Certified professional coder jobs in Dallas, TexasCrear alertas

Job Description 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 HCC Coding Team Leads to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! What you will do: • Coding Team Lead is responsible for supporting the Coding Supervisors in monitoring coders in quality and efficiency, serving as a resource and facilitator while assisting in monitoring quality and production of the coding team., • Reviews rebuttals submitted by coders. Provides education to the coder if the error is correct or sends the rebuttal through the process if they agree the coder's initial coding was correct., • Answers coding questions for assigned coders; trending the questions to identify opportunities for additional training. Collaborate with the Client Team and Training Team., • Tracks audits completed per coder to ensure coders are receiving timely feedback. Assists with auditing when the coder has not received recent feedback., • Support new hires released to the production team by being their coder-buddy., • Conducts one on one with coders focused on quality improvement., • Assists in tracking coder KPI and quality metrics on a daily, weekly, and monthly basis., • Coaches employees who are not meeting the expectations including recommending performance improvement initiatives as needed., • Collaborates with the Quality Department to ensure 95% accuracy expectation is met., • Report trends for education opportunities in both quality and productivity to management for review and/or action., • Assists in coding to meet the monthly production goals while maintaining quality at 95% or higher., • AHIMA certified credentials (CCS, CCS-P) or AAPC certified credentials (CPC, CPC-H, COC, CIC, CRC), • Extensive knowledge of ICD -10, • 2 years' HCC coding experience, • 1+ years' Team Lead experience a plus, • A strong knowledge base of medical terminology, medical abbreviations, pharmacology and disease processes, • Ability to work in a fast-paced production environment while maintaining high quality, • Must be able to follow instructions, meet deadlines and work independently, • Ability to be flexible in work environment, • Excellent written and verbal communication skills, ability to work in a remote environment and time management skills, • You have current Team Lead experience, • Full Benefits including a 401k Savings Plan, • Access to 20-24 free CEUs per year, provided by Datavant, to support your continuous professional development, • Compensation for AAPC/AHIMA dues, • Company-provided equipment including computer, monitor, mouse, etc, • Comprehensive training led by a credentialed professional coding manager This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Description • Assign CPT, ICD-10, and HCPCS codes for anesthesiology procedures., • Analyze medical records for accurate code assignment., • Apply appropriate modifiers for precise coding., • Generate and submit claims promptly., • Verify patient insurance information and resolve discrepancies., • Address denied claims, process appeals as needed., • Collaborate with providers for clear documentation., • Stay updated on coding regulations and compliance requirements., • Liaise with insurance companies and patients for billing inquiries., • Provide coding guidance to team members. Additional Skills & Qualifications Additional Skills & Qualifications • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) desired., • 3-5 years of anesthesiology coding and billing experience preferred, • Proficient in coding and billing claims software., • Thorough understanding of compliance and regulatory requirements. Experience Level Intermediate Level Job Type & Location This is a Permanent position based out of Addison, TX. Pay and Benefits The pay range for this position is $60000.00 - $75000.00/yr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Addison,TX. Application Deadline This position is anticipated to close on Feb 17, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Job DescriptionJob Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records to determine accurate required abstracting elements (facility/client/payer-specific elements) including appropriate discharge disposition · IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition. · Coding: Uses discretion and specialized coding training and experience to accurately assign ICD-10, CPT-4 codes to patient medical records. · Abstracting: Reviews medical records to determine accurate required abstracting elements (client specific elements) including appropriate discharge disposition. · Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by SOW. · Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Attends mandatory coding seminars on an annual basis (IPPS and OPPS, ICD-10-CM, and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls · Create audit schedules and manage workflows to adhere to the audit schedule. · Develop methods to effectively communicate information through presentations, graphs, reports, educational materials, etc. · Develop, establish, and review policies and objectives consistent with those of the organization to ensure efficient departmental operations. · Performs charge audits by comparing itemized bills to medical record documentation to ensure appropriate charging. · Review, assess, study, and analyze the overall coding, billing, documentation, and reimbursement system for potential compliance problems. · Performs all other duties as assigned. Qualifications & Experience: · Ability to consistently code at 95% accuracy and quality while maintaining client-specified