53 jobs found in Raleigh

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

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...

A leading managed care organization in North Carolina is seeking an experienced Compliance Coordinator. The role involves monitoring and auditing internal departments for compliance, conducting quality audits, and ensuring timely documentation of compliance tasks. Ideal candidates will have relevant experience in behavioral health or substance abuse and must reside in North Carolina. This position offers a chance to contribute to essential compliance activities in a supportive environment. #J-18808-Ljbffr

DMV - Nurse Supervisor I - Medical Review page is loaded## DMV - Nurse Supervisor I - Medical Reviewlocations: Nash County, NCtime type: Full timeposted on: Posted Todaytime left to apply: End Date: February 13, 2026 (7 days left to apply)job requisition id: JR-108490**Agency**Dept of Transportation**Division**Division of Motor Vehicles**Job Classification Title**Nurse Supervisor I (NS)**Position Number**60030743**Grade**MH18It’s the mission of the NC Department of Transportation to connect people, products and places safely and efficiently with customer focus, accountability, and environmental sensitivity to enhance the economy and vitality of North Carolina. We encourage you to consider joining NCDOT where our work not only serves the citizens of North Carolina but has an impact on our world through all modes of transportation.**Description of Work**The primary purpose of this position is to review medical records, statements from attending physicians, driving records,...

A state transportation department in North Carolina is seeking a Nurse Supervisor I to review medical records and make recommendations on driving privileges. The supervisor will also train and manage nursing staff while ensuring compliance with health guidelines. The ideal candidate will be a licensed Registered Nurse in NC with at least two years of nursing experience and strong leadership skills. This full-time role offers a competitive salary range of $69,027 to $113,896. #J-18808-Ljbffr

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

Overview As a Certified Hospital Coder III, you will be part of the Corporate Coding team supporting patient care by driving accuracy and adherence to coding guidelines, governmental and private Third-Party rules, and regulations. What You’ll Do Review inpatient records to assign ICD-10-CM and PCS codes with precision, adhering to official coding guidelines and compliance regulations. Abstract and enter required data elements from coded medical records into the electronic medical record (EMR) system. Verify discharge dispositions, dates of service, and admission status for accuracy; process corrections as needed. Ensure medical necessity by coding all documented disease processes; maintain accuracy standards set by Corporate Compliance. Conduct research on unfamiliar procedures and complex cases using authoritative resources such as AHA Coding Clinic, CPT Assistant, and The Merck Manual. Communicate with physicians for documentation clarification using approved procedures;...

Medical Biller We are seeking a skilled Medical Biller to join our client's healthcare team. The ideal candidate will be responsible for accurately and efficiently processing medical claims and invoices, ensuring timely reimbursement from insurance companies and patients. The Medical Biller will work closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and ensure compliance with regulatory requirements.

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. (60%) 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...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Health Information Coding Specialist Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient...

About Otsuka We defy limitation, so that others can too. In going above and beyond-under any circumstances-for patients, families, providers, and for each other. It's this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. About the Role The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka's opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for an Omnichannel Data Scientist , Medical Omnichannel with strong expertise in artificial intelligence, encompassing...

Outpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role...

Certified Professional Coder, Independent Contractor Join to apply for the Certified Professional Coder, Independent Contractor role at Constellation Quality Health Constellation Quality Health is a non‑profit health care quality consultancy headquartered in the North Carolina Research Triangle. We offer a range of quality improvement, clinical review, audit, technical and consulting services to improve care delivery, system performance and patient outcomes. What You’ll Do Perform coding reviews in a manner consistent with contract requirements for timeliness and accuracy. Review and compare provider service documentation to billed claims to determine compliance with clinical policies and state and federal regulations. Qualifications Associate or bachelor’s degree in a human services field or five (5) years of related experience may substitute for degree. Certified Professional Coder (CPC) certification with at least two (2) years’ experience in DRG coding in an inpatient...

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...

A leading health data platform company is seeking experienced outpatient coders to join their remote team in North Carolina. Ideal candidates will have AHIMA or AAPC certifications and at least 2 years of coding experience. The role involves reviewing medical records, ensuring coding accuracy, and maintaining productivity standards while providing exceptional customer service. The company offers competitive benefits, including medical coverage, paid time off, and professional development support, with a flexible working schedule. #J-18808-Ljbffr

Join Datavant, the leader in health data exchange, and contribute to a mission where every healthcare decision is driven by accurate data. Our extensive platform connects the healthcare ecosystem, providing secure and accessible data that enhances health decisions. We are proud to work with top life sciences companies, government entities, and healthcare providers. As a part of our high-performing, values-focused team, you will help tackle complex healthcare challenges with innovative, technology-driven solutions. At Datavant, we value diverse experiences and backgrounds, and we’re seeking experienced and credentialed outpatient coders like you! This fully remote position offers a flexible schedule, allowing you to make a difference in healthcare from the comfort of your own home. Role Overview: Review medical records to accurately code diagnoses and procedures. Sequence codes based on medical record documentation. Assign appropriate discharge dispositions. Abstract...

