Medical Coder Columbia Orthopaedic GroupMedical CoderColumbia, MOYou will work closely with clinical and administrative teams to resolve documentation questions, support audits, and maintain coding accuracy across all orthopaedic services. This role ensures documentation integrity, supports revenue cycle performance, and helps reduce denials through precise coding practices.
Certified Medical Coder Affinia HealthcareCertified Medical CoderSt. Louis, MOFull timeIdentifies clinician services provided but not adequately documented in the medical advise supervisor and clinicians of deficiencies to support charge capture of all billing services. Position Summary: Verifies and ensures the accuracy, completeness, specificity and appropriateness of diagnosis codes on services rendered.
Certified Coder (Hybrid) - Physicians Billing Service Washington University in St LouisCertified Coder (Hybrid) - Physicians Billing ServiceSt. Louis, MO$25.30–$37.94 / hourCertified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA). Required Qualifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee's department).
NewCertified Coder (Remote) - Surgery Washington University in St LouisCertified Coder (Remote) - SurgeryMORemote$26.25–$39.36 / hourCertified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA). Required Qualifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee's department).
NewCoder Certified (Remote) - Neurology Washington University in St LouisCoder Certified (Remote) - NeurologyMORemote$26.25–$39.36 / hourCertified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physican based (CCS-P) - American Health Information Management Association (AHIMA), Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC), Certified Professional Coder - Hospital Apprentice (CPC-H-A) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA). Required Qualifications: Must have one of the following coding credentials: AHIMA (CCA, CCS, or CCS-P); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the AAPC specialty-specific coding credentials (the specialty-specific credential is only valid for that employee's department).
Lead HIM Hospital Coder/Auditor (In-Patient - Observation) The University of Kansas Health SystemLead HIM Hospital Coder/Auditor (In-Patient - Observation)MORemoteMaintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM/PCS coding guidelines to inpatient and outpatient diagnoses and procedures. Position Summary / Career Interest: The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)MO$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.
Coder II - Professional SSM HealthCoder II - ProfessionalMissouriRemoteIdentifies all billable services through review of all applicable data sources, including but not limited to: electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs, nursing home visit documentation, procedure reports generated from non-the electronic health record systems, etc. Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Coder - Hospital Inpatient SSM HealthCoder - Hospital InpatientMissouriCoordinates with the clinical documentation and quality teams to ensure validation of Medicare Severity Diagnosis Related Group (MSDRG), patient safety indicators, and hospital acquired conditions are supported by physician documentation to support appropriate coding. Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Coder I - Professional SSM HealthCoder I - ProfessionalMissouriRemoteReviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs (aka Op Logs), nursing home visit documentation, procedure reports generated from non-the electronic health record systems, etc. Is watchful for charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement.
Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX) University of Florida Health Science CenterSupervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX)MORemoteDemonstrated knowledge of hospital billing, reimbursement, denials and appeals, third-party payer contracts, insurance protocols, and revenue cycle workflows. Trains staff on revenue integrity policies, analyzes financial data for strategic insights, and implements improvements to optimize revenue capture.
Professional Billing Lead Coder (Remote) University Health.Professional Billing Lead Coder (Remote)MORemote5 years comprehensive medical record coding, of high level CPT/HCPCs & ICD-9/10, for multi-specialty Physician's services, including experience in an academic teaching health care organization - candidates with demonstrated abilities/skills at this level without the full years of experience can be considered. Expert level knowledge of Medicare rules and Local Carrier Determination (LCD) and national Correct Coding Initiative (NCCI) edits and proper procedure code sequencing.
NewCoder II (Remote) University HealthCoder II (Remote)Kansas City, MORemoteCoder II (Remote) 101 Truman Medical Center Job LocationWork From Home-City Tax Exempt Lees Summit, Missouri Department Corporate Professional Billing Position Type Full time Work Schedule 7:30AM - 4:00PM Hours Per Week 40 Job Description The coding leads serve as liaisons and leaders between coding staff, the operation, and the Director. 5 years comprehensive medical record coding, of high level CPT/HCPCs & ICD-9/10, for multi-specialty Physician's services, including experience in an academic teaching health care organization - candidates with demonstrated abilities/skills at this level without the full years of experience can be considered.
Coder - Hospital Outpatient SSM HealthCoder - Hospital OutpatientMissouriFlexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
Inpatient II Coder BJC HealthCareInpatient II CoderSaint Louis, MORemoteIn addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations.
NewCoder II (Remote) Truman Medical CentersCoder II (Remote)Kansas City, MORemote2 or more coding certifications, i.e. CPC or CPMA, and must maintain active certifications for continued employment* 5 years comprehensive medical record coding, of high level CPT/HCPCs & ICD-9/10, for multi-specialty Physician's services, including experience in an academic teaching health care organization – candidates with demonstrated abilities/skills at this level without the full years of experience can be considered* Demonstrated ability and experience identifying documentation improvement opportunities* Knowledge of insurance company, third-party and government reimbursement programs; i.e. Medicare, Medicaid, MC+, etc.* Knowledge of medical insurance billing and collection* Extensive knowledge with CPT, ICD 9/10 CD, and HCPCS coding and medical terminology in multiple physician practice specialties* Fluency with Medical terminology, anatomy and physiology* Knowledge of medical information systems for physician billing* Demonstrated proficiency in use of computer hardware and software systems, programs and devices.* Professional Billing Lead Coder (Remote) page is loaded## Professional Billing Lead Coder (Remote)locations: Work From Home-City Tax Exempttime type: Full timeposted on: Posted Todayjob requisition id: R0017223**If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site.****Please log into to search for positions and apply.**Professional
NewInpatient Coder I BJC HealthCareInpatient Coder ISaint Louis, MOIn addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations.
