-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Chicago, US-IL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:05:07
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Tallahassee, US-FL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:05:06
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Jacksonville, US-FL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:05:06
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Wilmington, US-DE
Salary / Rate: Not Specified
Posted: 2026-07-07 10:05:04
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Dover, US-DE
Salary / Rate: Not Specified
Posted: 2026-07-07 10:05:01
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:59
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Colorado Springs, US-CO
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:55
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Hartford, US-CT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:54
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Sacramento, US-CA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:53
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Bridgeport, US-CT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:51
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:49
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Denver, US-CO
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:46
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Fort Smith, US-AR
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:40
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Tucson, US-AZ
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:39
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Phoenix, US-AZ
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:39
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:38
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Los Angeles, US-CA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:38
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Little Rock, US-AR
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:37
-
Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS117, P3, Band 6
Job-Specific Essential Duties and Responsibilities:
- Analyze AWS and Azure cloud environments to support provisioning, operations, lifecycle management, and performance monitoring across enterprise platforms.
- Evaluate cloud systems for alignment with enterprise architecture and governance standards, partnering with Cloud Engineers and Architects to support system suitability assessments and modernization efforts.
- Support operational analysis across cloud platforms, including monitoring trends, incident data, and reliability metrics to identify improvement opportunities.
- Develop reports and dashboards to provide visibility into cloud performance, availability, cost, and consumption metrics, supporting data-driven decision making.
- Assist in coordinating testing activities related to production deployments, ensuring readiness and alignment with operational and governance requirements.
- Support integration of cloud services into ITSM/ITOM processes, including incident, change, and service management reporting.
- Contribute to disaster recovery (DR) planning and testing by tracking readiness, documenting outcomes, and supporting continuity of operations across cloud and hybrid environments.
- Analyze cloud cost and usage trends, identifying optimization opportunities and supporting budget and FinOps-related reporting activities.
- Track and report on SLA performance, supporting continuous service improvement initiatives across cloud and platform services.
- Collaborate with cross-functional teams to document processes, maintain governance artifacts, and ensure compliance with enterprise policies and standards.
Job-Specific Minimum Requirements:
- Bachelor's degree in Information Systems, Business, Data Analytics, Engineering, or a related field (or equivalent experience).
- 4+ years of experience in business process analysis, cloud analysis, IT operations analysis, or related roles.
- Demonstrated experience analyzing cloud environments (AWS and/or Azure), including performance, availability, and operational metrics.
- Experience developing reports, dashboards, and data visualizations using tools such as Excel, Power BI, Tableau, or similar.
- Proven ability to analyze cloud cost and consumption data and provide actionable insights for optimization.
- Experience supporting ITSM/ITOM processes, including incident, change, and service performance reporting.
- Familiarity with enterprise architecture and governance frameworks and ability to support documentation and compliance tracking.
- Experience analyzing system performance, monitoring data, and incident trends to support operational improvements.
- Experience supporting disaster recovery planning, testing documentation, and continuity tracking.
- Ability to develop and maintain process documentation, reports, and governance artifacts.
Preferred Skills and Qualifications:...
....Read more...
Type: Permanent Location: Eau Claire, US-WI
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:36
-
Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS117, P3, Band 6
Job-Specific Essential Duties and Responsibilities:
- Analyze AWS and Azure cloud environments to support provisioning, operations, lifecycle management, and performance monitoring across enterprise platforms.
- Evaluate cloud systems for alignment with enterprise architecture and governance standards, partnering with Cloud Engineers and Architects to support system suitability assessments and modernization efforts.
- Support operational analysis across cloud platforms, including monitoring trends, incident data, and reliability metrics to identify improvement opportunities.
- Develop reports and dashboards to provide visibility into cloud performance, availability, cost, and consumption metrics, supporting data-driven decision making.
- Assist in coordinating testing activities related to production deployments, ensuring readiness and alignment with operational and governance requirements.
- Support integration of cloud services into ITSM/ITOM processes, including incident, change, and service management reporting.
- Contribute to disaster recovery (DR) planning and testing by tracking readiness, documenting outcomes, and supporting continuity of operations across cloud and hybrid environments.
- Analyze cloud cost and usage trends, identifying optimization opportunities and supporting budget and FinOps-related reporting activities.
- Track and report on SLA performance, supporting continuous service improvement initiatives across cloud and platform services.
- Collaborate with cross-functional teams to document processes, maintain governance artifacts, and ensure compliance with enterprise policies and standards.
Job-Specific Minimum Requirements:
- Bachelor's degree in Information Systems, Business, Data Analytics, Engineering, or a related field (or equivalent experience).
- 4+ years of experience in business process analysis, cloud analysis, IT operations analysis, or related roles.
- Demonstrated experience analyzing cloud environments (AWS and/or Azure), including performance, availability, and operational metrics.
- Experience developing reports, dashboards, and data visualizations using tools such as Excel, Power BI, Tableau, or similar.
- Proven ability to analyze cloud cost and consumption data and provide actionable insights for optimization.
- Experience supporting ITSM/ITOM processes, including incident, change, and service performance reporting.
- Familiarity with enterprise architecture and governance frameworks and ability to support documentation and compliance tracking.
