Coding Specialist - Hospital Services Gundersen Health SystemCoding Specialist - Hospital ServicesMinnesota, MNEmplify Health, a partnership of Bellin Health and Gundersen Health System, is a leading not-for-profit, patient-centered healthcare network based in Green Bay and La Crosse, Wisconsin. We are seeking a detail‑oriented Coding Specialist to support accurate outpatient hospital coding and ensure compliance with ICD‑10‑CM, CPT, and HCPCS guidelines.
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)mendota heights, MN$86,560–$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.
Charge Master Analyst Sutter HealthCharge Master AnalystSaint Paul, MN$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
Pharmacy Retail Home Infusion Billing Analyst Sanford HealthPharmacy Retail Home Infusion Billing AnalystMNRemote$19–$30.50 / hourSanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Ensure that all pharmacy processes are completed in a timely manner and that projected incoming revenue is captured and reconciled against prescription records.
Director of Revenue Cycle Management Ellie Mental HealthDirector of Revenue Cycle ManagementMendota Heights, MinnesotaThe Director of Billing holds operational accountability over Ellie’s billing account management function, providing leadership, organization, planning, and direction to the Revenue Cycle Performance Leads who serve as liaisons between the Billery and Ellie’s franchise practice partners. This role contributes to the overall organizational and financial health by evaluating metrics and performance by franchisee, presenting the health of the revenue cycle, and delivering comprehensive reporting to franchise owners and Clinical Directors on relevant trends, KPIs, and insights.
Medical Coder UnitedHealth Group IncMedical CoderSaint Paul, MN$20–$36 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities: Identify appropriate assignment of CPT and ICD-10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility.
Medical Coder- CVIR/IR UnitedHealth Group IncMedical Coder- CVIR/IRSaint Paul, MN$20–$36 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. diagnostic angiography/venography, angioplasty, stent, atherectomy, embolization, thrombectomy, thrombolysis, central venous access devices, epidural injections, myelography, lumbar puncture, biopsy, drainage, aspiration, etc.).
NewMedical Coder- Cvir/Ir UnitedHealth Group Inc.Medical Coder- Cvir/IrSaint Paul, MN$20–$36 / hourdiagnostic angiography/venography, angioplasty, stent, atherectomy, embolization, thrombectomy, thrombolysis, central venous access devices, epidural injections, myelography, lumbar puncture, biopsy, drainage, aspiration, etc.). Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, and CPC-A) to be maintained annually.
Senior Inpatient DRG Medical Coder UnitedHealth Group IncSenior Inpatient DRG Medical CoderSaint Paul, MN$24–$43 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities: Identify appropriate assignment of ICD-10 CM, ICD-10-PCS, DRG, and abstraction for facility services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility.
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadMendota Heights, MN$89,520–$161,136 / 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. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
DRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadMendota Heights, MN$89,520–$161,136 / 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. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Senior Product Manager (PM/RCM) - Full Time - Remote Experity IncSenior Product Manager (PM/RCM) - Full Time - RemoteMNRemote$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.
Consultant, Informatics Risk Adjustment HealthPartners InstituteConsultant, Informatics Risk AdjustmentSaint Paul, MNThe Informatics Consultant -supports the Health Plan's risk adjustment operations by delivering trusted, prioritized, and compliant data insights that drive efficient workflows and improve risk score accuracy, while continuously refining processes through feedback. 5+ years of experience in health plan and/or risk adjustment-related domains, such as: risk adjustment operations, encounter data management, coding, clinical documentation integrity, provider performance, quality improvement, or healthcare analytics.
Medical Biller (Start ASAP) Ultimate Staffing ServicesMedical Biller (Start ASAP)Maplewood, Minnesota$27–$29 / hourMinimum of 4 years of experience in medical billingExperience with O&P, DME, or specialty practice billing is highly advantageous. Manage the full billing cycle for orthotic and prosthetic services, including claim creation, submission, and follow‑up.
Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubMN$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Senior Director Reimbursement BaxterSenior Director ReimbursementSaint Paul, MinnesotaThis role drives reimbursement strategy across commercial and government payers, ensuring optimized coding, coverage, and payment for current and pipeline products, while shaping policy and advocacy efforts to remove barriers to patient access. The Senior Director, Reimbursement – Front Line Care (FLC) leads multiple teams to define and execute the reimbursement, market access, and health policy strategy across Baxter’s Front Line Care portfolio.
RN Readmission Manager, Payment Integrity Centene Corporation GroupRN Readmission Manager, Payment IntegrityMN$87,700–$157,800 / yearEducation/Experience: Bachelor's degree in Healthcare Administration, Business, Public Health, Health Information Management, Nursing, or a related field required; an additional four (4) years of directly related experience may be considered in lieu of a degree. License/Certification: Active Health Information Management or coding credentials required, such as RHIT, RHIA, CCS, CIC, or CCDS or Registered Nurse licensure or higher clinical qualification, in combination with a coding credential, required.
Medical Director MPO CVS Health CorpMedical Director MPOMN$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.
Medical Director-Part-time FACE TO FACE HEALTH & COUNSELING SERVICES, INCMedical Director-Part-timeSAINT PAUL, MN$60–$100 / hourAt Face to Face we are dedicated to building a diverse, inclusive and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. We take a strengths-based and trauma-informed approach to our work and center the needs of young people impacted by racism and other forms of oppression and marginalization.
Primary Care Physician Herself HealthPrimary Care PhysicianSaint Paul, MNWe are building a new model of primary care for women 65+ to solve long-standing problems: rushed appointments, long wait times, and care that's generalized rather than specialized towards women's needs later in life such as post-menopausal care, bone density, weight management, and mental, social and emotional well-being. Functioning as a value-based care model, our team of clinicians proactively and strategically manage our population's health in accordance with IHI's Quintuple Aim, adopt best practices in coding compliance and achieve our HEDIS quality metrics.