- Conduent (Dallas, TX)
- …a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification ?** **Would you like to ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …as a Quality Assurance Manager in a manufacturing setting + A Certified Aerospace Auditor certification is preferred + Qualified candidates must be an ASQ ... Certified Manager of Quality/OE, Certified Quality Auditor or a Certified Quality Inspector + Experience with...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Elevance Health (Houston, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- Elevance Health (Houston, TX)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Highmark Health (Austin, TX)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... as assigned. **QUALIFICATIONS:** Minimum + High school diploma / GED + Certification from American Academy of Professional Coders (AAPC) or American Health… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with ... processes. + Reviews, assesses and analyzes medical records, coding, billing, claims , reimbursements and workflow processes to ensure accuracy, completeness, and… more
- Houston Methodist (Houston, TX)
- …annual training program budget. + Where applicable assists with pre-billed claim edits to ensure complaint coding, charting and billing. **GROWTH/INNOVATION ... REQUIRED** + For inpatient/outpatient coding: RHIT, RHIA, or CCS certification from AHIMA is required + For professional fee...Coders only) **OR** + CPMA - Certified Professional Medical Auditor (AAPC) -- (CBO Coders only) **KNOWLEDGE, SKILLS, AND… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …billing/collection staff to ensure accurate physician reimbursement is achieved and claims denials are reduced by ensuring documentation integrity. * Educates all ... (RN) will be required after 6 months of employment. Preferred: Certified Professional Medical Auditor ( CPMA ) from American Academy Professional Coders ( AAPC ) or… more