FULL_TIME

FEED

UNKNOWN

Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night… we could go on and on. Payer & Industry ExpertiseMonitors industry updates, CMS releases, CPT/ICD changes, and payer-specific policies; disseminates relevant information to clinicians, team members, and leadership.

YEAR

<p><b>Description</b></p><div>Looking for a career where you love what you do and who you do it with? You’re in the right place.</div><div>Healthcare here is different – we’re locally owned and led by our physicians, and all decisions are <i>always </i>made right here in Central Iowa.</div><div> </div><div>By working at The Iowa Clinic, you’ll get to make a difference while seeing a difference in our workplace. Because as one clinic dedicated to exceptional care, we’re committed to exceeding expectations, showing compassion and collaborating to provide the kind of care most of us got into this business to deliver in the first place.</div><div> </div><div>Think you’ve got what it takes to join our TIC team? Keep reading…</div><div> </div><div><b>A day in the life…</b></div><div><b></b></div><div>Wondering what a day in the life of <b>Biller/Coder II</b> at The Iowa Clinic might look like?</div><div> </div><div><b>Coding, Audit & Revenue Integrity</b></div><ul style="margin-top:0in"><li>Performs detailed review of complex patient encounters, procedures, specialty services, and high-risk documentation to ensure accurate, complete, and compliant coding.</li><li>Ensures documentation supports all assigned codes and actively identifies inconsistencies, trends, or opportunities for improvement.</li><li>Serves as the coding subject-matter expert for assigned specialties, maintaining deep knowledge of CPT/ICD/HCPCS, modifiers, NCCI edits, payer guidelines, and regulatory requirements.</li></ul><div><b>Clinician Engagement & Education </b></div><ul style="margin-top:0in"><li>Provides real-time feedback and consultation to physicians and APPs on coding, documentation, and payer requirements.</li><li>Participates in specialty meetings, education sessions, and provider onboarding to improve documentation accuracy and reduce downstream denials.</li><li>Responds to clinician questions related to coding, documentation, and direct-to-bill workflows, ensuring timely and accurate guidance.</li></ul><div><b>Payer & Industry Expertise</b></div><ul style="margin-top:0in"><li>Monitors industry updates, CMS releases, CPT/ICD changes, and payer-specific policies; disseminates relevant information to clinicians, team members, and leadership.</li></ul><div><b>Team Collaboration & Professional Standards</b></div><ul style="margin-top:0in"><li>Participates in coding audits, documentation improvement projects, and interdepartmental initiatives.</li><li>Demonstrates professionalism, maintains confidentiality, and promotes a positive impression of The Iowa Clinic internally and externally.</li><li>Supports the overall workload of the coding team, offering assistance as appropriate.</li><li>Perform other tasks as assigned.</li></ul><div> </div><div><b>This job might be for you if…</b></div><div>Education</div><ul style="margin-top:0px"><li>High school diploma or equivalent.</li></ul><div>Qualifications</div><ul style="margin-top:0px"><li>Previous experience working in a medical office and a working knowledge of ICD-10, CPT, and HCPCS coding required. </li><li>Exposure to different types of insurance programs preferred. </li></ul><div style="margin-bottom:0in;line-height:normal;background:white"> </div><div>Required Licenses</div><ul style="margin-top:0px"><li>Certified Professional Coding Certificate is required.</li></ul><div>Know someone else who might be a great fit for this role? Share it with them!</div><div> </div><div>What’s in it for you</div><ul style="margin-top:0px"><li>One of the best 401(k) programs in central Iowa, including employer match and profit sharing</li><li>Employee incentives to share in the Clinic’s success</li><li>Generous PTO accruals </li><li>and paid holidays</li><li>Health, dental and vision insurance</li><li>Quarterly volunteer opportunities through a variety of local nonprofits</li><li>Training and development programs</li><li>Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night… we could go on and on</li><li>Monthly departmental celebrations, jeans days and clinic-wide competitions </li><li>Employee rewards and recognition program</li><li>Health and wellness program with up to $350/year in incentives</li><li>Employee feedback surveys</li><li>All employee meetings, team huddles and transparent communication </li></ul>

The Iowa Clinic

Biller/Coder II - Revenue Cycle (Full-Time)

Billing

Current Procedural Terminology (CPT)

Dental Insurance

Documentation

Healthcare

Healthcare Common Procedure Coding System (HCPCS)

ICD-10

Insurance

International Classification of Diseases (ICD)

