34 jobs found in Raleigh

Datavant is the data collaboration platform trusted for healthcare. 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. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. 1,500 Sign on Bonus We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule,...

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits and provide feedback to coders using ICD-10-CM/PCS, HCPCS, CPT and related references to ensure accurate classification and billing. The role collaborates with Clinical Documentation Specialists, abstracts data, and completes production coding when required. A certified coder with 5 years of experience (RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC) is preferred, with at least 1 year as an auditor. #J-18808-Ljbffr

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

CVS Health is seeking a Certified Professional Coder to perform medical claim reviews for the Special Investigations Unit. The CPC will ensure coding compliance, review medical records, and identify billing irregularities across providers and plans. The role requires CPC certification, 3+ years in coding/auditing, and strong knowledge of CPT/HCPCS/ICD-10. A statewide or NC-based focus with thorough documentation and collaboration with Medical Directors is expected. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves reviewing inpatient hospital claims and ensuring accurate coding and reimbursement. Candidates should hold an RHIA, RHIT, or CCS certification with substantial experience in coding audits. Strong attention to detail, excellent communication skills, and the ability to manage multiple priorities are essential. The job offers competitive compensation and various benefits to support overall well-being. #J-18808-Ljbffr

A healthcare data solutions provider is seeking an Inpatient Auditing Specialist who will perform audits on medical records and ensure compliance with DRGs. This fully remote role requires 3+ years of coding and auditing experience and offers a flexible schedule. Responsibilities include conducting audits, providing education, and maintaining communication with healthcare staff concerning clinical issues. Competitive salary and generous benefits are included in the role's compensation package. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The 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. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

**Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) + Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) + Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Syneos Health in Raleigh, NC is seeking an experienced Medical Science Liaison to advance scientific exchange and collaboration with medical leaders. You will confer with internal stakeholders and develop relationships with policymakers and advocates to move healthcare forward. Key responsibilities include building KOL networks, developing medical strategy for assigned areas, and serving as a primary resource for unsolicited scientific questions while ensuring compliance with corporate policies. #J-18808-Ljbffr

Senior Coding Specialist Serves as the senior member of the corporate coding team by providing extensive knowledge for timely and accurate coding and DRG assignment. Performs the function of coding, DRG assignment, collection of predefined indicators, and abstracting medical records. Provides timely and accurate ICD-10-CM and ICD-10-PCS codes for reimbursement and specific information for statistical purposes. Serves as a liaison between coders and CDS team on coding and documentation issues. Reviews SMART accounts on a daily basis as assigned. **Eligible remote states include NC, FL, GA, SC, SD, TN, TX and VA.** Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Registered Health Information Technician Required - Or...

Description This position qualifies for our UNC Rex Incentive Program, which includes up to $20,000 commitment incentive or up to $25,000 tuition loan forgiveness. In addition, this position is also eligible for up to $10,000 in relocation assistance (based on location) and our employee referral program. Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: Serves as nursing Team Leader. Provides education, training, and oversight to assigned nursing staff. 4 East is a 31 bed pulmonary and nephrology intermediate care unit. Nurses on this unit care for patients with lung, kidney and heart related illness or diagnoses. Nurses monitor and manage patients with ventilators, peritoneal dialysis, arrhythmias and cardiac drips. We provide an exceptional level of care, continuously utilizing critical thinking and a wide range of clinical skills for patients with...

Serco Inc. in the United States seeks qualified Medical Coding Auditing Specialists to support the DHA Medical Coding Program Branch. The role focuses on audits across DHA Markets to ensure ICD-CM, CPT, HCPCS, and DRG compliance while contributing to enterprise risk assessment. Candidates will audit DHA facilities, help develop annual work plans, and assist with government surveillance activities. A HIM/health information management background and professional coding certifications are required. #J-18808-Ljbffr

Veradigm is seeking an RCS Medical Coding Auditor in Raleigh, NC, to audit professional medical coding. This role requires strong experience with ProFee coding and deep knowledge of relevant guidelines. Ideal candidates will demonstrate excellent communication and analytical skills. Responsibilities include conducting audits, providing education, and ensuring compliance. The position offers a salary range of $57,728-$80,243 and a comprehensive benefits package. #J-18808-Ljbffr

The State of North Carolina - OSHR Temporary Solutions is seeking an Internal Auditor I (S) to evaluate agency fleet operations. This temporary position in Raleigh offers an hourly rate of $35.38 based on relevant experience. Responsibilities include conducting compliance reviews and ensuring adherence to state vehicle laws. Minimum education requires a Bachelor's degree in a relevant field. Temporary employees may be eligible for health insurance coverage. #J-18808-Ljbffr

About Us The North Carolina Department of Revenue is committed to excellence in tax administration, ensuring secure and efficient collection of revenue to fund vital public services. We are an employer of choice offering excellent benefits, competitive pay, professional development, and career advancement. Our dedicated team provides accurate information, achieves high compliance, and delivers innovative services with integrity and fairness. DOR is an equal opportunity employer hiring qualified candidates regardless of race, color, gender, national origin, religion, age, disability, or political affiliation. Agency Department of Revenue Division Examination Job Classification Title Revenue Tax Auditor II (NS) Position Number 60083162 Grade NC17 Description Of Work ***PLEASE NOTE: THIS WILL CLOSE AT 11:59 P.M. THE DAY PRIOR TO THE END DATE LISTED ON THIS JOB POSTING*** **This is an anticipated vacancy** This auditor classification requires a transcript. Please include an...

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies,...

A leading pharmaceutical company located in Raleigh, North Carolina is seeking an Associate Director, Scientific Communications. In this role, you will manage the execution of the scientific communications strategy, oversee global publication plans, and ensure all materials are scientifically accurate and compliant. The ideal candidate will have an advanced scientific degree and extensive experience in medical communications. This position offers a competitive salary ranging from $164,530 to $245,985, plus incentives and comprehensive benefits. #J-18808-Ljbffr