• Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified ... Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review… more
    Molina Healthcare (09/06/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Dallas, TX)
    …Any one or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager ... compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/ medical reviews of previously denied cases in which a formal… more
    Molina Healthcare (09/26/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Fort Worth, TX)
    …must be active and unrestricted in state of practice. + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case ... Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ). To all current Molina employees: If… more
    Molina Healthcare (09/20/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Austin, TX)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years ... factors. With technical direction and assistance from management, designs and implements coder education program, continuing education programs and Medical Staff… more
    Highmark Health (09/20/25)
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  • Clinical Data Abstraction Specialist

    Apex Health Solutions (Houston, TX)
    …experience in a hospital, a physician setting or a Managed Care Organization as a medical coder . * Minimum of five (5) years ICD-10 CM coding experience ... Data Abstraction Specialist Supervisor: Director, VBC Operations Required License(s)/ Certification(s): Certified Risk Adjustment Coder (CRC), Certified more
    Apex Health Solutions (09/26/25)
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  • Manager, Risk Adjustment Coding Support

    Evolent (Austin, TX)
    …equivelent years of work experience. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder ) or demonstrated ability.** + 5+ years of ... The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be Doing:**… more
    Evolent (09/23/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (TX)
    …responsible coding experience required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder ... (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered… more
    Banner Health (09/06/25)
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  • Regional Coding Operations Manager WFH

    HCA Healthcare (Dallas, TX)
    …Health Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder (CPC(R)) credential or Certified ... Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: +...operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices… more
    HCA Healthcare (09/27/25)
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  • Coding Quality Auditor

    Houston Methodist (Houston, TX)
    …Specialist Physician-based (AHIMA) -- For professional fee coding **OR** + CPC - Certified Professional Coder (AAPC) -- For professional fee coding **LICENSES ... and/or inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory… more
    Houston Methodist (09/30/25)
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  • Coding Data Quality Auditor

    CVS Health (Austin, TX)
    medical record documentation review, diagnosis coding, and/or auditing. + CPC ( Certified Professional Coder ) or CCS-P ( Certified Coding ... Specialist-Physician) required. + CRC ( Certified Risk Adjustment Coder ) + Computer proficiency including experience with Microsoft Office products (Word, Excel,… more
    CVS Health (09/27/25)
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