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Humanas Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patients physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value based care provider focused on quality of care for the patients we serve. Our care team consists of Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our PCP to see fewer patients and spend more time with those they do. Responsibilities:The Nurse Practitioner (NP) works in our team-based care environment. We are a value based care provider focused on quality of care for the patients we serve. Our care team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our Nurse Practitioner to see fewer patients and spend more time with them. Patient Care:Evaluates and treats center patients in accordance with standards of care.Follows level of medical care and quality for patients and monitors care using available data and chart reviews.Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care.Acts as an active participant and lead with the care team through daily huddles.Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor.Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. Follows policy and protocol defined by Clinical Leadership.Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. Participates in potential growth opportunities for new or existing services within the Center.Participates in the local primary care on-call program of CenterWell Senior Primary Care. Assures personal compliance with licensing, certification, and accrediting bodies. Required Qualifications: Minimum of two to five years directly applicable experience preferred Successful completion of a Nurse Practitioner program with Board CertificationActive, unrestricted Nurse Practitioner license in state of practice locationExcellent communication skills; written and verbal, demonstrate a high level of skill with interpersonal relationships and communications with all colleagues; fully engaged in the concept of Integrated team based care.Willingness and ability to learn/adapt to practice in a value based care setting. Superior patient/customer service.Basic computer skills, including email and EMR.Appropriate certification to write prescriptions under the authority of a collaborating physician/medical directorThis role is considered patient facing and is a part of our Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Preferred Qualifications:Active and unrestricted DEA licenseMedicare Provider Number/ Medicaid Provider Number Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment.Knowledge of Medicare guidelines and coverage. Bilingual is a plusKnowledge of HEDIS quality indicators.Additional Information:Guaranteed base salary + quarterly bonusExcellent benefit package health insurance effective on your first day of employmentCME Allowance/TimeOccurrence Malpractice InsuranceRelocation and sign-on bonus options401(k) with Employer MatchLife Insurance/DisabilityPaid Time Off/HolidaysMinimal call

The Revenue Cycle Medical Coder position is responsible for supporting the Revenue Cycle Management (RCM) Department with claims coding and billing review, best practices, coding recommendations and policy setting, and staff training and education.

Job DescriptionDescription: Our World-Class Team Begins with YOU! Barrow Brain and Spine is a physician-owned specialty practice focused in the areas of neurosurgery and advanced spine care and pain management. As a partner of Barrow Neurological Institute, the practice encompasses 42 neurosurgeons, 8 physiatrists and performs more than 10,000 surgeries each year. This globally recognized group directs the Neurosurgery Residency Program at St. Joseph’s Hospital in Phoenix, Arizona and serves more than 21,000 patients per year. Do you have what it takes to be part of our World-Class team? At Barrow Brain and Spine, each team member is dedicated to the highest levels of performance, integrity, collaboration, and commitment to patient care. These are not just words on a page, this is our culture. If you are looking for an extraordinary work environment dedicated to enhancing the lives of our patients and team members, we look forward to hearing from you. Job Information: As one of the largest private group practices in the US, BBS is looking for a Lead Care Coordinator to join our Ahwatukee Team 2 days per week. This position will also travel to Gilbert 2 days per week and to Chandler 1 day per week. Essential Duties and Responsibilities: • Oversee the daily workflow of physician’s office. Provides direct support to physician and Care Coordinator as needed., • Manages staff work schedules to reflect volume and operational need. Reviews and approves employee timesheets and PTO requests in accordance with BBS guidelines., • Manages physician’s personal, clinical, and surgical schedules. Ensure all appointments are reflected in the physician’s Outlook and personal calendar. Manages physician’s travel schedule and arrangements., • Ensure proper medical reports are available to the physician prior to patient arrival., • Triages telephone calls when Care Coordinator is not available., • Obtains authorization from insurance carriers for surgeries in accordance with hospital guidelines., • Schedules surgeries and outpatients testing. Maintains patients recalls., • Coordinates referrals for patients through insurance and other physician offices., • Trains new Care Coordinators on patient registration, scheduling, taking vitals, rooming patients, entering orders, using medical equipment and supplies, arranging referrals, and other clinical operations required for the daily clinic workflow. We offer a comprehensive compensation package. This includes benefit offerings you’d expect to see at a large company, all designed to help you take good care of yourself and your family. The benefits include: • Choice of two types of medical plans – 2 HDHP/HSA options & 1 PPO/HRA option, • Dental and Vision plans, • Disability – short-term & long-term, 100% employer paid., • Basic Life/AD&D, 100% employer paid., • Voluntary Life/AD&D available for employee, spouse, and children, • Voluntary Critical Illness and Accident coverage, • Paid Time Off, • Paid Holidays Preferred method of response is via our Careers page: barrowbrainandspine.com Requirements: Qualifications: • HS diploma or GED required., • 2 years in a medical setting required., • Experience with athenaOne a plus!

