• Medical Coder

    Robert Half Office Team (Waukesha, WI)
    Description We are seeking a Medical Coder in Waukesha, Wisconsin. This role will involve determining appropriate assignment of various codes for services ... provided in different healthcare settings, evaluating medical records, conducting quality assurance audits, and providing training to new providers. This position is… more
    Robert Half Office Team (12/14/24)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Racine, WI)
    …and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case Manager ... knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal… more
    Molina Healthcare (01/21/25)
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  • DRG Coding Auditor

    Elevance Health (Waukesha, WI)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG Coding Auditor** is responsible for auditing ... inpatient medical records and generating high quality recoverable claims for...Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with… more
    Elevance Health (01/11/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Waukesha, WI)
    …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
    Elevance Health (01/01/25)
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  • Investigator, Coding SIU (Remote)

    Molina Healthcare (Racine, WI)
    …for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and ... medical records to document relevant findings of a post...registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's degree… more
    Molina Healthcare (12/15/24)
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  • Nurse and CPC - Clinical Fraud Investigator II…

    Elevance Health (Waukesha, WI)
    …prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as necessary to ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more
    Elevance Health (12/31/24)
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