- Elevance Health (Grand Prairie, TX)
- ** Claims Auditor I, II and Senior**...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… more
- Elevance Health (Houston, TX)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer… 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 ... or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… 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 ... help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical...the accuracy of provider contract payments in our payer systems , and by ensuring correct claims payment… more
- Elevance Health (Houston, TX)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Title:** Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG) **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- US Bank (Irving, TX)
- …Operations business line. Operations support multiple business lines, including claims , disputes, complaints, electronic payments and call center activities. The ... CAS Staff Auditor is primarily responsible for assisting in completing audit...assess IT and automated control risks within the digital systems and applications that support various business lines. +… more
- Aramco Services Company (Houston, TX)
- OVERVIEW: This position serves as the in-charge auditor on large, complex and sensitive internal auditing assignments. Audits are directed at reviewing internal ... contract compliance, reviews of selected internal controls, reviews of IT systems , and audits of organizations. Audits may be organizational, functional, financial… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …Medical Coder to to assign procedure,diagnosis codes for insurance billing, review claims data, research and corresponds with insurance companies in an effort to ... obtain accurate reimbursement for healthcare claims . . Duties include but are not limited to:...Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Professional Medical Auditor (CPMA) + Experience: A minimum of 1 year… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, research, and correspond with insurance companies to obtain accurate ... reimbursement for healthcare claims . This person will also be responsible for analyzing,...Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Professional Medical Auditor (CPMA) + Experience: A minimum of 1 year… more
- Houston Methodist (Houston, TX)
- …jointly with applicable management to deploy the overall strategy for system -wide coding operations consistent with Houston Methodist strategic plans. **PEOPLE ... annual training program budget. + Where applicable assists with pre-billed claim edits to ensure complaint coding, charting and billing. **GROWTH/INNOVATION… more