• Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    …service rendered to patients. * Conducts complex reviews of physician/provider billing compliance activities in accordance with applicable laws, regulations, rules ... retrospective audits of documentation to confirm compliance with documentation and billing rules and government regulations. Provides feedback and education related… more
    University of Texas Rio Grande Valley (09/23/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical ... an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues.… more
    Molina Healthcare (09/06/25)
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  • Inpatient Audit Specialist

    Datavant (Austin, TX)
    …for reviewing records via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. **What You Will Do:** + Performs Inpatient ... to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in...via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. + 5+ years of… more
    Datavant (10/04/25)
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  • Medical Coding Auditor

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    …(CertifiedProfessional Coder ), CCS (Certified Coding Specialist), or CBCS (Certified Billing and Coding Specialist) **Does this position work in a research ... Auditor Manager + Participate in the development of coding and billing strategies, evaluating processes related to Revenue Cycle andmaking recommendations while… more
    Texas Tech University Health Sciences Center - El Paso (10/01/25)
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  • Supervisor, Coding

    Baylor Scott & White Health (Austin, TX)
    …to meet daily un-coded accounts receivable. + Is a resource for resolving billing edits using the National Correct Coding Initiative and Local and National Coverage ... Determinations. Facilitates billing issues with Physician Fee Schedules (PFS) and informs...Certified Coding Specialist-Physician Based (CCS-P), or + Certified Professional Coder (CPC), or + Reg Health Info Administrator (RHIA),… more
    Baylor Scott & White Health (09/10/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Grand Prairie, TX)
    …identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more
    Elevance Health (10/03/25)
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  • Senior Analyst, Encounters

    Molina Healthcare (Austin, TX)
    …GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 5-7 years of experience in billing , claims, encounters, and data analysis + 5 years or more of managed ... multiple organizations **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : + Certified Professional Coder (CPC) To all current Molina employees: If you are… more
    Molina Healthcare (09/24/25)
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  • Education & Quality Coding Analyst- Remote Days

    Texas Health Resources (Arlington, TX)
    …- Certified Coding Specialist 12 months **REQUIRED** COC (Certified Outpatient Coder ) 12 months **REQUIRED** **Skills** Proficient in software applications (Excel, ... CPT-4. Expert in coding convention/automated encoder (knowledge management of NCCI/OCE billing edits). Knowledgeable in APC and DRG methodologies and all… more
    Texas Health Resources (09/20/25)
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  • Coding Charges & Denials Specialist - (Telecommute…

    Houston Methodist (Houston, TX)
    …FUNCTIONS** + Provides education to revenue cycle team and attends monthly billing staff meetings as appropriate. + Pursues ongoing professional growth and ... preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + CPC - Certified Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** +… more
    Houston Methodist (09/12/25)
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  • Coding Educator FT-Katy CC (Hybrid)

    Houston Methodist (Houston, TX)
    …with pre-billed claim edits to ensure complaint coding, charting and billing . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Designs, implements, and monitors effective ... is required **LICENSES AND CERTIFICATIONS - PREFERRED** + CPC-I - Certified Professional Coder Instructor (AAPC) -- (CBO Coders only) **OR** + CPMA - Certified… more
    Houston Methodist (07/23/25)
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