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The Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) program plays a vital role in safeguarding the integrity of the Medicare Fee-for-Service (FFS) program by ensuring that taxpayer-funded healthcare payments are accurate, appropriate, and compliant with federal requirements. The Medical Records Case Review Specialist must have experience with medical records, knowledge of what constitutes required documentation in inpatient/outpatient medical records, physician office records, laboratory/radiology, and other types of medical records in order to provide first level expertise in clinical documentation review.

Serco, Inc. is the North America division of Serco Group, plc, one of the world’s leading service companies. At Serco we serve every branch of the U.S. Military, federal, state and local governments, Canadian and provincial governments, as well as commercial customers. We are a leading provider of professional, technology, engineering, trades, and management services, and we support the public service areas of Defense, Citizen Services, and Transportation.
Headquartered in Herndon, Virginia, Serco has over 9,000 employees working at over 100 sites across the U.S. and Canada. Serco is a business where people and values matter. Our workplace culture is one that embraces diversity and fosters equity, respect, and belonging for every individual. Put simply, Serco is a place you can count on. We embody a holistic approach to wellbeing and offer our employees a suite of benefits that enable you to achieve your physical, emotional, financial, social, community and career goals.
Serco is a place where you can make a difference because every contribution matters. So while your place at Serco may vary depending on your role, we know you will find your place here. You are invited to come discover your place in our world.

Serco Group plc

Medical Review Specialist III

Facilitate safe and effective discharges from inpatient settings by communicating member needs and issues identified during the course of inpatient treatment to other members of the care team, including but not limited to Facility CM, SCAN Care Management staff, medical group case managers, and Primary Care Physicians (PCPs). Build effective professional relationships with providers and other internal and external partners by using excellent verbal and written communication skills, developing trust, meeting timelines, respecting cultural differences, using active listening skills, and maintaining confidentiality.

HOUR

SCAN Health Plan

Medical Management Specialist RN (SCAN Temp)

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The Clinical Appeals Specialist ensures that appeals are thoroughly reviewed, accurately documented, and effectively communicated to insurance providers, healthcare professionals, and members. ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

Independent Living Systems LLC

Clinical Appeals Specialist

As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most - patient care. Headquartered in Stamford, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

ONS MSO LLC

Medical Records Specialist

Utilizing the Universal Software Solutions HDMS platform, this role requires deep regulatory knowledge to craft effective, logic-based written appeals that maximize reimbursement. HDMS Queue Navigation: Utilize Universal Software Solutions HDMS to monitor, prioritize, and process daily denial workflows and collections worksheets.

J & B Medical Supply Co Inc

Medical AR Follow-up & Denial Specialist (DME)

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Pride Technologies LLC

Remote Clinical Documentation Specialist

Must possess one of the below: Current Registered Nurse License, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) required, licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school. Through extensive interaction with physicians and other members of the healthcare team, achieves appropriate clinical documentation to support code assignment, medical necessity, severity of illness, risk of mortality and level of services rendered to all patients.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, the Trinity Health system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. In fiscal year 2023, the Livonia, Michigan-based health system invested $1.5 billion in its communities in the form of charity care and other community benefit programs.

Trinity Health

RN Clinical Documentation Specialist - ST Peters Hospital

FULL_TIME

Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. As a 152-bed, Joint Commission-accredited, Medicare-certified hospital, Havasu Regional combines compassionate hometown care with advanced medical technology while serving the Lake Havasu City community as a regional healthcare provider.

Havasu Regional Medical Center

Clinical Documentation Specialist

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The Specialist serves as a central resource for coordinating claims, managing medical documentation, processing billing and reimbursement activities, and facilitating communication among healthcare providers, employers, insurance carriers, Managed Care Organizations (MCOs), attorneys, and injured workers. Employment Status : FULL-TIME Working Hours : 40 hours a week/80 hours per pay period Shift: 1st shift Position Reports to: Occupational Health Manager Position Summary Wilson Health is seeking an organized, detail-oriented professional to join our team as an Occupational Health Claims & Revenue Cycle Specialist.

Wilson Health

Occupational Health - Occupational Health Claims & Revenue Cycle Specialist - FT - 1st Shift

Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field. This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings.

Saint Francis Health System

Coder Specialist III (ECB)

Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field. Work Experience: Minimum of 3 years related experience and a score of 80% or above on the outpatient and inpatient coding exam.

Coder Specialist III

WEEK

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Pride Global is a minority-owned integrated human capital solutions firm headquartered in New York with operating companies throughout the United States, Canada, India and Brazil. Pride Global companies focus on a diverse array of services including vendor management, payroll programs, business process optimization, and staffing for both direct hire and contingent labor.

