49 jobs found in Raleigh

Job Title Auditor I (NS) – Position Number 60009046, Grade NC10. Overview The role supports compliance reviews and audits of unclaimed property holders in accordance with North Carolina General Statute 116B. Duties include assisting holders with voluntary compliance, conducting audits, coordinating vendor audits, issuing audit reports, and performing outreach to owners. Responsibilities Respond to holder inquiries and conduct outreach via phone, email, and mail; send questionnaires; follow up on unanswered communications. Assist holder education and compliance activities, including preparing and presenting material for education events. Conduct unclaimed property audits by examining financial records, analyzing schedules, and determining liability per audit procedures. Track and report audit schedules, ensuring accurate and organized status updates. Support vendor audits by reviewing proposals, analyzing costs versus expected findings, preparing related documents, and resolving...

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. 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. Registered Health Information Technician Required - Or Registered Health Information Administrator Required - Or Certified Professional Coder Required - Or Certified Coding...

Medical Coding Specialist Perform dictionary coding in accordance with study specific coding conventions using MedDRA and WHO Drug within various coding systems. Manage end-to-end delivery of clinical data management coding responsibilities concurrently for single/multiple projects ensuring quality and timeliness. Provide leadership and mentorship to Medical Coding Specialists as needed. Create, review, and maintain guidance and training documentation for coding guidelines an accordance with ICH guidance, official coding guidelines and dictionary definitions. Responsibilities: Perform coding in accordance with study specific coding conventions as outlined in the Data Management Plan (DMP) Perform coding using MedDRA and WHO Drug of (eCRF) verbatim terms using various coding systems Provide independent review of coded data by ensuring consistent code assignment within a project by reviewing coding and re-assignment Responsible for medical coding review, synonym dictionaries...

AgencyDept of Health and Human ServicesDivisionO'Berry Neuro-Medical Treatment CenterJob Classification TitleNurse Supervisor I (S)Position NumberGradeMH18About UsThe North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.Description of WorkUnder the direct supervision of the Nurse Supervisor II (Nurse Manager), this position is responsible for the coordination and supervision of the resident care and certified nursing assistants of his/her group home on their assigned shift. The position is responsible for making decisions in collaboration with the Nurse Manager on the assigned shift...

Orthos Inc is seeking a Billing Specialist to handle patient inquiries, insurance claims, and accounts receivables in a remote setting. Candidates must reside in specific states including North Carolina. The role requires a minimum of 2 years of medical billing experience and strong knowledge of insurance procedures, claims processing, and coding terminologies. Excellent communication and organizational skills are also essential for this position. The company values professional development and innovation in healthcare practices. #J-18808-Ljbffr

Dormont Manufacturing Co is looking for an RCS Medical Coding Auditor to ensure the accuracy and compliance of professional fee coding. This includes performing daily quality assurance, conducting medical audits, and providing targeted feedback and education to enhance coding accuracy. The perfect candidate possesses a CPC certification, has over 2 years of ProFee auditing experience, and exhibits strong analytical and communication skills. Compensation ranges from $57,728 to $80,243 based on various factors including experience and market conditions. #J-18808-Ljbffr

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...

Nursing Team Leader Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. 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 multiple comorbidities. We are a strong team that places high importance on providing the best in care and top patient satisfaction results. Summary: Serves as nursing Team Leader. Provides education, training, and oversight to assigned nursing staff. Responsibilities: Coordinates, designs and implements educational programs to meet identified learning needs of staff, patients and...

Surgery Coder – Full-Time Position – Raleigh Location We are seeking an experiencedSurgery Coder to join our team. This position is responsible for accurately reviewing operative reports, assigning CPT and ICD-10 codes, posting surgical charges, and supporting reimbursement and appeals processes. Responsibilities Review and code orthopaedic surgical procedures from operative reports Assign and validate CPT and ICD-10 codes and appropriate fees Enter surgical charges accurately and timely Track on-call patients and maintain coding-related documentation Assist with coding corrections, claim denials, reimbursement reviews, and appeals Provide coding support for surgery estimates, pre-certifications, and second opinions Remain current on coding guidelines, payer requirements, and reimbursement regulations Collaborate with physicians, billing staff, and insurance representatives to ensure accurate coding and payment Qualifications CCA, CCS, CPC-A, or CPC certification...

