NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)AZ$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.
Certified Coder Lee Hecht HarrisonCertified CoderPhoenix, AZ$25–$34 / hourThis contract role is ideal for detail-oriented coding professionals with a strong background in neurology coding who are looking for a competitive hourly rate and stability within a specialty practice. Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment.
NewCertified Coder American Vision PartnersCertified CoderPHOENIX, ArizonaFull timeOur practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. Company Intro: At American Vision Partners (AVP) , we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible.
Certified Coder - Cardiology IMS Care CenterCertified Coder - CardiologyAvondale, ArizonaThis position uses knowledge of CPT and ICD-10 codes to determine the appropriate order and combination of alpha, numeric or symbolic data to ensure accuracy in entering medical claim information by following the Organization's and Department's established policies and procedures. The Certified Coder will be accountable for processing medical claim information through data-entry in the Practice Management System and researching and correcting data entry errors using various electronic healthcare systems.
Certified Coder - Cardiology IMS Care Center LLCCertified Coder - CardiologyAvondale, AZPart timeThis position uses knowledge of CPT and ICD-10 codes to determine the appropriate order and combination of alpha, numeric or symbolic data to ensure accuracy in entering medical claim information by following the Organization's and Department's established policies and procedures. The Certified Coder will be accountable for processing medical claim information through data-entry in the Practice Management System and researching and correcting data entry errors using various electronic healthcare systems.
Profee Coder Complex Neurosurgery Neurology Banner HealthProfee Coder Complex Neurosurgery NeurologyAZRemote$25.54–$38.30 / hourRequires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Ideal Candidate: 3 years recent/consistent experience in Neurology Profee EM coding (clearly reflected in your attached resume); Neurosurgery Specialty experience preferred; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below.
Profee Coder GI Trauma Surgery Banner HealthProfee Coder GI Trauma SurgeryPhoenix, AZRemote$23.16–$34.74 / hourRequires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Certified Coding Associate (CCA), Certified Professional Coder - Apprentice (CPC-A), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Ideal Candidates: Minimum 1 year recent experience in Gen Surg, Trauma, and/or GI coding (clearly reflected in your attached resume); Experience with split shared EM coding a plus, as well as experience with Trauma (academic); Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below.
Profee Complex Coder Surgical Cardiology Banner HealthProfee Complex Coder Surgical CardiologyAZRemote$25.54–$38.30 / hourRequires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Ideal Candidates: 3 years recent experience in Surgical Cardiology Profee EM coding (clearly reflected in your attached resume); Specialty Cardiology coding experience preferred; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below.
Revenue Cycle Medical Coder (7179) Terros HealthRevenue Cycle Medical Coder (7179)Phoenix, AZStay up to date on coding requirements and best practices, including attending external trainings and meetings to proactively develop and implement forward thinking best practices. Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment.
CPC Coder- Onsite TTF, LLCCPC Coder- OnsitePhoenix, AZTTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. The TTF Coding and HIM Division partners with healthcare organizations nationwide to match top talent in the Coding and HIM industry with organizations that want to hire the best talent.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)AZ$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.
HIM Coder III Tucson Medical CenterHIM Coder IIIPhoenix, AZLICENSURE OR CERTIFICATION: Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician-based (CCS-P), or Certified Professional Coder (CPC), or Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC). Provides timely and accurate administrative and clinical data through the accurate assignment of current ICD-10-CM/PCS, CPT or HCPCS codes while complying with the regulations and requirements of the Federal Government, State licensing agencies and the Hospital's policies and procedures.
Sr. Clinical Coder Cook SystemsSr. Clinical CoderPhoenix, ArizonaWe partner with Fortune 500 enterprises and high-growth companies alike to deliver agile technology solutions, AI-driven talent strategies, and our signature FastTrack program that develops the next generation of tech talent. As a subject matter expert, this role provides coding-related information to various departments and functions as the designated recipient for factual network provider claim review requests.
Critical Access Medical Coder (Full-Time ONLY) Coding Concepts LLCCritical Access Medical Coder (Full-Time ONLY)Gilbert, AZRemoteResponsibilities: Accurately assign codes for a variety of services, including Inpatient (IP) Profee, Observation, Emergency Department (ED), Clinic, and other applicable areas. In this role, you will play an essential part in ensuring accurate coding and supporting the operational integrity of a Critical Access Hospital environment.
NewRemote Professional Fee Audit Specialist Flexible Schedule DatavantRemote Professional Fee Audit Specialist Flexible SchedulePhoenix, AZRemote$35–$45 / hourThis fully remote position requires over 5 years of Professional Fee coding and auditing experience, and candidates must possess CPC certification. Datavant is looking for a Professional Fee Auditing Specialist to conduct audits on medical records while ensuring compliance and providing coder education.
