- Molina Healthcare (Fort Worth, TX)
- …+ Experience independently reviewing and processing simple to moderately complex High dollar claims and knowledge of all claim types of reimbursements not ... such Stoploss, DRG, APC, RBRVS, FFS applicable for HD Inpatient, Outpatient and Professional claims . + 2+ years of comprehensive claim audits as preference +… more
- Elevance Health (Grand Prairie, 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...Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims … more
- Sedgwick (Houston, TX)
- …Carrier, Broker, or TPA. + Background in property, liability, and/or CAT claims preferred . + AIC and AIS professional insurance designations or ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you'll have the… more
- Humana (Austin, TX)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42594BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to… 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
- Molina Healthcare (Fort Worth, TX)
- …updates/changes within claims processing system . + Experience using claims processing system (QNXT). ** PREFERRED EDUCATION:** Bachelor's Degree or ... equivalent combination of education and experience ** PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working… 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 ... from AHIMA or CPC from AAPC is required **LICENSES AND CERTIFICATIONS - PREFERRED ** + CPC-I - Certified Professional Coder Instructor (AAPC) -- (CBO Coders only)… 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