- Molina Healthcare (TX)
- …performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and ... information to make medical determinations as necessary, and applies clinical knowledge to assess the medical necessity, level of...responsible for recognizing and adhering to national and local coding and billing guidelines in order to maintain … more
- Community Health Systems (Victoria, TX)
- …reimbursement while maintaining patient and physician satisfaction. Ensures accurate coding and billing practices across clinical departments. Collaborate ... physician and nursing documentation support charges and works with coding to ensure all charges are entered correctly so...to support charges + Stays updated on changes in coding guidelines (eg ICD-10, CPT, HCPCS) and reimbursement policies.… more
- Centene Corporation (Houston, TX)
- …education for HEDIS measures, appropriate medical record documentation and appropriate coding . Assists in resolving deficiencies impacting plan compliance to meet ... on HEDIS measures, appropriate medical record documentation and appropriate coding . Supports the development and implementation of quality improvement interventions… more
- Houston Methodist (Houston, TX)
- …resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or coding related appeals. ... of Diseases Tenth Revision (ICD-10), and Healthcare Common procedure Coding System (HCPCS) coding + In depth...Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic… more
- Datavant (Austin, TX)
- …2 Coders, where applicable + Champion documentation improvement opportunities and coding issues, facilitating resolution with relevant stakeholders + Uphold an ... overall 95% coding accuracy rate and a 95% accuracy rate for...communication with colleagues, management, and hospital staff, while addressing clinical and reimbursement issues + Occasionally travel for professional… more
- MD Anderson Cancer Center (Houston, TX)
- …billing (ie, cellular therapy). This includes the evaluation and appeal of both clinical and technical denials. Position ensures that all processes within HB Billing ... including communication to Financial Clearance Center, Revenue Operations and Coding (ROC), Patient Access Services, Health Information Management, Managed Care,… more
- HCA Healthcare (San Antonio, TX)
- …establish/implement goals, objectives, policies, procedures and systems for the assigned clinical areas. + Participates in the development and implementation of ... clinical plans. + Selects, trains/orients, and supervises departmental personnel....+ MA or LVN is required. CPR Certification. CPC Coding is requirement if coding duties are… more
- HCA Healthcare (Kingwood, TX)
- …of the Patient Assessment Instrument for each rehabilitation inpatient. This individual provides clinical support in completion of data contained in the PAI for each ... information.** **Job Responsibilities:** **Coordinate IRF-PAI Function:** + **Thoroughly researches clinical documentation for evidence of co morbid conditions. Verifies… more
- Sunny Springs Nursing Center (Sulphur Springs, TX)
- …tracking, etc. With direction from the Director of Nursing and VP of Clinical Reimbursement, may coordinate information systems operations and education for the ... clinical department. Principal Responsibilities * Works in collaboration with...is present in the medical record to support MDS coding . * Maintains current MDS status of assigned residents… more
- MD Anderson Cancer Center (Houston, TX)
- …procedures in Nuclear Medicine and Positron Emission Tomography studies. Scope: Impacts clinical and research imaging services and education to patients, staff and ... by monitoring his/her environment. a. Safely screens patients, and manages the clinical and research driven clinical /evaluation process for implanted devices… more