- Experience analyzing system performance, monitoring data, and incident trends to support operational improvements.
- Experience supporting disaster recovery planning, testing documentation, and continuity tracking.
- Ability to develop and maintain process documentation, reports, and governance artifacts.
Preferred Skills and Qualifications:...
....Read more...
Type: Permanent Location: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:36
-
Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS117, P3, Band 6
Job-Specific Essential Duties and Responsibilities:
- Analyze AWS and Azure cloud environments to support provisioning, operations, lifecycle management, and performance monitoring across enterprise platforms.
- Evaluate cloud systems for alignment with enterprise architecture and governance standards, partnering with Cloud Engineers and Architects to support system suitability assessments and modernization efforts.
- Support operational analysis across cloud platforms, including monitoring trends, incident data, and reliability metrics to identify improvement opportunities.
- Develop reports and dashboards to provide visibility into cloud performance, availability, cost, and consumption metrics, supporting data-driven decision making.
- Assist in coordinating testing activities related to production deployments, ensuring readiness and alignment with operational and governance requirements.
- Support integration of cloud services into ITSM/ITOM processes, including incident, change, and service management reporting.
- Contribute to disaster recovery (DR) planning and testing by tracking readiness, documenting outcomes, and supporting continuity of operations across cloud and hybrid environments.
- Analyze cloud cost and usage trends, identifying optimization opportunities and supporting budget and FinOps-related reporting activities.
- Track and report on SLA performance, supporting continuous service improvement initiatives across cloud and platform services.
- Collaborate with cross-functional teams to document processes, maintain governance artifacts, and ensure compliance with enterprise policies and standards.
Job-Specific Minimum Requirements:
- Bachelor's degree in Information Systems, Business, Data Analytics, Engineering, or a related field (or equivalent experience).
- 4+ years of experience in business process analysis, cloud analysis, IT operations analysis, or related roles.
- Demonstrated experience analyzing cloud environments (AWS and/or Azure), including performance, availability, and operational metrics.
- Experience developing reports, dashboards, and data visualizations using tools such as Excel, Power BI, Tableau, or similar.
- Proven ability to analyze cloud cost and consumption data and provide actionable insights for optimization.
- Experience supporting ITSM/ITOM processes, including incident, change, and service performance reporting.
- Familiarity with enterprise architecture and governance frameworks and ability to support documentation and compliance tracking.
- Experience analyzing system performance, monitoring data, and incident trends to support operational improvements.
- Experience supporting disaster recovery planning, testing documentation, and continuity tracking.
- Ability to develop and maintain process documentation, reports, and governance artifacts.
Preferred Skills and Qualifications:...
....Read more...
Type: Permanent Location: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:35
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Montgomery, US-AL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:34
-
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
#ClinicalServices #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 ...
....Read more...
Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:34
-
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
#ClinicalServices #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 ...
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Type: Permanent Location: Mobile, US-AL
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:33
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Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS117, P3, Band 6
Job-Specific Essential Duties and Responsibilities:
- Analyze AWS and Azure cloud environments to support provisioning, operations, lifecycle management, and performance monitoring across enterprise platforms.
- Evaluate cloud systems for alignment with enterprise architecture and governance standards, partnering with Cloud Engineers and Architects to support system suitability assessments and modernization efforts.
- Support operational analysis across cloud platforms, including monitoring trends, incident data, and reliability metrics to identify improvement opportunities.
- Develop reports and dashboards to provide visibility into cloud performance, availability, cost, and consumption metrics, supporting data-driven decision making.
- Assist in coordinating testing activities related to production deployments, ensuring readiness and alignment with operational and governance requirements.
- Support integration of cloud services into ITSM/ITOM processes, including incident, change, and service management reporting.
- Contribute to disaster recovery (DR) planning and testing by tracking readiness, documenting outcomes, and supporting continuity of operations across cloud and hybrid environments.
- Analyze cloud cost and usage trends, identifying optimization opportunities and supporting budget and FinOps-related reporting activities.
- Track and report on SLA performance, supporting continuous service improvement initiatives across cloud and platform services.
- Collaborate with cross-functional teams to document processes, maintain governance artifacts, and ensure compliance with enterprise policies and standards.
Job-Specific Minimum Requirements:
- Bachelor's degree in Information Systems, Business, Data Analytics, Engineering, or a related field (or equivalent experience).
- 4+ years of experience in business process analysis, cloud analysis, IT operations analysis, or related roles.
- Demonstrated experience analyzing cloud environments (AWS and/or Azure), including performance, availability, and operational metrics.
- Experience developing reports, dashboards, and data visualizations using tools such as Excel, Power BI, Tableau, or similar.
- Proven ability to analyze cloud cost and consumption data and provide actionable insights for optimization.
- Experience supporting ITSM/ITOM processes, including incident, change, and service performance reporting.
- Familiarity with enterprise architecture and governance frameworks and ability to support documentation and compliance tracking.
- Experience analyzing system performance, monitoring data, and incident trends to support operational improvements.
- Experience supporting disaster recovery planning, testing documentation, and continuity tracking.
- Ability to develop and maintain process documentation, reports, and governance artifacts.
Preferred Skills and Qualifications:...
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Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:04:32
