-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:17
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Spokane, US-WA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:17
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:16
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:14
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:12
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:09
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:04
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:04
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:03
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:02
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:02
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Sioux Falls, US-SD
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:01
-
Create an outstanding customer experience through exceptional service.
Establish and maintain a safe and clean environment that encourages our customers to return.
Assist the department manager in reaching sales and profit goals established for the department, and monitor all established quality assurance standards.
Embrace the Customer 1st strategy and encourage associates to deliver excellent customer service.
Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.Based in Salt Lake City, Utah, Smith's Food and Drug merged with The Kroger Company in 1998.
Today, we're proudly serving Smith's customers in over 140 stores throughout Utah, Nevada, New Mexico, Arizona, Montana, Idaho and Wyoming.
As part of the Kroger family of companies, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit.
With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.
Here, people matter.
That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life.
We help feed your future by providing the value and care you need to grow.
If you're caring, purpose-driven and hungry to learn, your potential is unlimited.
Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you.
Apply today to become part of our Smith's family!
What you'll receive from us:
The Kroger Family of Companies offers comprehensive benefits to support your Associate Well-Being, including Physical, Emotional, Financial and more.
We'll help you thrive, with access to:
* A wide range of healthcare coverage, including affordable, comprehensive medical, dental, vision and prescription coverage, through company plans or collective bargaining agreement plans.
* Flexible scheduling in full- and part-time roles with paid time off, including holiday and sick pay based on eligibility and length of service.
* Emotional and financial support with free counseling through our Employee Assistance Program and free, confidential financial tools and coaching with Goldman Sachs Ayco.
* Valuable associate discounts on purchases, including food, travel, technology and so much more.
* Up to $21,000 in tuition reimbursement over your career, through our industry-leading Continuing Education program.
* Vast potential for growth, through an abundance of industry-leading training programs and diverse career pathways.
For more information about benefits and eligibility, please visit our Benefits Page ! Minimum
* Ability to handle stressful situations
* Effective communication skills
* Knowledge of basic math (counting, addition, and subtraction)
* Must be at least 18 years of age.
Desired
* Retail experience
* Second language (speaking, reading...
....Read more...
Type: Permanent Location: Las Vegas, US-NV
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:00
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2026-06-02 08:18:00
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:59
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:59
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Rapid City, US-SD
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:56
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:54
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Charleston, US-SC
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:52
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Pittsburgh, US-PA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:50
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:49
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Columbia, US-SC
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:48
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Providence, US-RI
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:47
-
Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Eugene, US-OR
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:46
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Essential Duties and Responsibilities:
- Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data.
- Enter coded data into a system accurately and validate date entered.
- Research correct coding practices, clearly document and share findings with others.
- Write clear and concise rationales that provide defensible support of decisions.
- Train staff members on the coding processes (both project specific and general coding).
- Perform QA audits on coding process.
- Recommend and suggest improvements to assigned projects.
- Perform other duties as assigned by management.
- Apply California Workers' Compensation regulations and calculate fee schedule allowances.
- Evaluate the accuracy and appropriateness of coded and billed medical information
- Develop final determination letters based on regulatory and clinical standards
- Abstract key data from complex case files and medical records
- Assign and verify CPT, HCPCS, and ICD-10-CM codes using industry-standard billing guidelines
- Apply specialized regulations including California Workers' Compensation, CMS policies, AMA CPT coding guidelines, and CA fee schedules
- Collaborate virtually with cross-functional teams to drive quality and compliance
Minimum Requirements
- High school diploma or equivalent with 4+ years of experience, or AA with 2+ years of experience.
- Preferred risk adjustment auditing experience of coding inpatient and outpatient medical records.
- CPC, CCS, or RHIT Certification required.
- Ability to use critical thinking skills.
- Must have excellent writing skills.
- Experience coding physician, inpatient and/or outpatient medical records required.
- Strong computer skills, including Word, Excel, and Outlook.
- Mathematical skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Active CPC, CCS, CIC, COC, CCS or RHIT certification required (AAPC or AHIMA accredited)
Preferred Requirements
- Bachelor's degree from an accredited institution
- Experience as a medical claim examiner, reviewing physician and hospital PPO contracts
- Experience with California Workers' Compensation Official Medical Fee Schedule
- Experience with CMS payment methodologies: IPPS, OPPS, DMEPOS and Physician Fee Schedule
Home Office Requirements
- Maximus provides company-issued computer equipment
- Private and secure workspace
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
#LI-Remote
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various f...
....Read more...
Type: Permanent Location: Newport, US-RI
Salary / Rate: Not Specified
Posted: 2026-06-02 08:17:46
