-
Essential Duties and Responsibilities:
- Oversee the daily operations of a call center team to ensure performance metrics are met.
- Maintain updated knowledge of the Call Center performance requirements as well as corporate and project policies and procedures.
Provide updates to staff regarding these policies and procedures.
- Evaluate the need for training to ensure that staff maintains current knowledge of multiple programs.
- Address inadequate quality issues with Supervisory team in relation to reviews and corrections of calls monitored.
- Monitor performance goals and objectives for the call center staff and complete daily and weekly reports.
- Provide leadership with updates on all issues regarding quality, training, policy, procedures, staff issues and departmental performance levels.
- Monitor call center compliance with ISO standards as applicable.
- Implement necessary corrective actions to ensure consistent application of all laws, regulations, policies, and procedures pertinent to the Call Center.
- Monitor and evaluate performance, write performance appraisals, and provide corrective actions as needed.
- Responsible for identifying and resolving issues, problems, and concerns with employees.
- Recommend changes to policies and establish procedures and assist in the implementation of process improvements when necessary.
- Provide direction to staff when complaints are escalated to management level.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Must be willing and able to work onsite in greater St.
Louis, MO.
- Experience with a large-scale telephony system.
- Experience in call center operations.
- Experience working with Customer Relationship Management (CRM) systems, including tracking customer interactions, managing case information, and maintaining accurate records.
- Experience supporting Medicaid enrollment processes, including assisting applicants, verifying eligibility information, and navigating Medicaid policies or systems.
- Minimum two (2) years of call center management experience or five (5) years in any management role.
#LI-Onsite #maxPriority
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 factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Annual salary is just one component of Maximus's total compensation package.
Other rewards may include short- and long-term incentives as...
....Read more...
Type: Permanent Location: Saint Louis, US-MO
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:06
-
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: Eau Claire, US-WI
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:06
-
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: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:05
-
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: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:04
-
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: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:04
-
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: Milwaukee, US-WI
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:03
-
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
#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: Charleston, US-WV
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:03
-
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
#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: Spokane, US-WA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:02
-
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
#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: Morgantown, US-WV
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:01
-
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: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:01
-
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: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:07:00
-
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
#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: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:59
-
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: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:59
-
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: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:58
-
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: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:57
-
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: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:57
-
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: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:56
-
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
#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: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:55
-
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: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:55
-
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: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:51
-
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: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:49
-
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: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:46
-
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: Charleston, US-SC
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:43
-
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: Newport, US-RI
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:43
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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
#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: Sioux Falls, US-SD
Salary / Rate: Not Specified
Posted: 2026-07-07 10:06:42
