- Highmark Health (Austin, TX)
- …activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code ... which supports compliant coding. Interacts with external consultants regarding billing , coding and/or documentation and evaluates their recommendations and/or… more
- UTMB Health (Galveston, TX)
- …as throughout the institution to ensure compliance with all Federal and State-mandated billing and coding laws. The Manager of Clinical Coding is responsible for ... UTMB to promote compliance with Federal, state and hospital documentation, coding and billing standards. * Analyzes monthly DRG key indicators data from the area of… more
- Robert Half Management Resources (Dallas, TX)
- …Deliver feedback and documentation improvement recommendations to providers Lead billing compliance education for newly onboarded providers Evaluate medical records ... on coding guidelines and healthcare regulations Required Qualifications: Certified Professional Coder (CPC) credential Minimum of 10 years of experience in medical… more
- Elevance Health (Houston, TX)
- …and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and ... quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, … more
- Elevance Health (Grand Prairie, 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
- 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
- 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
- Humana (Austin, TX)
- …clinical and coding experience to conduct reviews of provider codes and billing . + Decisions are typically related to resources, approach, and tactical operations ... knowledge. + Experience validating and interpreting medical record documentation to ensure billing for services is complete and accurate. + Certified Professional … more
- The Hartford (San Antonio, TX)
- …Team Leader is responsible for overseeing a small team within the Medical Billing department, ensuring efficient operations and timely completion of tasks. This role ... with a solid understanding of medical terminology, insurance policies, billing procedures, and reimbursement practices. Proficiency in Microsoft Office… more
- CVS Health (Austin, TX)
- …we do it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations ... focus on meeting state, federal, and company requirements while identifying concerning billing patterns or trends. **Responsibilities:** + Lead and mentor a team of… more