Job Description Salary Range: $20.00 per hour Benefit Eligible: Yes Location: Onsite in Mesa, AZ Classification: Non-exempt, full time Reports to: Production Manager About the Company Paleovalley and Wild Pastures were born from a simple but radical idea: real food can heal — people, animals, and the planet. When Paleovalley co-founders Autumn and Chas Smith saw how industrialized food was affecting human health and the health of the land, they refused to play along. Autumn’s own journey of healing through nutrient-dense foods lit a fire that became Paleovalley. From there, the mission grew roots, sprouted wings, and eventually expanded into Wild Pastures to bring regeneratively raised meats directly to families nationwide. Today, Paleovalley crafts deeply nourishing snacks and supplements made with organic ingredients and honorable sourcing. Wild Pastures connects small American farmers practicing regenerative agriculture with customers who believe better food is worth fighting for. Every product, every partnership, and every decision is guided by a commitment to real ingredients, regenerative practices, and the belief that health is built from the soil up. We’re a team of grounded doers, curious thinkers, bold builders, and warm humans who like to laugh while doing meaningful work. We're growing quickly, fueled by purpose and a shared desire to repair the food system one thoughtful choice at a time. If you feel energized by impact, drawn to mission, and ready to join a company rewriting the future of food, we’d love to meet you! About the Opportunity The Machine Operator plays a critical role in ensuring our production processes run safely, efficiently, and in full compliance with food safety standards. By operating and maintaining key processing equipment such as kettles, dehydrators, and packaging systems, this role directly supports the consistent production of high-quality products our customers trust. Through attention to detail, sanitation excellence, and operational reliability, the Machine Operator helps protect product integrity and keep our production goals on track. What You’ll Do • Operate and monitor food-grade processing and packaging equipment including kettles, dehydrators, separators, mills, labelers, and date coders to ensure efficient and consistent production., • Execute machine setups and changeovers accurately and efficiently to support production schedules and minimize downtime., • Perform Clean-in-Place (CIP) and sanitation procedures to maintain food safety standards and ensure equipment is audit-ready at all times., • Maintain proper production flow by monitoring materials, removing finished goods, and adjusting machine settings as needed., • Inspect finished products for correct labels, seals, net weights, and date codes to ensure compliance with specification sheets., • Document batch, LOT, and production data accurately to maintain full traceability and regulatory compliance., • Troubleshoot minor equipment issues and escalate mechanical concerns promptly to reduce downtime and protect product quality., • Collaborate with QA, Production Leads, and Maintenance teams to ensure smooth operations and adherence to GMP, FDA, and USDA standards., • Identify opportunities for process improvement and proactively communicate recommendations that enhance efficiency and quality., • Maintain a clean, organized, and safe work environment by consistently following PPE requirements and safety protocols.What You’ll Need to Succeed, • 1+ year of experience in a food, beverage, supplement, or pharmaceutical manufacturing environment., • Experience operating production or processing equipment in a regulated manufacturing setting., • Ability to follow Good Manufacturing Practices (GMP), SOPs, and food safety regulations (FDA/USDA)., • Ability to perform equipment cleaning and sanitation procedures, including adherence to safety protocols., • Basic mechanical aptitude and ability to troubleshoot minor equipment issues., • Ability to lift up to 50 pounds and stand/walk for the duration of a shift in a manufacturing environment., • Flexibility to work assigned shifts, including evenings or overtime as needed., • Legally authorized to work in the United StatesBonus Points, • Experience operating kettles, dehydrators, milling equipment, or other food-grade processing systems., • Familiarity with Clean-in-Place (CIP) systems and advanced sanitation procedures., • Experience performing equipment changeovers, labeler/date coder adjustments, and production line setups., • Bilingual (English/Spanish) communication skills., • Experience in CPG, nutraceutical, or regulated food manufacturing environments with batch/LOT traceability systems.Our Commitment to You, • Medical, dental, and vision coverage with 100% employer-paid dental/vision and a small monthly medical premium for employees; dependents may be added at employee cost, • Generous Paid time off to support balance and rest, • Paid sick time for when you need it, • Six (6) paid holidays each year, • Paid parental leave for growing families, • 100% company-paid Short-Term Disability, Long-Term Disability, and Life Insurance, • 401(k) with up to a 4% company match after one year of service This role takes place in a manufacturing/warehouse environment and may involve exposure to varying temperatures, noise, and airborne particles. Employees must follow all safety guidelines and use required Personal Protective Equipment (PPE). The position requires regular standing, walking, bending, reaching, and the ability to lift and move items up to 50 pounds. Work may involve operating or working near machinery and other equipment. These physical demands are representative of those necessary to perform the essential functions of the job, with or without reasonable accommodation. Compliance & Employment Practices Paleovalley and Wild Pastures are proud to be equal opportunity employers. All employment decisions — including hiring, promotion, discipline, and termination — are made based on qualifications, merit, and business needs. We do not discriminate on the basis of race, color, religion, national origin, ancestry, age, sex, gender identity or expression, sexual orientation, disability, medical condition, pregnancy, genetic information, marital status, veteran status, or any other status protected by applicable federal, state, or local law. We are committed to providing reasonable accommodations to qualified individuals with disabilities. If you need assistance or an accommodation during the application or hiring process, please reach out to to let us know. Reasonable accommodations are considered on a case-by-case basis in accordance with the Americans with Disabilities Act (ADA) and applicable laws. Applicants must be authorized to work in the United States for any employer. At this time, Paleovalley and Wild Pastures are unable to sponsor or assume sponsorship of employment visas, including but not limited to H-1B, TN, or OPT. This role is open until filled. EEO Statement: Paleovalley and Wild Pastures are equal opportunity employers. Employment and processes, including decisions to hire, promote, discipline, or discharge, are based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. E-Verify: Paleovalley and Wild Pastures participate in E-Verify, the federal program for electronic verification of employment eligibility. Powered by JazzHR 9HUROCTyzv

Job Description Certified Medical Coder (Remote Production Role) Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! Main Responsibilities (may include but are not limited to): • Meet minimum production goals while maintaining accuracy requirements, • Review provider medical coding of services rendered for medical claim submission, • Review and respond to medical coding inquiries submitted by providers and staff, • Work directly with providers to resolve specific medical coding issues, • Analyze data for errors and report data problems, • Partner with billing office to correct and resubmit claims based on review of the records, provider input, and payor input, • Work with clinical and non-clinical groups to identify undesirable coding trends, • Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalate issues that may impact this immediately to the Compliance Committee, • Abide by HIPAA and Coding Compliance standards, • Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment, • Accomplish other tasks as assigned Other Duties That May be Assigned: • Work hand in hand with partner facilities to verify resident stay status, • Review patient information to assist in decision making process in regard to advance modalities, • Coordinate with outside partners for advanced modalities Skills required to succeed: • Must live in one of the following states: WA, OR, ID, UT, AZ, TX, VA, FL, GA, PA, IA, • 2+ years coding, • 2+ years medical billing experience (preferred but not required), • Experience with insurance and revenue cycle management processes, • Ability to read and understand insurance EOB’s, • Proficient in reviewing edits between CPT, ICD10, and HCPCS codes, • Experience in