record so that process and outcome measures based on documentation reflect performance accurately.
NewOnline Visiting Professor Outpatient Coding DeVry University IncOnline Visiting Professor Outpatient CodingIL$1,500–$2,700 / weekFaculty must have a minimum of 5 years of working knowledge of healthcare operations related to the following areas: Faculty must have a minimum of five years of recent in-field outpatient coding experience. Uses appropriate technological options for online technologies and course-related software, including Websites, e-mail, and online discussions for preparing the course and making it accessible to students.
NewSTEM & Coding Teaching Opportunities Concorde EducationSTEM & Coding Teaching OpportunitiesChicago, IL$50–$100 / hourPreferred qualifications include: • At least 60 college credits, where required by the applicable assignment or site; • Experience with coding, programming, computer science, or related technology subjects; • Experience teaching, tutoring, coaching, mentoring, or leading activities with school-age students; • Strong communication, organization, and classroom facilitation skills; • Availability to provide services for the accepted assignment schedule and communicate schedule issues as soon as reasonably practicable; and. Payment for completed services is generally made by direct deposit on the fifteenth day of the month following the month in which services were completed, unless otherwise stated in the accepted assignment terms or required by applicable law.
ML Engineer - Coding Agent Expert - AI Trainer MercorML Engineer - Coding Agent Expert - AI TrainerChicago, IllinoisRemoteUse frontier AI coding agents to complete and evaluate complex machine learning and AI engineering tasks. Regular use of AI coding agents such as Cursor, Claude Code, Codex, Windsurf, Gemini CLI, or similar tools.
Lead Product Manager- Agentic SDLC/ Claude Code P4170 84.51 LLCLead Product Manager- Agentic SDLC/ Claude Code P4170Chicago, IL$125,000–$207,000 / yearPowered by cutting-edge science, we utilize first-party retail data from more than 62 million U.S. households sourced through the Kroger Plus loyalty card program to fuel a more customer-centric journey using 84.51° Insights, 84.51° Loyalty Marketing and our retail media advertising solution, Kroger Precision Marketing. You will work closely with business stakeholders, software engineers, data scientists, and cross-functional teams to understand their needs, enable teams with reusable tools and patterns, and drive the evolution of the enterprise SDLC through AI.
Code Enforcement Officer Village of LIncolnwoodCode Enforcement OfficerILThe Village of Lincolnwood offers a comprehensive and competitive benefits package that includes Blue Cross PPO and High-Deductible Medical Coverage, Delta Dental PPO and HMO plans, life insurance, vision insurance, participation in the Illinois Municipal Retirement Fund (IMRF), paid sick, vacation and holidays, along with other benefits. The Essential Functions of the position include but are not limited to: Inspect sites for zoning or property maintenance code compliance as a result of complaints by residents, as direct assignments by supervisor, or as self-initiated.
Code Enforcement Officer Village of LincolnwoodCode Enforcement OfficerLincolnwood, ILThe Village of Lincolnwood offers a comprehensive and competitive benefits package that includes Blue Cross PPO and High-Deductible Medical Coverage, Delta Dental PPO and HMO plans, life insurance, vision insurance, participation in the Illinois Municipal Retirement Fund (IMRF), paid sick, vacation and holidays, along with other benefits. The Essential Functions of the position include but are not limited to: Inspect sites for zoning or property maintenance code compliance as a result of complaints by residents, as direct assignments by supervisor, or as self-initiated.
Certified Medical Biller and Coder Intergrated Pain Management SCCertified Medical Biller and Coderchicago, AL$17–$19.50 / hourThe "Appeal Artist": You don’t just accept a denial; you know how to interpret an EOB, identify the root cause, and craft winning appeals to recover revenue. The ideal candidate isn't just a data entry clerk; you are a denial management expert who understands the complexities of Workers’ Compensation (IWCC) and commercial insurance claims.
Nurse Auditor - Medical Bill Review (Remote) Rising Medical SolutionsNurse Auditor - Medical Bill Review (Remote)Chicago, ILRemoteJoin our team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from within!
Physician Billing Coder III Ann & Robert H Lurie Children's Hospital of ChicagoPhysician Billing Coder IIIChicago, IL$28.50–$46.60 / hourPerforms job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. Lurie Children's utilizes certain AI-enabled features within our recruiting platform to support candidate engagement and assist recruiters in identifying and prioritizing applicants whose experience aligns with job requirements.
Physician Billing Coder III Ann & Robert H. Lurie Children's Hospital of ChicagoPhysician Billing Coder IIIChicago, IllinoisPerforms job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. Lurie Children’s utilizes certain AI-enabled features within our recruiting platform to support candidate engagement and assist recruiters in identifying and prioritizing applicants whose experience aligns with job requirements.
Reimbursement Specialist, Appeals Belay Diagnostics IncReimbursement Specialist, AppealsChicago, IL$70,000–$85,000 / yearUtilizing next-generation sequencing (NGS), our cerebrospinal fluid (CSF) testing platform detects arm level chromosomal alterations and mutations, enabling diagnostic insights to help guide clinical decisions. The specialist prepares, submits, and tracks multi-level appeals to ensure appropriate reimbursement while maintaining full compliance with HIPAA and applicable regulatory requirements.
Part-time Biller/Coder - Claims Analyst Alera GroupPart-time Biller/Coder - Claims AnalystChicago, IllinoisRemoteThe Part-time Biller/Coder - Claims & Alert/Trigger Criteria supports Vital Oversight's continuous monitoring of medical and pharmacy claims by reviewing claims for coding accuracy and reimbursement appropriateness and by developing and maintaining alert and trigger logic that identifies high-risk or outlier claims. This role works collaboratively with claims, clinical, and oversight stakeholders to surface actionable findings that support proactive cost and payment integrity oversight.
Medical Coder I Tempus AIMedical Coder IChicago, IllinoisTempus' proprietary platform connects an entire ecosystem of real-world evidence to deliver real-time, actionable insights to physicians, providing critical information about the right treatments for the right patients, at the right time. Maintains worklists for patient billing, ICD-10 coding, medical record requests, COB/expired insurance, and refund requests in Tempus’ billing system.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorIL$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)IL$82,232–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistIL$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Field Reimbursement Manager (Oncology) – (Central Local Account Team, Chicago Territory IL, WI) Johnson and JohnsonField Reimbursement Manager (Oncology) – (Central Local Account Team, Chicago Territory IL, WI)Chicago, ILFull timeThe Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Oncology therapies. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
NewFacility Biller Insight Health SystemsFacility BillerChicago, IL$46,000–$62,000 / yearThe Facility Biller & AR Specialist will review coding, correct and submit front‑end rejections from the clearing house, review rejections from third‑party payers, along with analyzing and monitoring any aged accounts receivable through identifying areas of concern by age, category, payer, provider specialty, and facility to order to resolve claim issues and resubmit in a timely manner. BenefitsPaid Sick Time – effective 90 days after employmentPaid Vacation Time – effective 90 days after employmentHealth, vision & dental benefits – eligible at 30 days, following the 1st of the following monthShort and long‑term disability and basic life insurance – after 30 days of employmentInsight Employees are required to be vaccinated for COVID‑19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)IL$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Field Reimbursement Manager Syneos - Commercial - ProdField Reimbursement ManagerChicago, IL5+ years’ experience pharmaceutical and/or biotech experience and 2+ years’ relevant experience in the following: patient journey navigation, payer, reimbursement, medical billings & coding, specialty pharmacy & distribution, and patient support services engagement. Provide information to HCP on how the products are covered under the benefit design and educate key private and public payer coverage and changes that impact the products access for patients.