production standards · Must successfully pass a coding test · Knowledge of medical terminology, ICD-9-CM and CPT-4 codes · Must be detail-oriented and can work independently · Computer knowledge of MS Office · Must display excellent interpersonal skills · The coder should demonstrate initiative and discipline in time management and assignment completion · The coder must be able to work in a virtual setting under minimal supervision · Intermediate knowledge of disease pathophysiology and drug utilization · Intermediate knowledge of MS-DRG classification and reimbursement structures · Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures EDUCATION / EXPERIENCE · Associate degree in a relevant field preferred or a combination of the equivalent of education and experience · Three years of coding experience including hospital and consulting background CERTIFICATES, LICENSES, REGISTRATIONS · AHIMA Credentials, and or AAPC · Certified Professional Medical Auditor by AAPC PHYSICAL DEMANDS · Requires visual acuity to inspect and analyze work close to the eyes and ability to hear sound with or without correction; Ability to climb, stoop, kneel, reach, stand, walk pull, push lift, and able to exert up to 40 pounds of force occasionally and/or up to 10 pounds of force constantly to move objects. · Moderate physical activity performing somewhat strenuous daily activities of a primarily administrative nature. · The physical demands for this position include adequate vision, hearing, and repetitive motion. · Ascending or descending stairs, ramps, and the like, using feet and legs and/or hands and arms. · Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner - Bending legs downward and forward by bending leg and spine - Standing, particularly for sustained periods of time. Using upper extremities to exert force to draw, drag, haul or tug objects in a sustained motion. · Raising objects from a lower to a higher position or moving object horizontally from position to position WORK CONDITIONS • While performing the duties of this job, the employee is frequently required to stand, walk, sit, reach with hands and arms, and talk or hear., • The employee is occasionally required to stoop, kneel, crouch, or crawl and taste or smell., • The employee is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures, transcribing, and viewing a computer terminal. Powered by JazzHR gVCkZcc1h2

Job DescriptionDescription: Work Where You Matter! At Lifecare Home Health Family we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Compliance Specialist (Clinical) Position Overview The Compliance Specialist is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that Lifecare Home Health Family complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Specialist will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls. Essential Functions and Skills Responsibilities • Governmental Additional Documentation Requests (ADRs), • Responds timely and accurately to governmental audits for hospice and homecare, • Prepares and tracks appeals processes, • Compliance Audit Program Development and Execution, • Assist with the development and implementation of a comprehensive compliance audit program tailored to meet the requirements of CMS, Medicaid, Medicare, Medicare Advantage plans, other government payors, private insurers, the Office of Inspector General (OIG) and the Department of Justice (DOJ)., • Develop audit frameworks, methodologies and policies that align with regulatory requirements and best practices within healthcare., • Ensure audits are thoroughly documented and findings are reported with corrective action recommendations., • Assist with the establishment of a continuous monitoring system for compliance risks and policy effectiveness., • Risk Assessment, Audits and Internal Controls, • Assist with enterprise-wide risk assessments to identify gaps with federal and state laws and regulations and internal policies., • Conduct risk-based audits to assess the effectiveness of internal controls and adherence to internal policies., • Develop risk mitigation strategies and ensure corrective action plans are implemented., • Collaborate with departments such as Legal, Human Resources, Finance, IT, Quality, Billing and Coding to enhance internal controls and address and remediate compliance risks., • Provide guidance to operational teams on improving processes to ensure compliance with federal and state laws and regulations and internal policies., • Monitor emerging regulatory trends and enforcement actions to proactively address potential risks., • Policy Development and Training, • Draft and update audit related policies, procedures and guidelines., • Provide guidance on internal controls, regulatory requirements and audit best practices., • Develop and deliver compliance audit training and education to employees on regulatory requirements, compliance best practices and audit procedures., • Investigations and Corrective Actions, • Oversee internal investigations related to risk assessment and/or audit findings, conducting root cause analysis to identify trends or patterns of non-compliance., • Develop corrective action plans (CAPs) and track their implementation., • Ensure confidentiality and integrity in all investigations and reporting., • Work closely with Legal, Human Resources and Risk Management teams to conduct investigations and recommend disciplinary action, as applicable., • Regulatory Compliance and Reporting, • Ensure compliance with relevant federal and state regulations including, but not limited to, HIPAA, Stark Law, Anti-Kickback Statute, OIG Guidelines, CMS, OSHA and