Remote PB Medical Coder - Neurology Clinic GuidehouseRemote PB Medical Coder - Neurology ClinicAkron, OhioRemoteCompensation 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. The Remote Neurology Clinic Coder reviews clinical documentation and diagnostic results to assign accurate ICD-10, CPT, and HCPCS codes for billing, reporting, and compliance.
Certified Medical Coder Area TempsCertified Medical CoderBeachwood, OHWork hours for this position could range between 24-40 hours each week and would have flexibility with times between 7a.m. to 6 p.m. We are seeking a Certified Medical Coder who has strong Anesthesia coding experience.
Remote PB Medical Coder - Neurology Clinic Guidehouse IncRemote PB Medical Coder - Neurology ClinicAkron, OHRemote$38,000–$64,000 / 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. What You Will Do: The Remote Neurology Clinic Coder reviews clinical documentation and diagnostic results to assign accurate ICD-10, CPT, and HCPCS codes for billing, reporting, and compliance.
Coder Quality Auditor Ensemble Health PartnersCoder Quality AuditorOHRemote$57,400–$99,000 / yearReporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW. Required Certifications: Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred): CPC (Certified Professional Coder).
Certified Coder Special Investigations Unit SIU SummaCare IncCertified Coder Special Investigations Unit SIUAkron, OH$28.10–$42.15 / hourSummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Maintain excellent working knowledge of process improvement techniques, methodologies and principles applying these in the normal course of operations.
Coder III - Remote ProMedica Health System IncCoder III - RemoteOHRemote$45,968–$72,488 / yearThe organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Associate's or bachelor's degree in HIT/HIM OR High school diploma AND Certificate of Completion of AHIMA Coding Basics Program and Coding Assessment and Training Solutions Program.
HIM Coder-Coding Services (DRG); 80hrs Biweekly Days MetroHealthHIM Coder-Coding Services (DRG); 80hrs Biweekly DaysCleveland, OHb>Analyzes clinical information in the inpatient medical record and translates into diagnosis and procedure codes for the most appropriate Diagnosis Related Group (DRG), Present on Admission (POA), Patient Safety (PSI) indicators, Severity of Illness (SOI), and Risk of Mortality (ROM ) scores for the purpose of hospital reimbursement, research and compliance with federal regulations. Assigns ICD-10-CM/PCS codes and abstracts pertinent data to ensure completeness, accuracy and compliance with established guidelines of all governmental regulatory agencies and third party payers.
Medical Biller - Part-time Area TempsMedical Biller - Part-timeParma, OHWe have an immediate opening for a Medical Biller who will be responsible for managing patient billing processes, ensuring accurate claim submissions, and facilitating communication between healthcare providers, patients, and insurance companies. Analyze and address denied claims by identifying reasons for denial, appealing decisions when appropriate, and implementing corrective actions to prevent future denials .
Medical Coding Specialist Ensemble Health PartnersMedical Coding SpecialistOHRemote$20.45–$24.70 / hourRemain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. We are seeking candidates with experience in multiple pro-fee specialties: Hem/Onc, Interventional Radiology, CVTS, Ortho, Podiatry, Wound Care, Rad/ONC, General Surgery, Allergy and ENT, OBGYN, Radiology and Urology.
Physician Coding Auditor Ensemble Health PartnersPhysician Coding AuditorOHRemote$57,400–$99,000 / yearThe Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or researches educational resources to meet those needs.
Coding Specialist-AR Management (Prof) MetroHealthCoding Specialist-AR Management (Prof)Cleveland, OHPreferred: Associate's Degree in Health Care Administration or a related field, or at least one year of experience with professional Fee-For-Service (FFS) coding in a hospital/physician's billing office. Comprehensive understanding of the Health Care Financing Administration (HFCA) billing practices, and health care issues effecting billing and reimbursement.
NewCoding Specialist-AR Management (Prof) The MetroHealth SystemCoding Specialist-AR Management (Prof)Cleveland, OHPreferred: Associate's Degree in Health Care Administration or a related field, or at least one year of experience with professional Fee-For-Service (FFS) coding in a hospital/physician's billing office. Comprehensive understanding of the Health Care Financing Administration (HFCA) billing practices, and health care issues effecting billing and reimbursement.
Coding Supervisor Ensemble Health PartnersCoding SupervisorOHRemote$57,400–$86,100 / yearExperience We Love: 3 years of coding experience in either pro-fee or acute care setting to include inpatients, outpatients, and emergency department records or provider coding. Thorough working knowledge of coding classification systems to include Diagnosis Related Groups, (DRGs) and All Patient Refined - Diagnosis Related Groups, (APR-DRGs.).
Coding Educator Ensemble Health PartnersCoding EducatorOHRemote$62,500–$119,700 / yearPlan, develop, and present educational opportunities for workflow enhancements, clinical documentation improvement, coding and billing regulatory issues, charging processes, and other related revenue cycle trends. Experience We Love: 5 + years of coding and educational experience in Professional Fee Coding or consulting setting with preference for Cardiology, General Surgery, Neurosurgery or Ob GYN specialties.
NewQuality Senior Analyst CVS Health CorpQuality Senior AnalystOH$46,988–$112,200 / yearResponsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the submission to the Centers of 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. Serves as the training resource and subject matter expert to vendors, providers and other team members for questions regarding ICD coding and documentation requirements.
Manager, Clinical Payment Integrity Medical MutualManager, Clinical Payment IntegrityCleveland, OhioManages vendor relationships specific to clinical coding and claims payment audits, ensuring adherence to contractual limits, validating alignment between vendor deliverables and internal MMO activities to avoid duplication, and assessing cost effectiveness to ensure maximum value from vendor services. Provides leadership and oversight for the Clinical Review & Recovery teams to strengthen the effectiveness of the clinical coding and claims payment auditing program and provides clinical coding and clinical review expertise for the Medical Policy and Clinical teams.
Professional Coding Fee Analyst Dayton Children's HospitalProfessional Coding Fee AnalystOHJob Details: Ensures the accuracy, efficiency, and maximum financial return of Dayton Children''s professional billing claims for reimbursement. Ensures billing compliance; maintains knowledge of CPT and ICD-10 coding guidelines, as well as Medicare/Medicaid billing rules and regulations.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Cleveland, OHRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Nurse Practitioner FirstHand Health IncNurse PractitionerOHThe Centralized Health Guide is responsible for virtual whole person assessments and management of our vulnerable population, collaborating closely with community primary care and behavioral health providers, as well as an internal team of triage registered nurses and psychiatric nurse practitioners. Supporting individuals in developing and exercising self management skills and skills skills person-centered care around their individual goals and preferences via motivational interviewing and holistic care planning.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)OH$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
NewInvestigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)OH$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. 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.
NewInvestigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)OH$43,888–$93,574 / yearExperience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research. Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience.