NewForensic Medical Coder Ensemble Health PartnersForensic Medical CoderWilliston, ND$24.65–$27.10Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects.
NewSpecialized Coder - Cardiology, Vascular and CVTS Ensemble Health PartnersSpecialized Coder - Cardiology, Vascular and CVTSGrand Forks, ND$29.75–$32.70Extensive knowledge/experience in physician coding with expert knowledge in Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery coding specialty and the ability to provide education/support to coding team and providers. Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)ND$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
NewCoder Altru Health SystemCoderGrand Forks, North DakotaAccesses designated resources such as coding initiatives, local medical review policies, HCPCS, Coders Desk Reference, etc. to research appropriate codes for adherence with coding guidelines. The Coder monitors daily activity reports to assure all encounters are being coded and performs documentation review and audits to validate coding efforts.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)ND$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.
RN- L&D IconmaRN- L&DBismarck, ND$63.99–$67.02 / hourWith a proven track record, our Healthcare and Clinical Division has successfully placed candidates in various roles, from Allied Professionals, Healthcare IT to Business Professionals, Finance/Accounting, Registered Nurses (both travel and local), Case Managers, Medical Coders, and more. Required Experience: Minimum of 3yrs experience in L&D, Post Partum and Gyn STABLE preferred not required Willing to float to NB nursery and NICU Willing to work nights and some days.
RN- L&D Iconma LLCRN- L&DBismarck, NDWith a proven track record, our Healthcare and Clinical Division has successfully placed candidates in various roles, from Allied Professionals, Healthcare IT to Business Professionals, Finance/Accounting, Registered Nurses (both travel and local), Case Managers, Medical Coders, and more. Required Experience: Minimum of 3yrs experience in L&D, Post Partum and Gyn STABLE preferred not required Willing to float to NB nursery and NICU Willing to work nights and some days.
Payment Integrity Nurse I Cambia HealthPayment Integrity Nurse IFargo, NDRemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
Payment Integrity Nurse I Cambia Health Solutions IncPayment Integrity Nurse IFargo, NDRemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
NewProgram Integrity Auditor NACBAProgram Integrity AuditorBismarck, NDEducationAssociate's degree or equivalent experience (2+ years of relevant experience + high school diploma or GED).Anticipated Weekly Hours40Time TypeFull timePay Range$46,988.00 - $122,400.00This 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. Primary ResponsibilitiesServe as an audit team member for a health plan(s) which currently administers benefits to Medicaid members across multiple lines of business including acute, behavioral health, individuals with developmental disabilities, and children in out-of-home care.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystFargo, NDRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Fargo, NDRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
NewInpatient Audit Specialist FT DatavantInpatient Audit Specialist FTBismarck, NDRemote$35–$45 / hourAs an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
NewProFee Audit Specialist- FT DatavantProFee Audit Specialist- FTBismarck, NDRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
NewAccount Representative (4007) Trinity Health Systems IncAccount Representative (4007)Minot, NDThis role ensures complete and accurate account documentation while working collaboratively with clinical teams, patient access staff, coders, and other billing personnel to gather required information and resolve discrepancies efficiently. As part of a coordinated revenue cycle team, the Account Representative contributes to timely reimbursement, reduced accounts receivable delays, and the overall financial health of the organization through consistent communication and shared accountability.
Utilization Review Specialist West River Health ServicesUtilization Review SpecialistHettinger, NDAdditional coding certifications also acceptable such as certified coding specialist (CCS), certified coding specialist physician (CCS-P), certified professional coder (CPC) and certified professional coder – hospital (CPC-H). Position Summary: Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources, risk management and quality of care for patients in accordance to established guidelines and criteria for designated setting and status.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)ND$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.