DOJ., • Oversee regulatory reporting requirements and respond to inquiries from auditors, regulators and enforcement agencies, collaborating with Lifecare Home Health Family leadership and General Counsel., • Prepare audit reports, present findings and recommended corrective actions to executive leadership, the Compliance Committee and the board of directors., • Leadership and Collaboration, • Serve as a trusted advisor to the Chief Compliance Officer, executive team and leadership., • Foster a culture of compliant and ethical behavior across the organization., • Collaborate with key stakeholders., • Support external auditors and regulatory agencies during compliance reviews and investigations. Requirements: Qualifications Requirements/Qualifications • Extensive knowledge of hospice Local Coverage Determinations (LCDs), • 2+ years of compliance auditing, internal audit or regulatory compliance experience., • Extensive knowledge of audit methodologies, internal controls and risk assessments., • Strong understanding of healthcare fraud, waste, and abuse prevention, coding compliance, and billing practices within the context of hospice care., • Experience in healthcare, finance, billing, coding, compliance and government regulations., • Ability to build relationships with internal and external stakeholders, including leadership, clinical teams, providers, payers, and regulatory bodies., • At least one of the preferred certifications or the ability to obtain certification within 1 year of employment is required., • Additional certifications in healthcare compliance, law, privacy, data security, or information management are a plus., • Experience working collaboratively with regulatory agencies, auditors, and healthcare providers to ensure compliance with hospice requirements., • Strong analytical and problem-solving skills, with the ability to identify compliance risks, assess organizational performance, and develop actionable solutions., • Ability to pass DHS background study. Preferred • Associate’s degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field., • Excellent verbal and written communication skills with the ability to clearly communicate complex compliance issues to senior executives and staff members at all levels., • Preferred Certifications: o Certified in Healthcare Compliance (CHC) o Certified Internal Specialist(CIA) o Certified Billing and Coding Specialist (CBCS) o Certified Professional Coder (CPC) o Certified Professional Medical Specialist(CPMA) o Certified Compliance and Ethics Professional (CCEP) Physical Requirements The physical requirements described are representative of those that must be met to successfully perform the essential responsibilities of this position. Reasonable accommodation may be made. • Prolonged periods sitting at a desk and working on a computer., • Pushing/Pulling and Lifting/carrying up to 10 pounds.

Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts., • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards., • Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits., • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process., • Support in the identification of document improvement opportunities for provider education in both MA and ACA line of business., • Identify process improvements to enhance medical encounter review efficiency., • Compliance with all applicable laws and regulations, • Bachelor's degree in a relevant field of study or commensurate work experience., • Certified professional coder (CPC), • Certified Risk Adjustment Coder (CRC) or similar certification At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description We are hiring for an Endovascular clinic in need of an experienced Certified Medical Biller & Coder. Experience in Endovascular and outpatient surgery, preferred. Duties include the following: • Perform audits of clinical documentation, physician billing and applicable industry standard billing codes by analyzing medical records, coding records and health system bills. Validate clinical documentation in conjunction with the bill; assess the level and accuracy of coding, determine that governmental and third party payer regulations are being complied with; and evaluate appropriateness of billing and coding procedures., • Prepare reports and provide individual and/or group education to physicians and others based on results of audit., • Must have at least 2 years of recent experience, • Endovascular billing is highly preferred, • Current certification as a Medical Biller & Coder, • Cleared background, • • CPT code 37221: Endovascular revascularization • CPT codes 34701, 34702, 34703, 34704, 34705, 34706, 34707, or 34708: Repair of an abdominal aortic/iliac artery aneurysm (with or without rupture) with an endovascular prosthesis, • CPT code 34717 and 34718: Endovascular repair of the iliac artery using an iliac branched endograft Job Type: Full-time Company DescriptionMedicalWorx Staffing is committed to making sure the performance of our employees meets or exceeds your productivity expectations. MedicalWorx wants to have a measurable impact on your culture and increase our value to your company. We can provide talented, qualified employees for temporary, contract to hire or direct hire positions or payroll services.MedicalWorx Staffing is committed to making sure the performance of our employees meets or exceeds your productivity expectations. MedicalWorx wants to have a measurable impact on your culture and increase our value to your company. We can provide talented, qualified employees for temporary, contract to hire or direct hire positions or payroll services.

