• Diagnosis Related Group Clinical Validation…

    Elevance Health (Houston, TX)
    …recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions ... Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or… more
    Elevance Health (12/09/25)
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  • DRG Coding Auditor Principal

    Elevance Health (Houston, TX)
    …Technician, CCS as a Certified Coding Specialist, CIC as a Certified Inpatient Coder , or Certified Clinical Documentation Specialist (CCDS). + Requires minimum of 10 ... environment preferred. + Broad, deep and niche knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, … more
    Elevance Health (12/06/25)
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  • RN Medical Review Nurse Remote

    Molina Healthcare (Dallas, TX)
    …or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by ... applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case… more
    Molina Healthcare (12/03/25)
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  • Medical Coding Auditor

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    …Profressional Coder ), CCS (Certified Coding Specialist), or CBCS (Certified Billing and Coding Specialist) **Does this position work in a research laboratory?:** ... 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 (11/22/25)
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  • Medical Records Technician

    Kelly Services (Temple, TX)
    …documentation clarification. + Collaborate with clinicians and claims staff regarding coding and billing issues. + Maintain an accuracy rate of 95% or higher for ... ) + Registered Health Information Administrator ( **RHIA** ) + Certified Professional Coder ( **CPC** ) + Expertise in ICD-10-CM, CPT, HCPCS coding. + Familiarity… more
    Kelly Services (12/11/25)
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  • Payment Integrity Clinician

    Highmark Health (Austin, TX)
    …member satisfaction. Will be expected to identify potential discrepancies in provider billing practices and intervene for resolution and education or if necessary ... or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability to solve issues that… more
    Highmark Health (11/14/25)
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  • Director, Clinical Data Acquisition

    Molina Healthcare (Fort Worth, TX)
    …projects, and other state specific audit projects and deliverables related to accurate billing and coding. This role also works with the Health Plan Risk/Quality ... Nursing License (RN may be preferred for specific roles) * Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you are interested in applying… more
    Molina Healthcare (10/22/25)
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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 (10/22/25)
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