• Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …in Health Administration, Finance, or related field preferred. + Certified Professional Coder ( CPC ) - AAPC + Certified Claims Professional (CCP) + Other AHIMA ... 011250 CCA- Claims **_This position is available to remote employees...role is responsible for the end-to-end review, analysis, and resolution of complex reimbursement issues - including underpayments, overpayments,… more
    Commonwealth Care Alliance (08/31/25)
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  • Medicare/Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr....the request based on business needs and requirements, provider resolution option based on financial ability and forecasting for… more
    Commonwealth Care Alliance (08/26/25)
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  • Insurance Specialist I - Corporate Patient…

    Guthrie (Sayre, PA)
    …payers. Reports possible payer or submission issues. 2. Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train ... payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy,...in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to… more
    Guthrie (08/22/25)
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  • Insurance Specialist II - Corporate Patient…

    Guthrie (Towanda, PA)
    …spreadsheets, creates and runs reports as needed to be used in the resolution of outstanding claims (ex. trending, projects, worklists) Identifies trends and ... Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a...required and requested. Works with insurance payers on problem claims and processes. Resolves outstanding Accounts Receivable and credit… more
    Guthrie (10/22/25)
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  • On-Site Procedural Billing Specialist I…

    Mount Sinai Health System (New York, NY)
    …and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. ... **Job Description** The Procedural Billing Specialist I is responsible for multiple components of...Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and… more
    Mount Sinai Health System (10/10/25)
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  • Billing & Certified Coding Specialist II-…

    Beth Israel Lahey Health (Burlington, MA)
    …helps to resolve callers' issues, retrieving critical information that impacts the resolution of current or potential future claims . 3. Establishes relationships ... within the Central Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials, and appeals. 16. Completes projects… more
    Beth Israel Lahey Health (10/30/25)
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  • Medical Services Coordination Specialist

    Excellus BlueCross BlueShield (Rochester, NY)
    …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and… more
    Excellus BlueCross BlueShield (10/21/25)
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  • Revenue Cycle Specialist IV (Remote)

    Cedars-Sinai (Torrance, CA)
    …collections support, performing duties which may include reviewing and submitting claims to third party payors, performing account follow-up activities, updating ... experience to include hospital billing and/or collections experience required. + CPC preferred. **Skills/Experience we are Seeking:** Proven ability to handle… more
    Cedars-Sinai (09/17/25)
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  • Medicare Specialist I

    Southeast Health (Dothan, AL)
    …Summary Performs daily activities involved in the reimbursement process, ie claims filing/follow-up, entry of payments/adjustments, and follow-up on non-payment or ... payer portals, work traditional Medicare and Medicare Advantage/Replacement inventory to full resolution . Job Description Essential Functions + Works as part of a… more
    Southeast Health (09/24/25)
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  • Coding Quality Specialist 3 - Urology

    University of Virginia (Charlottesville, VA)
    …edits and follow-up work queues, identifies areas of opportunity based on findings/ resolution of errors. + Manages assigned charge review and coding-related claim ... for Business Services and physician office requests regarding non-billed or non-reimbursed claims . + Completes special projects as directed by coding leadership. +… more
    University of Virginia (10/30/25)
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  • Supervisor, Medical Coding

    University of Rochester (Rochester, NY)
    …include, but are not limited to, coding abstraction, pre-bill coding edits, claims resolution functions, and providing recommendations to enhance coding acuity, ... by effectively managing the assigned functional area and serving as the team's coding specialist . This role acts as a subject matter expert on team functions and… more
    University of Rochester (08/07/25)
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  • Revenue Integrity Charge Description Master…

    Fairview Health Services (St. Paul, MN)
    …Info Tech or + Registered Health Info Admin or + CHRI, or + Certified Coding Specialist or + CPC + Epic Certification in Resolute Professional Billing or + Epic ... updates to the CDM that contribute to generating clean claims , enabling the collection of expected payments. + Participates...accuracy of all CDM data elements and assists with resolution of CDM related revenue issues + Conducts service… more
    Fairview Health Services (10/28/25)
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  • APC Coordinator Virtual

    AdventHealth (Tampa, FL)
    …- Registered Health Information Technician Required or + Certified Pension Consultant ( CPC ) Required or + CCS-Certified Coding Specialist Required This facility ... may assist in training outpatient coders on the appropriate resolution of NCCI edits. Work alongside members of the...billed as well as ensure we are billing clean claims . The APC Coordinator will assist in the oversight… more
    AdventHealth (08/22/25)
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  • Medical Coder II

    Ellis Medicine (Schenectady, NY)
    …Requirements: High School Diploma or Equivalent required. Certified Professional Coder ( CPC ), Certified Coding Specialist (CCS), Registered Health Information ... and related work lists to ensure complete, timely and accurate submission of claims , (3) facilitating the accuracy and completeness of the practice's codes and… more
    Ellis Medicine (10/28/25)
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  • Ambulatory Payment Classification Coordinator

    AdventHealth (Maitland, FL)
    …Registered Health Information Technician (RHIT) - Cert Required + Certified Professional Coder ( CPC ) + Certified Coding Specialist (CCS) This facility is an ... may assist in training outpatient coders on the appropriate resolution of NCCI edits. Work alongside members of the...not final billed and ensure we are billing clean claims . The APC Coordinator will assist in overseeing the… more
    AdventHealth (10/02/25)
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  • Coder II ER (Remote)

    Trinity Health (Livonia, MI)
    …Patient Business Services (PBS) teams, when needed, to help resolve billing, claims , denials and appeals issues affecting reimbursement. Exhibits awareness of health ... or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate. Utilizes EMR communication tools to track missing… more
    Trinity Health (10/30/25)
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  • Coding Auditor Educator, Inpatient

    Highmark Health (Harrisburg, PA)
    …of the change or problems and takes appropriate steps to effect resolution . (10%) + Reviews and interprets medical information, classifies that information into ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder (… more
    Highmark Health (10/23/25)
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  • Med Records Coder III, Complex

    University of Rochester (Albany, NY)
    …Coding Specialist (CCS) preferred or + Certified Professional Coder ( CPC ) from American Academy of Professional Coders (AAPC) or Certified Medical Coder ... guidelines. + Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides feedback for correction… more
    University of Rochester (10/21/25)
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  • Coding Supervisor (Evaluation & Management) - FT…

    Texas Health Resources (Arlington, TX)
    …and 2 Years Managing a team or as a lead preferred Licenses and Certifications CPC - Certified Professional Coder Upon Hire REQUIRED or CCS-P - Certified Coding ... Specialist - Physician-based Upon Hire REQUIRED and Other Advanced...Excellent communication (verbal and written) and interpersonal and conflict resolution skills. * Comfortable speaking in front of groups… more
    Texas Health Resources (10/21/25)
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  • Med Records Coder III

    University of Rochester (Rochester, NY)
    …Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred + Certified Professional Coder ( CPC ) from ... for system edit reviews and follows up on insurance coding denials for resolution . **ESSENTIAL FUNCTIONS** + Uses knowledge of coding systems and system logic to… more
    University of Rochester (10/08/25)
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