21 rn medical coder for benefit plans jobs found

DaMar Staffing in Minnesota is seeking an experienced Certified RN Medical Coder to support a full-time COC/SPD project, blending clinical expertise with coding accuracy to ensure compliant plan documentation. You will review coding selections, collaborate with peers and business analysts, and contribute your subject matter knowledge to reimbursement discussions while working remotely with a dispersed team. #J-18808-Ljbffr

DaMar Staffing in Minnesota is seeking an experienced Certified RN Medical Coder to support a full-time COC/SPD project, blending clinical expertise with coding accuracy to ensure compliant plan documentation. You will review coding selections, collaborate with peers and business analysts, and contribute your subject matter knowledge to reimbursement discussions while working remotely with a dispersed team. #J-18808-Ljbffr

DaMar Staffing in Minnesota is seeking an experienced Certified RN Medical Coder to support a full-time COC/SPD project, blending clinical expertise with coding accuracy to ensure compliant plan documentation. You will review coding selections, collaborate with peers and business analysts, and contribute your subject matter knowledge to reimbursement discussions while working remotely with a dispersed team. #J-18808-Ljbffr

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

Responsibilities Cedar Hill Regional Medical Center Cedar Hill Regional Medical Center GW Health is the first new full-service hospital in Washington, DC in more than 20 years, integrating clinical care with existing community providers, Federally Qualified Health Centers (FQHC’s), The George Washington University Hospital, and our Urgent Care Center in Ward 8. This integrated delivery system is a robust network of care for all District residents, but more importantly, it ensures that residents of Wards 7 and 8 have access to high quality care in their community. This full-service hospital includes 136 beds (with the ability to expand to 184 beds), a verified trauma center, adult and pediatric emergency departments, maternal health and newborn delivery, an ambulatory pavilion for clinic visits and other outpatient services, a 500-car garage, and a helipad for emergency transport. We are currently seeking a RN Clinical Supervisor - Medial Surgical (Full Time-Days) The RN...

Medical Compliance AuditorWe are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical necessity...

Nurse Coder Drg Auditor Iii This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Nurse Coder Drg Auditor Iii based in United States. This role serves as a subject matter expert in clinical coding, claims auditing, and payment integrity. You will independently audit inpatient and outpatient claims using coding and clinical guidelines alongside supporting medical documentation. The position combines clinical expertise with advanced coding validation, quality assurance, and appeal response responsibilities. You will evaluate diagnoses, procedures, sequencing, discharge statuses, and levels of care to identify accurate and compliant claim outcomes. The role also provides opportunities to influence coding standards, develop new concepts, and contribute to strategic recommendations. Strong collaboration with internal teams and, when needed, clients will be essential to communicating audit findings...

About Us As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive. House Supervisor – Maryview Medical Center Job Summary The Facility Nursing Supervisor is responsible for maintaining continuity of patient care in the absence of the unit nurse managers/directors in all areas of the hospital. Essential Functions Supervises and coordinates activities of hospital personnel to maintain the continuity of a safe and efficient standard of care. Makes patient care assignments according to staff ability and patient needs. Evaluates care given by others under his/her...

We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Think you've got what it takes? Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical necessity...

DEPT OF HEALTH SERVICES The Arizona Department of Health Services promotes and protects the health of Arizona’s children and adults. Our mission is to promote, protect, and improve the health and wellness of individuals and communities in Arizona. We strive to set the standard for personal and community health through direct care, science, public policy, and leadership. ADHS promotes alternative work schedules, flexible hours. We have positions that can fit any stage in your career, from entry to senior level. We offer a robust benefit package, including the ADHS Student Loan Assistance Program, where eligible employees can receive up to $300 per month for their outstanding student loans. Come check us out and see how you can make a difference in the lives of all Arizonans. Healthcare Compliance Officer Supervisor - Bureau of Medical Facilities Licensing Job Location: 150 N. 18th Ave Phoenix, AZ 85007 Posting Details: Salary: $77,000 Grade: 23 Job Summary: Make a lastingimpact on...

Overview Texas Oncology is looking for a Medical Assistant Supervisor to join our team! This position will support the Dallas Presbyterian location. This is a full-time Monday - Friday (hours 8:30am-5pm) position with no weekends, call, or major holidays. Texas Oncology is the largest community oncology provider in the country and has approximately 600+ providers in 220+ sites across Texas and southeastern Oklahoma. Our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology , we use leading-edge technology and research to deliver high-quality, high-touch, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." in their fight against cancer. Today, Texas Oncology treats half of all Texans...