reviewing insurance review denials and payer policies, • Professional coder certification through a recognized organization such as AAPC (preferred) or AHIMA, • Leadership qualities with the ability to effectively educate providers remotely, • Acute attention to detail with a strong, self-sufficient work ethic, • Excellent organization and use of time management skills, • Ability to prioritize workload and have a strong sense of urgency when time sensitive situations arise, • Proficient with computers and navigating within multiple applications, • Proficient in MS Office (specifically Teams, Outlook, Excel, and Word), • Ability to collaborate with other UWH team members electronically via email, messaging, and telephone conferences, • Strong verbal and written communication, as well as customer service skills; must be able to listen and communicate effectively with leadership, providers, and co-workers, • Goal-oriented and a consistent performer, • Must be self-motivated, punctual, dependable, and able to work independently, • Must be trustworthy, honest and have a positive and professional attitude Location: Remote – corporate office location in WA Compensation: $25.00 - $33.00 hourly - DOE and location This position is classified as: Hourly, Non-Exempt; Full-Time employment Hours: Typical hours are Monday through Friday; 7:30am – 4:00pm PST, (occasional overtime depending on claim volume) Benefits: • Work remotely from a home office, • Associates working 20+hrs per week:, • Medical/Dental/Orthodontic/Vision/RX - 80% towards employee monthly premiums covered, HSA, dependent coverage available at employee’s expense, • Employer Sponsored Life, AD&D, and Disability Insurance, • Voluntary Supplemental Insurance: Accident, Cancer, Critical Illness, STD, Life, • Paid Time Off:, • Accruals up to 132 hours (16.5 days) your first year of employment based on 1.0FTE status, • 8 paid Holidays for full-time employees, • 401(k) match on first 4%, • Core Values that promote work-life harmony, • Work with amazing people who have created a culture where we recognize each other’s wins and don’t tolerate gossip or drama Website: *Do you want to grow personally and professionally by working with the best? We’d love to hear from you! Apply now: We are a drug-free workplace. All offers of employment are contingent upon a successful drug screen and criminal background check. EEO.

Job Description Job Summary: We are seeking an experienced Medical Biller & Certified Coder with a strong focus on Accounts Receivable to join our busy, high-volume Family Practice. This role is essential to maintaining the financial performance of the practice and requires a candidate who is highly skilled in A/R follow-up, denial resolution, and insurance collections. The ideal candidate is detail-oriented, persistent, and results-driven. Key Responsibilities: • Manage and maintain all aspects of Accounts Receivable, with a focus on timely follow-up and resolution, • Investigate and resolve denied, rejected, and unpaid claims with insurance carriers, • Work aging reports to ensure prompt reimbursement and minimize outstanding balances, • Communicate with insurance companies to correct claim issues and secure payment, • Post payments and reconcile Explanation of Benefits (EOBs) accurately, • Submit corrected claims and appeals as needed, • Handle patient billing inquiries, statements, and collections professionally, • Ensure accurate coding using ICD-10, CPT, and HCPCS to support clean claim submission, • Identify trends in denials or underpayments and recommend process improvements, • Certified Professional Coder (CPC), CCS, or equivalent certification preferred, • Minimum of 3 years of medical billing experience with a strong emphasis in Accounts Receivable, • Proven success in denial management, appeals, and insurance follow-up, • Strong knowledge of ICD-10, CPT, and HCPCS coding systems, • Experience with Medicare, Medicaid, and commercial payers required, • Experience with eClinicalWorks (eCW) EMR strongly preferred, • Excellent problem-solving, analytical, and organizational skills, • Ability to work independently, prioritize tasks, and meet deadlines in a high-volume environment Compensation & Benefits: • Competitive pay based on experience, • Benefits and paid time off offered after a 90-day introductory period, • Full-time, stable position in an established practiceCompany DescriptionWe are a busy Family Practice Office with 3 locations in the West Valley.We are a busy Family Practice Office with 3 locations in the West Valley.