Pride Global

jobdiva

JOB DESCRIPTION: Compliance Specialist position reporting to Manager of Medical Necessity and Authorization Denials that supports quality audit of Authorization and Medical Necessity internal and vendor staff to ensure quality, appropriateness of appeals, the effectiveness of denial review, etc. Four years of administrative experience to acquire competence in applying compliance, coding, and auditing principles as they relate to insurance billing, collections, consulting, and other revenue cycle-related functions.

Duke University

Compliance Specialist

Under general supervision of the Clinical Documentation Integrity Program Manager, the Clinical Documentation Specialist is responsible for improving overall quality and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality through extensive interaction with physician, case management, nursing staff, other patient caregivers and coding staff. Tenet's hospital operations segment includes 52 acute care and specialty hospitals in nine states, as well as other facilities such as primary and specialty care clinics, diagnostic imaging centers, micro-hospitals and off-campus emergency departments.

Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans. Since 2003, Tenet's Commitment to Quality has improved the quality of medical care and patient safety at its hospitals and other businesses by evaluating processes and promoting best practices. As the world in which Tenet operates continues to change, Tenet's Commitment to Quality will remain focused on quality, the growing quality gap relative to top performers in the industry, and the fact that payers and employees use quality as a distinguishing factor. Visit the Quality Care page for more information. Tenet has taken the lead in addressing the needs of the uninsured through its Compact With Uninsured Patients. Established in 2003, the Compact focuses on treating patients without insurance fairly and with respect during and after their treatment, regardless of their ability to pay. Tenet also is committed to working with its patients through financial counseling and alternative payment options.

Tenet Healthcare Corp

Clinical Documentation Specialist II

For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. Recognized as the No. 1 ASC EHR vendor by Black Book for 11 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2026, 2025, 2023, and 2022, SIS remains the trusted choice for surgical providers seeking to enhance their performance.

Surgical Information Systems LLC

Team Lead, Coding

We are seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral Health coding experience to support a state Medicaid program engagement. Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission.

RADcube - A NLogix Company

Medical Record Audit Specialist

Zoho

The Clinical Document Improvement Specialist - (CDS) is responsible for providing CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients' patients. The goal of the CDS oversight and practice is to assess the technical accuracy, specificity, and completeness of provider clinical documentation, and to ensure that the documentation explicitly identifies all clinical findings and conditions present at the time of service.

YEAR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc.

Clinical Documentation Improvement Specialist

2+ years of experience as an AHIMA or AAPC Certified coder with 2+ years of CPT/HCPCS/ICD/Modifiers- 10/CM/PCS coding experience or Licensed nurse with medical record auditing and coding/billing experience. Certified Coder AHIMA or AAPC Certified coder (CPC, CCS, CCS-P) or Nurse (RN, LPN) with unrestricted and active license/certification with medical record auditing and coding/billing experience.

M&R Coding Clinical Investigator

LICENSURE/CERTIFICATION/REGISTRATION: Required: Current MA Certification from one of the following: The American Medical Technology Association (AMT), The National Center for Competency Testing (NCCT), The American Association of Medical Assistants (AAMA), The National Association for Health Professionals (NAHP) Certification, National Healthcareer Association (NHA) or current Oregon licensure as an intermediate or paramedic level EMT, LPN, RN, or Athletic Trainer. Charles Health System encompassing practices in three Central Oregon counties and numerous specialties including orthopedic services, family care, internal medicine, obstetrics and gynecology, pediatrics, immediate/urgent care, cardiology, pulmonology, rheumatology, general surgery, cancer care, behavioral health, and sleep medicine.

Medical Coding Specialist Jobs in the United States

Medical Review Specialist III Serco Group plc

Medical Management Specialist RN (SCAN Temp) SCAN Health Plan

Clinical Appeals Specialist Independent Living Systems LLC

Medical Records Specialist ONS MSO LLC

Medical AR Follow-up & Denial Specialist (DME) J & B Medical Supply Co Inc

Remote Clinical Documentation Specialist Pride Technologies LLC

RN Clinical Documentation Specialist - ST Peters Hospital Trinity Health

Clinical Documentation Specialist Havasu Regional Medical Center

Occupational Health - Occupational Health Claims & Revenue Cycle Specialist - FT - 1st Shift Wilson Health

Coder Specialist III (ECB) Saint Francis Health System

Coder Specialist III Saint Francis Health System

Remote Clinical Documentation Specialist Pride Global

Compliance Specialist Duke University

Clinical Documentation Specialist II Tenet Healthcare Corp

Team Lead, Coding Surgical Information Systems LLC

Medical Record Audit Specialist RADcube - A NLogix Company

Clinical Documentation Improvement Specialist UnitedHealth Group Inc.

M&R Coding Clinical Investigator UnitedHealth Group Inc.

Medical Assistant - Heart & Lung Specialists St. Charles Health System

Compliance Specialist Duke University

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