Job Description Integrative Emergency Services, LLC (“IES”) is seeking a Director of Revenue Cycle - Specialty Services who will be responsible for the general supervision and management of the billing and revenue cycle functions for physician practices supporting complex specialty service lines. This role is responsible for the strategic oversight and operational management of specialty services revenue cycle operations, including but not limited to Surgical and Critical Care. This role serves as a subject-matter expert in specialty services revenue cycle operations, partnering closely with service line leadership and physicians to optimize reimbursement, ensure compliance, and support scalable revenue growth across specialty divisions. ESSENTIAL DUTIES AND RESPONSIBILITIES The responsibilities listed here represent the majority of the role but are not all-inclusive; other duties may be assigned. • Develop and implement the strategic vision and goals for the service lines with division leadership aligning with the overall organizational mission., • Collaborate with executive leadership to define priorities and drive initiatives that enhance the quality of client management and practice support., • Partner with service line leaders to scope and onboard new business within specialty services, including assessing systems and applications, tracking and communications, and operational outcomes specific to specialty workflows and reimbursement models., • Oversee and manage the performance and development of all RCM processes related to specialty service lines, including but not limited to change capture, coding, billing, collections, denials, and appeals., • Serve as a liaison between specialty services and other departments, fostering collaboration and communication across the organization to support specialty-specific revenue cycle needs., • Plan, develop, organize, implement, direct and evaluate systems, processes and payor specific reimbursement mechanisms and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement., • Engage with physicians and other stakeholders to gather feedback and address concerns related to specialty services’ revenue cycle performance, documentation, and reimbursement outcomes., • Oversee coding auditing and education related to specialty-specific documentation, coding accuracy, and compliance requirements., • Reviews, analyzes and interprets financial data to monitor progress towards established goals, identifies deterrents to success and implements improvements as necessary to enhance efficiencies and results within specialty service lines., • Provides direction and coordination for the development and implementation of performance and quality improvement processes for the specialty services physician revenue cycle., • Oversees resolution of escalated issues with third party payors specific to specialty services, including underpayments, appeals, and contractual discrepancies., • Stays current on payor regulations including managed care, Medicare, Medicaid, and other payor regulations that impact billing activities for specialty and procedure-based services., • Manage revenue cycle operational team members assigned to specialty service line portfolios, ensuring expertise aligned to specialty complexity. SUPERVISORY RESPONSIBILITIES This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. QUALIFICATIONS Knowledge, Skills, Abilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. • In-depth understanding of revenue cycle operations across specialty services, including patient access, billing, collections, and compliance, • Strong knowledge of healthcare regulations, payer requirements, reimbursement methodologies, and industry best practices., • Expertise in financial reporting, budgeting, and performance metrics related to revenue cycle management., • Exceptional leadership and strategic planning skills to drive operational efficiency and revenue optimization., • Advanced analytical and problem-solving skills with the ability to interpret complex data and develop actionable insights., • Superior communication and presentation skills for engaging executive leadership, physicians, and cross-functional teams., • Proficiency in revenue cycle technology platforms, EHR systems, and data analytics tools., • Ability to develop and implement long-term strategies that align with organizational goals and regulatory requirements., • Ability to lead large teams, foster collaboration, and manage change in a dynamic healthcare environment., • Ability to influence stakeholders and negotiate effectively to achieve financial and operational objectives. Required: • 1-2 years leadership experience and/or operations management experience, • Minimum five (5) years of Hospital or Physician Practice Revenue Cycle management required., • Bachelor’s degree in Business Administration, Accounting, Healthcare Administration, Finance, or related field., • Minimum of 10 years of experience in professional services and hospital coding, billing and collecting., • Strong knowledge of various EMR systems including but not limited to: EPIC, eClinicalWorks (eCW), MedHost, Cerner, and Allscripts., • Certification in one of the following: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Clinical Documentation Specialist (CCDS), and/or Certified Professional Medical Auditor (CPMA)., • Advanced computer skills required, • Strong knowledge of health plan requirements, • MBA, Master's degree in Health Systems Management, or related field, • Prior experience with revenue cycle vendor management, • Prior experience with Surgical & ICU service line billing, • Proficient understanding of data mining, statistical predictive modeling and financial modeling practices. PHYSICAL DEMANDS: • Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus, • While performing the duties of this job, the employee is regularly required to talk and hear, • Frequently required to stand, walk, sit, use hands to feel, and reach with hands and arms., • Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to: remaining seated for periods of time to perform computer based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.), • Occasionally lift and/or move up to 20-25 pounds, • Fine hand manipulation (keyboarding) WORK ENVIRONMENT: • Office environment, Hybrid schedule after initial training period, • 4835 Lyndon B Johnson Fwy, Dallas, TX 75244, • Tuesday-Thursday in office 8am-5pm, • Monday/Friday remote, • May visit hospital locations and vendors, • Up to 10% travel may be required including overnight stays based on business needs ADA & Reasonable Accommodation Statement: IES is committed to providing equal employment opportunities to qualified individuals with disabilities. In accordance with the Americans with Disabilities Act (ADA), reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. If you require accommodation during the application or employment process, please contact . The company is committed to creating a diverse, inclusive, and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age, race, religion, nationality, sexual orientation, gender identity or expression, disability, or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds, experiences, and abilities and believe that the unique experiences of our team drive our success. Powered by JazzHR 7uRzW1swCl

Job Description The Bill Review Manager is responsible for the overall operation of a designated bill review office. The Manager participates in formulating and administering company best practices as well as developing long-range goals and objectives, analyzing costs, activities and operations, supporting the goals of Bill Review department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Responsible for financial operations, including, but not limited to: productivity, profitability, expenses, budgeting, billing and collections, • Responsible for implementing new business development, including marketing and sales activities, • Responsible for directing a team of employees in their day-to-day operations ensuring productivity and quality goals are met in accordance with company expectations, • Responsible for quality provider, claims, and client interaction, • Responsible for human resources matters, • Must be able to travel overnight and attend meetings, • Requires regular and consistent attendance, • Visit CorVel customers and participate in training sessions with management, • Represents the company in a professional manner to both internal and external customers and clients, • Directs the performance and development of the employees in their department. Assures peak performance of the team through continued training and coaching, coupled with regular performance evaluations, • Ensures staff compliance with Workers’ Compensation laws and ensures mandated regulatory reporting requirements, • Utilizes Jurisdictional Expertise and knowledge of regulatory rules, statutes and procedures governing the jurisdictions assigned to ensure compliance Acts as subject matter expert for appropriate jurisdictions, • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses, • May be required to visit customers and participate in training sessions with management, • Monitors operational workflow and manages appropriate/adequate staffing levels and staff retention strategies, • Develops and oversees the implementation of common bill review practices and procedures, • Promotes operational efficiency and quality by continuously improving processes, people and systems to enhance efficiency, consistency and quality, • Ensures consistent and complete compliance with CorVel’s policies and procedures, • Comply with all safety rules and regulations during work hours in conjunction with the Injury Illness Prevention Program (IIPP), • Additional projects and duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to assist team members to develop knowledge and understanding of bill review practice, • Effective quantitative, analytical and interpretive skills, • Technical knowledge of laws, policies, and procedures in defined territory, • Strong leadership, management and motivational skills, • Ability to travel overnight and attend meetings if required, • Ability to remain poised in stressful situations and communicate diplomatically via telephone, computer, fax, correspondence, etc., • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to work both independently and within a team environment, • Knowledge of processing bills on multiple lines of business, • Knowledge of medical terminology, medical billing codes, applicable state fee schedules and/or U&C charge processing, • Contract interpretation, • Ability to be a liaison between multiple departments within the company EDUCATION & EXPERIENCE: • Bachelor's degree, national certification or a combination of education and related experience, • Minimum of 2 years’ experience medical billing and supervisory/management experience, • Certified Professional Coder (CPC) designation preferred, • Licenses as required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 – $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Job Description Senior Medical Coder – Pulmonology, Cardiology, or Sleep Specialty preferred Location:Texas, USA Compensation & Schedule • $35.75/hr – Non-Certified Coder, • $42/hr – Pulmonology, Cardiology, or Sleep Specialty Certified Coder, • Monday–Friday | 8:00 AM–5:00 PM | 8-hour shifts, • Temp-to-perm opportunity The Specialty Coder Sr ensures accurate, compliant coding for high-dollar and specialty inpatient and outpatient accounts. This role directly supports revenue integrity by maintaining high coding accuracy, reducing denials, and ensuring timely reimbursement. Success is measured by achieving 95%+ coding accuracy, strong collaboration with HIM and Clinical Documentation teams, and adherence to national coding guidelines. KEY RESPONSIBILITIES • Assign accurate ICD-10-CM (diagnosis), ICD-10-PCS (inpatient procedures), and CPT (Current Procedural Terminology) codes for inpatient and outpatient services, • Review clinical