Job Description ESSENTIAL FUNCTIONS Abstracts data in compliance with national, regional, and local policies, and interprets and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure codes. · Utilizes practice management system (PMS) to accurately account for demographics and services performed for all scheduled and unscheduled surgical cases according to standard procedures and coding guidelines. · Utilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures. · Provides education and support to clinical areas regarding appropriate documentation and coding of services to achieve accurate billing. Maintains effective communication with providers concerning coding issues. EDUCATION · High school diploma/GED or equivalent working knowledge preferred. · Accredited by the American Health Information Management Association (CCS-P) or the American Academy of Professional Coders (CPC) EXPERIENCE · At least three years of experience in provider coding and medical terminology with extensive knowledge of ICD-10, CPT, and HCPC coding required. · Preferred specialty experience in areas of Orthopedics, Neurology, Physical Medicine, and Rehabilitation or Pain Management. REQUIREMENTS · A minimum of one of the following credentials: CCS-P or CPC. · Meets established coding and abstracting quality and productivity standards. · Experience with various coding software. Previous experience with remote coding is preferred. Possesses PC skills, both keyboarding and applications. · Requires a good understanding of anatomy, physiology, medical terminology, and disease processes. · Ability to work independently. · Excellent attention to detai

Job DescriptionAbout Optima Medical: Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation's top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and dedicated professionals aboard. We are currently seeking a Medical Coding Specialist to join our team! This role will transition to a fully remote position after up to 30 days of training. To be eligible, you'll need to complete your initial training onsite at our Scottsdale office and remain in good standing. Must reside in Arizona! Job Responsibilities: • Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for medical diagnoses and procedures based on clinical documentation., • Ensure coding compliance with CMS guidelines, and state/federal regulations., • Ability to write precise, professional, and well structured feedback to providers and team members., • Assist with claim reviews, denials, and coding-related audits to optimize revenue integrity., • Maintain up-to-date knowledge of medical coding guidelines, regulatory changes, and industry best practices., • Meet coding productivity and quality standards as required by Optima Medical., • High attention to detail and analytical skills to ensure accuracy and compliance., • Minimum 2 years of experience in medical coding (physician practice or healthcare facility)., • Certified Professional Coder (CPC) required (AAPC or AHIMA certification). No CPC-A or CCA., • Strong understanding of ICD-10-CM, CPT, and HCPCS., • Experience with EHR systems, billing software, and Microsoft Office (Outlook, Word, Excel), • Strong analytical, problem-solving, and communication skills., • Ability to work independently in a fast-paced production environment while maintaining high accuracy., • Must demonstrate strong written communication skills to provide clear feedback and improve coding accuracy., • Strong knowledge of medical terminology, disease processes, and physiology to ensure accurate interpretation of provider documentation., • Substantial growth opportunities, • Leadership and mentoring., • Fun work environment (lunches, events, holiday parties), • Comprehensive benefits (medical, vision, dental, 401k, paid holidays), • Supportive and positive work culture

Job DescriptionCertified Professional Coder (AR & Denials) - Phoenix, AZ Direct Hire | $27-$32/hr | Monday-Friday, 8AM-5PM Confidential Employer - Third?Party Recruiter Posting Potential Remote Flexibility for Experienced Candidates About the Role We are seeking an experienced Certified Professional Coder to support Accounts Receivable (AR) and Denials Management for a specialty medical group based in Phoenix, AZ. This is a direct?hire opportunity offering stability, growth, and the potential for remote work for top?tier candidates. The ideal candidate brings strong coding accuracy, experience working denials end?to?end, and comfort working with specialty practices-Neurology experience is a major plus. Familiarity with Athena (Athenahealth) is also preferred. Key Responsibilities • Perform accurate coding using ICD?10?CM, CPT, and HCPCS, • Audit and scrub claims to ensure high clean?claim rates, • Investigate and resolve payer denials; submit corrected claims and appeals, • Monitor AR aging reports and identify trends in payer issues, • Collaborate with providers, billing, and admin teams to prevent repeat denials, • Maintain compliance with payer guidelines and HIPAA regulations, • Apply neurology?specific coding knowledge when applicable, • Use Athena or similar EHR/PM systems for coding and billing workflows What We're Looking For, • Active CPC or CCS?P certification required, • 3+ years professional coding experience, with strong AR/denials focus, • Neurology specialty experience strongly preferred, • Experience with Athena is a plus, • Strong analytical skills and attention to detail, • Ability to work independently and meet productivity/accuracy expectations, • Excellent communication and documentation skills Compensation & Schedule, • Pay: $27-$32/hr (Direct Hire), • Schedule: Monday-Friday, 8:00AM-5:00PM, • Location: Phoenix, AZ (Onsite preferred; remote flexibility may be available for experienced candidates) Why This Opportunity?, • Stable direct?hire role, • Opportunity to specialize in a high?demand field (Neurology), • Collaborative environment with supportive leadership, • Ability to influence AR performance and denial reduction, • Potential remote option (case?by?case) Pay Details: $27.00 to $32.00 per hour Search managed by: Gabrielle Hernandez Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: • The California Fair Chance Act, • Los Angeles City Fair Chance Ordinance, • Los Angeles County Fair Chance Ordinance for Employers, • San Francisco Fair Chance OrdinanceMassachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Job Description Hi, we're Oscar. We're hiring an Associate, SIU Coding Auditor 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 Associate, Special Investigations Unit Coding Auditor executes on Oscar's anti-fraud initiatives by supporting operational and financial targets while adhering to legal and regulatory obligations. You will help execute on audit strategy by ensuring team productivity is met while ensuring quality remains high. The associate networks across all partners, and recommends enhancements to processes, policies, and procedures to support a best in class Fraud Waste and Abuse program. We ask that you have attention to detail, innovation, and ability to shift priorities to align with operational needs. You will report into the Manager, SIU Coding Audit. 