Creative coder jobs | Healthcare Careers

Full Time

Lyric Healthcare Remote

The Senior Medical Director serves as a pivotal clinical leader within Lyric, providing strategic oversight for the development, validation, and continuous improvement of pre-payment edits to ensure robust payment integrity. In this capacity, the Senior Medical Director partners with executive leadership, clinical teams, and external stakeholders, acting as a trusted advisor on complex clinical scenarios and claims outcomes. As the primary liaison between Lyric and its customers, this role represents the organization in industry forums and payer-provider collaborations, fostering strong relationships and advancing Lyric’s reputation as an industry leader. The Senior Medical Director is also responsible for remaining at the forefront of evolving healthcare trends, regulatory requirements, and advancements in medical practice, ensuring that Lyric’s strategies and solutions consistently reflect best practices and support organizational objectives. Role Responsibilities:...

Full Time

Clinical DRG Auditor – Remote

Gainwell Technologies Remote (USA)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

HS

Contract

Medical Policy Manager

Health System Innovations Remote

The Medical Policy Manager is responsible for overseeing all cap thresholds and medical review triggers, ensuring they are routed either for administrative evaluation by the vendor or referred to the state’s Utilization Management (UM) vendors for clinical review. Qualifications Certified Coding Specialist credential issued by the American Health Information Management Association (AHIMA) Minimum of five years’ experience creating and administering medical and/or Utilization Management (UM) policies for state Medicaid programs or Medicare Strong working knowledge of Centers for Medicare & Medicaid Services (CMS) procedure and diagnosis coding, including dental and Current Dental Terminology (CDT) codes Bachelor’s degree in a related discipline

Full Time Part Time

Fractional CoCM Billing Compliance & Audit Lead (CPMA required)

Mederva Health Remote

About the role We run a fast-growing care management program billed under partner clinic TINs across a mixed payer population. We need an expert to tighten CoCM billing yield while keeping documentation audit-proof as we scale from ~24 clinics to 100+. The right candidate will be able to convert this into a full-time role with equity, and grow with the company. Looking to hire ASAP. What you’ll own Design and audit CoCM and CCM billing workflows , including appropriate patient stratification between programs. Define clear, defensible criteria for assigning patients to CoCM vs CCM (and transitions over time). Build “gold standard” documentation templates and checklists for 99492/99493/99494, 99490, 99439 , and related codes as applicable. Design simple, audit-proof time capture and attribution workflows across care team members. Create and run a QA sampling plan with feedback loops for care teams and clinic billers. Partner with...

Full Time

Director, Reimbursement and Market Access

Magnolia Market Access Remote

About the Job The Director of Reimbursement and Market Access is responsible for assisting the Senior Vice President of Reimbursement and Market Access by collaborating with life sciences clients to provide analysis and insight related to coding, reimbursement, practice management, and policy. This individual will leverage internal data sources and professional experience to effectively support clients in developing and implementing reimbursement and market access strategies for their drugs, devices and other healthcare technologies. Duties and Responsibilities Develop and implement coding and reimbursement strategies for new and existing drugs, biologics, medical devices, digital technologies and diagnostic tests Lead client project engagements by serving as the direct point of contact for clients and coordinating with project teams Evaluate drugs and technologies to assess the potential applicability of coding options (HCPCS, CPT, ICD-10-PCS, and ICD-10-CM)...

Be

Full Time

Senior Consultant, Healthcare Compliance

Berrydunn Remote

Overview: BerryDunn is seeking a Senior Consultant to join our Healthcare Group as a member of the Healthcare Compliance Practice Area. You will join a core team tasked with assisting the firm’s clients with clinical documentation improvement, revenue integrity efforts, regulatory research, and general coding and billing compliance in a multitude of healthcare settings. This role involves complex audit reviews , provider education , and data-driven analysis to identify trends, mitigate risk, and optimize revenue integrity. This position is planned to sit remotely. The ideal candidate for this position will possess both a clinical and compliance background with experience coding/auditing a diverse array of professional services and specialties, including behavioral health. You Will: Perform comprehensive audits of facility and outpatient/professional claims for coding accuracy (i.e. CPT, HCPCS, ICD-10-CM/PCS, DRG, APC, and E/M levels) Review clinical...

Full Time

Rev Cycle Customer Success Manager - RCM

Flagler Health Remote

What You'll Be Doing As Flagler continues to grow, there is a unique opportunity to strengthen customer relationships and leverage deep revenue cycle expertise to help our provider partners maximize financial performance. This is where you come in - to design and own customer success processes with a specific focus on RCM operations for MSK practices. Note: this role is not responsible for direct claim submission or coding production, but requires the ability to diagnose revenue cycle issues and guide execution across billing vendors, clinical staff, and practice leadership. Work directly with the CEO, Head of Business Operations, and Head of Clinical Operations to own dozens of relationships with provider groups, ensuring customer satisfaction and retention. Serve as the primary point of contact and subject matter expert for all RCM-related questions, issues, and escalations from provider partners. Onboard new customers, ensuring fast, smooth...

UM

Full Time

INPATIENT CODING EDUCATION ANALYST

UW Medicine Remote

UW Medicine Enterprise Records and Health Information has an outstanding opportunity for an INPATIENT CODING EDUCATION ANALYSTS. WORK SCHEDULE 100% FTE Mondays - Fridays 100% Remote POSITION HIGHLIGHTS Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for. Serve as an expert in Inpatient coding, respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure. DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical...

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