If you are a dedicated and organized individual with a passion for healthcare and leadership, we encourage you to apply for this exciting opportunity. We are seeking a highly motivated and experienced Medical Office Supervisor to join our team. The Medical Office Supervisor will be responsible for overseeing the daily operations of our medical office, ensuring efficient and effective delivery of services to patients. This is a full-time, permanent position with competitive salary. Key Responsibilities Manage and supervise the day-to-day operations of the medical office, including scheduling, patient flow, and staff management Monitor and maintain office policies and procedures to ensure compliance with industry regulations and standards Train and supervise office staff, including receptionists, medical assistants, and administrative personnel Coordinate and oversee patient appointments, including scheduling, follow-up, and rescheduling as needed Ensure timely and accurate...

Position Summary The 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 Responsibilities Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback Validate 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 guidelines Conduct medical chart audits of professional services across multiple specialties Identify coding...

JMA Pediatrics located in North Carolina is seeking a Full-time Medical Customer Service Representative Supervisor. In this role, you will oversee the front office's operations, ensuring efficient patient flow and high-quality service. Candidates should have a relevant degree and supervisory experience in a healthcare setting. This position offers competitive compensation and excellent benefits including medical, dental, and retirement plans. #J-18808-Ljbffr

Auditor I (NS) The primary purpose of this position is to assist with or perform compliance reviews and audits of holders to ensure compliance with North Carolina General Statute 116B. Such holders can include banks and other financial institutions, insurance companies, manufacturers, retailers, public utilities, hospitals, and other private and public sector entities. This position will also assist Holders with their voluntary efforts to comply with North Carolina requirements. Assist with Holder Education and Compliance – 40% Respond to Holders' unclaimed property inquiries through phone calls, emails, and mail. Send out unclaimed property questionnaires to potential Holders. Follow up and assist Holders that have not responded to prior communications. Assist with processing and review of holder reports. Assist Holders in becoming compliant through the various audit and compliance programs. Assist with composing and presenting PowerPoint presentations and...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Become a part of our caring community The 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 Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

A leading university in North Carolina seeks a clinician-scientist specializing in chronic illness and aging. The candidate will provide excellent patient care, engage in teaching and mentoring, and conduct impactful research. Candidates must hold an MD or DO, with board eligibility or certification in Family Medicine. Fellowship training or an advanced degree is preferable but not mandatory. Competitive benefits, a supportive environment, and a commitment to diversity are prioritized. #J-18808-Ljbffr

Humana is seeking a Senior Market Consultation / Partnership Professional to support Clinical Support Team initiatives by enhancing documentation and coding practices. This role involves reviewing medical records, validating coding accuracy, and collaborating with various teams to promote compliance standards. Candidates should possess an active RN license, certification as a Professional Coder, and strong analytical skills while working in a remote environment with occasional required travel. #J-18808-Ljbffr

Raleigh Orthopaedic Clinic is seeking an experienced Surgery Coder for a full-time position in Raleigh, North Carolina. The candidate will accurately review operative reports, assign CPT and ICD-10 codes, and support reimbursement processes. Key responsibilities include coding orthopaedic surgeries, entering charges, and collaborating with physicians and billing staff to ensure accurate payments. The ideal candidate will possess relevant certification and coding experience, particularly in orthopaedic surgery. #J-18808-Ljbffr

Direct Jobs is seeking a Senior Coder in Raleigh, North Carolina, providing expertise in accurate coding and DRG assignment. The role includes abstracting medical records and timely coding for reimbursement purposes. The ideal candidate will possess certifications as a Registered Health Information Technician, Certified Professional Coder, and a degree in Health Information Management. Join us to deliver quality healthcare services and support the community's health. #J-18808-Ljbffr

Role, Inc. in Raleigh, North Carolina, is seeking a Document Review Specialist to perform post-closing audits of loan documentation to ensure compliance with regulatory guidelines. The role involves auditing real estate loan documentation and resolving discrepancies with internal departments and external agents. The ideal candidate will have 2-5 years of experience in real estate lending and a solid understanding of federal regulations. A hybrid work environment is offered. #J-18808-Ljbffr