documentation, physician notes, and diagnostic results to maintain a 95% or higher coding accuracy rate, • Abstract coded data into electronic medical record (EMR/EHR) systems accurately and timely, • Validate patient dispositions and ensure physician documentation supports billed services, • Follow Official ICD-10-CM, ICD-10-PCS, and AMA CPT coding guidelines to ensure compliance, • Collaborate with Health Information Management (HIM) and Clinical Documentation Improvement (CDI) teams to reduce denials and support accurate billing, • Active Certified Professional Coder (CPC) or (AHIMA) credential required (verification required upon submission), • 2+ years physician (Profee) coding experience, • Specialty coding experience in: Pulmonology, Cardiology, or Sleep preferred, • Demonstrated proficiency in ICD-10-CM, ICD-10-PCS, and CPT coding for specialty and high-dollar cases, • Strong attention to detail, analytical skills, and ability to work independently in a remote environment, • Must have personal laptop and dual monitors available, • Stable employment history (minimum 1 year tenure per role), • Epic or Cerner EMR, • EncoderPro or 3M 360 Encompass, • Microsoft Excel and Outlook, • Specialty coding experience in Pulmonology, Cardiology, or Sleep Medicine, • Strong knowledge of physician documentation review and denial prevention strategies, • In-person interview, • Background check (criminal, education, and employment verification), • Drug screen #IRVING123 Company DescriptionCornerStone Staffing has been servicing the Dallas-Fort Worth metroplex since 1991. We are committed to supporting our community through our core values of compassion, integrity, self discipline, and faith. CornerStone currently has 11 offices across the Metroplex to serve your needs. If you are a job seeker looking for short-term supplemental income or a full-time position that will launch a new career, we can assist you in finding the right opportunity!CornerStone Staffing has been servicing the Dallas-Fort Worth metroplex since 1991. We are committed to supporting our community through our core values of compassion, integrity, self discipline, and faith.\r\n\r\nCornerStone currently has 11 offices across the Metroplex to serve your needs. If you are a job seeker looking for short-term supplemental income or a full-time position that will launch a new career, we can assist you in finding the right opportunity!

Job Description We are hiring a part-time Medical Coder to to assign procedure,diagnosis codes for insurance billing, review claims data, research and corresponds with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. . Duties include but are not limited to: • Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing., • Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission., • Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims, • Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10., • Answer coding questions, • Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes, • Performs related duties, as requested., • Education: Certificate or associate's degree in medical coding/CPC. These additional certifications are not required but a plus: Certified Professional Coder (CPC), CPC-Hospital, CPC-Payer, Certified Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Professional Medical Auditor (CPMA), • Experience: A minimum of 1 year coding experience required preferably with psychiatric services, • Knowledge, Skills & Abilities:, • Knowledge of medical terminology; basic and advanced ICD-9-CM coding; anatomy and physiology; computer data entry; and medical law, privacy and ethics., • Knowledge of CMS rules and regulations and current coding resources, • Knowledge of Healthcare Common Procedure Coding Systems (HCPCS), Current Procedural Terminology (CPT) coding and healthcare reimbursement methods., • Critical thinking skills and ability to resolve complex coding issues, • Knowledge of mathematical computations using addition, subtraction, multiplication, division, percentages in order to perform personnel/payroll assignment. Ability to integrate multiple facts, statistics, and/or mathematical values when solving mathematical equations., • Ability to accurately enter data, prepare and maintain records, files, and reports., • Outstanding skills in giving attention to details with display of dexterity in maintaining confidentiality, • Must have advanced PC skills that include a combination of working in a Windows Operating System and Microsoft Outlook, Word and Excel as well as ability to use financial software and payroll systems (Kronos a plus)., • Communicate effectively with a variety of individuals and function calmly in situations, which require a high degree of sensitivity, tact, and diplomacy., • Ability to exercise appropriate judgment in answering questions and releasing information; analyze and project consequences of decisions and/or recommendations., • Skill to research and analyze various personnel/payroll matters to recommend alternative actions and/or take an appropriate course of action., • Skill to independently interpret reference materials to comply with law, rules, regulations, policies, procedures, etc., • Ability to apply time management practices to prioritize, schedule and complete work effectively to comply with mandated policies and deadlines., • Ability to work on multiple tasks or parts of tasks simultaneously to ensure timely completion of work activities., • Screening: Must successfully pass background check, drug screen, physical and be able to provide positive employment references. If you are among the most competitive and qualified candidates for the job, you will be contacted directly by one of our hiring managers. Due to the high volume of applications we receive, we are unable to respond to individual inquiries regarding your application status. Good Luck & we hope to meet you soon! Dallas Behavioral Healthcare Hospital is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status. Benefits Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.