Certified Medical Claims Auditor ValenzCertified Medical Claims AuditorPhoenix, AZRemoteFull timeVālenz ® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification.
Senior Director, Telehealth Operations Banner HealthSenior Director, Telehealth OperationsPhoenix, AZSkilled in coaching and developing direct reports and/or other employees that results in enhanced performance outcomes; setting and pursuing aggressive priorities and goals that demonstrate a strong commitment to overall organizational success; effectively allocating resources in order to accomplish goals and objectives; quickly assessing and assimilating facility and industry financial dynamics in order to act quickly and appropriately to changing environmental factors; negotiating win-win scenarios with outside vendors/partners while representing the facility and organization in the best possible light; developing collaborative and positive relationships with medical staff, employees, volunteers, the community, and/or other applicable parties; measuring and managing work outputs. Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Driver's License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association.
NewSenior Manager, Corporate Compliance - Risk Adjustment CVS Health CorpSenior Manager, Corporate Compliance - Risk AdjustmentScottsdale, AZ$75,400–$165,954 / yearThis position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements. As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements.
NewSIU Coding Manager & Audit Lead CVS HealthSIU Coding Manager & Audit LeadPhoenix, AZCVS Health is seeking the Certified Professional Coder (CPC) Manager to oversee a team of medical coders within the Special Investigations Unit, ensuring compliance through comprehensive record reviews across medical and related healthcare providers. You will lead, train, and mentor CPCs, conduct audits for CPT/HCPCS compliance, and drive performance with clear goals and measurable outcomes.
Quality Nurse – QAPI Coordinator Innovative Health CareQuality Nurse – QAPI CoordinatorScottsdale, Arizona$75,000–$85,000The Quality Nurse will conduct clinical chart audits, review documentation for accuracy and compliance, ensure appropriate ICD-10 and CPT coding practices, and support adherence to Medicare and state regulatory requirements. Position Summary The Quality Nurse – QAPI Coordinator is responsible for supporting and managing the organization’s Quality Assurance and Performance Improvement (QAPI) program under the direction of the Program Director.
Cardiovascular Service Line Executive Banner HealthCardiovascular Service Line ExecutivePhoenix, AZDepending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Driver's License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association. Leads the design, development and implementation of a comprehensive Service Line strategic plan to drive growth, operational effectiveness, supply-chain management, clinical effectiveness, personnel management, physician collaboration and support, and fiscal management.
NewRN Clinical Documentation Specialist Banner HealthRN Clinical Documentation SpecialistAZRemote$37.14–$61.90 / hourEnsures data integrity of the clinical documentation database through compliant, accurate and appropriate entries, which includes but is not limited to, accurate input of case data, correct assignment of documentation clarification types and provider responses, and ensuring precise case reconciliation with correct DRG shifts recorded. This position is a member of the clinical team responsible for assisting treating providers to ensure that documentation in the medical record accurately reflects the diagnostic related group (DRG), severity of illness (SOI), risk of mortality (ROM), risk adjustment, and the complexity of patient care rendered.
Clinical Trials Charge Review Specialist Banner HealthClinical Trials Charge Review SpecialistPhoenix, AZOur team is uniquely, passionately, and strategically committed to ending Alzheimer''s disease and other neurodegenerative disorders without losing another generation, advancing oncology research to improve cancer prevention and treatment outcomes, and providing an unparalleled model of care for families facing these devastating diseases. You will be responsible for maintaining billing compliance by reading payer coverage analyses, dividing patient charges between sponsor-paid and patient-paid procedures, and interpreting contracts, budgets, and tracking systems to determine clinical trial coverage according to Medicare guidelines.
Auditor, Risk Adjustment Oscar HealthAuditor, Risk AdjustmentTempe, AZRemote$82,717–$108,566 / yearResponsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Special Investigations Unit Investigator CareOregon IncSpecial Investigations Unit InvestigatorAZ$72,765–$88,935 / yearStrong research, investigative and problem-solving skills Strong communication skills, including written, verbal and listening skills Effective computer skills, including MS Office Suite Strong interpersonal and motivational skills Ability to think logically and creatively without undue influence from personal biases Ability to operate with a high degree of professionalism and confidentially Ability to plan, organize, manage, and monitor work projects Ability to facilitate learning opportunities in a variety of informal and formal settings Ability to make presentations to small and large groups. Ability to bend and speak clearly for at least 3 hours/day Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read and hear and for at least 6 hours/day Ability to perform repetitive finger and wrist movement for at least 3-6 hours/day Ability to work effectively with diverse individuals and groups.
Investigations Unit Investigator, Senior CareOregon IncInvestigations Unit Investigator, SeniorAZ$90,225–$110,275 / yearCareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). Help identify potential areas of FWA vulnerability and risk; assist department leadership in developing and implementing corrective action plans for resolution of problematic issues and provide general guidance on how to avoid or deal with similar situations in the future.