Responsibilities Cedar Hill Regional Medical Center Cedar Hill Regional Medical Center GW Health is the first new full-service hospital in Washington, DC in more than 20 years, integrating clinical care with existing community providers, Federally Qualified Health Centers (FQHC’s), The George Washington University Hospital, and our Urgent Care Center in Ward 8. This integrated delivery system is a robust network of care for all District residents, but more importantly, it ensures that residents of Wards 7 and 8 have access to high quality care in their community. This full-service hospital includes 136 beds (with the ability to expand to 184 beds), a verified trauma center, adult and pediatric emergency departments, maternal health and newborn delivery, an ambulatory pavilion for clinic visits and other outpatient services, a 500-car garage, and a helipad for emergency transport. We are currently seeking a RN Clinical Supervisor - Medial Surgical (Full Time-Days) The RN...

RN, EducatorLocation: Laguna Hills, CAStatus: Full-timeShift: DaysPay Range*: $54.59-$85.70/hrSign-on Bonus: $10,000At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.Position SummaryThis position is responsible for providing education and training to obstetric nursing and unlicensed nursing staff. Additional responsibilities include: Creating educational curriculum, present orientation programs and evaluate orientees for new graduate/new to specialty programs, labor...

TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments and/or medical necessity for inpatient level of care. This role will apply coding and clinical principles based on industry standards and...

AMG Sykes Hematology/Oncology NurseFull timeBenefits Eligible: YesHours Per Week: 40Schedule Details/Additional Information: Monday-Friday On-siteMedical OncologyAdvocate Christ Medical CenterAdvocate South Suburban HospitalAdvocate Trinity HospitalSykes Outpatient CenterOrland Park Outpatient CenterPay Range: $41.10 - $61.65Major Responsibilities:Clinical Care and Health Outcomes - Provides support in the delivery of quality clinical care. Works closely with healthcare team and physician to assure triage, telephone assessments, home therapies and patient visits are consistent with established guidelines and followed by the healthcare team. Takes a lead role in assisting the clinical team to meet/exceed CI goals. Assists physicians and associates in managing patient registries.Patient Satisfaction and Operations - Collaborates with the manager/director and physician leadership to maintain an environment that is patient centered as evidenced by the availability of open access;...

Medical Compliance AuditorWe are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria.Think you've got what it takes?Job Duties & ResponsibilitiesAssess the treatment plan, clinical information, and medical necessity of all requested servicesUtilizes established criteria to appropriately review billed services within established timeframe required.Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate.Refers case...

Memorial Regional Medical Center Primary Function / General Purpose of Position Supervises the clinical and administrative functions of the Hospital through proven management skills during designated tour of duty. Provides leadership and direction to nursing staff, collaborates with physicians and other departments throughout the Hospital, and the community in problem solving and resolution. Combines clinical skills, and organizational and administrative abilities to provide quality patient care through innovation. Employment Qualifications Must be a graduate from an accredited school of nursing with a BSN preferred. Must be licensed and currently registered as a professional nurse in the State of Virginia. Should have 3-5 years recent clinical experience including work experience in a supervisory role. Must be CPR certified and be able to perform both adult and child CPR in any setting throughout the hospital. ACLS and PALS certifications (Can obtain during orientation)....

Job Description Job Summary The Clinical RN Auditor is responsible for ensuring clinical documentation meets regulatory standards and procedures. This role involves reviewing potential quality of care issues, understanding workflows, and establishing patient care plans to support technical and clinical requirements. The auditor works to improve clinical outcomes by monitoring documentation accuracy and consistency, reducing risk, evaluating data, and collaborating with the manager of clinical outcomes to provide expertise in coding classifications. Initial Onboarding Initial onboarding will take place at our offices in Colchester, VT. The position will then be a hybrid work arrangement with 1-2 days per week in our offices located in Colchester, VT. In-person meetings are also required at least quarterly. Qualifications / Job Requirements Education and Licensure Current unencumbered Vermont RN Licensure Homecare Coding Specialist- Diagnosis, or ability to obtain within one year...

RN Clinical Coder/Auditor - Hybrid Colchester, VT. Initial onboarding will take place at our offices in Colchester, VT. The position will then be a hybrid work arrangement with 1–2 days per week in our offices located in Colchester, VT. In-person meetings are also required at least quarterly. Job Summary The Clinical RN Auditor is responsible for ensuring clinical documentation meets regulatory standards and procedures. This role involves reviewing potential quality of care issues, understanding workflows, and establishing patient care plans to support technical and clinical requirements. The auditor works to improve clinical outcomes by monitoring documentation accuracy and consistency, reducing risk, evaluating data, and collaborating with the manager of clinical outcomes to provide expertise in coding classifications. Qualifications / Job Requirements Education and Licensure Current unencumbered Vermont RN Licensure Homecare Coding Specialist – Diagnosis, or ability to...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...