- Humana (Austin, TX)
- …looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization,… more
- Elevance Health (Grand Prairie, TX)
- … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- Highmark Health (Austin, TX)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… more
- Elevance Health (Houston, TX)
- …**External Audit Facilitator** is responsible for managing the process for claims and customer service audits/ quality control reviews, including implementation ... + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims... auditor . + For implementation audits, ensures the claims system is coded accurately by independently developing and… more
- Wolters Kluwer (Houston, TX)
- …of Excellence ("LBACOE"), which consists of Legal Invoice Analysts, Quality Assurance Analysts, Operations Support Specialists, Managers, Associate Directors, and ... as needed. Further your responsibility is for the creation and implementation of quality assurance methodologies, subject to approval by management, as well as the… 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 ... needed. + Collaborates with the medical billing team to improve the quality of clinical documentation for compliance, billing, coding, and reimbursement processes. +… 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 ... and other times as necessary. * Presents recommendations for quality management and processes improvement opportunities regarding workflow and or… more