- CenterWell (Austin, TX)
- …continuous learning, and performance excellence. **Cross-Functional Collaboration:** + Partner with clinical , analytics, and compliance teams to support coding ... part of our caring community and help us put health first** The Director , Operational Excellence will lead strategic initiatives to enhance the efficiency, accuracy,… more
- CenterWell (Austin, TX)
- …conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews...is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Austin, TX)
- …Other duties include, but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes (including ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Humana (Austin, TX)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Austin, TX)
- …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by… more
- CVS Health (Austin, TX)
- …6:30am to 5pm in their respective time zone.** As a Care Management Associate you will be supporting comprehensive coordination of medical services including Care ... and refers outlier cases (eg, Length of Stay) to clinical staff Identifies triggers for referral into Aetna's Case...service delivery under the direction of nurse or medical director in the most appropriate setting at the most… more
- Covenant Health (Lubbock, TX)
- **Description** Under the direction of the Central Business Office Director and the direct supervision of the Manager and/or Supervisor, the Associate Billing ... and Collections Representative is responsible for ensuring correct coding initiatives are met for clean claim submission and correction of claim billed and collected… more
- Datavant (Austin, TX)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... new and existing coders. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and...results for review by the facility or CCS HIM director . + Review disagreements on APC/DRG changes with the… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …consistent with the industry-standard guidelines for CPT, ICD-9 and ICD-10. + Answer coding questions + Review clinical documentation to ensure it meets the ... ethics and customer service standards. Requirements + Education: Certificate or associate 's degree in medical coding /CPC. These additional certifications are… more
- CenterWell (Athens, TX)
- …calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary. + Maintains the client ... productivity / geographic issues and forwards schedule to Branch Director for approval prior to distribution to staff. +...internal transfer of patients between branch offices. + If clinical , receives lab reports and assesses for normality, fax… more