Audit and Coding Consultant 78 HonorHealth Medical Group SupportAudit and Coding ConsultantPhoenix, ArizonaUnder the direction of senior leadership, the Audit and Coding Consultant audits, develops educational materials, educates providers and coders regarding coding/documentation guidelines. ESSENTIAL FUNCTIONS Ensure appropriate methodology to include financial controls, identification of trends and unusual patterns, reimbursement deficiencies, and to improve processes.
NewSenior Billing Specialist Denova Collaborative HealthSenior Billing SpecialistPhoenix, AZExperience with Electronic Health Records (EHR) and practice management systems, preferably AMD.Skills & Knowledge Advanced knowledge of medical billing, insurance claims, CPT, HCPCS, ICD-10 coding, payer regulations, and reimbursement processes. Job Purpose Join Denova Collaborative Health as a Senior Billing Specialist, where your expertise in complex medical billing and revenue cycle operations helps ensure clean, compliant claims and maximizes reimbursement.
Program Manager Revenue Integrity CommonSpirit HealthProgram Manager Revenue IntegrityPhoenix, AZEssential Functions: Collaboration: Establish collaborative working relationship with research revenue producing departments (Physician Investigators, Research Program Leaders), revenue integrity teams, Optum 360 personnel, information systems personnel, technical and clinical personnel to identify research chargeable activities, establish charge capture mechanisms, and to properly code (or add modifiers) research charges for timely and accurate recording of research claim related revenue consistent with research regulations, state and federal requirements. Research Revenue Cycle: Manage research patient charge revenue cycle beginning with management of Medicare Cost and Coverage Analysis Worksheet (MCCAW) personnel required to translate MCCAW into research patient billing grid to identify billable versus non-billable research charges.
Auditor, Risk Adjustment Oscar Health IncAuditor, Risk AdjustmentAZRemote$82,717–$108,566 / yearResponsibilities: Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar''s unlimited vacation program and annual performance bonuses.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorAZ$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.
Program Integrity Auditor CVS Health CorpProgram Integrity AuditorAZ$46,988–$122,400 / yearThe Auditor will also be recommending follow-up action including (but not limited to) provider education, recoupment of funds or rebilling of claims, and referral to state regulators for any suspected fraud, waste, or abuse (FWA). Serve 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.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)AZ$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.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)AZ$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Phoenix, AZRemoteFull 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.
Clinical Documentation Improvement Lead Healthcare Outcomes Performance CompanyClinical Documentation Improvement LeadPhoenix, ArizonaMinimum 5 years of clinical documentation improvement, coding, or revenue cycle experience in orthopedic/MSK specialties required. • Partner with physicians, APPs, coding teams, and operational leaders to improve documentation workflows and reduce.
Clinical Documentation Improvement Lead The Center for Orthopedic and Research EClinical Documentation Improvement LeadPhoenix, AZPart timeMinimum 5 years of clinical documentation improvement, coding, or revenue cycle experience in orthopedic/MSK specialties required. • Partner with physicians, APPs, coding teams, and operational leaders to improve documentation workflows and reduce.
Medical Billing Specialist American Vision PartnersMedical Billing SpecialistPHOENIX, ArizonaFull timeOur practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. Responsibilities: MAIN: Analyze daily financial exceptions from the charge capture audit reports to determine areas of leakage and partner with information technology and clinical service lines to rectify charge capture issues by assisting service lines to improve their ability to capture compliant charges.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)AZ$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.
Clinical Bill Review Analyst ValenzClinical Bill Review AnalystPhoenix, AZRemoteFull timeVālenz ® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification.
NewInpatient Audit Specialist FT DatavantInpatient Audit Specialist FTPhoenix, AZRemote$35–$45 / hourBy joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.* 2,500 Sign on Bonus **As 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. Systems: Cerner PowerChart, 3M360.What you will bring to the table:3+ years experience coding and auditingAssociate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCSPreferred: CCS, RHIT, or RHIA credentials.
HIM Documentation Integrity Specialist Valleywise HealthHIM Documentation Integrity SpecialistPhoenix, AZ$21.34–$31.48 / hourExperience: Requires two (2) years of progressively responsible experience in Health Information Management, Clinical Documentation Improvement, Coding, or Clinical Auditing/Review related to the Revenue Cycle/Revenue Capture Assurance program or related healthcare field that demonstrates an understanding of the required skills and abilities. This position performs quality review and analysis of patient information documented byValleywise Healthmedical staff (hardcopy and electronic) for provider/documentation deficiencies and completes the required data entry for provider notifications and tracking of incomplete health records.