Certified Coder Ozarks HealthcareCertified CoderWest Plains, MOAccurately assigns ICD-10 codes to diagnosesand CPT codes to procedures respectively for reimbursement integrity and research purposes. Minimum of 3-5years previous inpatient coding experience in an acute care setting.
Coder I Inpatient Saint Luke's Health System IncCoder I InpatientKansas City, MOThe Opportunity: Review medical record documentation of lower acuity inpatients to assign appropriate ICD-10-CM, ICD-10-PCS, and DRG codes for billing, internal and external reporting, research, and regulatory compliance. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care.
Certified Coder Ozarks Medical CenterCertified CoderWest Plains, MOAccurately assigns ICD-10 codes to diagnoses and CPT codes to procedures respectively for reimbursement integrity and research purposes. Minimum of 3-5 years previous inpatient coding experience in an acute care setting is required.
Medical Coding Specialist (Dual Posted with Job ID 59698) University of MissouriMedical Coding Specialist (Dual Posted with Job ID 59698)Columbia, MO$20.58–$32.49 / hourReview complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. As part of your total compensation, the University offers a comprehensive benefits package, including medical, dental and vision plans, retirement, paid time off, short- and long-term disability, paid parental leave, paid caregiver leave, and educational fee discounts for all four UM System campuses.
Medical Coding Specialist Certified (Dual Posted with Job ID 59697) University of MissouriMedical Coding Specialist Certified (Dual Posted with Job ID 59697)Columbia, MO$23.66–$37.36 / hourReview complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. As part of your total compensation, the University offers a comprehensive benefits package, including medical, dental and vision plans, retirement, paid time off, short- and long-term disability, paid parental leave, paid caregiver leave, and educational fee discounts for all four UM System campuses.
Medical Records Technician (Clinical Documentation Improvement Specialist (Out/Inpatient)) U.S. Department of Veterans AffairsMedical Records Technician (Clinical Documentation Improvement Specialist (Out/Inpatient))Kansas City, MO$62,729–$81,553 / yearGS-9 Experience Requirement: In addition to the basic requirements, you must possess the following: One year of creditable experience equivalent to the journey grade level (GS-8) of a MRT (Coder-Outpatient and Inpatient); OR, An associates degree or higher and three years of experience in clinical documentation improvement (candidates must also have successfully completed coursework in medical terminology, anatomy and physiology, medical coding, and introduction to health records); OR, Mastery level certification through AHIMA or AAPC and two years of experience in clinical documentation improvement; OR, Clinical experience, such as Registered Nurse (RN), Medical Doctor (M.D.), or Doctor of Osteopathy (DO), and one year of experience in clinical documentation improvement. The Medical Records Technician (Clinical Documentation Improvement Specialist) (CDIS) is located within the Health Information Management Section (HIMS) of the Business Operations Service (BOS) at the Kansas City VA Medical Center (KCVAMC).Incumbent provides quantitative and qualitative review and analysis of medical records and encounter forms of both inpatient and outpatient encounters to ensure all diagnoses and conditions for which care is being rendered are documented by the provider in the proper sequence, and procedures have been documented and/or evaluation and management services.
SUPERVISOR, CODING & DATA MANAGEMENT University of MissouriSUPERVISOR, CODING & DATA MANAGEMENTColumbia, MO$59,322–$96,762 / yearReview medical coding staff work and provide feedback to ensure coding accuracy, coordinate workload and establish efficiencies for coding team, create processes and policies, provide feedback to providers regarding documentation improvements. Bachelor's degree in health services management, finance, business, accounting, nursing, or health-related profession, or an equivalent combination of education and experience from which comparable knowledge, skills and abilities can be acquired.
NewCoding Auditor Healthcare Fraud ShieldCoding AuditorChesterfield, MissouriRemoteUnder direct supervision of Healthcare Fraud Shield SIU management, this position executes routine coding reviews to ensure health records align accurately with billed ICD-10-CM, CPT, HCPCS, Revenue codes. REMOTE WORK REQUIREMENTS: Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.
Coding Educator SSM HealthCoding EducatorMissouriFlexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Act as subject matter expert for providers and coders while providing guidance and clarification on issues which present in their daily account processing.
Sr Inpatient Coding Specialist (Full Time) Days MercySr Inpatient Coding Specialist (Full Time) DaysChesterfield, MOPosition Details: Education: High school diploma Licensure: Experience: 3 years coding experience in ICD-10-CM diagnoses/procedure coding and HCPCS/CPT procedure coding in the acute care inpatient/outpatient hospital or professional services setting. Certifications: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Interventional Radiology Cardiovascular Coder (CIRCC) or completed within 6 months of employment.
