• Clinical Appeals Nurse (RN)

    Molina Healthcare (Milwaukee, WI)
    …Any one or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager ... compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/ medical reviews of previously denied cases in which a formal… more
    Molina Healthcare (05/16/25)
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  • Coding Auditor

    Ascension Health (Glendale, WI)
    …from the American Health Information Management Association (AHIMA) preferred. + Certified Professional Coder (CPC) credentialed from the American Academy ... and sufficiency of supporting documentation. + Audit specified number of records per coder as defined in the system coding audit plan. + Prepare audit reports… more
    Ascension Health (05/14/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Waukesha, WI)
    …Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
    Elevance Health (05/22/25)
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  • DRG Coding Auditor

    Elevance Health (Waukesha, WI)
    …Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, ... be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of… more
    Elevance Health (05/29/25)
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