A healthcare staffing agency in Raleigh is looking for an Entry-Level Medical Coder to join their administrative team. This role offers a great entry point into the healthcare field, focusing on accurately coding medical procedures for billing and insurance claims. Ideal candidates will have a high school diploma, strong communication skills, and a commitment to confidentiality. The position allows for hybrid work after training and provides a supportive, team-oriented environment with opportunities for advancement in a growing organization. #J-18808-Ljbffr

Overview Brunswick County Emergency Medical Services (EMS) is looking for a Logistics Supervisor to join our team! Responsibilities Overseeing proper storage of equipment and supplies at EMS warehouse. Tracking and ordering medical supplies and equipment. Managing logistics personnel, ensuring daily goals are being met to support EMS operations. Planning for current and future anticipated needs of EMS service (i.e., identifying improvement opportunities, developing and implementing operating procedures, overseeing maintenance and repairs of equipment and vehicles, etc.). Qualifications High school diploma (or equivalent) AND three (3) to five (5) years’ progressively responsible experience in Emergency Medical Care and/or logistics management, OR any equivalent combination of training and experience which provides the required knowledge, skills, and abilities. Bachelor’s degree is highly preferred. Physical Requirements Must be physically able to operate a variety of automated...

A leading healthcare provider in North Carolina is seeking a Senior Administrator / Clinical Coder. This role involves ensuring accurate clinical coding and timely data completion. The ideal candidate will have excellent knowledge of SystmOne and medical terminology, alongside strong attention to detail. Expectations include compliance with coding policies and assisting in staff training. Opportunities include access to NHS Pension, flexible work options, and comprehensive annual leave benefits. #J-18808-Ljbffr

Senior Administrator / Clinical Coder - HMP Durham To enable, promote and support the effective use of data through clinical coding, information, knowledge and technology to support and improve health and health care delivery. Main duties of the job To ensure accurate and timely completion of coded clinical data on the clinical information system.To assist in assuring that regular audits are undertaken to ensure that coding policies and procedures are being followed resolving issues as they are identified.To assist in ensuring there are comprehensive and effective procedures in place for the consistent provision of quality clinical information.To assist with ensuring all clinical staff are aware of their responsibilities and to assist with any training as appropriate.In line with the GDPR assist clinicians when subject access requests are made.Work with all clinical staff across the sites in developing and promoting both the clinical coding service and the access to SystmOne...

Raleigh, United States | Posted on 01/21/2026 We are seeking a motivated Entry-Level Medical Coder to join the administrative team. This position offers a great pathway into the healthcare field for individuals interested in medical billing and coding. Hybrid work is possible after the training period. Key Responsibilities Code medical procedures accurately for billing and insurance claims. Prepare financial reports and submit claims to insurance companies or patients. Enter and maintain patient data in administrative and billing systems. Track outstanding claims and follow up on unpaid accounts. Communicate with patients to discuss balances and develop payment plans. Maintain confidentiality and comply with HIPAA and all healthcare regulations. Qualifications High school diploma or equivalent required; healthcare coursework a plus. MediClear or equivalent HIPAA compliance credential required. Strong communication, organization, and time-management skills. Ability to remain...

This position is a hybrid role. Must live out of Atlanta, GA, Raleigh, NC, Charlotte, NC, or Dallas, TX and is comfortable with 80% travel.  The Self-Storage Property Compliance Auditor is responsible for upholding 10 Federal Self Storage’s operational, compliance, and brand standards across all properties. This field-based role serves as the eyes and ears of the Operations Department—conducting detailed site audits, identifying opportunities for improvement, and ensuring every facility reflects 10 Federal’s commitment to excellence. The auditor evaluates property conditions, verifies operational accuracy, and partners with Operations leadership to ensure consistency in cleanliness, functionality, and compliance. While not a direct supervisor, this position provides leadership through influence—coaching on-site staff and vendors to maintain company standards. Frequent travel is required. The Field Auditor will routinely visit properties across multiple states and may have...