Manager, Coding Compliance - Pediatrics Central Administration Washington University in St LouisManager, Coding Compliance - Pediatrics Central AdministrationSt. Louis, MO$68,100–$105,500 / yearThis leader is responsible for overseeing a team reviewing complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Skills: Accounting, Code Compliance, Coding Compliance, Compliance Management, Healthcare Auditing, Health Care Regulation, Health Insurance Portability & Accountability Act (HIPAA), ICD Coding, Medical Billing and Coding, Organizing, Supervisory Management, Trend Analysis, Trend Reporting.
Coding Quality Audit Inpatient Coordinator BJC HealthCareCoding Quality Audit Inpatient CoordinatorMORemoteQuality audits are inclusive of assessing compliance with federal and state regulatory coding guidelines, focusing on appropriate assignment of all diagnoses, procedures and DRG's to ensure accurate coding for reimbursement and clinical services (Quality Measures, Severity of Illness, Risk of Mortality). In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
Compliance Consultant Mosaic Life CareCompliance ConsultantSaint Joseph, MOWith a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more.
Pre-Certification Coordinator II (Remote) - Department of Medicine - Business Office Washington University in St LouisPre-Certification Coordinator II (Remote) - Department of Medicine - Business OfficeMORemote$22.78–$34.21 / hourSkills: Communication, Detail-Oriented, Epic EHR, External Customers, Family Communication, Fast-Paced Environments, Health Insurance Portability & Accountability Act (HIPAA), Insurance Claim Processing Software, Insurance Precertification, Insurance Terminology, Interact with All Levels of Management, Internal Customers, Interpersonal Communication, Managed Care, Medical Coding Software, Multitasking, Organizational Savvy, Patient Interactions, Prioritization, Third Party Payers. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
Pre-Certification Coordinator II - Pediatric Endocrinology Washington University in St LouisPre-Certification Coordinator II - Pediatric EndocrinologySt. Louis, MO$22.78–$34.21 / hourSkills: Communication, Detail-Oriented, Epic EHR, Fast-Paced Environments, Health Insurance Portability & Accountability Act (HIPAA), Insurance Claim Processing Software, Insurance Precertification, Insurance Terminology, Interpersonal Communication, Medical Coding Software, Multitasking, Organizational Savvy, Prioritization. Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and non-surgical procedures, outpatient testing, and medications; notifies financial counselor for pre-payment of un-coded services.
NewCharge Master Analyst Sutter HealthCharge Master AnalystMO$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.
NewPre-Certification Coordinator I (Remote) - Department of Medicine Washington University in St LouisPre-Certification Coordinator I (Remote) - Department of MedicineMORemote$21.33–$31.98 / hourThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistMO$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.
Pre-Certification Coordinator I - Pediatric Allergy & Pulmonary Medicine Washington University in St LouisPre-Certification Coordinator I - Pediatric Allergy & Pulmonary MedicineSt. Louis, MO$20.57–$30.84 / hourThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
Pre-Certification Coordinator I - Ophthalmology Washington University in St LouisPre-Certification Coordinator I - OphthalmologyCreve Coeur, MO$20.57–$30.84 / hourThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Kansas City, MORemoteFull timeTechnical 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.
Sr. Compliance Coordinator (Billing & Coding) BJC HealthCareSr. Compliance Coordinator (Billing & Coding)MORemoteConducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding. Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation.
Clinical Documentation Specialist Mosaic Life CareClinical Documentation SpecialistSaint Joseph, MOIdentifies need to clarify documentation in records and initiates communication with provider utilizing the appropriate query tools in order to capture the documentation in the medical record that accurately supports the patient's severity of illness. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more.
Manager Clinical Performance & Quality (Nurse Practitioner/Physician Assistant) Elevance Health IncManager Clinical Performance & Quality (Nurse Practitioner/Physician Assistant)St. Louis, MODevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorMO$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.
Provider Reimbursement Manager- Patient Safety Elevance Health IncProvider Reimbursement Manager- Patient SafetySt. Louis, MO$80,940–$134,190 / yearMinimum Requirements: Requires a BA/BS degree in a related field and a minimum of 7 years reimbursement experience including performing detailed financial modeling and economic analyses; or any combination of education and experience, which would provide an equivalent background. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Clinical Documentation Specialist - Registered Nurse CoxHealthClinical Documentation Specialist - Registered NurseSpringfield, MissouriNamed one of America’s Greatest Workplaces, Greatest Workplaces in Healthcare (2025, 2026), Greatest Workplaces for Women (2023, 2024), and Greatest Workplaces for Diversity (2024) by Newsweek and Plant-A Insights Group . Education Required: Graduate of an approved nursing program Preferred: Bachelor's Degree in Nursing Experience Required: 3 year’s acute care experience, 5 years preferred Preferred: Preferred experience in (ED, ICU, Neuro or Stepdown) Skills Ability to apply coding guidelines when reviewing documentation in the medical record.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MO$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.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)MO$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.