Professional Coder, Special Investigations

3 weeks ago


Dover, Kent, United Kingdom CVS Health Full time

About the Job:

This part-time position is a key component of our healthcare compliance audit team. As a Healthcare Compliance Auditor, you will be responsible for ensuring the accuracy of medical claims by conducting comprehensive reviews of medical records.

Responsibilities:

  • Conduct thorough medical record reviews to verify billing consistency.
  • Develop detailed reports summarizing medical record review findings.
  • Communicate results to relevant parties, including investigators, Medicaid leadership, law enforcement, legal counsel, healthcare providers, and state regulators.
  • Collaborate with Medical Directors to validate audit outcomes.
  • Research and analyze coding queries, state regulations, and federal policies.
  • Identify potential billing discrepancies, abuse, and fraud.
  • Highlight potential cost-saving opportunities resulting from prepayment review.
  • Occasional travel required for meetings and potential testimony.

Qualifications:

  • Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC).
  • At least 3 years of experience in medical coding or documentation auditing.
  • In-depth understanding of standard industry coding guides and guidelines (CPT, HCPCS, ICD-10, CMS 1500, and UB04 data elements).
  • Familiarity with coding, state regulations, and policy research.
  • Proficiency in Microsoft Excel.
  • Strong analytical and critical thinking skills.

Compensation Package:

We offer a competitive compensation package, including a salary range of $43,888.00 - $102,081.60, along with additional benefits such as medical, dental, and vision coverage, and an Employee Stock Purchase Plan for eligible employees.



  • Dover, Kent, United Kingdom Remedy Recruitment Group Full time

    **Job Title:** Special Educational Needs Support Professional**About the Role**We are seeking a highly motivated and dedicated individual to join our team as a Special Educational Needs Support Professional. As a key member of our staff, you will provide critical support to students with various special educational needs, including Autism and ADHD.**Key...


  • Dover, Kent, United Kingdom CVS Health Full time

    Job Summary:We are seeking a skilled Medical Coding Specialist to join our team. As a Medical Coding Specialist, you will be responsible for performing medical claim reviews to ensure compliance with coding practices.About the Role:The ideal candidate will have experience in medical coding or documentation auditing and possess a strong knowledge of standard...


  • Dover, Kent, United Kingdom Baylor Scott & White Health Full time

    About the RoleWe are seeking a skilled Coding and Compliance Auditor to join our team. As a Coding and Compliance Auditor, you will be responsible for ensuring the accuracy of coding practices within our organization. This role involves performing coding quality audits, reviewing coder performance, and providing feedback to improve overall coding quality.The...

  • Healthcare Coder II

    1 month ago


    Dover, Kent, United Kingdom Baylor Scott & White Health Full time

    About Us:Baylor Scott & White Health is a leading healthcare organization committed to providing exceptional patient care. Our team of experienced healthcare professionals is dedicated to delivering high-quality services that meet the unique needs of each patient. We are seeking a highly skilled Outpatient Coding Professional to join our team and contribute...

  • Educational Assistant

    1 month ago


    Dover, Kent, United Kingdom St Richard's Catholic Primary School Full time

    School Support RoleWe are looking for a dedicated School Support professional to join our team as a Teaching Assistant.In this role, you will work closely with our teachers and support staff to deliver a high-quality education to our students.You will be responsible for engaging and motivating students, contributing to the class team, and supporting students...


  • Dover, Kent, United Kingdom Reeson Education Full time

    We are currently looking for a dedicated SEN Teaching Assistant to join our team at Reeson Education. This is a fantastic opportunity to work with a highly motivated and enthusiastic primary school in East London, making a positive impact on the lives of pupils with special educational needs.About the Role:Support pupils with special educational needs in...


  • Dover, Kent, United Kingdom Remedy Recruitment Group Full time

    As a Special Educational Needs Teacher Assistant at a primary school in Newham, you will contribute to the creation of a supportive and inclusive learning environment for students with SEMH-related needs. Your role will involve collaborating with teachers, professionals, and parents to ensure students receive tailored support to meet their individual...


  • Dover, Kent, United Kingdom JCC Greater Boston Full time

    About the PositionWe are seeking a highly skilled and compassionate professional to join our team as the Director of Pathways. As the leader of the Pathways program, you will be responsible for creating a supportive and inclusive environment for children with special needs. Your key responsibilities will include developing and implementing program...