Medical Coding

Medical Office

Medical Treatment

Nonprofit

Regulatory Requirements

Risk

Support Documentation

Training Program

Training/Teaching

Trend Analysis

Vision Plan

Jobvite Talemetry Organic Easy Apply

OTHER

Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).<p>Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.</p><p>Veteran, Military Spouse or Military Affiliated are encouraged to apply!</p><p><strong>Job Summary</strong><br/><br/> Under the direction of the Director, Program Integrity, assists in the identification, analysis, case development and reports of any suspected fraud and/or abuse as defined by TRICARE. Reviews medical records for fraud and abuse issues. Complies with Program Integrity requirements within the TRICARE West Region; assists with trending and reporting requirements; and interfaces with TRICARE beneficiaries, providers and subcontractors on fraud and abuse issues. Assists with the update of education and training. Assists with the update of policy and procedure protocols for the Program Integrity unit.</p><p><strong>Education & Experience</strong><br/><br/><strong>Required: </strong></p><p> • Registered Nurse or Physician's Assistant with at least five years varied clinical experience in a managed care setting <br/> • Education or experience to perform anti-fraud and abuse pre-payment and post-payment reviews <br/> • 3 years utilization review, quality management, or case management experience <br/> • Must be a U.S. Citizen <br/> • Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation </p><p><strong>Preferred: </strong></p><p> • Experience in the preparation and presentation of teaching materials; assessment evaluations, and writing skills <br/> • Certified Coder (CPC, CPC-P, CCA, CCS-P), AHFI, CFE, or other related certification</p><p><strong>Key Responsibilities</strong><br/><br/> • Resource clinician for Program Integrity staff. <br/> • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews. <br/> • Conducts medical records and claims reviews for potential fraud and abuse issues, as well as medical necessity, benefit coverage, utilization and quality of care issues and outcomes. <br/> • Coordinate and compile written Investigative Summary Reports in conjunction with PI investigators upon completion of records review. <br/> • Maintains the confidentiality and non-discoverability of all fraud and abuse, quality assurance, quality management and risk management issues. <br/> • Facilitate and support the Program Integrity Goals and Objectives. <br/> • Readily accesses and interprets TRICARE and Medicare coverage guidelines, policies and procedures as well as TriWest policies and procedures. <br/> • Effective utilization of the antifraud artificial intelligence software. <br/> • Effective utilization of all documentation systems related to fraud and abuse activities and reporting systems.</p><p>• Participates in DHA directed investigation, data collection and medical record reviews for fraud and abuse case development. <br/> • Performs as a witness in court as requested. <br/> • Prepares and submits medical records for peer review as appropriate. <br/> • Ensures accuracy, completeness and timely submission of all required reports, review audits, case development activities and documents. <br/> • Collaborates with all government agencies as directed to support the fraud and abuse efforts. <br/> • Participates and contributes to program integrity education and training for beneficiaries, providers, subcontractor and TriWest staff regarding fraud and abuse. <br/> • Participates in system enhancements for reporting fraud and abuse activities. <br/> • Participates in the annual review of Program Integrity policies, procedures and desk procedures. <br/> • Demonstrates effective use of documentation systems for communication, tracking, trending and reporting purposes. <br/> • Establishes and maintains effective working relationships with all levels of TriWest employees, government and subcontractor staff. <br/> • Demonstrates flexibility and adaptability. <br/> • Other duties as assigned. <br/> • Regular and reliable attendance is required.</p><p><strong>Competencies</strong><br/><br/><strong>Communication / People Skills: </strong>Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate. </p><p><strong>Computer Literacy: </strong>Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions. </p><p><strong>Delegation Skills: </strong>Provide clear performance expectations for projects and ensure adequate access to resources for completion. </p><p><strong>High Intensity Environment: </strong>Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow. </p><p><strong>Multi-Tasking / Time Management: </strong>Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment. </p><p><strong>Organizational Skills: </strong>Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented. </p><p><strong>Problem Solving / Analysis: </strong>Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues. </p><p><strong>Team-Building / Team Player: </strong>Influence the actions and opinions of others in a positive direction and build group commitment. </p><p><strong>Technical Skills: </strong>Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. Proficient with Current Procedural Terminology coding.</p><p><strong>Working Conditions</strong><br/><br/><strong>Working Conditions: </strong></p><p> • Availability to cover any work shift <br/> • Department of Defense security clearance required <br/> • Repetitive data entry with telephone headset and long periods of sitting</p><p><b>Company Overview</b></p><p><strong> Taking Care of Our Nation's Heroes. </strong></p><p><strong> It's Who We Are. It's What We Do. </strong></p><p> Do you have a passion for serving those who served? </p><p><strong> Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®! </strong></p><p> Our job is to make sure that America's heroes get connected to health care in the community. </p><p> At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.</p><p><b>DoD Statement</b></p><p>Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.</p><p><b>Benefits</b></p><p>We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: <br/></p><ul><li> Medical, Dental and Vision Coverage </li><li> Paid time off </li><li> 401(k) Retirement Savings Plan (with matching) </li><li> Short-term and long-term disability, basic life, and accidental death and dismemberment insurance </li><li> Tuition reimbursement </li><li> Paid volunteer time </li></ul><br/> TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $90,000 to $95,000 per year.<p><b>Equal Employment Opportunity</b></p><p>TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

