- CVS Health (Austin, TX)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient in abstraction… more
- Guidehouse (San Antonio, TX)
- …patterns of coding errors and opportunities for coder and /or clinical education. + Serves as a technical expert/resource for department manager, staff, ... **Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:**...Remote Fully Remote Fully Remote!** **Join Our Growing Medical Coding Team! All roles are 100% REMOTE.** **What You… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …domains, including pre-payment review, post-payment audit, FWA detection and prevention, coding accuracy, clinical integrity, and provider data management. * ... domains, including pre-payment review, post-payment audit, FWA detection and prevention, coding accuracy, clinical integrity, and provider data management.… more
- HCA Healthcare (Houston, TX)
- …Collects and analyzes data surrounding the sepsis patients to assist with documentation, coding , clinical care, and outcomes. This includes review of abstracted ... or C-suite role, shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data science, case management or transfer… more
- Datavant (Austin, TX)
- …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing...CPC-H, COC, CIC or CRC). + Proficient in ICD-10 coding . + Experienced in HCC coding across… more
- Elevance Health (Grand Prairie, TX)
- …of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.** PRIMARY ... policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support… more
- Banner Health (TX)
- …area of specialty. Requires five or more years of specialized, complex professional coding experience for clinical specialty areas. Must demonstrate an elevated ... **Department Name:** Coding Ambulatory **Work Shift:** Day **Job Category:** Revenue...practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance… more
- Texas Health Resources (Arlington, TX)
- …accurate reimbursement. . Assesses high risk quality cases to accurately trigger pre-bill coding review process. . Abstracts and complies clinical data elements ... the record is ambiguous, inadequate, unclear or incorrect for coding and compliance purposes. . Collaborates with Clinical... coding and compliance purposes. . Collaborates with Clinical Documentation Specialist to improve coding and… more
- Elevance Health (Houston, TX)
- …of claims, provider contracts and data, eligibility, member contracts, benefits, clinical decisions, pharmacy on pre-service and post service appeals and grievances ... related to non- clinical and clinical services, quality of service and quality of care issues including executive and regulatory grievances. + Oversees and… more
- Humana (Austin, TX)
- …**Preferred Qualifications** + Advanced degree (MPH, MBA, or similar). + Experience in clinical operations or medical coding . + Strong financial acumen. + ... insights to inform product strategy. + Collaborate cross-functionally with clinical , financial, actuarial, and operational teams to develop value-added benefits… more