  • Teaching Assistant

    4 weeks ago


    Dover, Kent, United Kingdom Folkestonegirls Full time

    We are seeking an exceptional Teaching Assistant to join our SEND department at Folkestone Girls School. As a Higher Level Teaching Assistant, you will play a crucial role in supporting the academic and personal growth of our students with Special Educational Needs and Disabilities.The ideal candidate will possess excellent communication skills, be patient...


  • Dover, Kent, United Kingdom JCC Greater Boston Full time

    **Creating Meaningful Connections:**We are seeking a skilled and compassionate Camp Coordinator to lead our efforts in providing high-quality programs and services for children with special needs. As a key member of our team, you will be responsible for overseeing the coordination of our summer camp programs, collaborating with colleagues, and communicating...


  • Dover, Kent, United Kingdom Reeson Education Full time

    Reeson Education is seeking an experienced SEN Teaching Assistant to join a highly reputable primary school in East London. The successful candidate will play a vital role in supporting pupils with special educational needs to reach their full potential.Job Description:Collaborate with the SENCO and teaching staff to provide targeted support and assistance...


  • Dover, Kent, United Kingdom Michael Page Full time

    We are seeking a dedicated and knowledgeable Commercial Accountant to join our client, a Manufacturing business based in East Kent, on a full-time and permanent basis. This position will suit a detail-oriented Finance professional who can manage Financial Reporting and analysis with the ability to work collaboratively with team members and other internal...


  • Dover, Kent, United Kingdom Remedy Recruitment Group Full time

    Job Title: Autism Support ProfessionalAbout the Role:This is an exciting opportunity to join our team as a Special Educational Needs (SEN) Teaching Assistant. Working in a supportive and inclusive environment, you will be responsible for providing social, emotional, and cognitive support to students with various SEMH-related needs.Key...


  • Dover, Kent, United Kingdom Folkestonegirls Full time

    **About the Role**We are looking for a talented SEN Teaching Assistant to join our team at Folkestone Girls' School. As a member of our SEND department, you will play a vital role in supporting the learning and development of our students with special educational needs.The successful candidate will have a passion for education and a commitment to delivering...


  • Dover, Kent, United Kingdom GSL Education - Kent Full time

    Role OverviewWe are seeking a dedicated individual to support students with special educational needs in a reputable school in Dover, Kent.This role allows you to make a real difference in students' lives by providing tailored support within a caring and inclusive environment.Key Responsibilities:Support students with special educational needs in the...


  • Dover, Kent, United Kingdom Ribbons and Reeves Limited Full time

    About Us:Ribbons and Reeves Limited is a forward-thinking primary school in Tower Hamlets, London. We are committed to providing a supportive and inclusive learning environment for all students, particularly those with Special Educational Needs (SEN).Salary:The estimated salary for this role is £40,000 - £50,000 per annum, depending on experience.Job...


  • Dover, Kent, United Kingdom Remedy Recruitment Group Full time

    At Remedy Recruitment Group, we are seeking a dedicated and compassionate Special Educational Needs Teaching Assistant to join our team in a primary school located in the London borough of Newham.The ideal candidate will have a related degree and prior experience working with students with Special Educational Needs (SEN). Aspiring to pursue a career in...


  • Dover, Kent, United Kingdom Reeson Education Full time

    A qualified SEN Teaching Assistant is required to join our team at a reputable primary school in East London. The successful candidate will work closely with the SENCO and teaching staff to provide support and assistance to pupils with special educational needs.Liaise with external agencies and professionals to ensure pupils receive comprehensive...


  • Dover, Kent, United Kingdom Pinnacle Recruitment Ltd Full time

    Project Management Professional Wanted for Construction FirmSalary: £80,000 - £90,000 + packageLocation: Bromley and surrounding areasWe are seeking a highly skilled Project Manager to join our client's team on a permanent basis. The ideal candidate will have experience working on new build, refurbishment, and fit-out projects across various sectors, with...


  • Dover, Kent, United Kingdom ISN Corporation Full time

    Job OverviewWe are seeking a skilled Recall Audit Inspector to join our team at ISN Corporation. As a Recall Audit Inspector, you will play a critical role in ensuring compliance with regulatory requirements. Your primary responsibility will be to conduct RAC assignments, visiting consignees or making telephone calls as described in the RAC assignment memo...