<img alt=" " height="1" src="https://ars2.equest.com/?response_id=55152f29a99e80c336b24d01309536b0&view" width="1"/></p>

TriWest Healthcare Alliance

Program Integrity Clinical Specialist (RN or PA Req'd)

Adjudication

Analysis Skills

Artificial Intelligence (AI)

Background Investigation

Case Management

Certified Coding Specialist (CCS)

Certified Financial Examiner (CFE)

Certified Professional Coder (CPC)

Clinical Medicine

Communication Skills

Communication Systems

Community Health

Computer Skills

Data Collection

Data Entry

Detail Oriented

Diversity

DoD Clearance

Establish Priorities

Government

Government Contracts

Interpersonal Skills

Investigative Reports

Mail Processing

Managed Care

Medical Records

Medical Research

Medicare

Multitasking

Organizational Skills

Physician Assistant

Presentation/Verbal Skills

Problem Solving Skills

Process Analysis

Quality Assurance

Quality Management

Quality of Care

Registered Nurse (RN)

Reporting Skills

Resource Management

Risk Management

Security Clearance

Team Building

Team Lead/Manager

Team Player

Time Management

Training/Teaching Materials

United States Citizen

United States Department of Defense (DoD)

Utilization Management

Writing Skills

equestftpin

PART_TIME

Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night… we could go on and on. Because as one clinic dedicated to exceptional care, we’re committed to exceeding expectations, showing compassion and collaborating to provide the kind of care most of us got into this business to deliver in the first place.

<p><b>Description</b></p><div>Looking for a career where you love what you do and who you do it with? You’re in the right place.</div><div>Healthcare here is different – we’re locally owned and led by our physicians, and all decisions are <i>always </i>made right here in Central Iowa.</div><div> </div><div>By working at The Iowa Clinic, you’ll get to make a difference while seeing a difference in our workplace. Because as one clinic dedicated to exceptional care, we’re committed to exceeding expectations, showing compassion and collaborating to provide the kind of care most of us got into this business to deliver in the first place.</div><div> </div><div>Think you’ve got what it takes to join our TIC team? Keep reading…</div><div> </div><div><b>A day in the life…</b></div><div> </div><div>Wondering what a day in the life of Pre-Authorization Specialist at The Iowa Clinic might look like?</div><div> </div><ul style="margin-top:0in"><li>Arrive at work in the morning – no night shifts here!</li><li>Obtain insurance pre-authorization for procedures, imaging exams, injections and specialty medication prescriptions.</li><li>You must gather necessary details insurance providers require, submit for pre-authorization and follow up to ensure timely approval with patients scheduled procedures</li><li>Will also complete FMLA paperwork for patients </li><li>Strives to create The Iowa Clinic Experience with each interaction.</li></ul><div><b><i>This is a part-time position, and hours are flexible M-F between the hours of 7AM-5PM.</i></b></div><div> </div><div><b>This job might be for you if…</b></div><div>Qualifications</div><ul><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">High School diploma or equivalent required.</li><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">Highly organized</li><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">Excellent communication skills</li><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">Medical terminology necessary</li><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">Medical billing/coding experience or pre-authorization experience preferred.</li><li style="color:rgb( 51 , 51 , 51 );line-height:normal;background:white">Highly motivated to work in a healthcare setting.</li></ul><div>Know someone else who might be a great fit for this role? Share it with them!</div><div> </div><div>What’s in it for you</div><ul style="margin-top:0px"><li>One of the best 401(k) programs in central Iowa, including employer match and profit sharing</li><li>Employee incentives to share in the Clinic’s success</li><li>Generous PTO accruals</li><li>and paid holidays</li><li>Health, dental and vision insurance</li><li>Quarterly volunteer opportunities through a variety of local nonprofits</li><li>Training and development programs</li><li>Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night… we could go on and on</li><li>Monthly departmental celebrations, jeans days and clinic-wide competitions</li><li>Employee rewards and recognition program</li><li>Health and wellness program with up to $350/year in incentives</li><li>Employee feedback surveys</li><li>All employee meetings, team huddles and transparent communication</li></ul><div> </div><div> </div><p> </p>

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Medical Coder Jobs in Highland Park, IA

Biller/Coder II - Revenue Cycle (Full-Time) The Iowa Clinic

Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare Alliance

Pre-Authorization Specialist - Allergy (Part-Time) The Iowa Clinic

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