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: $75,265 - $98,785 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Perform quality checks of other team members' coding audit reviews and deliver in written or verbal form to ensure accuracy and compliance with coding standards and Oscar policy., • Review dashboards and interpret performance data in support of production goals; Recommend response and inform management before deadlines are missed., • Identify and help develop new processes to ensure efficient and effective audit functions., • Perform complex reviews of medical records and claims on both a prepayment and post payment basis to determine accuracy of claims submitted to Oscar., • Explicitly document findings including sources used to support decision making and in a way that can be easily understood by non clinicians or coders., • Participate in educational calls or written communications to articulate findings to providers under SIU review., • Facilitate team and cross-team education, • Compliance with all applicable laws and regulations, • Bachelor's degree or equivalent years of experience, • Certified Professional Coder (CPC) designation or similar, • Certified Professional Medical Auditor, • Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar, • Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity, • Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting., • 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, 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, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. The base pay for this role in the states of New Jersey and New York is: $72,036 - $94,546 per year. The base pay for this role in all other locations 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 This position is fully in office Mon- Fri 7:00 am - 5:00 pm (Flexible Hours) Transitioning to Hybrid after training. Address: 1929 W Lone Cactus Dr, Suite 4, Phoenix, AZ 85027 Pathology Billing Services is owned by one of the largest groups of pathology providers in the state of Arizona. The physicians practice at many hospitals and healthcare systems in Arizona. At Pathology Billing Services we provide the group with their medical billing and coding needs. Pathology Billing Services is excellent for individuals with various ranges of experience in Medical Billing and Coding. Those who possess attention to detail, dependability, teamwork, and are ready to learn and accept a challenge, would be good candidates. As a Certified Medical Coder you would be working in a multitask environment with Pathology patient accounts. It is the responsibility of the coder to accurately abstract and assign CPT/ICD-10 codes based on the finalized pathology report. The coder will identify missing information and follow up as necessary to ensure complete documentation is in place for all billable charges. Essential job functions include: • Review charges in our billing software for completeness and accuracy., • Complete coding tasks with a high level of attention to detail and accuracy., • Interpret Pathology reports, • Verify and apply appropriate modifier(s), ICD-10, and CPT code(s), • Ensure all charges are captured and billed out in a timely manner, • Review and resolve unpriced coding system edits, • Review and resolve coding related clearinghouse rejections, • Provide timely responses to coding inquiries from our AR department, • One year of Medical Billing and/or Coding Experience, • Current CPC or CPC-A certification required through AAPC, • Working knowledge of Excel and Word, • Previous Pathology Experience is a plus, • Detail Oriented, • Dependable, • Exceptional verbal and written communication skills, • Excellent organizational skills and ability to manage multiple and diverse priorities simultaneously, meeting deadlines as required, • Ability to handle highly confidential information, • Ability to exercise independent judgment, • Knowledge of standard office equipment, • Ability to lift a minimum of 35 pounds and sit for long periods of time The work environment: characteristics described here are representative of those individuals and employee encounters while performing the duties of this job. Pathology Billing Services provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, and gender identity. PBS complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This applies to all terms and conditions of employment including, recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training. Benefits: Pathology Billing Services, LLC, offers nationally competitive compensation and benefits. Our benefits program provides a comprehensive array of services to our employees including, but not limited to health insurance (Primarily covered by the company), dental insurance (100% covered by the company) vision insurance, paid time off, retirement contributions (401k), & flexible spending account (FSA). Powered by JazzHR KghYtiVhlg

A leading healthcare organization in the United States seeks a Certified Medical Coder with expertise in Neurology coding.

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Banner Health - 1111 East McDowell Road - Responsibilities: Provide routine patient care to promote patient health and comfort; Collect patient specimens and data including vital signs and input/output; Assist in activities of daily living and mobility; Transcribe and process physician orders using