Job DescriptionDescription: Join Life Care Home Health Family! Serving Texas, Florida, Nevada, and Georgia, we provide skilled nursing, therapy, homecare, hospice, palliative care, and private duty services. Why Work With Us? • Nestmed AI Scribe: Less charting, more caring!, • Competitive pay, 401k, health & life insurance, • Flexible schedules & career growth opportunities, • Continuing education & recognition programs Work Where You Matter! At Lifecare Home Health Family we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Position Overview The Compliance Specialist is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that Lifecare Home Health Family complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Specialist will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls. Essential Functions and Skills Responsibilities • Governmental Additional Documentation Requests (ADRs), • Responses timely and accurately to governmental audits for hospice and homecare, • Prepares and tracks appeals processes, • Compliance Audit Program Development and Execution, • Assist with the development and implementation of a comprehensive compliance audit program tailored to meet the requirements of CMS, Medicaid, Medicare, Medicare Advantage plans, other government payors, private insurers, the Office of Inspector General (OIG) and the Department of Justice (DOJ)., • Develop audit frameworks, methodologies and policies that align with regulatory requirements and best practices within healthcare., • Ensure audits are thoroughly documented and findings are reported with corrective action recommendations., • Assist with the establishment of a continuous monitoring system for compliance risks and policy effectiveness., • Risk Assessment, Audits and Internal Controls, • Assist with enterprise-wide risk assessments to identify gaps with federal and state laws and regulations and internal policies., • Conduct risk-based audits to assess the effectiveness of internal controls and adherence to internal policies., • Develop risk mitigation strategies and ensure corrective action plans are implemented., • Collaborate with departments such as Legal, Human Resources, Finance, IT, Quality, Billing and Coding to enhance internal controls and address and remediate compliance risks., • Provide guidance to operational teams on improving processes to ensure compliance with federal and state laws and regulations and internal policies., • Monitor emerging regulatory trends and enforcement actions to proactively address potential risks., • Policy Development and Training, • Draft and update audit related policies, procedures and guidelines., • Provide guidance on internal controls, regulatory requirements and audit best practices., • Develop and deliver compliance audit training and education to employees on regulatory requirements, compliance best practices and audit procedures., • Investigations and Corrective Actions, • Oversee internal investigations related to risk assessment and/or audit findings, conducting root cause analysis to identify trends or patterns of non-compliance., • Develop corrective action plans (CAPs) and track their implementation., • Ensure confidentiality and integrity in all investigations and reporting., • Work closely with Legal, Human Resources and Risk Management teams to conduct investigations and recommend disciplinary action, as applicable., • Regulatory Compliance and Reporting, • Ensure compliance with relevant federal and state regulations including, but not limited to, HIPAA, Stark Law, Anti-Kickback Statute, OIG Guidelines, CMS, OSHA and DOJ., • Oversee regulatory reporting requirements and respond to inquiries from auditors, regulators and enforcement agencies, collaborating with Lifecare Home Health Family leadership and General Counsel., • Prepare audit reports, present findings and recommended corrective actions to executive leadership, the Compliance Committee and the board of directors., • Leadership and Collaboration, • Serve as a trusted advisor to the Chief Compliance Officer, executive team and leadership., • Foster a culture of compliant and ethical behavior across the organization., • Collaborate with key stakeholders., • Support external auditors and regulatory agencies during compliance reviews and investigations. Additional Duties • Extensive knowledge of hospice Local Coverage Determinations (LCDs), • 2+ years of compliance auditing, internal audit or regulatory compliance experience., • Extensive knowledge of audit methodologies, internal controls and risk assessments., • Strong understanding of healthcare fraud, waste, and abuse prevention, coding compliance, and billing practices within the context of hospice care., • Experience in healthcare, finance, billing, coding, compliance and government regulations., • Ability to build relationships with internal and external stakeholders, including leadership, clinical teams, providers, payers, and regulatory bodies., • At least one of the preferred certifications or the ability to obtain certification within 1 year of employment is required., • Additional certifications in healthcare compliance, law, privacy, data security, or information management are a plus., • Experience working collaboratively with regulatory agencies, auditors, and healthcare providers to ensure compliance with hospice requirements., • Strong