12 jobs found in Akron, OH

Job Title: Registered Nurse (Rn) We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations. Key Responsibilities: Analyze claims data, medical records, and provider documentation to identify discrepancies, fraud, or non-compliance. Conduct retrospective case reviews, on-site provider audits, and recipient interviews. Review billing practices for upcoding, duplicate billing, and unbundling of services using ICD-10, CPT, and HCPCS manuals. Prepare reports, case findings, and recommend sanctions when violations are identified. Coordinate and participate in teleconferences, hearings, and legal proceedings with the Office of General Counsel and other agencies. Respond to provider complaints and compliance inquiries via hotline,...

Medical Coder Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The role is fully remote within the US, with infrequent travel to client locations for onboarding and training. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do: Accurately assign ICD-10 CM, E/M, ICD-10 PCS, CPT, HCPCS, modifiers and units based on documentation. Adhere to systems and standards required in multi-specialty medical coding encounters, including Outpatient, Emergency Room, Surgery, Inpatient facilities, Inpatient Professional Rounds, and others. Process encounters within required SLA on contract with deficiencies identified escalated as necessary. Review and respond to each audit within set...

Coding Specialist I Your job is more than a job The Coding Specialist I will be responsible applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters ambulatory/ provider-based clinics. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing...

Pro-Fee Hospital Multispecialty E/M & Surgery Coder (FT) GeBBS Healthcare Solutions, an industry leader in Health Information Management and Revenue Cycle Management solutions, is seeking highly motivated individuals with a passion for excellence for careers in the healthcare industry. Here is your opportunity to be part of this exciting team! GeBBS is looking for a Professional Fee Hospital Coder with multi-specialty E/M and Surgery coding experience on a full time basis. Responsibilities This position will provide accurate coding (EM, Surgery, CPT, diagnoses) and resolve coding related edits for hospital inpatient and outpatient professional services. Coders will be required to use ICD-10-CM, CPT, Modifiers and HCPCS Level II codes. Coding will be in the following settings: Hospital Emergency Departments Hospital Observations Hospital Outpatient and Medical Office Hospital Inpatient Multispecialty experience including: OB, Cardio, Urology, Neurology, GI,...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Position Summary MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. Position Summary: This job posting encompasses all available Physician coding roles, including Physician Coder I, Physician Coder II, and Physician Senior Coder positions. Applicants will be considered for the appropriate role based on current organizational needs, manager discretion, years of relevant experience, passing a coding assessment and how well they meet the qualifications outlined for each position. Accurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. At Orlando Health, we are ordinary people with extraordinary...

CPC - Certified Professional Coder (medical billing) Tutor Join to apply for the CPC - Certified Professional Coder (medical billing) Tutor role at Varsity Tutors, a Nerdy Company . Pay Range This range is provided by Varsity Tutors, a Nerdy Company. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range : $25.00/hr – $40.00/hr. Why Join Our Platform? Earn incrementally higher pay for each session with the same student—reaching up to $40/hour. Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions you conduct and invoice. Set your own hours and tutor as much as you’d like. Tutor remotely using our purpose-built Live Learning Platform—no commuting required. Get matched with students best-suited to your teaching style and expertise. Our AI-powered Tutor Copilot enhances your sessions with real-time instructional support, lesson generation, and engagement...

A leading healthcare institution is seeking an Operations Supervisor to manage daily operations for plastic and reconstructive surgery, overseeing a team and ensuring efficiency in patient flow and office finances. This full-time role requires strong leadership skills, organizational abilities, and preferably a background in healthcare administration. Salary ranges from $120,000 to $140,000. Competitive compensation and benefits are offered for this mid-senior level management position. #J-18808-Ljbffr

A global tire manufacturing company seeks a Quality Assurance Auditor to oversee compliance audits and enhance the Quality Management System. This full-time role requires a Bachelor’s degree in Engineering and at least 3 years of relevant experience, focusing on standards like IATF 16949 and ISO 17025. The candidate should possess strong problem-solving skills and fluency in English and Turkish, with a proactive approach to resolving non-conformities and improving quality standards. #J-18808-Ljbffr

A non-profit social service agency in Akron is seeking a full-time Medical Billing Representative. This role entails intake admissions, resolving claim denials, and working with payers for reimbursements. Candidates must possess a High School diploma and at least 2 years of relevant experience, particularly in Medicare and Medicaid billing. Benefits include medical, dental, and vision coverage, as well as 32 paid days off per year. Apply to join a supportive team aiding individuals affected by addiction. #J-18808-Ljbffr

Professional Medical Coder II - Remote Position, Must Reside in South Carolina $5,000 Sign-on Bonus Coding Full Time AM Shift 8 a.m. to 5 p.m Sign-On Bonus: 5,000 Consistently named best hospital, Lexington Medical Center anchors an expansive health care network that includes nearly 600 physicians and advanced practice providers at nearly 80 locations across the Midlands of South Carolina, making it the region's third largest employer. From general medicine and orthopaedics to oncology, cardiology and neurosurgery, these dedicated professionals combine the highest quality care with advanced medicine and state-of-the-art technology to help patients achieve the best possible outcomes. Its postgraduate medical education programs include family medicine and transitional year residencies. Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from...

US Healthcare Medical Biller for Athena - WFH/Remote Job Location: Remote (Philippines-based) Employment Type: Full-time, Mid-level Are you an experienced Medical Biller with a strong command of the Athena platform? Do you thrive in a remote work environment and are looking for a role where your expertise directly impacts healthcare revenue cycles? Neolytix is looking for a dedicated Athena Medical Biller to join our growing team! At Neolytix, we specialize in comprehensive revenue cycle management, helping healthcare providers maximize reimbursements and maintain compliance. We pride ourselves on our commitment to efficiency, accuracy, and client satisfaction. If you're passionate about medical billing and ready to contribute to a dynamic, diverse team, we want to hear from you! What You'll Do: As an Athena Medical Biller, you will be a crucial part of our operations, ensuring seamless financial processes for our US healthcare clients. Your responsibilities will include:...