- Cognizant (Austin, TX)
- ** Claims Auditor ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our Cognizant leadership ... regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing… more
- Molina Healthcare (Fort Worth, TX)
- …* Apply previous experience and knowledge to verify accuracy of updates to claim /encounter and/or system update(s) as necessary. * Works with fluctuating volumes ... updates/changes to member enrollment, provider contract, provider demographic information, claim processing guidelines and/or system configuration requirements.… 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...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… 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)
- **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
- 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
- Molina Healthcare (Fort Worth, TX)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… 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
- 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