analytical and problem-solving skills, with the ability to identify compliance risks, assess organizational performance, and develop actionable solutions., • Ability to pass DHS background study. Preferred • RN with hospice or homecare governmental audit (Additional Documentation Requests (ADRs) experience strongly preferred. Will consider associate’s degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field., • Excellent verbal and written communication skills with the ability to clearly communicate complex compliance issues to senior executives and staff members at all levels., • Preferred Certifications:, • Certified Hospice & Palliative Care Nurse (CHPN), • Certified in Healthcare Compliance (CHC), • Certified Internal Specialist(CIA), • Certified Billing and Coding Specialist (CBCS), • Certified Professional Coder (CPC), • Certified Professional Medical Specialist(CPMA), • Certified Compliance and Ethics Professional (CCEP) Physical Requirements The physical requirements described are representative of those that must be met to successfully perform the essential responsibilities of this position. Reasonable accommodation may be made. • Prolonged periods sitting at a desk and working on a computer., • Pushing/Pulling and Lifting/carrying up to 10 pounds.

Job Description Hi, we're Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Analyst, SIU Clinical Investigator detects and audits aberrant billing patterns within claims and clinical documentation, using forensic clinical expertise to protect the integrity of healthcare spend. You will perform comprehensive pre-payment and post-payment reviews of medical records to ensure billed services align with established clinical guidelines, CMS regulations, and contractual obligations. Beyond individual claim accuracy, you will analyze provider behavior to identify schemes such as record cloning, upcoding, and unbundling that may be invisible to automated systems. As a clinical subject matter expert, you will act to translate audit findings into relevant education. You will facilitate professional discussions with colleagues and providers to correct billing behaviors and promote long-term compliance. You will partner with clinical and non-clinical investigators to build evidentiary files for potential recovery, legal action, or referrals to appropriate outside agencies. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct clinical audits into suspected FWA with high autonomy, • Document findings, to include formal reports, graphs, audit logs, and other supporting documentation., • Metrics to align with unit goals., • Participate in the development and presentation of FWA-related education for Oscar teams, • Compliance with all applicable laws and regulations, • Active, unrestricted Registered Nurse (RN) license, • 3+ years of direct patient care clinical experience. Case Management experience a bonus., • 2+ years of experience in Medical Review, Utilization Management, or Clinical Documentation Improvement, featuring demonstrated expertise in the forensic application of complex clinical guidelines (e.g., MCG, CMS, and specialty-specific professional organizations) to multifaceted medical records., • Bachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience., • Experience working in health insurance with competency regarding claims processing, billing, reimbursement, or provider contracting., • Experience delivering feedback or education to providers/physicians in a professional, non-confrontational, and persuasive manner., • Identifying trends, for example "cloned documentation" or change in billing habits of a provider., • Experience with HIPAA, data privacy, and/or data security processes At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a Senior Analyst, SIU Investigator to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Analyst, SIU Investigator identifies and investigates aberrant behavior observed in medical claims data and member enrollment data. You will manage an investigative caseload from case identification through to resolution, including data mining, investigation planning, data analysis, sampling, medical records requests, audit interpretation, overpayment recovery, reporting to regulatory agencies and monitoring ongoing provider behavior. The Senior Analyst will meet metrics set forth related to caseload, turn around times, and other unit-wide goals. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct investigations into suspected FWA with high autonomy, • Document findings to include formal investigative reports, tables, graphs, audit logs, and other supporting documentation, • Met metrics to align with caseload, turn around times, and other unit-wide goals, • Continue to monitor providers with substantiated findings to track behavior change, • Participate in the development and presentation of FWA-related education for Oscar teams, • Build evidentiary files for potential recovery, legal action, and/or referrals to appropriate outside agencies, • Compliance with all applicable laws and regulations, • 3+ years of healthcare fraud investigation experience or professional investigation experience with law enforcement agencies, • Bachelor's degree in Criminal Justice or a related field, • Experience with HIPAA, data privacy, and/or data security processes, • Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.